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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 2 COMMUNITY DEVELOPMENT Permit#: FPS2016-00039 TCC,AR o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/19/2016 Parcel: 1S136AA01201 Jurisdiction: Tigard Site address: 6919 SW OAK ST Project: Oak Street Care Home Subdivision: 2007-031 PARTITION PLAT Lot: 2 Project Description: Fire sprinkler system for group living facility. Contractor: GRAVITY PLUMBING Owner: BARE LLC 14935 S. GREEN TREE DRIVE 22275 SW SCHOLLS SHERWOOD RD OREGON CITY, OR 91045 SHERWOOD, OR 97140 PHONE: 503-490-0763 PHONE: FAX: 503-650-3866 FEES Description Date Amount Specifics: Permit Fee-RES 07/19/2016 $310.05 12%State Surcharge-Building 07/19/2016 $37.21 Type of Use: SF Info Process/Archiving-Lg$2.00(over 07/19/2016 $2.00 Class of Work: ALT Type of Const: VB 11x17) Occupancy Grp: R-3 Height: 24 ft Info Process/Archiving-Sm$0.50(up to 07/19/2016 $11.50 Stories: 1 11x17) 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 $360.76 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 5487 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 UtilityN . 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 dir questions t UNC b ailing 503.232.1987 or 1.800.332.2344. Issue By: -'e/611r Permittee Signature: X 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 RECEIVED FOR OFFICE HSE ONE City of Tigard Received ,�^n, IIIDateBy: /6 a Permit No.: Agog,, ■ a 13125 SW Hall Blvd.,Tigard,OR 97223 A It p 1 2016 01 1 G Plan Review) )' Phone: 503.718.2439 Fax: 503.598.19�''�' ' DateBy: v Other Permit: TI G A R D Inspection Line: 503.639.4175iTy Date Read B . t Jugs: H See Page 2 for Internet: www.ti ard-or. ov t 1 �t i Ready y g g Notified/Method:�r�(� (� �) Supplemental Informafion TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING NNew construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rotnded to the nearest dollar)of all ❑Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. X 1-and 2-family dwelling ElCommercial/industrial Valuation: $ ElAccessory building ❑Multi-family Number of bedrooms: 0 Master builder ElOther: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ‘29`9 S*-.% 67,4-p. New dwelling area: 5N7 square feet City/State/ZIP: r � l/,,,.‘4-v-d �� ? .!L.y Garage/carport area: square feet Suite/bldg./apt.no.: Project name: C?4Y,6.. f4,77,6 Covered porch area square feet Cross street/directions to job site: <0/ 4, 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.: /s'/ 3 ig� 0 ray Indicate the value(rotnded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. ? �7 5/--4 ie-J 0t- r: .,.._,.. 7 Valuation: $ Existing building area square feet New building area: square feet PROPERTY OWNER 0 TENANT Number of stories: Name: LG Type of construction: Address: 22_2_75- 5„,„) s_it,LZf 'sGa.i"t-ucrya �-Z. Occupancy groups: City/State/ZIP: S Y1:e. w s.a. �- Z Ci . � tC 0 Existing: Phone:($ ) 64... -3s/f' Fax:K.;,3 ) C.Ly'-5y2./ AAL APPLICANTNew: 0 CONTACT PERSON NOTICE < Business name: 1304-/-pro--A...4 (.yra 7'47%1Z-- All contractors and subcontractors are required to be Contact name: ---74 Lziz-c000 � licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the S' Address: 2_2,2_1 ...1`�__5 0 j jurisdiction in which work is being performed.If the City/State/ZIP: Sk.,-�, Cr97f(110applicant is exempt from licensing,the following reasons apply: MPhone (mss ) f2 S ` < Fax: : ) GP' e E-mail: r—, CONTRACTOR �L BUILDING'PERMIT FEES* Business name: ` " ,�� (Please refer to fee schedule) '' Address: if-vi 5--' �` '/ 61� ©�r Permit fee: 3City/State/ZIP: ,/ State surcharge(12%of permit fee): �0� �l r, �0e - 9�a s� ,{ z../.9e,..-016,3,- FLS plan review(40%ofpermit fee): ^") Phone:(/L j) Fax:(5171 cr G 3 (Due upon application submtttal.) CCB lic.: / 4J 1 5-0 5 Total permit fees: t") Authorized signature: . Amount received: ..9___ � This permit application expires if a permit is no obtained Print name:2 �� c Date: i7r 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.doc 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 0 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: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component El 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_PernutApp_071514.doc 2