Permit (20) vpi CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1. COMMUNITY DEVELOPMENT
Permit#: FPS2019-00122
T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2019
Parcel: 2S 104BC 10600
Jurisdiction: Tigard
Site address: 14090 SW WALNUT LN
Project: Fern Ridge,Lot 3 Subdivision: FERN STREET SUBDIVISION Lot: 3
Project Description: Sprinkler system.
Contractor: G&B PLUMBING&SONS INC Owner: K5 URBAN PROPERTIES&MANAGEMENT
PO BOX 92 PO BOX 25571
ST PAUL, OR 97137 PORTLAND, OR 97239
PHONE 503-868-1417 PHONE: 503-292-9344
FAX:
FEES
Description Date Amount
Specifics: Fire Protection System Permit-RES 10/16/2019 $246.45
12%State Surcharge-Building 10/16/2019 $29.59
Type of Use: SF Info Process/Archiving-Lg$2.00(over 10/16/2019 $4.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: R-2 Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 0.1 Design Area: 1500
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 $280.04
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 3486
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Special Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire 'f work is not arted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you t'- fo ow the rul= adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0i•0. You may btain a copy of the rules
or direct questions to OUNC by callir,_ 503.232/1'87 or 1.800. •.2.2344.
Issued By: / Permittee Signature: AA
Call 503.639.4175 by 7:00 a.m.for the next available inspect'..n date.
This permit card shall be kept in a conspicuous place on the job site until mpletion of the project.
Approved plans are required on the job site at the time of eac inspection.
Building Permit Application
Fire Protection System RECEIVE 11 FOR OFFICE I'SE ONL\
Ilk City of Tigard SEP 2 3 , RDate/B d -�iZ.GI L 41 P�i;20 "a /Z2_
. " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review S'' "pr,{ l�
Phone: 503.718.2439 Fax: 503.598.196( CITY OF TIGARD DateBy:4 VAC * e,Fr r••1e: j L
Inspection Line: 503.639.4175 Date Ready/By: Cf 4 coHKir oris: Et See Page 2 for
TIGARD BUILDING DIVISION otified Method: / Supplemental Information
Internet: www.tigard-or.gov l yl Frey ♦ PP
-..lic.un---- ------ Lta�j/LI�L�
TYPE OF WORK REQUIRED DATA: 1-AND 2-FAMILY DWELLING
® 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
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $450
® 1-and 2-family dwelling ❑Commercial/industrial
li[11Accessory building 111Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 2.--
Job site address: 14090 SW Walnut Lane New dwelling area: �seh square feet
City/State/ZIP:Tigard OR Garage/carport area: � k:6 square feet
Suite/bldg./apt.no.: Project name:Fern Ridge Covered porch area: 21c..`c3 square feet
Cross street/directions to job site:sw fern ridge terrace Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:fern ridge Lot no.:3 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 WORK work indicated on this application.
sprinkler system Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:k5 urban properties&management Type of construction:
Address:po box 25332 Occupancy groups:
City/State/ZIP:portland or 97298 Existing:
Phone:(503)2929344 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON NOTICE
Business name: bella terra homes All contractors and subcontractors are required to be
Contact name:chris mcgehee licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: po box 25571 jurisdiction in which work is being performed.If the
City/State/ZIP: portland or 97298 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)2929344 Fax: :( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name:G&B plumbing (Please refer tafee schedule)
Permit fee:
Address:po box 92
State surcharge(12%of permit fee):
City/State/ZIP:St Paul,OR 97137 0
FLS plan review(40%of permit fee):
Phone:(503)868 1417 Fax:(503)524 8447 (Due upon application submittal.)
