Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2014-00103
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2014
Parcel: 25101 BB01500
Jurisdiction: Tigard
Site address: 12244 SW GARDEN PL
Project: Colossae Church Subdivision: CROW PARK 217 Lot: 3
Project Description: Modification of approximately(11)fire sprinkler heads for TI
Contractor: JR MERIT INC Owner: WALTON CWOR PARK BC 8 LLC
4504 NE 68TH DRIVE BY EQUITY OFFICE MANAGEMENT LLC
VANCOUVER,WA 98661 PO BOX A-3879
CHICAGO, IL 60690
PHONE: 360-693-7474 PHONE:
FAX:
FEES
Description Date Amount
Specifics:, Permit Fee-COM 06/17/2014 $112.96
12%State Surcharge-Building 06/17/2014 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 06/17/2014 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 06/17/2014 $2.00
Occupancy Grp: A-3 Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 06/17/2014 $5.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 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 $178.70
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 withi 80 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requi • ••• : ollow the rules adopted • the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y may obtain a co• of the rules
or direct • _= r• • •UNC by calling 503.232.1987 or 1.800.332.2344.
Iss =d By: it / 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.
Buildin Permit A lication
Fire Protection System Er,FIVFD FOR OFFICE USE ONLY
City of Tigard - 9 7 014 v ,Eillim i Permit No.: ,5,,# _00103
1111 I • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.196Q- Date/By: �/a( q Other Permit:
r I t `I,I t Inspection Line: 503.639.4175 Cl+Y Oi-I iLiAtiU Date Ready/By: , Jury ® See Page 2 for
Internet: www.tigard-or.gov II' �lps.r ";1;t,Inli Notified/Method: Lf' fief/(D1-b Supplemental Information
TYPE OF WORK (QUIRED 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 ® m
Comercial/industrial Valuation: $
❑Accessory building ID Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12244 Garden Place New dwelling area: square feet
City/State/ZIP:Tigard oregon 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Colossae Church 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: 1 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: $ 3 7 00 �----
add remove and relocate fire sprinklers as necessary for new tenant improvent -
per plan Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name:robert todd construction Type of construction:
Address:4080 ne international way Occupancy groups:
City/State/ZIP:milwaukie,oregon 97222 Existing:
Phone:(503)653-5704 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name:JR Merit All contractors and subcontractors are required to be
Contact name:Jason Sampson licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:4504 ne 68th drive jurisdiction in which work is being performed.If the
City/State/Z1P:vancouver,wa 98661 applicant is exempt from licensing,the following reasons
apply:
Phone:(360)693-7474' Fax::( )
E-mail:jason.sampson @jrmerit.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:JR Merit (Please refer to fee schedule
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application)
CCB lic.: 123738 if('l.4,l 6 Total permit fees:
Authorized signature __ Amount received: —15----J�
-.)/I'. This permit application expires if a permit is not obtained
Print name:jason Sampson Date:6-6-14 within 180 days after It has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-46t3T(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 )S 11+heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
T ,e of S stem Corn i lete A, B, C or D as a. I licable :
A.) Commercial Sprinkler
Wet ❑ Dry
Additional Standpipes
Information: Hazard Group 1.---l41Y(
Density 0,
Design Area [ 515 v
K. Factor Jm C. (o
Sprinkler Project Valuation: $
B.) Type I - Hood Firs Spp ression System
Hood Project Valuation: f) $
C.) Fire Alarm
0 0 Submittal shall Battery Calculations ❑ Yes
�j 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 fi' $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.
r
1. V:\R\Robert Todd Construction,Inc\Projects\0102\4115 Colossae Church\TigardFirelpp.doc Rev 01/05/2012
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
12244 SW GARDEN PL, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
August 5, 2014 at 11:43:36 AM
FPS2014-00103
Jeff Grove
Violation Summary:
Inspector Contractor