Permit i
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a
IN � :. COMMUNITY DEVELOPMENT Permit #: FPS2013 00018
T 1 CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 2S112AC01600
Jurisdiction: Tigard
Site address: 14975 SW 74TH AVE
Project: Meyer Sign Co Subdivision: FANNO CREEK ACRE TRACTS Lot: 17
Project Description: Fire suppression for paint booth
Contractor: METRO SAFETY & FIRE INC Owner: SKOURTES, JOHN & JACKIE
PO BOX 33650 17010 SW WEIR RD
PORTLAND, OR 97068 BEAVERTON, OR 97007
PHONE: 503 - 231 -2999 PHONE:
FAX: 503 - 256 -4691
FEES
Description Date Amount
Specifics: Permit Fee - COM 01/28/2013 $123.72
12% State Surcharge - Building 01/28/2013 $14.85
Type of Use: COM Plan Review - Fire Life Safety - COM 01/28/2013 $49.49
Class of Work: ALT Type of Const: VB Info Process /Archiving - Sm $0.50 (up to 01/28/2013 $6.50
Occupancy Grp: S -1 Height: ft 11x17)
Stories: 2 ,
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Unknown
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 $194.56
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $4,900.00
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. f �f
Issued By: / ` n � jt ,� /i J- Per mitte e Sign ature: I / e 0 /
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.
Building Permit Applican CEVED
Fire Protection System JAN 28 2013 FOR OFFICE USE ONLY
`J Tigard
of Ti d Received / 1 permit No.: / 0ey7 n,, i �e,
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p
1
13125 SW Hall Blvd., Tigard, OR I �GR Date/13 : Plan Review �►
I 0 Phone: 503.718.2439 Fax: 506 U 1 T G DIVISION Date/B : 4 Other Permit:
�`,���
TI G A R D Inspection Line: 503.639 Date Ready/By: c, � Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Metho : � �,, I A I ,3 �I Supplemental Information
ddd�
TYPE OF WORK U 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
Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El I- and 2- family dwelling Commercial /industrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / (, j 9j - - 1 5 - 9W -1 L T A A 02__ New dwelling area: square feet
City /State /ZIP: T�' p ),, j 0 IS 7 -7f0-Z- q Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Alp y p, S, •,yl a,,,, iq y ,� �J� Covered porch area: square feet
Cross street/directions to job site: //11,4 Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: 41 1 Lot no.: `/A 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 srofit for the
DESCRIPTION OF WORK work indicated on th' .mplication.
it, Sd7A /1 0)--,) CA Y1 r .S5,'Oy '/ Valuation: $ / l .2--
/l7 G 1 O -11 • Existing building .1 .. _.I , ..
New building area: // square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: y
Name: Type of construction: (T f- f t ) eciYIC - 'e- - Q__
Address: i 49' 14- 5 4t1 A vQ-- Occupancy groups:
5Yo,
City /State /ZIP: T ;r ,,,,- y J D 5' Z
Z '( Existing:
Phone: (503) 6z_o _ ' 5 Ze9a Fax: ( ) New:
❑ APPLICANT CONTACT PERSON NOTICE
Business name: fiat to ( f),_ 4 _,, �,,_ ,,-,/,,.,,€_- = All contractors and subcontractors are required to be
Contact name: v, i �l r�� licensed with the Oregon Construction Contractors Board
p under ORS 701 and may be required to be licensed in the
Address: l y 3 `Z�1 f S/= S Ys< J d— jurisdiction in which work is being performed. If the
City/State /ZIP: (pp-i -4- oP o� C - 23 7 applicant is exempt from licensing, the following reasons
apply:
Phone: ( 503 2_3 ( - - z_q Qi 9 I Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule,
Business name: /4 "2-4--5"0-Ad— ,,- e i i,-'r, Permit fee:
Address: / ` 13 2 y 5) S' -c,,, sa
v7 D State surcharge (12% of permit fee):
City /State /ZIP:
� /i h 1
1 . 2 3 3 FLS plan review (40 % ofpermit fee):
Phone: ( . 23 1 - 2 99 I Fax: (9) 3) .z SG -- yE q ! (Due upon application.)
CCB lic.: , 3 G Total permit fees:
Authorized signature: _t► Amount received: /9 / 7 /5-K,
( This permit application expires if a permit is not obtained
Print name: 5 17 C Date: / ( (3 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits \FPS- PermitApp.doc Rev 01/05/2012 440- 4613T(I 1 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - .Supplemental Information
Describe work to be done: . Y
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:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ' Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor -
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2;000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
1: \ Building \ Permits \FPS- PermitApp.doc Rev 01 /05/2012 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14975 SW 74TH AVE, TIGARD, OR, 97224
Commercial - Fire Protection System
920 Suppression Trip Test
02/28/2013 00:00
FPS2013-00018
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14975 SW 74TH AVE, TIGARD, OR, 97224
Commercial - Fire Protection System
920 Suppression Trip Test
02/28/2013 00:00
FPS2013-00018
PASS
Violation Summary:
Inspector Contractor