Permit r q CITY OF TIGARD � FIRE PROTECTION SYSTEM PERMIT
1 COMMUNITY DEVELOPMENT ®1`r! Permit #: FPS2012 -00173
T I G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 ® Date Issued: 11/20/2012
Parcel: 1 S 133AD02200
Jurisdiction: Tigard
Site address: 10730 SW 130TH AVE
Project: Westgate Baptist Church Subdivision: HAWK'S BEARD TOWNHOMES Lot: 62
Project Description: Add (4) sprinkler heads at bathrooms on north side of 2nd floor. 12/5/12, reprinted to correct address from SW
Scholls Ferry Rd to 10730 SW 130th Ave. 12/13/12, reprinted to add (6) fire sprinkler heads to be modified.
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 11/20/2012 $56.47
12% State Surcharge - Building 11/20/2012 $6.78
Type of Use: COM Plan Review - Fire Life Safety - COM 11/20/2012 $22.59
Class of Work: FPS Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $85.84
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
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
issuan. .r if work is • 'ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utif . Notification Center. Th. e rules are set forth in OAR 952 - 001 -0010 through_ • • R • . .. -.090. You may obtain a copy of the rules
. direct questi ns to OUNC . g • r . .1987 or 1.800.332.2344. `
•
Issued By: itr ,/ /I I • Permitt = i • nature:
Call 503.639.4175 by 7:00 a.m. for the next available in , • . tion date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FOR OFFICE USE ONLY – SITE ADDRESS:
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.
1,11 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
1 , 1 I SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
N
TO:
DATE
•
DEPT: BUILDING DIVISION
DEC 13 2012
FROM: o
COMPANY: CI1 F1'I
B UILDINGDN GARD ISION
b_.) , ' ii _ '
.s_ _/ _� ' i�i�'�
PHONE: , By:
RE: 1 �7 ! TA 4 e– .90/--e40/75 ite • • ress (Permit Number)
j_____
'roject name or •T 'vision name an. o num• - r
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: I Copies: I Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain):
j
REMARKS: Ci ln ( /
1e) �v1no-�– � ...1)1.L.").....L.3
. k \ 0 / 1 - 701
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes _ ❑ No ❑ Done
Applicant Notified: Date: Initials:
1:\ Building\Fonns \TransmittalLetter- Revisions.doc 05/25/2012
�y n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 00173
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 � /9 •
Date Issued: 11/20/2012
Parcel: 1 S133AD02200
Jurisdiction: Tigard
Site address: 10730 SW 130TH AVE
Project: Westgate Baptist Church Subdivision: HAWK'S BEARD TOWNHOMES Lot: 62
Project Description: Add (4) sprinkler heads at bathrooms on north side of 2nd floor. 12/5/12, reprinted to correct address from SW
Scholls Ferry Rd to 10730 SW 130th Ave.
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 11/20/2012 $56.47
12% State Surcharge - Building 11/20/2012 $6.78
Type of Use: COM Plan Review - Fire Life Safety - COM 11/20/2012 $22.59
Class of Work: FPS Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $85.84
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
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 if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility 'cation Ce Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or d' ct questions to OUN . ing 503.232.1987 or 1.800.332.2344.
I sued By: / A i �, Permittee Si :nature:
Call 503.639.4175 by 7:00 a.m. for the next available inspe. on date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 - COMMUNITY DEVELOPMENT Permit #: FPS2012 -00173
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/20/2012
Parcel: 1 S133AD02200
Jurisdiction: Tigard
Site address: 12930 SW SCHOLLS FERRY RD
Project: Westgate Baptist Church Subdivision: HAWK'S BEARD TOWNHOMES Lot: 62
Project Description: Add (4) sprinkler heads at bathrooms on north side of 2nd floor.
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 11/20/2012 $56.47
12% State Surcharge - Building 11/20/2012 $6.78
Type of Use: COM Plan Review - Fire Life Safety - COM 11/20/2012 $22.59
Class of Work: FPS Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System: •
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $85.84
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
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 if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
• Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a • , y of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: S- go., P Signature: / //
•� Call 503.639.4175 by 7:00 a.m. for the next available inspect • n date.
This permit card shall be kept in a conspicuous place on the job site until ompletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System RECEIVED 'FOR OFFICE USE ' ,
`J g Date �� /. v ,' 4. ��J O�0 i9
City of Tigard r 2012
III •erm
14
' a 13125 SW Hall Blvd., Tigard, OR 97223 N 1 5 2 012 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 CITY TIG�111i J
Internet: www.tigard or.gov Date ReReady/By: 3 js El See Page 2 for
!TIGARD Notified/Method: /// /Q ,6c2 4W 7 i Supplemental Information
BUILDING DIVISION (//y z i 66' E
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❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
lg.-Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
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� � •. } x ��. , y . v �.3 <<�, t ' �� � - work indicated on this application.
