Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2013-00121
Date Issued: 11/12/2013
.TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S102BD00100
Jurisdiction: Tigard
Site address: 12520 SW GRANT AVE
Project: St Anthony Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 52
Project Description: Fire sprinkler system for new community center assembly building.
Contractor: FIRESTOP CO Owner: ST ANTHONY CATHOLIC CHURCH TIGAR
3203 NE 65TH ST#2 9905 SW MCKENZIE ST
VANCOUVER,WA 98663 TIGARD, OR 97223
PHONE: 360-718-8604 PHONE:
FAX: 360-718-8603
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/12/2013 $459.82
12%State Surcharge-Building 11/12/2013 $55.18
Type of Use: COM Plan Review-Fire Life Safety-COM 11/12/2013 $183.93
Class of Work: NEW Type of Const: VB Info Process/Archiving-Lg$2.00(over 11/12/2013 $2.00
Occupancy Grp: A-3 Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 11/12/2013 $13.50
11x17)
Misc Administration Fee 11/12/2013 $5.00
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 Design Area: 1460
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 $719.43
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $39,800.00
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: Permittee Signature: 0'4N /976,(/e-49-1170A/
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 ApplicationRE�G CEIVED
Fire Protection System FOR OFFICE USE ONLY
City of Tigard AUG 2 6 2013 Received / Permit No.:
V 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review al.
''-, a. Phone: 503.639.4171 Fax: 503.598.@4 OF TIGARD Date/B : r mum Other Permit: A u/9A013_40065-
Inspection Line: 503.639.4175 Date Read/B /, lens: ® See Page 2 for
T I C;n li Internet: www.tigard-or.gov BUILDING DNISION Notified/Method:/I �..3 I.�'." Supplemental Information
TYPE OF WORK 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.
❑ 1-and 2-family dwelling f 6ommercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION /ATZaT 4_,,,e Total number of floors:
Job site address: New dwelling area: square feet
City/State/ZIP: 7! 6 4 /Z b/ 0 ft . /A.S O S)) 6,Z.4 /T G Garage/carport area: I square feet
Suite/bldg./apt.no.: Project name: S't, A NT H o NY CATHo U C Covered porch area: square feet
Cross street/directions to job site: <'H(42-C H 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.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
be s) G-N 4 , Nisi-At-L.- w£T FIP E P(Le T il0r) Valuation: $ '39/ 800, a
s y srE/'vi '1a ACcomoD/4rE PMASE 3 D Existing building area: square feet
C o 4'V 1 v /1/ iT'( CEP/ , E 1.. A b0►n oft) New building area: )7/ Sd a square feet
[PROPERTY OWNER I ❑ TENANT Number of stories: j
Name: S'T. A NTH o WY CA-T H 01.4 C CH VAL.H Type of construction: V-13
Address: 190 5 s W ,v1 e KG 1v' I E 5 T. Occupancy groups: A 3/ 8 J r 4/ 5-i
City/State/ZIP: -) A-10._D i O JL Existing:
Phone:( ) Fax:( )
New:
I 1 PPLICANT B tONTACT PERSON NOTICE
Business name: F)JZEs-ra p co/V)P/1.)t/l( Li--C- All contractors and subcontractors are required to be
Contact name: 00 N licensed with the Oregon Construction Contractors Board
_ under ORS 701 and may be required to be licensed in the
Address: '3 2.,,3 �E 6 5Th_ s ( , / S P/ -CE Z jurisdiction in which work is being performed.If the
City/State/ZIP: VA r ) co v V ERL wA - 9,9 6 63 applicant is exempt from licensing,the following reasons
apply:
Phone:(3(0 ) 119 -g 6 0 el- Fax::(360)-718 -6 60 3
E-mail: b 0 b€ 9- re e r, ® fl're s p co . C-0 N
CONTRACTOR BUILDING PERMIT FEES*
Business name: M E As A-,z V6-- (Pleaserejer.�o/eeschedule)
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
PI ) Fax:( ) (Due upon application.)
r__.:Cb sic.: s 1 5 3 7_-.) 9 Total permit fees:
Authorized signature: - / ' - s�-�— Amount received:
This permit application expires if a permit is not obtained
Print name: tz 0 g 6 pi- b, /tG is N Date: g f 2 g/'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 10/01/09 440-4613T(11/02/COM/NEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
El 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 2 sets of plans at submittal. Plan review fees are required at submittal.
