Permit (58) � a
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111.. COMMUNITY DEVELOPMENT Permit#: FPS2017-00112
TEC jAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2017
Parcel: 1S 134BC00300
Jurisdiction: Tigard
Site address: 12284 SW SCHOLLS FERRY RD
Project: Cyclebar Subdivision: None Lot: None
Project Description: Fire sprinkler-modification of(35)heads
Contractor: T&L COMMUNICATIONS INC Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 87387 PO BOX 790830
VANCOUVER, WA 98687-7387 SAN ANTONIO, TX 78279
PHONE: 360-737-9725 PHONE:
FAX: 360-737-9648
FEES
Description Date Amount
Specifics: Info Process/Archiving-Lg$2.00(over 08/07/2017 $2.00
11x17)
Type of Use: COM Permit Fee-COM 08/07/2017 $231.32
Class of Work: ALT Type of Const: IIB 12%State Surcharge-Building 08/07/2017 $27.76
Occupancy Grp: Height: ft Plan Review-Fire Life Safety-COM 08/07/2017 $92.53
Stories: 1 Info Process/Archiving-Sm$0.50(up to 08/07/2017 $4.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
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 $357.61
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $15,000.00
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
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 questions to OUNC by/calling 503.232/1987 or 1.800.332.2344.
Issued By: /%/
Permittee Signature: c
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.
it
Building Permit Applic 'on
-etwiwitiii -5' Ece
FOR OFFICE USE ONLY
City of Tigard // S FOR
13125 SW Hall Blvd.,Ti 4,OIt 472�3 Date/By: �7 Permit No...„--
City
o.:r �T7�e//-2
• i Q Plan Review
Phone: 503.718.243' Sg8.196U 20,7III
Date/By: p�Cj J J) Other Permit ��e/T�///�
TIG R D Inspection Line: 50 �' './.4 O/C Date Ready/By: Juris: ® See Page 2 for fir)
Internet: www.tigard-or.gov /V/_1 I(74 Notified/Method:'7 7 I S pp mental Information
Li '7 Q,�/ le
r ,„. L//"2/'.`
WORK
, a, s ,., ltaRb I1iAili..t=' AiLYIIWBtfi* ,.
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
n/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY, N U '` work indicated on this application.
❑1-and 2-family dwelling ommercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
s
JOB SITEINFORMATION AND LOCATION -
Total number of floors:
Job site address:12284 SW Scholls Ferry Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:A Project name:Cyclebar Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:("ONIMERCL4 -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 IVOIII work indicated on this application.
Fire Sprinkler Tenant Improvement Valuation: $15,000.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0•TENANT - Number of stories:
Name:
Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( )
New:
'cl APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:T&L Communications,inc. (Please rifer to feescheduk)
Contact name:Larry Bushaw
Structural plan review fee(or deposit):
Address:PO Box 87387 FLS plan review fee(if applicable):
City/State/ZIP:Vancouver,WA 98687 Total fees due upon application:
Phone:(360)737-9725 Fax::(360)737-9648 Amount received:
E-mail:office@tl-communications.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:T&L COmmunications,Inc. Submit two(2)sets of roof plan with connection details
Address:PO Box 87387 and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver,WA 98687 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(360)737-9725 Fax:(360)737-9648
State surcharge(12%of permit fee): $21.60
CCB lie.:67787
Total fee due upon application: $201.60
Authorized signature: ���euvv, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Print name:Larry Bushaw Date:7/20/2017
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
A
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:
❑ w system Number of sprinkler heads: ,7� Number of alarm devices:
Addition or ❑ 1-10 heads: Affidavit required and 1=1 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
r.
Sprinkler Type IR Wet ❑ Dry
Additional Standpipes A//�-
Information: Sprinkler Supply Line 2 Yes ❑ No
Hazard Group /i,(4-
Density
Design Area Si O
K. Factor $'.to
Sprinkler Project Valuation: $ /Si ®o a
B.) Type I 'Hood Fire Siuppression System '`
Hood Project Valuation: $
3.
t �y
C , ire Alarm 4, '. �e` 7'7 7
a
Submittal shall Battery Calculations El Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
) sideal S nker( � � o m)
Square Footage: Permit Fee:
$198.75 y ;
0 to 2,000 i
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.
° a qtr. , Fir Protection ermit Fees x # $
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_031016.doc 2
I -
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Date/Bed
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
= Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: Ed See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New const tion ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alter. ion/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated o this application.
Valuation: $
0 1-and 2-family dwe 'ng ❑Commercial/industrial
Number.f bedrooms:
❑Accessory building ❑Multi-family
❑Master builder 0 Other: Nu er of bathrooms:
JOB SITE I, ORMATION AND LOCATION T s tal number of floors:
Job site address: ew dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.: Project -me: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
ib IiIRII DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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
..x SC E `P 1 .®F 'YORK "
� work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
GROPE e 14Y ❑-TEN 41k Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax ( ) New:
• API' k CACT,. NoTiqx
Business name: All contractors and subcontractors are required to be
Contact name: ensed 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:
y:
Phone:( ) Fax: `( )
E-mail:
.UILDIING FE I FEES*
Please re0r4o fee srhedule)��..
Business name:
Permit fee:
Address:
State surcharge(1=°o of permit fee):
City/State/ZIP: FLS plan review(40%.f permit fee):
Phone:( ) Fax:( ) (Due upon applicat on submittal)
CCB lic.: Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date:
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp 031016.doc 440-4613T(11/02/COM/WEB)