Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
g `• COMMUNITY DEVELOPMENT Permit #: FPS2012 00159
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/25/2012
Parcel: 1S133AD02200
Jurisdiction: Tigard
Site address: 10730 SW 130TH AVE
Project: Westgate Baptist Church Subdivision: HAWK'S BEARD TOWNHOMES Lot: 62
Project Description: Add and relocate (37) fire sprinkler heads as required for 2nd floor remodel.
Contractor: WYATT FIRE PROTECTION INC. Owner: WESTGATE BAPTIST CHURCH
9095 SW BURNHAM 12930 SW SCHOLLS FERRY RD
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 684 -2928 PHONE:
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 10/25/2012 $112.96
Plan Review - Fire Life Safety - COM 10/10/2012 $45.18
Type of Use: COM 12% State Surcharge - Building 10/25/2012 $13.56
Class of Work: FPS Type of Const: VB Info Process /Archiving - Lg $2.00 (over 10/25/2012 $2.00
Occupancy Grp: E Height: ft 11x17)
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 10/25/2012 $5.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: ORD1
Density: 0 Design Area: 0
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $178.70
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $3,373.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or i ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility • • 'cation Ce -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a cop ••ft e rules
or • ect questions to OUN • . in. 503.232.1987 or 1.800.332.2344.
I -ued By: Permittee Signature: /AP"
Call 503.639.4175 by 7:00 a.m. for the next available inspectio • ate.
This permit card shall be kept in a conspicuous place on the job site until c• pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System RECEIVED Received FOR OFFICE USE ONLY
. City of Tigard q Date/By: /6 / �� /3 ' / ' 2 /2— � b. Perm tNo.: P� 062 — /I5
111 q 1hne S50 Hall Blvd., Tigard, OR7 0 2 D Plan teBy: T ( Other Permit: iiue eA ea / _/
Phoone: 503.639.4171 Fax: 503. � 1 6 d 2
Inspection Line: 503.639.4175 � Date Ready/By: ] ur is: El See Page 2 for
TIGARD Internet: www.tigard - or.gov Clll l OF�t1RD Notified/Method: (014' /� / f(3/ Supplemental Information
BUILDING DIVISION - 1—ca toi 6 up /
• TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING .
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0 -Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
. CATEGORY OF CONSTRUCTION . work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling ommercial/industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder � ❑ Other: Number of bathrooms:
/07.36, ,O� ` N l
/1 � 9 v eORMATION AND LOCATION Total number of floors:
Job site addres • / -� �; � - �,aw ' , IVO New dwelling area: square feet
City/State /ZIP: -i7 , t / 02 / 7 Z 3 Z Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: eS 94 7 Mei /5 cif Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: 1 Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
A� f C / ./ iP/2//it Ire 5 637) Valuation: $ 3 , c°c_
'D 6 .z - � /°L ilop ,�! �� . Existing building area: square feet
� New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 0 2
Name: Type of construction: _-----
Address: Occupancy groups:
City/State /ZIP: Existing: 4-$S , ,L)
Phone: ( ) Fax: ( ) New: Sjgy`j
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: // ��,, ✓� e,,
� cw/V � /�Ci`Q/___— All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
. CONTRACTOR BUILDING PERMIT FEES*
Business name: �/� ,p /�� p�� T —�9� (Please refertafeeschedule,
'! Permit fee:
Address: 9D% p S 6�i 4 T —
City/State /ZIP: 174 /9 Dk_ q 7 Z Z3 State surcharge (] 2% of permit fee):
FLS plan review (40% of permit fee): (�
Phone: (93 ) z, &I_ _ Z� Z� Fax: (rp3) (. ¢ < 96s7 (Due upon application.) / 5 / �
CCB lic.: (D #07 7 / Total permit fees:
� �, /t7
Authorized signature: • Amount received: V
�� / This permit application expires if a permit is not obtained
Print name: i /Vt 7`�jt) Date: `D /` // within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
is \Building\Permils \ FPS- PemutApp.doc 03/23/06 440- 4613T(1 l /02 /COM /WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describewbrkto be done
1.) 0 New 2.) Modification to sprinkler heads only:
D Addition 0 1-10 heads: No plan review required.
fl Alteration F-1.1.+ heads: Plan review required.
El Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable)
A.) Commercial Sprinkler
, -
Wet 0 Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B), T I 7 FioodPire:'Siiiipiegsion.Sygi,eiri
Hood Project Valuation:
C) FireAlarm
Submittal shall Battery Calculations El Yes
include: Individual Component 0 Yes
Cut Sheets
File Alarm Project Valuation: $
Residential Sprinider (StandAtoneSYsten : 1: .
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
, —'• , — Ftre'Protection:,Pertnit,Fs
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
hap://www.ci.tigard.or.us/city_hallidepartments/cd/docs/FPS-PermitApp.doc 2
FOR OFFICE USE ONLY — SITE ADDRESS: � 6 90Z E
This form is recognized by most building departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
III City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
tta e to r
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: )4 0 DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVE
E
///1/-/-frii) 0V 2 : 012
6 FROM: �
CITY • TIGARD
COMPANY: j JW l 7/,f ,P1 7 7. A) BUI NG DIVISION
PHONE: 5 - 6 - i ' BY.
RE: /527 Kf /at
rte ress ' emit um l er
:s uN . a � u s►.. � X 73
'roject name or su t*•" ision name an. of
ATTACHED ARE TH OLLOWING ITEM a
Copies: Descriptio Copies: Description:
Additio .1 set(s) of plans. 3 Revisions: ?34---jr-it./
Cross • ction(s) and details. Wall bracing and/or lateral analysis.
Floor oof fra 'ng. Basement and retaining walls.
Bea calculatio s. _ Engineer's calculations.
Ot er (explain):
REMAR
FOR A FF E USE ONLY
Routed to Permit Technician: Date: rZ Initial : _
Fees Due: • Yes I1 T F - e Description: Amount l ue:
40 . . ' _ ! A-K.0 $
— A_ APAI � PI I $
Special
Instructions:
Reprint Permit (per PE): ❑ Yes No ►: Done
Applicant Notified: Date: /1,_. ��' // Aals4 nitials.�
L \ Building\ Forms \TransmittalLetter- Revisions.doc 05/25/2012