Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'. COMMUNITY DEVELOPMENT Permit#: FPS2014-00030
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/18/2014
Parcel: 1S135BA00100
Jurisdiction: Tigard
Site address: 10205 SW WASHINGTON SQUARE RD
Project: Thirsty Lion Subdivision: MYERS ESTATES Lot: A
Project Description: Add(2)fire sprinkler heads
Contractor: PACIFIC FIRE SYSTEMS LLC Owner: PPR SQUARE TOO LLC
6704 RIVERIA CT PO BOX 847
WEST LINN, OR 97068 CARLSBAD, CA 92018
PHONE: 503-710-6646 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/18/2014 $51.09
12%State Surcharge-Building 02/18/2014 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 02/18/2014 $20.44
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 $77.66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $425.00
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 o• • a copy of the rules
or dire ••- ions • i-• b . mg 03.232.1987 or 1.800.332.2344.
I ;ued By: 01,0 ( Permittee Signature:
• AWr/
Call 503.639.4175 by 7:00 a.m.for the next available inspection dat
This permit card shall be kept in a conspicuous place on the job site until comple ion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System ECE1VED FOR OFFICE USE ONLY
Recccd CI of Ti and A / I /�, Permit No.: ,
`J Tigard O` /� �`t ,�/ �1��i ��/D AI
13125 SW Hall Blvd.,Tigard,OR 97223 FEB 18 2014 Plan Review JA�o^ �y a�rt?Q
1 7 Other Permit: / 1 Z6t/v /
Phone: 503.718.2439 Fax: 503.598.1960 Date./13y:
T I G ARD Inspection Line: 503.639.4175 CITVOF 1'�GARD Date ReadyBy: Juris El See Page 2 for
Internet: www.tigard-or.gov r��I��l^Ir 1, l Notified/Method: Supplemental Information
7 i�IH�,SI(lt►
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 0-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: (C)p,,0 5 Sto as-%( 7:0-.., S IX Jed New dwelling area: square feet
City/State/ZIP: � vtj_ ( • 7R 2 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: i <tKij � Covered porch area square feet
Cross street/diredions 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.
Valuation: $ 9 .5- ,
40) 02 /V e-.w <t.-t',// /
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 lensed 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:( ) Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*/ (Please refer to fee schedule)
Business name: 4 e t "mil G A.;2, Sys Ti.vu S Permit fee:
Address: ?d Y 2l t(/i--cc/ £7
State surcharge(12%of permit fee):
City/State/ZIP: ��t ht5t�t /9� 97U r 6 FLS plan review(40%ofpermit fee):
Phone:(563 ) 7/o-w to 4,4 Fax:( ) (Due upon application.)
CCB lic.: / -- J C. () Total permit fees: �(
/Authorized signature:
Amount received: �4'7 7, 64'
rt This permit application expires if a permit is not obtained
A within 180 days after it has been accepted as complete.
Print name: Date: 07 f ///
t �K3c'9r∎ �� 7 * Fee methodology set by Tri-County Building Industry
Service Board.
L\BuildingTermits\FPS-PermitApp.doe Rev 01/05/2012 440-46137(11/02ICOM/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:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ 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 Mann 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.
I:\Building\Pemuts\IPS-PermitApp.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
10205 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler Final
2014-02-20 00:00:00
FPS2014-00030
PASS - No C of O
Violation Summary:
Inspector Contractor