Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'111 COMMUNITY DEVELOPMENT Permit #: FPS2013 -00084
T EGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/01/2013
Parcel: 1 S135BB00800
Jurisdiction: Tigard
Site address: 10655 SW GREENBURG RD
Project: Ewing Irrigation Subdivision: HILLSBORO Lot: PTS 1 -2
Project Description: Installation of double check valve for fire supply line.
Contractor: OREGON UNDERGROUND INC Owner: EWING IRRIGATION PRODUCTS INC
PO BOX 777 3441 E HARBOUR DR
CLACKAMAS, OR 97015 PHEONIX, AZ 85034
PHONE: 503 - 657 -6123 PHONE:
FAX: 503 - 656 -2061
FEES
Description Date Amount
Specifics: Permit Fee - COM 07/01/2013 $177.52
12% State Surcharge - Building 07/01/2013 $21.30
Type of Use: COM Plan Review - Fire Life Safety - COM 07/01/2013 $71.01
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 $269.83
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $9,500.00
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 " • k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility . ification Cen - Those rules are set forth in OAR 952 - 001 -0010 through OA • - :: • 1. You may obtain a copy of the rules
or di -ct questions to OUNC • g 51 32.1987 or 1.800.332.2344.
Iss ued By: 0 / • Permitte- ignature: ���j�
Call 503.639.4175 by 7:00 a.m. for the next availa • :. spection 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.
Plumbing Permit Application < Saq0l3
Site Utilities FOR O USE ONLY ,
City of Tigard RD ate/R
e ceived 6 Ar�� Permit No.: , r
a 13125 SW Hall Blvd., Tigard, OR ;,,� 3
Plan Review
_ Phone: 503.718.2439 Fax: 5)41' '�.`' , D a1e /R Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready /By: turns: ® See Page 2 for
Internet: www.ttgard- or.gov Natifncd /Mclhud: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 0. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
❑ I- and 2- family dwelling ® Commercial /industrial SFR (2) bath 437.78
❑ Accessory building El Multi-family SFR (3) bath 500.32
❑ Master builder ❑ Other: Each additional bath/kitchen 25.02
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 10655 SW Greenberg rd. Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City /State /ZIP: Tigard
Footing drain (no. linear R.: _ ) Page 2
Suite/bldg. /apt. no.: I Project name: Lamphere Building Manufactured home utilities 50.03 _
_Cross street/directions to job site: Just off 217 (South Manholes 18.76
r l Rain drain connector 18.76
Sanitary sews (no. linear ft.: _ ) Page 2
Storm sewer (no. linear f).: _ ) Page 2
Water service (no. linear 0.: _ ) Page 2
N U Subdivision: I Lot no.: Fixture or item:
C Tax map /parcel no.: Backllow preventer I 31.27
1 DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer . 25.02
Dishwasher 25.02
r New Double Check Installation Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
_ ^
Name: Ewing Irrigation
Address: Fixturdsewcrcap 25.02
Floor drain/ loot sink /hub 25.02
v' Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: S ) Pagc 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City /State/ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Oregon Underground, Inc., Water piping/DWV 56.29
Address: P.O. Box 777 Other: 25.02
City / State/ZIP: Clackamas Subtotal
\ Mini mum permit fee: 572.50
Phone: (503)657 -6123 Fax: (503) 656-2061 1' 72- x. 182
CCB Lic.: 1 16 $ j(� 1 °/ Plumbing Lic. no.: 3 -541 PB G
Plan review (25% of pcnnit fee) �-
7/r //it State surcharge (12% of permit fee)
Authorized si TOTAL PERMIT FEE e 1 , -4
Print name: Tom Rasch I Date: 6/12/13 This permit application expires if a permit is not obtained within IRO days
after it has been accepted as complete.
•fee methodology set by 1'6-County Building Industry Service Board.
1:16uilding\Perm iu \PLMU- Permit App.doc 10/01109 440.4616T( IOIO2ICOM/WF.n1
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10655 SW GREENBURG RD, TIGARD, OR, 06/19/2013 00:00
97223
Record Type: Record ID:
Commercial - Plumbing PLM2013 -00186
Inspection Type: Result:
399 Plumbing final CNCL
Comments:
NOTE. Permit is a double check for a fire line not potable water, needs new permit
issued.
Violation Summary:
Inspector Contractor
City of Tigard UI
13125 SW Hall Blvd.
Tigard, OR 97223
Phone: 503- 639 -4171
T I GARD
FAX TRANSMITTAL
Date June 27, 2013
Number of pages including cover sheet 5
To: Tom Rasch From: Debbie Adamski
Co: Oregon Underground Inc Co: City of Tigard
Fax #: 503 - 656 -2061 Fax #: 503 - 598 -1960
Ph #: 503 - 718 -2450
SUBJECT: Lanphere Building, 10655 SW Greenburg Rd, Tigard, OR
MESSAGE:
Attached is a copy of the original receipt (191760) showing the fees paid for the plumbing permit that
was created for the double check valve. The inspector said as the double check valve was part of a fire
protection system, it should have been on a fire protection permit. FPS2013 -00084 was created and
the paid fees were applied to the new permit (191952). Because the fees are calculated differently for a
fire protection permit (the fees are based on project valuation) there is a remaining fee balance of
$188.63.
This permit is on hold until the fees are paid, at which time the permit will be issued, and then the
inspection can be requested as a sprinkler final.
I have also attached a copy of our credit card authorization form if you would like to complete this
and fax it back we can process the payment in this method and fax the new permit to you and also
mail a copy of the permit and receipt.
I:1ENG\FA%.DOT