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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT �.; COMMUNITY DEVELOPMENT Permit #: FPS2011 -00141 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/22/2011 Parcel: 2S112DC00100 Jurisdiction: Tigard Site address: 15705 SW 72ND AVE Project: Bridgeport Distributing Subdivision: HERN PACIFIC TIGARD INDUSTRIAL Lot: 1 -2 Project Description: Replacing backflow preventer in existing fire suppression system. Contractor: DELTA FIRE INC Owner: UNION PACIFIC RAILROAD CO 14795 SW 72ND AVE 1700 FARNAM ST, 10TH FL SOUTH PORTLAND, OR 97224 OMAHA, NE 68102 PHONE: 503 - 620 -4020 PHONE: FAX: 503 - 620 -1058 FEES Description Date Amount C Specifics: Permit Fee - COM 11/22/2011 $102.20 12% State Surcharge - Building 11/22/2011 $12.26 Type of Use: COM Plan Review - Fire Life Safety - COM 11/22/2011 $40.88 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Sm Sheet (up to 11/22/2011 $1.50 Occupancy Grp: S -2 Height: ft 11x17) Stories: 1 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 Cates Provided: Cut Sheets Required: Total $156.84 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 Notification 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 direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: "�� / Permittee Signature: d , /V / / O je . A Tj _0 �V 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. NOV /17 /2011 /THU 11:01 AM FAX No, P. 002 Building Permit Application , Fire Protection System RECEIVED FOR o hha(: I. :S E ONLY City of Tigard Received B : i � Date/ �� . B : �=, M 7 13125 SW Hall Blvd., Tigard, oa NOV O V 1 2011 97223 y q O 1 � Review ....,, Plan a • Phone; 503.718.2439 Fax: 503,598.1960 I Datnai : I' 1 I . / I Othes Pest; T I C: A l i 1 ) Inspection Line: 503.639.4175 ` 1 ' Dam Ready/By: him: El Sec Page 2 for Internet: www,tigard or.gov CITY O TIGARD Nadfied/Method: • i' y Supplemental Information glili DIVISION TYPE OP WORK Q REQUIRED DATA: 1- AND 2-FAMILY DWELLING ❑ New construction Q Demolition 6 ,� r \ .e' f P Permit fees* are based on the value of the work performed. - y — Indicate the value (rounded to the nearest dollar) drill 2 Addition/alteration/replacement El Other: 1 ce4 equipment, materials, labor, overhead, and the profit fbr the CATEGORY OF CONSTRUCTION work indicated on this application. 12 1- and 2-family dwelling ^/ Commercial/industrial 1%11 ro Valuation: $ 111 Accessory building El multi-family 8.1' Number of bedrooms: El Master builder © Other: Number of bathrooms: .XOIII SITE INFORMATION AND LOCATION Total number of floors: Job site address: 15705 SW 72 Ave. New dwelling area; square feet City /State/ZIT: Portland, Or 97224 Garage/carport area: square feet Suite/bldg /apt, no.: Project name: Bridgeport Distr. Covered porch area: square feet Cross street/directions to job site: Deck area; square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECICLIST Subdivision; Lot no.: Permit fees' are based on the value of the work performed. Tax map /parcel no,: Indicate the value•(unmdcd to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. _ Replace 6" Backflow Device with Wilkins 350 Da DCDA Backflow Device Valuation: $52,250.00 Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER Lf TENANT Number of stories: Name; Type of ConatruCtlotl: Address: Occupancy groups; City /State/ZIP: Existing: Phone: ( ) Pax: ( ) New: ® APPLICANT ❑ CONTACT PERSON NOTICE Business name; Delta Fire, Inc. J 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. tithe City /state /ZIP: Portland, Or 97224 applicant is exempt from licensing, the following reasons amply: Phone: (503) 620 -4020 Fax:: (503) 620 -1058 — E -mail: heidis@deltafire.com CONTRACTOR g1RIC.DINGPERNIIT FEES" Business name: Delta Fire, Inc. SPdease refer to fee schedule) Permit fee: Address: 14795 SW 72 Ave. - City /State/ZIP; Portland, Or 97224 State surcharge (12% of permit fee): FLS plan review (40% of permit fee): Phone; (503) 620 -4020 Fax: (503) 620 -1058 (Due upon application) CCB lie,; 64174 — j Total permit fees: 4 (5p (Pi 1.!----- Authorized signature: , InfigAPOBIlifigli Amoun t received: i 1 Aton This permit application expires If a permit Is not obtained Print name; Heidi Scarbrough 'Date: 11-17-11 within 180 days after it has been accepted as complete. " Fee methodology set by Tri- County Building Industry Service Board c\ auadineu'amite\N's- remdfADp.sor avow 1 440 4613T(11 /0YCOM/WEB)