Permit CITY OF TIGARD a s l3 FIRE PROTECTION SYSTEM PERMIT
I I ° • COMMUNITY DEVELOPMENT Permit #: FPS2013 -00007
T F G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/14/2013
Parcel: 1S134BC00300
Jurisdiction: Tigard
Site address: 12240 SW SCHOLLS FERRY RD
Project: Rite Aid Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Add (1) and relocate (1) sprinkler to accommodate new walls in existing building 2/5/13 REPRINTED to correct
permit specific information
Contractor: PATRIOT FIRE PROTECTION INC Owner: FW OR- GREENWAY TOWN CENTER LLC
4708 NE MINNEHAHA ST PO BOX 790830
VANCOUVER, WA 98661 SAN ANTONIO, TX 78279
PHONE: 360 - 699 -4403 PHONE:
FAX: 360 - 699 -4485
FEES
Description Date Amount
Specifics: Permit Fee COM 01/14/2013 $51.09
12% State Surcharge - Building 01/14/2013 $6.13
Type of Use: COM Plan Review - Fire Life Safety - COM 01/14/2013 $20.44
Class of Work: ALT 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 $77.66
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $400.00
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 copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: tit i f Permittee Signature: y ' 0000���llll.....X���GC/ 9 0 ,0 PPU cizi nvkl
Call 503.639.4175 by 7:00 a.m. for the next available inspection 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
a COMMUNITY DEVELOPMENT Permit #: FPS2013 -00007
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/14/2013
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12240 SW SCHOLLS FERRY RD
Project: Thrifty PayLess Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Add (1) and relocate (1) sprinkler to accommodate new walls in existing building
Contractor: PATRIOT FIRE PROTECTION INC Owner: FW OR- GREENWAY TOWN CENTER LLC
4708 NE MINNEHAHA ST PO BOX 790830
VANCOUVER, WA 98661 SAN ANTONIO, TX 78279
PHONE: 360 - 699 -4403 PHONE:
FAX: 360 - 699 -4485
FEES
•
Description Date Amount
Specifics: Permit Fee - COM 01/14/2013 • $51.09
12 %State Surcharge - Building 01/14/2013 $6.13
Type of Use: COM Plan Review - Fire Life Safety - COM 01/14/2013 $20.44
Class of Work: ALT 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 $77.66
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 copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: i c '] or Permittee Signature: 0 id A11 Y /1(..-( / „O /ll , I
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. C % /
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.
JAN. 10. 2013 1:53PM PATRIOT FIRE VANC NO. 1620 P. 2
Buildin&Permit Aimlication
Fire Protection System REcE NED 1 oil 01 ii: 1:
City of Tigard se:eivre 1 /" / 5 s r_ Petit No.; OS ot'3 -09007
I -- 13125 SW Hall Elvd_, Tigard, OR 97251i 1 0 2013 Plan RCVS=
ti 5 TDI
DIV ISION
Phone: 503.71&2439 Floc 503.5A&1960
ARDISION Dareil3v OtherPerrai:
Ice on tium 03.639.4175 CITY Z
Dare Iteactealy +T I WI SeePage a tbr don
bltallet: WWW-tigarti-OtgOV BUILD' Notifledatetheab
ANW;PiWA'sgltaA**: .::::Y.,,..:.' : ,.,,,,,,:' Agoo*******g.***ftis‘•:z.:.iwThr::,v,„'
0 Now contraction Et Demolition - ...I fees* ON based on the value of the work perfo ,. - ..
• In . " - t the value (rounded to the nearest dollar) o .,
El Addition/alteraticereplacement 0 Othm: equipm - t materials, labor_ overhead, and the •'. 1 for the
.talg '':. : ';'' - ''', : . ' :: -•., ': .. ' work in ' - — on this application.
