Permit
s
y n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2010-00010
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/02/2010
Parcel: 2S 112AA00400
Jurisdiction: Tigard
Site address: 14280 SW 72ND AVE
Subdivision: NELSON BUSINESS CENTER Lot: 0
Project: Leifs Collision Center
Project Description: Relocate (6) existing pendent sprinkler heads.
Owner: FEES
WALTON CWOR NELSON 13 LLC Description Date Amount
BY TTA/EPROPERTYTAX DEPT 735, PO BOX Permit Fee - COM 02/02/2010 $53.78
4900 12% State Surcharge - Building 02/02/2010 $6.45
PHONE:
Contractor:
JND FIRE SPRINKLER INC
12155 SW GRANT STE D
TIGARD, OR 97223
PHONE: 503-968-5200
FAX: 503-968-5920
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
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 $60.23
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 0
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 day f
issuan , or if work is ended for more the 180 days. ATTENTION: Oregon law requires you to follow lies adopted by the gon
Util' Notification Center. ose a set forth in OAR 952-001-0010 through OAR 952-001-0100. ou m obtain a copy of h rules
o direct questions to OUNC callin 5 3.246.6699 or 1.800.332.2344.
ssued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business
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.
-iguildina Permit Application
Fire Protection System
City of Tigard D~e/B /D Permit No.: q0 -aoole
e 13125 SW Hall Blvd, Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 DateB : Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: ]uris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: SupplementalIntDrmation
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 %Other: IMME 5m. Yw" K&OW equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2-family dwelling ❑ Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 42 ec 4W -TWO Aoe New dwelling area. square feet
City/State/ZIP: OR Garage/carport area: square feet
Suite/bldg./apt. no.: Project name: L.afrrS COLLIt11GV Covered po h area: square feet
Cross street/directions to job site: 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 OF WORK work indicated on this application.
® Valuation: $ C)
A &K-1 Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. Ifthe
City/State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fa`t:: ( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES"
Business name: SP;?JV) &4W +JL)t` irefer to eeschedule
A . '
Address: 17_t45,5 qs%L) a-a4wr AVE Permit fee:
City/State/ZIP: 'T' ~Z State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: ( ) ~~j ~jZOv Fax: 'J& 48 54WO (Due Von application)
CCB lic.: 9 S Total permit fees:
Amount received:
Authorized signature:
4LAW11vow This permit application expires If a permit is not obtained
Print name: 0"gs T'rJ Date: E$LCS#W /40 within 180 days after it has been accepted as complete.
' Fee methodology set by Tri-County Building Industry
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1) ❑ New 2) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
tza. T- Svc- E!W-15n0*, OVIlt~21
T lee of S tem Com lete A, B, C or D as a licable
A.) Commercial Sprinkler
Iff Wet ❑ D
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Pro ect Valuation: $ t:)
B. Type I - Hood Fire Sup ssion 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 Foota : Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and eater $381.50
Sprinkler Project Square Footage: sq. fr.
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 : $
FIS Plan Review 40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"Need" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or
NICET level "3" technicians.
CAPERMIT APPLICATIONS\Ttgard FPS-PemutApp.doc 7