Permit V CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
14 1 COMMUNITY DEVELOPMENT Permit #: FPS2009 -00026
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/01/2009
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 7007 SW CARDINAL LN 135
Subdivision: Lot: 0
Project: North American Trade
Project Description: Relocate (6) heads, add (1), demo (1). •
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee - COM 05/01/2009 $62.50
#300 Tax - 12% State Surcharge 05/01/2009 $7.50
PHONE:
Contractor:
DELTA FIRE INC
14795 SW 72ND AVE
PORTLAND, OR 97224
PHONE: 503 - 620 -4020
FAX: 503 - 620 -1058
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
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 $70.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 950
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 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 -0100. You may obtain a copy of the rules
■
Issued By: \ 1 9 j * Permittee Signature: / / / ; `
I JCJ� Y \ J
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
Fire Protection System
Building Permit Application . r FOR OFFICI. ISI. OSl.\
City of Tigard Received •--
14 - . 13125 SW Hall Blvd., Tigard, OR 97223 MAY 0 1 201 'Date' : �' Permit No.: .� .`, ell f
g Plan Rev `�/
Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 CITY OF { - 'GA : "Date Ready /By: H See Page 2 for
Internet: www.tigard-or.gov BUILDING DiVIS l �N ; otified/Methad: Supplemental Information
❑ New construction ❑ Demolition Permit prfm
Indicate fees* the value are based (rounded on the to the value nearest of the dollar ) o all or ed.
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
\ "�: - i ' , t ,� °` work indicated on this application.
1.3 1- and 2- family dwelling ® m
Comercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
Total number of floors:
Job site address: 7007 Cardinal Lane New dwelling area: square feet
City/State/ZIP: Portland, OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: North American Trade Covered porch area: square feet
Cross street/directions to job site: Pacific Corp Center Deck area: square feet
Other structure area: square feet
' tA3 m I to "� 3. € ;i >�.;��4d IFm
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, abor overhead, and the profit t l ad a e ofit for the r
A W z'.: a i (5ii'tlp ¢ , _ „C work indicated on this application.
.. _ , 4.,..A. „_
Relocating 6 Fire Sprinkler heads, Adding One head, Valuation: $$950.00
& Demoing One Head For New TI. Existing building area: square feet
New building area: square feet
t g '* „ " s Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
Business name: Delta Fire, Inc. All contractors and subcontractors are required to be
Contact name: Heidi Scarbrough licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 14795 SW 72" Ave. jurisdiction in which work is being performed. If the
City/State /ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 620 -4020 I Fax:: (503) 620 -1058
E -mail: heidis @deltafire.com
x
a
Business name: Delat Fire, Inc.
Permit fee:
Address: 14795 SW 72" Ave.
City/State /ZIP: Portland, OR 97224 State surcharge (8% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 620 -4020 Fax: (503 -) 620 -1058 (Due upon application.)
CCB lic.: 64174 @ , l \ • Total permit fees:
Authorized signature: / J � Amount received:
ALA v Iii( .. . - This permit application expires if a permit is not obtained
Print name: Heidi Scarbrough D. f 4/30/09 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.doc 03/23/06 440-4613T(11 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Dewitt (*bi ytrs' h+ `'' rtic
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
Type of System (Complete A, B, C or D as applicable): ._
® Wet ❑ Dry
Additional Standpipes N/A
Information: Hazard Group Light
Density 0.10
Design Area 1500
K. Factor 5.62
Sprinkler Project Valuation: $ 950.00
B.) Type I Hood Fire Suppression System
Hood Project Valuation: I $ N/A
C.) Fuel ; •: ,
_ x
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $ N/A
.) Residential Sprinkler (Stand Alone System)
Sq uare Foot. :e: Permit Fee: r, t e z4
0 to 2,000 $187.50
2,001 to 3,600 $232.50 1 `y
3,601 to 7,200 $292.50
7,201 and • reater $381.50
Sprinkler Project Square Footage: I N/A sq. ft.
Project valuation subtotal (see A, B & C above): $ 950.00
Permit fee based on project valuation (see fee schedule): $ 62.50
Permit fee based on square footage (see D above): $ N/A
State Surcharge (8% of permit fee): $ 7.50
FLS Plan Review (40% of permit fee): $ N/A
TOTAL: $ 70.00
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.
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