CCB lic.: 184372 Total permit fees:
Amount received:
Authorized si
it ` This permit application expires if a permit is not obtained
Print name: er. V+v2Ez_ Date:• jb `� 1 /7 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:
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 El 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 El 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
Sprinkler Type ❑ Wet El Dry
Additional Standpipes
Information: Sprinkler Supply Line El Yes ❑ No
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 ❑ 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: 3486 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: $
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t liil 0 t:omroar ial/tridustriai SFR{3)bath ' 5.0032„,,,,
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a Mester builder a Other: Pier aprillkiet:{ sq;(i,) 2
Cahctl basin a drain
yob: ttddre s: c-(07 Vit% L 1 SGT l lit prywen,icacb 110e,o (reach duxin -. ICS
I CityiStatetZ1P: 'It 6 ii,%to 0 va., 91- 223 footing Grein(no.linear f1.:.
uite/bldg./apt.no.: Project nom:-fe.rti,_1 12oto 64- - Mengtactured home utilities sorra.,
Cross stteeetldirections to job site: W 4V' qa%,._ NIX O 6E Manhole* ,, , 1.1.1;7:0 .
Tv-vu d cE
Rain drain connector 18: 6 - _
Sitttitary sewer(no,iinoas}t.s ) _
Si •
on:i sewer •tno.linear ft, ,_ .- ,
- 'Water persica(no.linear fs:_) _1 . Pte 2.w;
Subdivision: Ri-1 '02x0(3E_ Lot no.; 3 P_ ..l art •1,: .
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flow xeventer 31:27
T. maptparcet tlo, Backwater valve )Z.51-
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'.: ' 'h.Giothes 4112 ,
0 V.,,\1/\, t.`e_.. S-c.S Dishwasher 25.02
Drinking fountain.., 444 .
Ejectors/sump2$10.2
„ . -• /i < g” t' s *meson tank, 4.33 r
Ntrme ICcj l'"JQI'l + f 5 P1>we wee cap
Ptoordrain/floor siitlltiubYS
Address: 'Pa 9-J(TIC a. sAR, , G6tba$e disposal 25,02
� 2 Hose bib 2
City/State/ZIP: ( 00,- t
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ausinegs i;,stme' 1.21 G1. re.r 1'A.. cmeS
primer 1zS1
Contact tom: e,v\t'i S plc_eleIn.0-2 , V
Roof (commercial) ii
Address: t?O 93 Q>Y. a.6 Sink/basin/lavatory is e�w
City/State/ZIP: ( t ` Solar tsnits(potable water) 1 5231
Rhone:( ) oa 01344- Fax::
ox::( ) •-rTuWstawedahower Pen -12$l
Urinal
E-mail: Ckny i ta\kirrLa 6-Yek l.
a ` e .‘3.4,;
� Waits ciosst
u j ,: �?''-f- U '.r ,.rl's",v' water hewer 37:5
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Business name'
G & B Plumbing& Sons, Inc. Water rtDwv 5620 r
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tee: PO Rax.92 _ Other 25.41
City/state/ZIP: St. Paul, OR .97137 - sabtolbtt
Minimum permit fee:V12330
Phone:(50 3) 8613-1417 Fax:{ 1 Plan review(25%of Permit ftp)
CCB Lic.: 1 372 f plumb- : it.no.: PB634 State surcharge(12%of;tomtit fee)
I
TOTALPERMIT FEE
Authorized signature: or"-dr .___ �{
Date: I l L�l 141 I Th"rr permit appNdtien euparte lir pertintr Is Gat ehtaleed while CSU days
Print name: Kelly 1 ■tier It hat bcrn:fitevted es cwa cls.
-Fo '�er '- "Fee methodology set by Tri-County Building Industry Service Board
V-UtuiftilogVermitc\PI M ti-PernmArp dot i Pro IfO' 440-4a I6T(10/03/C.OMW68)
151 .
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Plumbing Permit Application - City of Tigard
'Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
site utilities toy Fee(ea) Total ' Square Footage: Permit Fee:
Footing drain-1"100' 50.03 0 to 2,000 3 e} .6 - $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 t $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Permit Fee:
Valuation:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Fie( ) }Dk7tl . each additional$100.00 or fraction thereof,to
Other Inspections or Fees Q�' and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Review fair Plullh%dg IISIo1 s;.
Quante by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added` Relocate `
0 Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial ❑ Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4"
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2