Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
S. COMMUNITY DEVELOPMENT Permit#: FP52014-00159
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2014
Parcel: 2S102AD01900
Jurisdiction: Tigard
Site address: 8935 SW BURNHAM ST
Project: TVF&R Subdivision: TIGARD HIGHWAY TRACTS Lot: 21
Project Description: Add sprinklers to addition,add flex connections to existing heads in drop ceiling.
Contractor: VIKING AUTOMATIC SPRINKLER CO Owner: TUALATIN VALLEY FIRE&RESCUE
3245 NW FRONT AVE 11945 SW 70TH AVE
PORTLAND, OR 97210 TIGARD, OR 97223
PHONE: 503-227-1171 PHONE: 503-259-1188
FAX: 503-227-1552
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/07/2014 $285.12
12%State Surcharge-Building 10/07/2014 $34.21
Type of Use: COM Plan Review-Fire Life Safety-COM 10/07/2014 $114.05
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 10/07/2014 $2.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 10/07/2014 $22.50
11x17)
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 $457.88
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $19,650.00
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 Bflf1 439,`.
Issued By: / •• mittee Signature:
C. I .• .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 RECEED Receiv City of Tigard Received fo - �� Permit No.: P`j�I4-1i9 f Sq
• 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review /�
0 Phone: 503.718.2439 Fax: 503.598.19W-,T 2 2 U DatelBy: t'o(�/`i' /�l9-•n/ `Permit: /.I�P�O( ��cl�p
I i� .�);(� Inspection Line: 503.6394175 Date Ready/By: r� Juris: IN See Page 2 for
Internet: www.tigard-or.gov CITY 'I(U Notified/Method: !p Cr ('--c _ Supplemental Information
• t I?,t 1.'1 M r .- a- /
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 ® m
Comercial/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: 86(35— .5___I 13,41E.ti Naw, New dwelling area: square feet
City/State/ZIP: ItLiWizC::, OR gilt-5 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: TciF tz 51 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: f 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" Sretl�tElE>¢S —Co 1 IACVr cte� Valuation: $ Ig,(,SO
Existing building area: square feet
ADP Flay— C ecttcs.� To Fotri- ,—y.< Nd►o s t..) —
-pkg.? ze►(1w�c.)< New building area: square feet
❑ PROPERTY WNER ❑ TENANT Number of stories:
1
Name:—rud tATla.) "ticA Fag. ! geice.t Type of construction: Vie)
Address: IIii4s— .5_, 70111 ILE Occupancy groups:
City/State/ZIP 1 alAlzt,:„ ct q Z3 Existing: .3
Phone:( ) Fax:( ) New:
MI APPLICANT lit CONTACT PERSON NOTICE
Business name: \it� ez.t i All contractors and subcontractors are required to be
Contact name: i e 0,`m licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3Z _ 1At, jurisdiction in which work is being performed.If the
�J applicant is exempt from licensing,the following reasons
City/State/ZIP: l deeTt k.a=, Oct 1 Z10 apply:
Phone:(Sca)LZ'7-1111 Fax: ( °3)22.1-l -s 7.
E-mail:lc-71`7E, attw.c \/Lt lax t►y.1ev-.r l
CONTRACTOR\ BUILDING PERMIT FEES*
(Please refer Melee scheMtig
Business name:
l K I.X �, u_ t tat
Permit fee:
Address: -SZ���� a�� .3c iLe. State surcharge(12%of permit fee):
City/State/ZIP l
�„...g■I O ac"t'Z 1 p FLS plan review(40%of permit fee):
Phone:(563)ZZ7_tri I Fax:(5cS3) tn- tSSZ (Due upon application submittal.)
CCB Iic.: ly) Total permit fees:
Authorized signs Amount received: --t)
�yI�� This permit application expires if a permit is not obtained
J within 180 days after it has been accepted as complete.
Print name: VE
T UvJts� Date: i o/t Z01 e-( • Fee methodology set by Tri County Building Industry
1 Service Board.
I:Ruildi Pumits\FPS-PermitApp_071514.doc 4404613T(1I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices:
Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3)copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System(Complete A,B,C or D as applicable):
A.) Commercial Sprinkler
[i Wet ❑ Dry
Additional Standpipes
Information: Hazard Group I t tt'f
Density • %D
Design Area
K. Factor c.Co
Sprinkler Project Valuation: I $ ( j, (4,52)
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: I $
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: $
C:\Omni Jobs\Permit Applications\City of Tigard\City of Tigard FP PertnitApp.doc 2