Permit ., CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
``1 ' COMMUNITY DEVELOPMENT Permit#: FPS2015-00081
TEGAAD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/19/2015
Parcel: 1 S 134AA01900
Jurisdiction: Tigard
Site address: 10115 SW NIMBUS AVE 100
Project: The Filling Station Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Installing(10)sprinklers in new ceiling and capping(9)sprinklers.
Contractor: EXPRESS FIRE SYSTEMS INC Owner: ROBINSON, CONSTANCE A
1913 41ST STREET BY KILLIAN PACIFIC LLC
WASHOUGAL,WA 98671 500 EAST BROADWAY, STE 110
VANCOUVER,WA 98660
PHONE: 360-953-8432 PHONE:
FAX: 360-953-8394
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/19/2015 $112.96
12%State Surcharge-Building 05/19/2015 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 05/19/2015 $45.18
Class of Work: ALT Type of Const: IIIB Info Process/Archiving-Sm$0.50(up to 05/19/2015 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
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 $173.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,877.00
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 952-0' -10• You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:de
AMY
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 FOR O141( F 1 SI: t)yl.v
Received
City of Tigard 1E Date/B • 7i PermitNo.: /J —e ;
• 13125 SW Hall Blvd.,Tigard,OR GEt EN E° Revi' l�� f�'� ,. /
= Phone: 503.718.2439 Fax: 503.59 Date/B ff, Other Permit: / er y
T 1 G A R D Inspection Line: 503.639.4175 .,q 2Q15 Date Rea.y:y: [' luris: ® See 'age 2 or
Internet: www.tigard-or.gov MAC B Notified/Methodd rQ �s tw• / Supplemental Information
TtAao /r_f
TYPE OF
V5 N �� �,��5�� RE UIRED DATA:1-AND 2-FAMILY DWELLING
❑New constructiong�jit on 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 Valuation: $
®Commercial/industrial
❑Accessory building 1=1 Multi-family
Number of bedrooms:
❑Master builder ❑Other. Number of bathrooms:
JOB SIFE'• INFORMATION AND LOCATION Tofal number of floors:
Job site address: 10115 SW Nimbus Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:The Filling Station 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: 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.
Install 10 Sprinkler drops due to new ceiling Valuation: $3,877.00
and add approx.9 sprinkler uprights due to new demising walls 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: Ordinary Hazard
Phone:( ) Fax:( ) New: Ordinary Hazard
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: �t r �� o 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*
Business name:Express Fire Systems,Inc. (Please rejerto fee schedule
Permit fee:
Address:670 S 28th Street
City/State/ZIP:Washougal,WA 98671 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(360)953-8432 Fax:(360)953-8394 (Due upon application.)
CCB lie.: 193272 3////? Total permit fees:
Authorized signature: A. Amount received:
This permit application expires if a permit is not obtained
Print name:Pattie Wenholz Date:05-11-15 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.doc Rev 01/05/2012 440-4613T(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: 10
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
' ® Wet ❑ Dry
Additional Standpipes N/A
Information: Hazard Group Ordinary Hazard
Density N/A
Design Area N/A
K. Factor 5.6 QR
Sprinkler Project Valuation: $ 3,877.00
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: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
S:\Design\_Express Misc\City of FORMS\Tigard City-The Filling Station.doc Rev 2l/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
10115 SW NIMBUS AVE 100, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2015-00081
Jeff Grove
Violation Summary:
Inspector Contractor