Permit (45) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'F 111 8. COMMUNITY DEVELOPMENT Permit#: FPS2018 00043
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/09/2018
T f � � g Parcel: 2S102CB00200
Jurisdiction: Tigard
Site address: 13115 SW PACIFIC HWY
Project: Specialty Retail Subdivision: None Lot: None
Project Description: Sprinkler supply line.
Contractor: MCPHERSON CONTRACTORS INC Owner: TIGARD-TUALATIN SCHOOL
3501 SW FAIRLAWN STE 100 DISTRICT 23J
TOPEKA, KS 66614 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 785-273-3880 PHONE:
FAX:
. FEES
Description Date Amount
Specifics: Permit Fee-COM 05/09/2018 $231.32
12%State Surcharge-Building 05/09/2018 $27.76
Type of Use: COM Plan Review-Fire Life Safety-COM 05/09/2018 $92.53
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 05/09/2018 $36.00
Occupancy Grp: M 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 $387.61
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.
e"----2
Issued By: .Permittee Signat_ ���
..„,‘,...e......
Call 503.6 . 75 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 FOR OFFICE USE ONI\
City of Tigard Received _
Date/By: S t7 �r Pennit No.: pc )01¢e. x
111 13125 SW Hall Blvd.,Tigard,OR 9722 l� Plan Review rJ r JJ� V Q
= Phone: 503.718.2439 Fax: 503.598.1960 Date/B : w •
j Other Permit: -
T 1 C A IZ D Inspection Line: 503.639.4175 MAY 7 2018 Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov ^' Notified/Method:V4it,S . 11d Supplemental Information
CITY 01- TitiAFTD i 0 '/>>I
`' TYPE OF GING DIVISION' fi /Le.,b d .REQUIRED DATA:I-AND 2-FAMILY DWELLING
- `New construction 0 Demolition P" 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
1 work indicated on this application.
CATEGORY OF CONSTRUCTION
:a
1111-and 2-family dwelling 9 Commercial/industrial Valuation: $
I=1Accessory building ❑Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
I'S I); JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1, p m�, w New dwelling area: square feet
City/State/ZIP: � G�/Z � � /Z � 7�Z� Gara a/carort area:
square feet
Suite/bldg./apt.no.: Project name: 5 ,'f G c Mil,I w Covered porch area: square feet
Cross street/directions to job site: Gj e /4 w y 4- Sc.ALIO(„ 6" 2- 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.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION Fr�W tK ''rail,- work indicated on this application.
AA S7A it A){ ti? l'Pc Ai Aviv 4 wd Valuation: $/.51krc..�-.
D D On C.-5,,fit t, 60 A4‹.IL, Existing building area: )3 3 4 S square feet
New building area: 13 3 S s--square feet
0 PROPERTY OWNER 4,4/
ET TEi4AI►,1T' � i. Number of stories: 1
Name: A.,&V G Type of construction:
Address: 12(0 12- W P 1_444 ZIP 4 j° k al i Occupancy groups:
City/State/ZIP: 1_4 kt 1CO) G d Existing:
Phone:(303) 1 s'4 C 0d t Fax:( )
New:
APPLIC ••t5:7 CONTACT PERSON V
. NOTICE _.x -.
Business name: m C r 4 b3 ON V G All contractors and subcontractors are required to be
Contact name: IT t - licensed with the Oregon Construction Contractors Board
tt ) ��f�� under ORS 701 and may be required to be licensed in the
Address: 3 To ( 5.1 6.). pi%t'2 (.l4 t,"/ 1z.. '( jurisdiction in which work is being performed.If the
City/State/ZIP: `fO P4 K t f C‘6 / t,( applicant is exempt from licensing,the following reasons
apply:
Phone:(2s' 5 9 2 r Q v-1,4 Fax::( )
E-mail:
[,w CONTRACTOR -, ,,,., BUILDING PERMIT FEES* 4
Business name:
AK,�4 S t (Please refer to fee schedule) :. '
1 ( '• Permit fee:
3
Address: f d / Atf2 L7 tv.) R.
State surcharge(12%of permit fee):
City/State/ZIP: tiI'44, K f 'C Ci Y FLS plan review(40%of permit fee):
Phone:()[S•) 9 Z c'01.34Y Fax:( ) (Due upon application submittal.)
CCB lic.: / 7�71(, Total permit fees:
Authorized signatur:-rte - � 9 �' Amount received:
This permit application expires if a permit is not obtained
Print name: � �
c,t i - Date:'? Amy 2.i e 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_031016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done: A.
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 ❑ 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): rr
A.) ommetcl al.Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.):Type I 'Hood Fire tension Stein .
Hood Project Valuation: $
C.) Dire:Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
A.) Residential Sprinkler(Stand*ane System)
Square Footage:f-* Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05 r "
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit es
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_PemutApp_031016.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13115 SW PACIFIC HWY, TIGARD, OR, 97223 October 16, 2018 at
10:34:57 AM
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00043
Inspection Type: Inspector:
999 Sprinkler final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor