Loading...
Permit (150) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT " COMMUNITY DEVELOPMENT Permit#: FPS2019-00014 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/27/2019 S Parcel: 1 S 135DA02400 Jurisdiction: Tigard Site address: 11045 SW HALL BLVD Project: Brookside Memory Care Subdivision: METZGER ACRE TRACTS Lot: 7 Project Description: Fire suppression. Installing Amerex KP 375 fire suppression system in 8'hood. Contractor: UNITED FIRE HEALTH &SAFETY EQUIPMENT CO IN Owner: BROOKSIDE RCF LLC 4611 NE MARTIN LUTHER KING JR BLVD 5987 SE ROBHIL DR PORTLAND, OR 97211 MILWAUKIE, OR 97222 PHONE: 503-249-0771 PHONE: FAX: 503-249-0572 FEES Description Date Amount Specifics: Permit Fee-COM 02/27/2019 $112.96 12%State Surcharge-Building 02/27/2019 $13.56 Type of Use: COM Plan Review-Fire Life Safety-COM 02/27/2019 $45.18 Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 02/27/2019 $8.00 Occupancy Grp: A-1 Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Unknown Standpipe Required: Hazard: UNK 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 $179.70 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 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 b calling 503.232.1987 o a. . • Issued By: Cl- 1111.111°, Permittee Signature: VIM 111 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 Q ' FOR OFFICE USE ONLY Received City of Tigard Date/By: ill /c �- P 1�1—D00/ `Y iii IIII13125 SW Hall Blvd.,Tigard,OR 9722 i 3 i u 3- Plan Revie �^ f) �� ly^� Phone: 503.718.2439 Fax: 503.598.16O 5076 Date/By: (/lf� TI G A R D Inspection Line: 503.639.4175 Date Ready/By: kris: 91 See Page ffor Internet: www.tigard-or.gov E,U;_.3r.., >< ,/, •,_i'l tified/Metho • fat Supplemental Information TYPE OF WORK RE9UIRED DATA:1-AND 2-FAMILY DWELLING' P3 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 ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the Ol CONSTRUCTION , work indicated on this application. .f �, CA° ORY O Valuation: $ 1 0 0 1-and 2-family dwelling ►o•!•mmercial/industrial — ❑Accessory building c4ulti-family Number of bedrooms: 0 Master builder 6 0 Other: Number of bathrooms: llS- .roB SITE IN +dry TION AND LWATION . Total number of floors: Job site address:'—F3(j) \' c 'i V 0, New dwelling area: square feet City/State/ZIP:1 400 Q CI')ZZ3 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:%i--u&%<. a Q C.• Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet I 1 DATA, MEI IAL-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 ..�,�>ESCfT 'ON���� rp.iiio �", g �,,r work indicated on this application. =4\ t1 Aw.�2Q 14-P576- .tczv., Sim AValuation: $ aits\-2a1 I 0 cQ Existing building area: square feet New building area: square feet Td . n ,•. ` Number of stories: Name: k-ks�cSt.� t'�L ca. Type of construction: Address: 1 t© A -j t(i it,„9, Occupancy groups: City/State/ZIP:T-% y 4('( , Q,2 y7z2'3 Existing: Phone:X03) 9 5 iCo Z Fax:( ) New: ;TRIC ": ,c ❑ CONTA .J-.:"7.2,',.. t Y ., ; r4 Ija Business name: Al & ‘YL.Q All contractors and subcontractors are required to be Contact name: ll licensed with the Oregon Construction Contractors Board ► under ORS 701 and may be required to be licensed in the Address: t.�) .0 ~ L. 1r�. J oG_ /. 00I jurisdiction in which work is being performed.If the City/State/ZIP: P (/ 10-H-,O 1012_ (�7 2. if apply: Phone:(q-)1f) .9°3 - �e l/1.59 2.. Fax::( ) E-mail: 'V(X 09 Leal �►- i f'( -P 0 k. Low/ RACTE4" n $= `BUILDING PERMIT-FEES* - t'�O ` (Please refer rd fee scdule . Business name: . 'l�t Permit fee: Address: (..t�i 4...7Crn_L. �. Is),o,t State surcharge(12%of permit fee): City/State/ZIP: 6/t,0 q Lit FLS plan review(40%of permit fee): Phone:( 71 ) 6E2 3— )ei5C(2 Fax:( ) (Due upon application submittal.) CCB lic.: 6 6_2_y 0 Total permit fees: ^. � Amount received: Authorized signature: 49/6 j This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: z2�(� �' Date: / / * 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 bvoi to be done _ ' 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: 0] New system Number of sprinkler heads: )— i`'CZi(4-7 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 I=111+ heads: Plan review required and El(36)+ devices: Plan review required and (3) sets of plans. sets of plans. Additional description of work: Type of Sys n{Complete A; C car D as plicabl jaa V 4 A.)` Commer *.. Sprinkler Type ❑ Wet El Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ A:) TypeI- 0 Fire Suppression System F � Hood Project Valuation: $ 3y/(2 �=' C.) Fire "5 545"Ir Alarm 1` u } fix",-"* ;�' Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ II: >eIJ) sides t al Spr r(Stam too m System) Square Footage: Permit Fee: ` . 0 to 2,000 $198.75 \ :r 2,001 to 3,600 $246.45 �� ' x ,; 3,601 to 7,200 $310.05y.. 7,201 and greater $404.39 � � Sprinkler Project Square Footage: sq. ft. Fire Prote ® ,4 rn 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\Pemuts\FPS_PermitApp_031016.doc 2 I City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11045 SW HALL BLVD, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Fire Protection System FPS2019-00014 Inspection Type: Inspector: 999 Sprinkler final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor