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Permit Support Document Building Permit Application 0 1 J c 4 rE O/ ttle Protection System /2-/;z(..?, a FOR OFFICE USE ONLY ,� t.,. Received City of Tigard �, .. l MI= permit No.: - 13125 SW Hall Blvd.,Tigard,OR 97223 DateBy: , _ ej Plan Review Phone: 503.718.2439 Fax: 503.598.19601 "C 2t11( Date/B : Other Permit `. 1 .� o Inspection Line: 503.639.4175 T I GARD p Date Ready/By: Jurist EL See Page 2 for Internet: www.tigard-or.gov 1 rymq ; r; t Notified/Method: pit., Supplemental Information n, Y � ,i u _yak „_y„ 'i � yrE4 � 3i�� � �� �1�r1. II � u El New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the 47Illli'1 fill - IOC work indicated on this application. ID1-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB LLVFORp DG� Total number of floors: Job site address:16060 SW 85th Ave New dwelling area: square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Durham TPS Covered porch area: square feet Cross street/directions to job site:SW 85th Ave Deck area: square feet Other structure area: square feet REQUI EDD TACT ? IR IAL4 J E yt,� , adz t iiu t 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 S PION OPt W (;_ equipment,materials,labor,overhead,and the profit for the _ work indicated on this application. :11Installation of a new fire sprinkler system on existing building Valuation: S$55,000.00 Existing building area: 6,250 square feet New building area: 6,770 square feet �e QI �R s r❑ Y) NAT °y _ Number of stories: 1 Name:TS Gray Type of construction: VB Address: 12705 SW Herman Rd Occupancy groups: City/State/ZIP:Tualatin,OR 97062 Existing: B Phone:(503)692-4675 Fax:( ) New: B ` r' „, 0 C+C,+ITACT ©v .. Business name:Firestop Company All contractors and subcontractors are required to be Contact name:Bob Green licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address:3203 NE 65th St Space 2 jurisdiction in which work is being performed.If the City/State/ZIP:Vancouver,WA 98663 applicant is exempt from licensing,the following reasons apply: Phone:(360)718-8604 Fax::( ) E-mail:bob.green@firestopco.com NTRA 1 D�It _ .. 'f IUI p G PE 4IT FES*, Business name:Firestop Company ^ref01.0:ee= k) Permit fee: Address:3203 NE 65th St Space 2 State surcharge(12%of permit fee): City/State/ZIP:Vancouver,WA 98663 FLS plan review(40%of permit fee): Phone:(360)718-8604 Fax:( ) (Due upon application submittal.) CCB lie.:OR 1832 Total permit fees: Authorized signature: Amount received: This permit application expires if a permit is not obtained Print name:Bob Green Date: 12/05/17 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. 1\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB) • City of Tigard: Fire Protection Permit Checklist 7P�age 2- Supplemental Information e W tO be,• 9 �) ,'v. - G 4 1 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: El New system Number of sprinkler heads: 103 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: T ie of Syste 1 (CO*iete A,)N13r C or Ty as applt.cab1e);° , 'iiry o f (��� iii ��� � �I ' �b r �� i iii� t i A.) Cez pi�.er �<<� � Sprinkler Type ® Wet ❑ Dry Additional Standpipes 0 Information: Sprinkler Supply Line ® Yes ❑ No Hazard Group Light Hazard Density .10 Design Area 2535 K. Factor 5.6 Sprinkler Project Valuation: $ 55,000 T .-)0 e..d Fire uppress i Sy-an 2.2,"2„,„_ Hood Project Valuation: $ �; ,'� mo � � 11 � k C. Submittal shall Battery Calculations El Yes include: Individual Component El Yes Cut Sheets Fire Alarm Project Valuation: $ D) xi. er'ir k1e • ®e # i) - �' ,A Square Footage: Permit Fee: ;y 74 0 to 2,000 $198.75TT' gRA dH 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 „1; ' 7,201 and greater $404.39 A '_ Sprinkler Project Square Footage: 6770 sq. ft. ,) FrePri„ctiot(*,1" !®i4a 411 kt�� '� Project valuation subtotal(see A,B &C above): $ 55,000 Permit fee based on project valuation (see fee schedule): $ 1379.16 Permit fee based on square footage (see D above): $ 310.05 State Surcharge (12% of permit fee): $ 209.30 FLS Plan Review(40% of permit fee): $ 781 TOTAL: $ 2734.91 C:\Users\Admin\Desktop\JOBS\DURAM TPS\SUBMITTAL\Durham TPS Permit A2p1cation.doc