0 1- and 2-fmnily dwelling t,3 Commercial/marsh:id Valuation: 1111=1V.4
CN:mAany building ID Multi-famlly Number of b , .1
0 lubstcs buildcr 0 Other Number of bathroom
Total number of iloorm
Sob site addles= 12240 SW Scholia libriy Reed a qu
11::=L ar e feet
City/StateraP: Tigerd, OR 97223 Garage/ . • AMIIMILIIIZIM
SnitetbldVapt. no I Projeetname: Rite Aid #5333 Iletr atra: square Cross stmet/dimetions to job site: SW 12e Avenue
‚mar= square feet' I . er structrue an= square feet
. F
Subdivision: I 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
ZaWf a P, " : •'„: ', work indicated on this a , , 'cation.
Valuation:
add (1) & relocate (1,) sminklers to accommodate new walls in misting building $400410
Existing building alta: same square feet
New building area: same square feet
, ...:•:),;:i,..: , '.::.c, ..:-::Ei.:**404:',. ...,, ',,, ,., Number of stories: 1
Name: RL & TL LLC do Thrifty Payless, Inc Type of construction: metal studs
Address: 30 Holster Lane Occupancy groups:
City/State/ZIP: Camp Hill ,PA 17011 Existing same (office)
Phone: ( ) Fax: ( ) NMY: 3141110
- ( n '`.; ";:;;0•!'"Ygoikii'r
Business name; Patrick Fire Protection, Inc All contractors and subcontractors are required to be
licensed with the Oregon Construction Cuntrectota Board
Ccutatet name: Ted Biker - under ORS 701 and may be required to be licensed in the
Addresm 4708 NE Minnelmba Street jurisdiction in which wart is being performed. If the
applicant is exempt from licenringoite following reasons
City/State/ZIP: Vancouver, WA 98661 - — apply:
--
Phone (360) 699 4403 Fax: : (360)699 4403
Email: ted.balter@palrlotfire.com
g ‘ ';' . '•• . ' 4 ' . : .. .,. s . i . „.' , '.: : • ; ,' ': , ' 11111/11112111
. ,
Business name: same m above
Permit fee:
Addles=
State surcharge (12% of permit fee)•
aty/State/Z1P:
FLS plan review (40% of permit fee):
Phone: ( ) _I Fax ( ) Ole t • • It • , lication.`
CCB lic.: 70822 Total permit fees: . -
Authorized signature: 411 Amount received: 1.4.... 4
This permit application expires if s permit is not obtained
Print name
Tad Baker Date: 1-943 wn 190 2Y it has been accepted as complete.
.. . • Fee methodology set by Tri-Couuty Building Industry
S 2— ii 0 5c
JAN. 10. 2013 1:54PM PATRIOT FIRE VANC NO. 1620 P. 3
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
1.) ❑ New 2.) : to sprinker heads only
❑ Addition ® 1 -10 heads: No plan review required.
® Alteration 0 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 2
Additional description of work add (1) sprinkler and relocate (1) sprinkler to
accommodate new walla and ceiling in CONSULT ROOM
'N'',4";4::.!' ' -" �, O'. ''' ' , ;C•:or D as' . j.'linable 1 , •' -i •••', L',; •
► ^i XTet ■ a
Additional Standpipes no
Informadon: Hazard Group light
Density .1
Des Area 335
K. Factor EMIIIIIIIMIMIN
Sprinkler Project Valuation: $ 400
k-' l .�,�t S O.Q ..File ;.rl 1 L'CS6k0ii c jt i : ., , , ,
• .. Project Vahtion: $
-
3 }. i . ..: ... . , • : S ; •
Submi . -hall Battery Calculations ❑
include: Individual Component
Cut Sheets J
Fire Maim Pro'ect Vahra 1 •
Tf:1 id ,1!4/. p leL'(StOd, : ' "..e y ..
Square Footage. _t..
■ 0 to 2,000 ANNIE .
2,001 to 3,600
3,601 to 7'00 / $310.0,1111iiill . . , • ;,•
• 7,201 and ,... ter A r $40439 • " .
rinider Project Square Poo 7 11 sq. ft
.'. r:, .,.,, , ;•i ;FireTtosecticiiiie mifFeea. .
' roject valuation subtotal see A, B & C above :
t fee based on . co' ect valuation see fee schedule :
Permit fee based on a• . e foo - see D above : �MIIII
State Surc . : - 12% of • ermit fee : $ IIIIII
FLS Plan Review 40% of • ermit fee : $ iii
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
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