Permit 1y® CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11 2 COMMUNITY DEVELOPMENT Permit#: FPS2014-00066
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2014
Parcel: 2S113AB00700
Jurisdiction: Tigard
Site address: 16255 SW UPPER BOONES FERRY RD
Project: The Circuit Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: Modifying existing sprinkler system for TI.
Contractor: PACIFIC FIRE SYSTEMS LLC Owner: COLEMAN BOULDERING LLC
6704 RIVERIA CT ATTN:ANDY COLEMAN
WEST LINN,OR 97068 16255 SW UPPER BOONES FERRY RD
TIGARD, OR 97224
PHONE: 503-710-6646 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/28/2014 $112.96
12%State Surcharge-Building 04/28/2014 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 04/28/2014 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 04/28/2014 $4.00
Occupancy Grp: A-3 Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/28/2014 $17.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Dry
Standpipe Required: Hazard: LT
Density: 0 Design Area: 0
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 $193.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,700.00
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 Notifi - - - s er. 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• estions to OU` by ing 503.232.1987 or 1.800.332.2344.
Issued •y: i /[ ? � Permittee Signature:
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 Application
Fire Protection System ‘*S)4 FOR OFFICE USE ONLY
City of Tigard �j
Received ed A Permit No.. 5 O
i• 13125 SW Hall Blvd.,Tigard OR �Q�Q �� • er Permit:
Phone: 503.718.2439 Fax: 503. �`0 O `c,_ : ,I ASi I a3 U A —
—
CIGARD Inspection Line: 503.639.4175 Q� Q`P t. :,• Re..,:y: t See Page 2for
Internet: www.tigard-or.gov P 't\G'`� Notified/Method: I��� rM Supplemental Information
I.
OF CY4 A_ -- . Mr_
TYPE OF WORK ��0� REQUIRE II.■ATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Da�tb�itnon Permit fees*are based on the value of the work performed.
Indicate the value(rotded to the nearest dollar)of all
Ad dition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the
( CATEGORY OF CONSTRUCTION work indicated on this application.
El 1-and 2-family dwelling (Commercial/industrial Valuation: $
❑Accessory building 12 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /G Z6-LJ /. ,,� / New dwelling area: square feet
City/State/ZIP: (1�ar / C� Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ei_tx,u t,- 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: I 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. _
_ r Valuation: $ po�j_`—
Fifa=- 'F Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ 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 licensed 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: tz ei_77. Fl SY er-T-5 Permit fee:
Address: tD7d)q 2ellit'c � (1 1--
State surcharge(12%of permit fee):
City/State/ZIP: l Q 6' 170 $'
�� 'K� / FLS plan review(40%ofpermit fee):
Phone:(S03) 7�4)-IC9‘ Fax:( ) (Due upon application.)
CCB lic.: 6�'01 Lf 6 Total permit fees:
Authorized signature: ' A Ci f`rfT- C004 t 51,/li et!" Amount received:
!, This permit application expires if a permit is not obtained
Print name: /� / �c��y� Date: �f�� _-�� within 180 days after it has been accepted as complete.
`—d * Fee methodology set by Tri-County Building Industry
Service Board
I:\Buildi°g\Permits\FPS-PermitApp.doc 02/01/2011 440-46131(11/02/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:
❑ 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: I $
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 three(3) sets of plans at submittal.
Plan review fees are required at submittal.
I:\Building\Permits\FPS-PermitApp.doc 02/01/2011 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16255 SW UPPER BOONES FERRY RD,
TIGARD, OR, 97224
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2014-00066
Chip Barnett
Violation Summary:
Inspector Contractor