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Valuation: $
❑ 1- and 2- family dwelling KCommercial/industrial
El Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
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, ; ,�,W<� =fix �;'�; r " r "' �= �" ., =., Total number of floors:
• * JUB. E -ND,ZLOCA'TJONr F . -� a+ '
- �'iJ� }'h S�. . -- !_ �;: '.r ;'7.+��'i �A�+r ,: .w:•7:�'K::.. /.�tS' + 6n- :s.�!'.3.7�S�:SS�7:z'F.. . i��_t4ui•
Job site address: n:9 3 0 . `i s'Gy yz,LL S i_'> -V ( • New dwelling area: square feet
City/ State/ZIP: -/ax,x /' / /` /, q- 2 Z 3 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: 2 577 ''4 -7 t777 - 6y , Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: . square feet
�`. �e^} +X�; "5.�:,y-�3�, �a�..as>s�2;r;y?_�p �:���'a+f.'+•°x; r.ti
,'REQl7ialkil 1TrA': ree4 1KEyR r'Hi a gig
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• Subdivision: Lot no.: • Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: • equipment, materials, labor, overhead, and the profit for the
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,z; rCn%i, -k e ':°10' i vies'+" i- - i. a _ .': n ' 6t ,: + - r . -. ry -- y
r •r "� .. � -• � ,� �'� ? =�::' < .��K�a y � � work indicated on this application.
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.:� ,,� ti s �v =. �_r r�.�:€- _�:�?;: :��_... � •. ,; �-�- ms < -, � -�� � ,_ = RK � .•:r�. u � �'« .. . - _ � -: , - _, . _�> ..::�
,�� 4 FI " � G/Zt�vk� � 5 i/,�,eo��5 Valuation: $6 -35,
/�
a � .s10 p , ' of �I' -vl9' Fi_co/e , . Existing building area: square feet
New building area: square feet
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Number of stories:
J 1•)'i20PER!TzY OVGNE = `' : ® -irT•E�VAN` . > �x. q
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Name: Type of construction:
Address: . . Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New: .
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Business name: ' e42/.) - 72Z./g - C...� �72.— 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:
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ld - 7fG�2 pe, oN f
Business name: w r���= '����(P��se�Frefarl ofdesc �RS+'s ,:�•x,� .�w
9 A /r � T Permit fee:
Address: /t-/�' —
City/ State/ZIP: 1164-1Z-0 19/e..... 97 ��3 _State surcharge (12% of permit fee):
/ FLS plan (40% of permit fee):
Phone: ( 5 &. g5 4' --2_9-0_4s Fax: ( 503) e, g,.4. .9 6 57 an review
upon application.)
CCB lic.: , 4-P77 Total permit fees:
Amount received:
Authorized signature: L%r J�
.��_ This permit application expires if a permit is not obtained
Print name: �I��[ �'u/ �� Date: I/ . - `,j -I Z within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1:\ Building lPermitsAFPS- PermiLApp.doc 03/23/06 440- 4613T(11 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
"e, �;�; °. ,� Ott,;. °� %�.�,'.,;` :� aTz°'€� T*s�r ^+c .s I„:� �, <;. �. --c »; .�' � =� a „� ° -�; u,�n
kria rrbe work_ r e done:t IV -` ;” °Y ; . , ; I w", ° C : , '' u-
...- .,4.a,..,,.... � fe. z.�;}'.ir' 'eS, ex�e.�� ' l ,? �; ��2� ,"m�.�'e4 . ,w ^n�J!ie
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition 1.,..10 heads: No plan review required.
.Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
��'A �� ��� 0' stem #otri ti,j3ii =�°3 r"�A ..... �_ L'�'S4Si^+ :4in"�; -J - ,+'�.` �'; �`'' .y ,, ; = zr$",i';r � ' Tc
;� ;,GYP,° �... Y�....._ v.._ p ete1,A x B�, iCorDas�appltcawble) :_... ; `�
�� 3- ' �, x :fix ti i s , v? kb ' �, b •- �z4 • "�
A: �Cotnmercta-1S rinkle`r le:
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K Factor
Sprinkler Project Valuation: $
NS) T.yp MIS atiff Fittal4ppreA113 firii' i ngf
Hood Project Valuation: $
W.' v � 7�,�'h
gip wire
qt;, ai°rri a '�' � ' „
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Piuject Valuation: $
" 5� ea`'a i R { s 5 - . .Jx i• L '� G
t aj .) Resi` S prinider (Stand Alone:S sl em���7 �"
Square Footage: Permit Fee:
0 to 2,000 $187.50
$187.50 �
2,001 to 3,600 $232.50 t ��
3,601 to 7,200 $292.50`
7,201 and greater $381.50 �
Sprinkler Project Square Footage: sq. ft.
;S =`� ?�.� +, � i�1,,,,�,n,�' v £., „�., �z�„ Y�t'z�e. J r-ur - .�, y � �> �;;�. �wm¢. ,,,�,: .c.�,o, t _ ,
�'? ',x taninf Z;: ; Fi i r ern M ;`�' - 1
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.
http: / /www.ci.tigard.or.us/ city_ hall/depart ments /cd /docs/FPS- PermitApp.doc 2