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Permit
n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit#: FPS2016-00038 R 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/29/2016 Parcel: 2S 114AA00100 Jurisdiction: Tigard Site address: 9000 SW DURHAM RD Project: Tigard High School Subdivision: None Lot: None Project Description: Fire sprinkler-Add(1)new sprinkler head in existing storage room behind the old stage. Contractor: FIRESTOP CO Owner: TIGARD-TUALATIN SCHOOL DISTRICT 3203 NE 65TH ST#2 6960 SW SANDBURG ST VANCOUVER,WA 98663 TIGARD, OR 97223 PHONE: 360-718-8604 PHONE: FAX: 360-718-8603 FEES Description Date Amount Specifics: Permit Fee-COM 02/29/2016 $64.54 12%State Surcharge-Building 02/29/2016 $7.74 Type of Use: COM Plan Review-Fire Life Safety-COM 02/29/2016 $25.82 Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 02/29/2016 $4.00 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 $102.10 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $1,000.00 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 Ut ,cationility er. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or rect questions to OU call, 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: 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. City of Tigard Permit No.: iPJ 13125 SW Hall Blvd.,Tigard,OR 97223 Q Phone: 503.718.2439 Fax: 503.598.1960 Date Received: Inspection Line: 503.639.4175 �L Internet: www.tigard-or.govov By: FIRE SPRINKLER AFFIDAVIT FOR ALTERATION R C I V 11PLAP OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) FEB 2 9 2016 CCTV Of T1( ARD Project Name: Tl C �f Z. t��� c6E?.a� Occupancy: 5c OC1.0.� i2ad0-� Job Address: 9604 S 16i (R J Type of Construction: Suite: Contractor: �llZ�.s�O� CO . Phone: `3d — -1A Number of Proposed or Altered Heads: Type: S S V Hazard: Density: k o O t Ky C R- Oregon Construction Contractors Board No. M's Z1 Y certify the following is true and reasonably defines the scope of work for this project: a) All work is limited to drops and armovers in a light-hazard occupancy. b) Positions of sprinkler heads relative to architectural features such as soffits, beams,partitions,walls, etc. complies with current adopted edition of NFPA 13. c) The proposed work does not require hydraulic calculations. d) Only one sprinkler head will be installed from one drop (exception: up to two heads from one drop may be installed when each head is in a separate fire area). e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13. f) Tenant improvements in a new building shall be equipped with Quick Response heads(see 2002 NFPA 13, Section 8.3.3.1 for exceptions). g) The installation shall comply with the requirements of the current adopted edition of NPFA 13. h) Piping shall not be concealed until hangers and bracing are inspected. i) Final approval shall be subject to onsite tests and inspections. In addition, I understand the following is required: • Submit(3) copies of a sketch showing the area of work within the building's structure. • Building fire protection system permit. • A copy of d u en t wit a copy of the sketch attached shall be available for all inspections. Signature: Date: 'L. 'Z, p- ZC L Print Name: Q% C k4 r*&1Z 6 (3t•.t c�s��'2. I:\Building\Fonns\FireSprinklerAffidavit 071514.docx Page 1 of 1 Building,Permit AQalication Fire Protection System D-VCity of Tigard CEIVEP ' Dattee/B Permit No.: / -0603013125 SW Hail Blvd.,Tigard,OR 9 Plan Review Phone: 503 718.2439 Fax: 503.598.1960 Date/B : odea Permit: InspectionLi4e: 503.639.4175 FEB 2 9 2016 � Surfs: Supplemental see Page blforormaUoo Internet: www.t1gard-or.gov _ PPk TY,P REQUIRED DATA:I-AND 2-FAMLY DWELLING ❑New construction Permit fees*are based on the value of the work performed. j Indicate the value(romded to the nearest dollar)of all ®. ' Addition/alteradon/replacement ❑Other: equipment,materials,labor;overhead,and the profit for the CATEGORY OF CONSIRUC ION 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 INiFI>iRMATKIN AND LOCATION Total number of floors: Job site address: 60 O 5\{� Qv\�\-�A Mk--,y New dwelling area: square feet City/State/ZIP: \ t� Z t O 1Z E-G,O ty Garage/carport area: square feet Suite/bldgJalpt.no.: Project name: k- k C V\ Covered porch area square feet Cross street/directions to job site: SW VA A S i- Deck area: square feet C o T O VJ g Sfi C ( L - l l-}ti \u okZ t��lS Other structure area: square feet M-;kAthKO —Dr-\E. 5 t A(0- 5 T O Z-ACA. \2o 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: S i)i�>�, o� pC S% ti C� gr X \Zr S t O l2 d�Gi E R oo Existing building area square feet New.building area: (a square feet 0 PROPERTY OWNER R TENANT Number of stories: Name: ^-` C t7,�Z 0 (A G\4 S C.,-\ 00 L. Type of construction: Address: b00 .s `r.( 0 U -4 \ZL Occupancy groups: City/State/ZIP: O CZIL G O tV Existing: Phone:( ) Fax:( ) New,. APPLICANT CONTACT PERSON NOTICE Business name: 1r\ S t p rte- C O All contractors and subcontractors are required to be Contact name: L« 2�� ty�� CZ licensed with the Oregon Construction Contractors Board _ under ORS 701 and may be iequired to be lbensed in the Address: 3�>3 tA.- G g D-1 S l(t g r_ SP11,G i- Z-. jurisdiction in which work is being performed.If the City/State/ZIP: V(Sty C-p vV t=2 63 A, 6j((3 applicant is exempt from licensing,the following reasons apply: Phone:(3(,6) -j l 8 -g(�,a A Fax::($g� 3 G Z- S 35 c5 E-mail: ��\ C.k n.2�7 . ljt�17L��-��\tZ�S16�CO . Co1� CONTRACTOR BUILDING PERMIT FEES* Business name: S M " m Permit fee: Address: City/State/ZIP: State surcharge(12%of permit fee): FLS-pian review(40%ofpermit fee): Phone:( 1,Fax:( ) Due upon application. CCB lic.: k 01 3 Z $ / /!� ' 'Total permit fees: Authorized signature: '� 'Amount received: M, J4�i�" This permit application expires if a permit is not obtained Print name: 1 k L rz,�q-o t "LID CZ Date:2_ Z 6 _ \6 within.180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board I:VSuilding\Permits\FPS-PermitApp.dx 07101/2011 440.4613T(l1/02/COM/wF9) 00 City of Tigard: Fire Protection Permit Checklist Page 2-Supplemental Information Describe'work to be doge: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition © 1-10 heads: No plan review required. fZj Alteration ❑ 11+heads: Plan review required. ❑ Repair Number of spritlkler heads: Additional description of work. Tme of S temCQxn to A,B`C or D as a licabie : A.) Commercial Sprinkler Q Wet ❑ Dry Additional Standpipes Information: Hazard GroupGia Density Design Area K Factor S rinlder Project Valuation: $ po p ov B. 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 Foo 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): $ C>oo . Permit fee based on project valuation see fee schedule): $ Permit fee based onsquare foo a see D above): $ State Surcharge 12%of pertnit fee): $ ` FLS Plan Review 40%ofertnit fee $ TOTAL: i $ t Plan review requires a completed application and three(3) sets of plans at submittal. Plan review fees are required at submittal. I:\Building\Pemuts\FPS-PerrrritApp.doc 02/01/2011 2