Permit • CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
!PI COMMUNITY DEVELOPMENT Permit #: FPS2009 -00081
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/03/2009
Parcel: 25101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY
Subdivision: FARMERS INSURANCE Lot: 0 .
Project: Triangle Pointe
Project Description: Add or alter (27) fire sprinkler heads for TI.
Owner: FEES
TRIANGLE POINTE LLC Description Date Amount
901 NE GLISAN ST #100
PORTLAND, OR 97232 Permit Fee - COM 08/28/2009 $91.10
12% State Surcharge - Building 08/28/2009 $10.93
PHONE: Plan Review - Fire Life Safety - COM 08/28/2009 $36.44
Contractor:
PATRIOT FIRE PROTECTION INC
4708 NE MINNEHAHA ST
VANCOUVER, WA 70822
PHONE: 360 - 699 -4403
FAX: 360 - 699 -4485
Type of Use: COM
Class of Work: FPS Type of Const: IIA
Occupancy Grp: B Height: ft
Stories: 5
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: .10 Design Area: 937
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 $138.47
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 6000
Residential Square Footage:
Fire Alarm Valuation:
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 , • s •ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N • "cation Center. Thoe rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. • •• • obtain a copy of the rules
or dir- t questions to OUNC b . ' g 03.246.6699 or 1.800.332.2344.
Is ued By: Pe ittee Signature: i' t./
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 • pletion of the project.
Approved plans are required on the job site at the ti • each inspection.
• Bidding Permit Application
. ec __,*
Fire Protection System FOR OF F I C E 1,S11 ONLY
City of Tigard Received g 7 , 7 (j(
Date Permit No p-, 06 eG1D
`J e
° 13125 SW Hall Blvd., Tigard, OR 97223 ii '/ � 1 ive ��►!
C Phone: 503.639.4171 Fax 503.598.1960 1 mina
: I • ra Other Permit:
f I G A h D Inspection Line: 503.639.4175 g, 1 e Read 8)0- / , / �J • , ' " H See Page 2 for
Internet: www.tigard-or.gov REC1-t1v _ �/� " r /� � oi �PP��ataliotormatloa
TYPE OF WORK i r L $ 2 009 t t , , , i t 2- FAMILY DWELLING
New construction 0 Demolition
P'‘3 2 Permit fees* are • . on the value of the work performed.
Y %NRD Indicate the value (rounded to the nearest dollar) of all
"Addition/alteration/replacement ❑ Other. �� CIT ►NUr G DivISIOI4 equipment, materials, labor, overhead, and the profit for the
CATEGORY OF C'ONSTRUCtft[t►tvLU work indicated on this application.
❑ 1- and 2- family dwelling V'• ommercial/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: (3S3S S vL/ Cp$ l-1i p � N,,,/y New dwelling area: square feet
City / State/ZIP: j ( -,bz, 1 pe ez e j GI 722, 5 Garage /carport area square feet
Suite/bldg./apt no.: I Project name: "ti, /,S (.E Q, e ATE_ Covered porch area: square feet
Cross street/directions to job site: Deck area square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECILJST
Subdivision: I 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.
PLC,V 1 r3 G 5$ (Z t ,L,e_Lcia s "rc, kie vv4u S Valuation: $ Cv
C E t L t J VrS Geo G i S T i AJ <) ( 6vlc4--C2 Existing building area: square feet
\,(Cz��w� New building area square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups: L t e i t 1,4 f
City/State/ZIP: Existing: \N / /
Phone: ( ) Fax: ( ) New: \ / /
,APPLICANT �- r ❑ CONTACT PERSON NOTICE
Business name: pp, } eE D,p'T G /��, 1 t....1L . All contractors and subcontractors are required to be
Contact name: E �� . " t licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4 1JE if-1 l LI JJ 6 4- -..-1 , jurisdiction in which work is being performed. If the
City/State/ZIP: vA, , wteN a 5G4 ( applicant is exempt from licensing, the following reasons
apply:
Phone: 3) 7_ C Go k I Fax: : S(OO) a>91 — 44 ,' E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: O'Teto t C 2.E IPleasere(ert schedule)
Permit fee: 9/. 1 C
Address: 3
City/ State/ZIP: State surcharge (12% of permit fee): /Q . 9
FLS plan review (40 °'s of permit fee): 3 * i /�
Phone: ( ) Fax: ( ) (Dire upon application.) 7
CCB lic.: 7 z Z-- Total permit fees: / 5g .47
Authorized signature: 5,...--'''' Amount received: / ,? g , '{7
�I This permit application esplres if a permit is not obtained
Print name: �E co �S I Date: iV a- C °i within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building industry
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•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) rc New 2.) :Modification to sprinkler heads only:
j$ Addition ❑ 1 -10 heads: No plan review required.
Ist Alteration 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
\Vet ❑ Dry
Additional Standpipes yES - Ex t 5Ti L1Lr
Information: Hazard Group LI L-r irT 144z-y Z Q
Density tCU
Design Area 6 1'73
K. Factor
Sprinkler Project Valuation: $ c:c,c, ° f
B.) Type I - Hood Fire Su ression System
Hood Project Valuation: 1 $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
(1/1t\ Fire Alarm Project Valuation: _ $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2000 $187.511
2,001 to 3,600 N $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinlder Project Square Footage: 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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
http: / /www.tigatd- or.gov/ city_ hall/departments /cd /flocs /FPS- PennitApp.doc 2