Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 q
' COMMUNITY DEVELOPMENT Permit#: FPS2014-00013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/21/2014
Parcel: 2S 101 CA00200
Jurisdiction: TIGARD
Site address: 7904 SW HUNZIKER RD
Project: Agilyx Subdivision: 1994-025 PARTITION PLAT Lot: 2
Project Description: Add(1)sprinkler head to BSOO control room
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 YARNS ST
PORTLAND, OR 97223
PHONE: 503-227-1171 PHONE:
FAX: 503-227-1552
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/21/2014 $67.23
12%Stale Surcharge-Building 01121/2014 $8.07
Type of Use: COM Plan Review-Fire Life Safety-COM 01121/2014 $26.89
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 Caics Provided: Cut Sheets Required:
Total $102.19
Valuations: Required Items and Reports(Conditions}
Sprinkler Valuation: $1,100.00
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 Noti newer. Tho .- rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire uestions to OUNC -Mind 50 .232.1987 or 1.800.332.2344.
Iss ed By: / `i` /A A ' Permittee Signature: 1
Call 503.639.4175 by 7:00 a.m.for the next available inspectio 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 I /� FOR OFFICE: I .1 (/\ )
City of Tigard PC H t ED / 9I if Permit loo.: I_dm,/ 'Da46
13125 SW Hall Blvd.,Tigard,OR 972!3 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Datc/B : Other Perm"
Inspection Line: 503.639.4175 JAN 2 1 Date Ready/By: Juns la See Page 2 for
Internet: www.tigard-or.gov Notified/Method- Suppkmental Information
ritIn I • r r).—.t,-,!}
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
I%Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: S
❑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: -II e7 q It,,, I.(v urt tcttt:. 2p — New dwelling area: square feet
City/State/ZIP: 1-1(44ap c,T 41111 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: J l yi. [ _2 '\) 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.
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.
Apt)A 5�z i1-)te_t`Et2 TQ / {, Valuation: S �`Cf7.r
�Q lP`ll�l?t. VLON-t •
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER [ TENANT Number of stories:
Name: pig 114 x Type of construction:
Address: e,a.1 Sa..a 1.4 u 7.1 ic e? RA> Occupancy groups:
City/State/ZIP: 11 aka i7 are Qr/21.3 Existing:
Phone:(So3 )TS,_Lo•.kLa 11`:( ) New:
CB-APPLICANT 4} CONTACT PERSON NOTICE
Business name: kl t 1/4.1 tv(1 ,rta t+-t G`lw! All contractors and subcontractors are required to be
Contact name: ) ��- ^� licensed with the Oregon Construction Contractors Board
-1 under ORS 701 and may be required to be licensed in the
Address: -32LK- 4,... Fir.N %Le jurisdiction in which work is being performed.If the
City/State/ZIP:) lot 0.a p2 1 apply applicant is exempt from licensing,the following reasons
Phone:($1,-9 227.- t t--1 t Fax::(S63)Z-C2 -tc Z
E-mail:'.4v( .-5A ►+EAU tJi Lo C j kitL- E
CONTRACTOR BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
t 1C i,,„. Mutt(b'2
Permit fee:
Address: z.{.S t„.1w FZo4si 01%-de
C ily/5tatelZIP: State surcharge(12%of permit fee):
-PR 11,Ar_sD CR �CIZ D FLS plan review(40%of permit fee):
Phone:(C-63)17.1 -L11 1 I Fax:(S,3 )t - I SQL (Dice upon application.)
CCB lie.: Get e,-.�-) Total permit fees:
Authorized signal -- �_
Amount received: /o,` . /9
This permit application expires if a permit is not obtained
ILA ISO days after it has been accepted as complete.
Print name: '�V E -�i .�+srJ Date: 1 11 L1 (14
* Fee methodology set by Tri-County Building Industry
Service Board.
1 lnuilding\Permits\FPS-PermiiApp.doc Rev 01/05/2012 440-4613T(It/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
0 Addition 0 1- 10 heads: No plan review required.
Alteration 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: I
Additional description of work:
T Ale of S stem (Corn.letc A, B, C or D as a. .licable :
A.) Commercial Sprinkler
® Wet ❑ 1)_r
Additional Standpipes
Information: Hazard Group
Density —Design Area
K.Factor
Sprinkler Project Valuation: $
B. T j. • I - Hood Fire Su. .ression S stem
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 ; eater $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 Surc . 12%of . rmit 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\Downloads\FPS-PcxmitApp.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
FPS2014-00013
PASS - No C of O
Violation Summary:
Inspector Contractor