Permit � CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 ' -1 :. - -- COMMUNITY DEVELOPMENT Permit #: FPS2011 00099
Date Issued: 08/09/2011
TIGAR;D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S101 DC00200
Jurisdiction: Tigard
Site address: 13535 SW 72ND AVE 200
Project: Optilink Subdivision: Lot:
Project Description: Adding (11) and relocating (2) sprinkler heads.
Contractor: AFP SYSTEMS INC Owner: PNWP LLC #2
19435 SW 129TH BY PACIFIC NW PROP LTD PTNSP
TUALATIN, OR 97062 PO BOX 2206
BEAVERTON, OR 97075
PHONE: 503 - 692 -9284 PHONE:
FAX: 503 - 692 -1186
FEES
Description Date Amount
Specifics: Permit Fee - COM 07/28/2011 $102.20
12% State Surcharge - Building 07/28/2011 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 07/28/2011 $40.88
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Sm Sheet (up to 07/28/2011 $3.50
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0 Design Area: 0
K Factor: 8
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $158.84
-
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,250.00
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 ► • -:... 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 . ect questions to ► NC b . ling 503.232.1987 or 1.800.332.2344. `
Is . ued By: • // (7 , , Permittee Signature: k
Cotiti/3itt,
........,-
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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
. . . . . •FOR oFFIcE.usEoNLy
.:..., . .:.
54 . City of Tigard , .CVO
OR 97 Rece rm
ived iew
Date/B : inirMil Peit No.: ' i
dla , a ' c i
, 4 13125 SW Hall Blvd., Tigard, '''.V , Plan Rev „Off own Other Permit:
TIGARD
: Phone: 503.639.4171 Fax: 503.598.1'.t ' 10 Date/By: _ .40 P
Inspection Line: 503.6394175
MV 6 1 .
Date Ready/By: .. limil 0 See Page 2 for
M
• allet: WWW.tigard-or.gov 3% , — Is si9 Notified/method: # -i - IMI Supplemental Information
n ONC- 3 ,1 00 . , CO ,T4 IV ' AttPi*J .... , . . ... , .....
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0 New construction 0 kti ti on Permit fees* are based on the value of the work perfonned.
indicate the value (rounded to the nearest dollar) of all
cajkddition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
C OF :.-' '."-.: - ' -- '• .-.::: - work indicated on this application.
Valuation: S
0 1- and 2-family dwelling -Commercial/industrial
0 Accessory building D Multi-family Number of bedrooms:
0 Master builder D Other: Number of bathrooms:
,= - - . - , -• : . • ' . - JOB SITEANFORMATION:AN6'LOCATION.; '' ' ',., ' ' ' " Total number of floors:
Job site address: I 3 CS ''''S 5 ij -74:- New dwelling area: square feet
City/State/ZIP: --- kc , .,,,, (*-- Garage/carport area: square feet
Suite/bldg./apt. no.: _A - I Project name: Opt ( I 4 - -- Covered porch area: square feet
%
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
. . „ .._ ,. ,.. . . .. . .. , „ . .....„. .- ...
=,-REQUIRED DATA: CIJECKLIST..
,•„_. — ::. . , .. . • -... .. „,... . ., .. •:.
Subdivision: I 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
. . . .. . . .. . .
; DESCRIPTION ,orivOOK:, - :: '',''.: ::, =, : , - •Z:':Y work indicated on this application.
A f --- « ...L .1 a. .. 4 • ; Valuation: S 9,Z
r . , • _ . ' 'i
Existing building area: SD square feet
New building area: )00.0 square feet
a PROPERTY OWNER . ' ,:r ••:-.:.:•.': ...'14TEN4IN't'••• '!- 2: . ;. - 1;• .; :: -,' Number of stories: 2_
Name: • 5 tk. ,... .. 0 Type of construction:
Address: 1 's.. -3 -;-----) a tk.) ‘-ja''' Occupancy groups:
City/State/ZIP: '"1 & C ..k Existing:
Phone: ( ) Fax: ( ) New:
Business name: A F f) s • , ....,, ai„.....c... All contractors and subcontractors are required to be
Contact name: i 0-‘, -- 3 /c,
tii a„
licensed with the Oregon Constniction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: I %%Ili; -. - sc) 1 4 64.'1/4* jurisdiction in which work is being performed. If the
City/State/ZIP: "‹ eiL Dr. applicant is exempt from licensing, the following reasons
-A
aPP
Phone: ( ) 1,A2.--a..v-A Fax: : ( ) i .1_1 1 c. _ 4,-,
E-mail: 3k ...._e_
:‘ „..:,....• ,,..:.: (Pleaiiieftiiiifiesi'heiltileY
Business name:
Permit fee:
Address:
State surcharge (12% of permit fee):
City/State/ZIP:
FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application)
CCB lie.: i;76 .i..4 Total permit fees:
Authorized signature: received:
ure.
t -
. This permit application expires if a permit is not obtained
Print name: 3 v eN isgkiav Date: 7 __al, .... t within NO days after it has been accepted as complete.
* Fee methodology set by Tri Building Induthy
Service Board.
1:113uildingTermitsVPS-PermitApp.doc.: 03/23(06 440-4613T(13/021COMAVE13)
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 0.11+ heads: Plan review required.
❑
Repair ���
Number of sprinkler heads: I/
Additional description of work: Q
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet El Dry
Additional Standpipes
Information: 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: 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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
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