Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
-• COMMUNITY DEVELOPMENT Permit #: FPS2013 -00033
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/21/2013
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15957 SW 72ND AVE
Project: Bikram Yoga Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: Add /Relocate heads to maintain coverage around new walls & ceilings
Contractor: CROSSFIRE SPRINKLER CO Owner: PACIFIC REALTY ASSOCIATES
17400 SE 82ND DR ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 210 -5506 PHONE:
FAX: 503 - 210 -5538
FEES
Description . Date Amount
Specifics: Permit Fee - COM 03/21/2013 $102.20
12% State Surcharge - Building 03/21/2013 $12.26
Type of Use: COM Plan Review- Fire Life Safety - COM 03/21/2013 $40.88
Class of Work: ALT Type of Const: IIB Misc Administration Fee 03/21/2013 $5.00
Occupancy Grp:. B Height: ft Info Process /Archiving - Sm $0.50 (up to 03/21/2013 $1.00
Stories: 1 11x17)
•
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
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 $161.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $3,000.00
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: U �i�� f ^ �' Permittee Signature: EA A PPL( C
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.
11
. Building Permit Application
Fire Protection System RECEIVED FOR OFFICE USE ONLY City of Tigard Date /B ea 3 � (( ( Permit No.: 5 Dot 3 - ow 3
n 13125 SW Hall Blvd., Tigard, OR 97 y Q f � p 7/ G D
Phone: 503.639.4171 Fax: 503.598. (P 1 2013 P lan Revie� Date /By: ✓ I Other Permit: I(P 3 - 'i 'F
TI G A RD Inspection Line: 503.639.4175 n Date Ready y: r ® See Page 2 for
Internet: www.tigard- or.gov C ITY OF TIGARD Notif d/Method: > / 3 Supplemental Information
BUILDNVG D V V 1 et; Lt_. sr
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING 12'
❑ New construction El 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: $ 1"
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder 111 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 15957 SW 72 Ave New dwelling area: square feet
City /State /ZIP: Tigard, OR Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Bikram Yoga 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: 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
DESCRIPTION OF WORK work indicated on this application.
Add/ Relocate Heads to maintain coverage around new walls & ceilings Valuation: $$3,000.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: 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: ( ) I Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: Crossfire Sprinkler Company (Please refer rnfecschedule
Permit fee:
Address: 17400 SE 82 Drive
State surcharge (12% of permit fee):
City/State /ZIP: Clackamas, OR 97015
FLS plan review (40% of permit fee):
Phone: (503) 210 -5506 I Fax: (503) 210 -5538 (Due upon application.)
CCB lie.: 174746 — ' Total permit fees:
signature: Amount received:
Authorized
,- This permit application expires if a permit is not obtained
Print name: Timothy A Bishop Date: 3/1/13 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1: \Building \Permits \FPS- PermitApp.doc 10/01/09 440- 4613T(11/02 /COM/WEB)
r
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) El New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
El Repair
Number of sprinkler heads: 18
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 Light Hazard
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 3000
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component El 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 2 sets of plans at submittal. Plan review fees are required at submittal.
C: \Documents and Settings \ CAD \ My Documents \ Permits \tigard permit.doc 10/01/092
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
15957 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Fire Protection System
999 Sprinkler Final
04/25/2013 00:00
FPS2013-00033
PASS - No C of O
Violation Summary:
Inspector Contractor