Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 COMMUNITY DEVELOPMENT Permit#: FPS2014-00181
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/01/2014
Parcel: 1 S 134AA01800
Jurisdiction: Tigard
Site address: 10110 SW NIMBUS AVE B10
Project: Refinish First Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 2
Project Description: Fire suppression system for paint booth.
Contractor: UNIVERSAL FIRE EQUIPMENT Owner: HANSON, RONALD D
18260 SW 100TH CT ROBINSON,CONSTANCE A
TUALATIN, OR 97062 ROBINSON,CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK,WA 99331
PHONE: 503-691-9000 PHONE:
FAX: 503-691-9004
FEES
Description Date Amount
Specifics:, Permit Fee-COM 12/01/2014 $112.96
12%State Surcharge-Building 12/01/2014 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 12/01/2014 $45.18
Class of Work: ALT Type of Const: IIIB Info Process/Archiving-Sm$0.50(up to 12/01/2014 $10.00
Occupancy Grp: Height: ft 11x17)
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 $181.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,250.00
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 direc,Lgaestions s : NC b -ling 503.232.1987 or 1.800.332.2344.
Iss d By: / , Permittee Signature: /■
Call 503.639.4175 by 7:00 a.m.for the next available' . tion d• e.
This permit card shall be kept in a conspicuous place on the job si = •ntil comple i.n of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application RECEIVE
Fire Protection System RECEIVE , 11,; t if , ,t
� � , (1\1 1
City hof Tigard Received
Date/By: // 43 / roil it No. ,
c vQ/y—D• D/p/� 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 10 2014
I Phone: 503.718.2439 Fax: 503.598.1960 Plan Rea �)
Date/B : V N& (
Other Permit: Page 2 for
1 I c]A R l) Inspection Line: 503.639.4175 CITY OFTIGARD Date Rea.y/a ��� ®P mental Information
Internet: www.tigard-or.gov BUILDING DIVISI� � , ���/
TYPE OF WORK _, 1.QU I'I'D DATA:1-ANBt2-FAMILY DWELLING
ew 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 at iii"---nmercial/industrial Valuation: $
El Accessory building ❑Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION_ �-7 Total number of floors:
Job site address:10110 L.5:4„:? 1 S ,S,4 4'f'�( _I 0 New dwelling area: square feet
City/State/ZIP:i n t v l f £� Z 3 7 Garage/carport area: square feet
E
Suite/bldg./apt.no.: '} Project name:Qezrryl;`5 A jr S 4r 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(roinded 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 2 �� r'`,
��L€ /0�h, - C.9- a(004-4.,� / 4�� Existing building area square feet
Styli N,SS-ik2.--1. 5 �J t rIPD ' e'o New building area: square feet
��❑ PROPERTY OWNER DINT Number of stories:
Name: ^e"T-G1/4,1,75 h I'-'t -r. .1- Type of construction:
Address: 101/0 3y) Alp h L4 S ,5u t f-e. 0...../Q Occupancy groups:
City/State/ZIP:T-- /4(-cf, 072_, c,722_3 Existing:
Phone:(5Q3) 7 )a J7 Fax:( ,,,..,�) New:
PLICANT 131-05-1C TACT PERSON NOTICE
Business name:/h4 tversA/i rt_e L4 j nO1.e"1,4- 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: )s>Z 6 0 ,!,%2 l o O cF. jurisdiction in which work is being performed.If the
City/State/ZIP: Tl r 4._f yq,4j-n 93 a77')6 Z applicant is exempt from licensing,the following reasons
apply:
Phone:bo3) 6 /��0.,.._) Fax:6 ) 6c,/ c uzao q
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
�`�� (Please refer to fee schedule)
Business name: s�`yy,_� s. Aq 6 Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FI.S plan review(40%ofpermit fee):
Phone:( ) I Fax:( ) (Due upon application submittal)
CCB lie.: g 723 Total permit fees:
Authorized signatur-• Amount received:j -- This permit application expires if a permit is not obtained
Print name: 4110 .,f , e L, Date: //—/v ,1 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_071514.dor 440-4613T(1 I/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
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: 1 $
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 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: $
I:\Building\Pemuts\FPS PemritApp_071514.doc 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
10110 SW NIMBUS AVE B10, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2014-00181
Chip Barnett
Approved by Dan Nelson on December 2
Violation Summary:
Inspector Contractor