Permit iy CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
B COMMUNITY DEVELOPMENT Permit#: FPS2015-00115
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2015
Parcel: 1 S136CC00100
Jurisdiction: TIGARD
Site address: 8200 SW PFAFFLE ST
Project: Westside Christian Subdivision: 2006-016 PARTITION PLAT Lot: 3
Project Description: Upgrading hood fire suppression system.
Contractor: NATIONAL FIRE FIGHTER CORP Owner: HILL LAND LLC,THE
6330 SE 101ST AVE BY ARQUITAS CAPITAL MGMT INC
PORTLAND, OR 97266 5300 MEADOWS RD, STE 400
LAKE OSWEGO, OR 97035
PHONE: 503-232-6646 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/27/2015 $102.20
12%State Surcharge-Building 07/27/2015 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 07/27/2015 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 07/27/2015 $3.00
Occupancy Grp: E 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 $158.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,250.00
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 c•• of the rules
or direct questions to OUNC by calling 503.232.1987• .;•r.- 2344. ��
Issued By: Permittee Signature: V-
C•'!'.639.4175 by 7:00 a.m.for the next available insp• tion date.
This permit card shall be kept in a conspicuous place on the job site until •mpletio of the project.
Approved plans are required on the job site at the time of each i pecti■n.
Building Permit Application
Fire Protection System RECEIV q FOR OFFICE USE ONLY
City of Tigard Y Date/By: 7 677 i Permit No..
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie �^ fir.,
S ! l Usher Permit:
Phone: 503.718.2439 Fax: 503.598.1960 �] DateBy:
Inspection Line: 503.639.4175 JUL ���5 Date Ready y: luris: ® See Page 2 for
TIGARD Internet: www.tigard-or.gov 1 17-jra � Supplemental Information
Date ReaMethod:
— CIE U1 [R AKU
TYPE OF WORICREEDING DIVISION 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
XAddition/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 Commercial/industrial Valuation: $
❑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: g 9.0D 5 N) P.rpt, 1 ( .. s+, New dwelling area: square feet
City/State/ZIP: T cJ ptpvrp(t D!� q 7a' 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 6 - ,- Covered porch area square feet
� �� l�� P q
Cross street/directions to job site: P-ajF" 1 S� kil AiXr Deck area: square feet
/(kr411- 5)de Or HA)// Q . 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
OM raj( -4t re- s✓/0/9Ws/c4 s y grE341 4 eteG f Valuation: rj ,
lJL 30o -ia-,d�oLs1 r�n.d / 4+•v -firers Spec;•�i e ior1S Existing building area square feet —
New building area: square feet
PROPERTY OWNER I ❑ TENANT Number of stories:
Name: eAS;otc C k r i i o,,i i7 k Sc tree, ( Type of construction:
Address: .5:- S(A) •fL s4- - Occupancy groups:
City/State/ZIP: I? c ce 17 t17�-3 Existing:
Phone:(fpj) �� -yl1' Fax:( ) New:
❑ APPLICANT Ai,CONTACT PERSON NOTICE
Business name: /11477044.( i`/jre 1,h-4ir Go c/9• All contractors and subcontractors are required to be
Contact name: jrjsij V� �Va I c-i7 licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: (D 3y 56 162154
ti/5" , jurisdiction in which work is being performed.If the
City/State/ZIP: Ord f pt,n p(r D 2 677 applicant is exempt from licensing,the following reasons
apply:
Phone:( j3) '2... 5-- 0/(0 of I Fax::( )
E-mail: 1O5ku pyi144 /AliifC S`� k+i•60i'✓l--('Z#-77)-7700
cJ J CONTRACTOR BUILDING PERMIT FEES*
/ Please re er to ee schedule
Business name22 a77D�•l4/ fire s �r i . _ Permit fee:
Address: X03"J .5-e-- (O1�f7W r "77 " 'e -
r
City/State/ZIP: er.t .,.,/ Og. �� � State surcharge(12%of permit fee):
�"r'9 FLS plan review(40%ofpermit fee): .• cc",
Phone:(X:73) 2.3 2-(4,4,g•o Fax:( ) (Due upon application submittal) zio•0 Q
CCB 1ic.: /%is/3 .5-70 k Total permit fees: is.v.,31
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name: j 0.51 al b 6 41--'o Date: 7/27/7_00 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board
1:\Building\Permits\FPS-Peru[.pp_071514.dec 440-4613T(11/02/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: _ $
B.) Type I- Hood Fire Suppression System
Hood Project Valuation: I $ 0-1?-50 ,(v
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\Permits\FPS_PemutApp_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
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Fire Protection System
920 Suppression trip test
PASS
FPS2015-00115
Jeff Grove
Violation Summary:
Inspector Contractor