Permit a CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: FPS2013 00175
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/03/2013
Parcel: 2S 101 CA00200
Jurisdiction: TIGARD
Site address: 7904 SW HUNZIKER RD
Project: Agilyx Subdivision: 1994 -025 PARTITION PLAT Lot: 2
Project Description: Adding (1) sprinkler in vent hood.
Contractor: VIKING AUTOMATIC SPRINKLER CO Owner: WALL STREET INDUSTRIAL LLC
3245 NW FRONT AVE A RICHARD VIAL EXECUTIVE CENTER LLC
PORTLAND, OR 97210 7000 SW VARNS ST
PORTLAND, OR 97223
PHONE: 503 - 227 -1171 PHONE:
FAX: 503 - 227 -1552
FEES
Description Date Amount
Specifics: Permit Fee - COM 12/03/2013 $64.54
12% State Surcharge - Building 12/03/2013 $7.74
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required. Spnnkler Type: Wet
Standpipe Required: No Hazard: LT
Density. .1 Design Area. 1500
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 $72.28
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation $950.00
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: _ 1 ittee Signature: (>/- 1(------:—
.-- i_,...... _�
Call 503.63 •. • ∎•- 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 Application .
Fire Protection System FOR OFFICE USE ONLV
City of Tigard ' , Permit No • •� .,, iS go ' ) .7
111. a 13125 SW Hall Blvd , Tigard, OR 97223 I " 4 �'
Phone: 503.718.2439 Fax. 503.598.1960 , _ , - : Other Permit
T G A R D O��
Inspection Line: 503.639.4175 ..- 3 ti Date Readyn3y ® See Page 2 for
Internet: www.tigard - or.gov , gfied/Method WI Supplemental Information
--1\C _..e,w
TYPE OF WORK G`�l Yr p�ti�i� REQUIRED DATA: 1 - AND 2- FAMILY DWELLING
❑ New construction ❑ Demolitio ������ \ev 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 ® Commercial /industrial
Valuation: $
- ❑ Accessory building ❑ Multi - family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 790 ,,...>, i4v t-� z t rr � .. . New dwelling area: square feet
Cit /ZIP: 17kfti2.--0 Si ZZ3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: i‘ratl Ly , Covered porch area: square feet
Cross street/directions to job site: T 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.
Valuation: $ 1m
. Aop S t t., \tea' t Ta 13a ' Fay g
�� Existing building area square feet
a
44. PST, Cj Lm r l Cioo-
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: A4 t f 1 x 6, v _,, Type of construction:
Address: tom, t`ktu...x A iwa: 5l.(T6 Zlero Occupancy groups:
City/State /ZIP: •- -6atkDai I0 , u,¢ Ct'100 l it> Existing:
Phone: ( ) Zl1 —'3ii00 Fax: (5-5) ZI') - 31101 New:
® APPLICANT ® CONTACT PERSON NOTICE
• Business name: V f, r )4 p All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: - ,,,J under ORS 701 and may be required to be licensed in the
Address: 3Zits ( 'Fir,-, ` Ittlnc- jurisdiction in which work is being performed. If the
City/State /ZIP Q 7LI applicant is exempt from licensing, the following reasons
n pczt,4r1� � 0 apply:
Phone: (.607, Z2'7 - Lt I Fax:: (s'i T Z21 -1 Z
E- mail:UWesi3c µ a VuL... tSQ e2
CONTRACTOR BUILDING PERMIT FEES*
• Business name: , I (Please refer to fee schedule)
g 1 t q Sf' t t' e� Permit fee:
Address: 3-2. 4,,, 5 ,....,-- N„0-
State surcharge (12% of permit fee):
City/State /ZIP`
1 z'S (+t „.,=, 01 CO 211) FLS plan review (40% of permit fee):
Phone: (5 ) - I1 1 Fax: (Sv3 ) 2z1- t 5 (Due'upon application.)
CCB lic.: ( Z ) Total permit fees:
�. /� Amount received: -y • °C 7 g
Authorized signatule: _ L � � � vv __..... /
�°� l ( > This permit application expires if a permit is not obtained
. Date: within 180 days after it has been accepted as complete.
Print name
�Wtt I2- • Fee methodology set by Tri -County Building Industry
Service Board.
1 \Buildmg\Permits \FPS- PemiitApp doc Rev 01/05/2012 4404613T(11/02/COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe workto be d one:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition O 1 -10 heads: No plan review required.
® Alteration 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: (
Additional description of work: Ava 5inz Tv .
::Type of System (Complete A, B, C or D as applicable):
Commercial Sprinkler
io Wet ❑ Dry
Additional Standpipes
Information: Hazard Group 1 G N r
Density , 1
Design Area t Sbo
•
K Factor s" Co
Sprinkler Project Valuation: $ ) 5 v
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
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.
C:\ Users \dave.bateman\ Desktop \City of Tigard FPS- PertmlApp.doc Rev 01/05/2012 2
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
7904 SW HUNZIKER RD, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler Final
2014-04-08 00:00:00
FPS2013-00175
PASS - No C of O
Violation Summary:
Inspector Contractor