I:\Building\Permits\FPS-PermitApp.doc 10/01/09 2
11/11/2013 23:25 5036206141 FIRESTOP PAGE 01/02
PESTOP CO.
AUTOMATIC FIRE PROTECTION RECEIVED
NOV 12 2013
CITY OF TIGARD
FAX BUILDING DIVISION
To: City of Tigard From: Julie Jensen
Attn: Diana Pages: 2
Fax: 1-503-598-1960 Date: 11/12/13
Re: Credit Card Authorization Form CC:
Urgent I For Review X Please Comment Please Reply Please Recycle
Comments:
3203 NE 65th Street,Ste,2,Vancouver,WA 98663
P 360-718-8604"F 360-718-8603
WA/FIRESCL922OH"OR/183279"CO/121482 4 MT/FPL-IEL-000751*WY/CT-14-29300
11/06/2013 21:28 5036206141 FIRESTOP PAGE 01/02
RECEIVED
FIRESTOP COMPANY NOV 7 2013
AUTOMATIC FIRE PROTECTION_ CITYOFTIGARD
3203 NE 65t Street,Space 2 3614 152°' St.NE,#4 OR/ 183279 BU LDING DIVISION
Vancouver,WA 98663 Marysville,Wa.98271 W.A./FIRESCL922OH
P 360-718-8604
• F 360-718-8603 •
FAX
Attention: Dan Nelson
Company or Government Office: City of Tigard Community Development
Regarding: St. Anthony Catholic Church Community Ctr. Seismic Brace
Details
FAX: 503- 4-•,•3681
E-mail:
From: Bob Green
Date: November 6, 2013
Subject Project and Address # of pages sent
including this cover
sheet is 2.
9905 SW McKenzie Ct.
Tigard, Or. 97223
Please see attached Seismic Details for St. Anthony Catholic Church Community
Ctr as requested. Please confirm receipt and when ready to pick up approved
plans and permit. Let me know if you need anything else.
Copy to file
Thank you
Bob Green •
bob.green @firestopco.com
360-718-8604
PLeCEIVEA
Fx
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•
° .' .® ID!NGD�SRD
ION
''''AUTOMATIC FIRE PROTECTION -
LETTER OF TRANSMITTAL
Attention: Fire Sprinkler Plan Reviewer
Jurisdiction: City of Tigard
Regarding: Fire Sprinkler Submittal for St. Anthony's Community Ctr
Address: 13125 SW Hall Blvd.
Tigard, Or. 97223
From: Bob Green
Date: August 26, 2013
Subject Address
9905 SW McKenzie St.
Tigard, Or. 97223
Includes:
1. 3 Sets of Stamped Shop Drawings
2. 2 Sets of Stamped Hydraulic Calculations
3. 2 Sets of Sprinkler Head Cut Sheets
4. 1 Building Permit Application
5. 1 Check for plan review fee based on $39,800.00 valuation
These are submitted for your approval.
If you have any questions, please call.
Copy: to file
Thank you,
Robert D. Green, CET
Bob.green @firestopco.com
360-718-8604
3203 NE 65`h Street,Ste. 2,Vancouver,WA 98663
P 360-718-8604 * F 360-718-8603
WA/FIRESCL9220H* OR/183279*CO/121482
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12520 SW GRANT AVE, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler Final
2014-03-10 (null)
FPS2013-00121
PASS - No C of O
Flow test preformed
Violation Summary:
Inspector Contractor