Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2015-00177
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/15/2015
Parcel: 1 S 135BB00501
Jurisdiction: Tigard
Site address: 10575 SW CASCADE AVE
Project: Biamp Subdivision: OAKBURG Lot: 27
Project Description: Fire sprinkler modification for new tenant,(758)fire sprinkler heads.
Contractor: WESTERN STATES FIRE PROTECTION Owner: ICON OWNER POOL 3 WEST LLC
13896 FIR ST STE B BY INDCOR PROPERTIES
OREGON CITY, OR 97045 2 NORTH RIVERSIDE PLAZA, STE 235
CHICAGO, IL 60606
PHONE: 503-657-5155 PHONE:
FAX: 503-657-5182
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/15/2015 $411.46
12%State Surcharge-Building 12/15/2015 $49.38
Type of Use: COM Plan Review-Fire Life Safety-COM 12/15/2015 $164.58
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 12/15/2015 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 12/15/2015 $10.00
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 $637.42
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $33,187.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct qu sti ns to Oby calling 503.232.1987 or 1.800.332.2344.
Issue By: Permittee S nature:
Call 503.639.4175 by 7:00 a.m.for the next available ins ction date.
This permit card shall be kept in a conspicuous place on the job sit until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit ApplicationECEND
Fire Protection System 5 2015 ' ' ONLY
Received �� Z 7
City of Tigard �I�Q Date/B : I� � �,� Permit /P`x�tS
13125 SW Hall Blvd.,Tigard,OR 97GING
OFT IG r1p' Plan Revie
Phone: 503.718.2439 Fax: 503.5,$, �IVI�1014 Date/BX: I Other Permit: �ap(S�O317
Inspection Line: 503.639.4175 �tjj����JJJJ Date Ready/By: -
Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notific"ethod: A� (� Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
�LAIndicate the value(rounded to the nearest dollar)of all
ddition/alteration/replacement Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ElI-and 2-family dwelling m
Comercial/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: 1Q45 lj GXSC New dwelling area: square feet
City/State/ZIP: OR
Garage/carport area: square feet
Sui;e/bldg./apt.no.: Project name: r3 s'l<� Covered porch area square feet
Cross street/directions to job site: pp�� o ��� Deck area: square feet
(�
IJ 4?_ ED 5 l_t,6 Other structure area: square feet
ID 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.
Valuation: $ 7
51.•1 ► G1 r �( Existing building area d square feet
New building area: �F-130 square feet
❑ PROPERTY OWNER VITENANT Number of stories: t
Name: of Type of construction:
Address: Occupancy groups:
City/State/ZIP: A Existing:
Phone:(0J) T5_ Fax:( ) New: - S—
&APPLICANT ❑ CONTACT PERSON NOTICE
Business name: (J 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]censed in the
Address: �"( 3 jurisdiction in which work is being performed. If the
City/State/ZIP: d Q 2�Z applicant is exempt from licensing,the following reasons
apply:
Phone:(� Z Fax: :( )
E-mail: A(e,
pr eo (� .e s K .CEJ
CONTRA OR BUILDING PERMIT FEES*
Business name: s �' Please re er to ee schedule
F&er :,
/ �� �� � S Permit fee:
Address:
0 y� � State surcharge(12%of permit fee):
City/State/ZIP: G
7�/ FLS plan review(40%ofpermit fee):
Phone:(62D 575-5— Fax:(531r) 65:1. 57$.2 Due upon application submittal.
CCB lic.: U Iq 570 V-4 ( Total permit fees:
,�—
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: t° &n u within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1.\BuildingNermits\FPS-PermitApp_071514 doc 440-4613T(I 1/02/COMMEB)
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:
F1 -r- "1/New system Number of sprinkler heads: 7" Number of alarm devices:
Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Iteration (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 ❑ D•
Additional Standpipes .
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 3
B. Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shallr1n ,tte Calculations El Yes
include: iidualComponent E] Yes
t 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 reater $404.39
Sprinkler Project Square Footage: 9 1,7,/)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 onsquare footage see D above): $
State Surcharge 12% of permit fee): $
FLS Plan Review 40% of permit fee): $
TOTAL: $
I:\Building\Pcrrnits\l�PS_PermitApp_071514.doc 2