Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II. • COMMUNITY DEVELOPMENT Permit #: FPS2012 -00037
T t G A R..D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2012
Parcel: 2S112AD01100
Jurisdiction: Tigard
Site address: 6600 SW BONITA RD
Project: Paul Schatz Furniture Subdivision: 2000 -020 PARTITION PLAT Lot: 1
Project Description: Install backflow preventer to existing fire sprinkler system. Device is located in loading dock area.
Contractor: VIKING AUTOMATIC SPRINKLER CO Owner: PACA PROPERTIES LLC
3245 NW FRONT AVE 6600 SW BONITA RD
PORTLAND, OR 97210 TIGARD, OR 97224
PHONE: 503 - 227 -1171 PHONE:
FAX: 503 - 227 -1552
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/09/2012 $134.48
12% State Surcharge - Building 03/09/2012 $16.14
Type of Use: COM Plan Review - Fire Life Safety - COM 03/09/2012 $53.79
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 $204.41
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $5,600.00
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 Notific- enter. 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 • •estions to • • C • " ailing 503.232.1987 or 1.800.332.2344.
Issue. By: , /,Ie Permittee Signature:
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 RECEIVED
City of Tigard d `� 4.2_ Permit No.:
Ili
2012 �5A�� -oa037
a 13125 SW Hall Blvd., Tigard,OR 9722�' 9 p Plan Review
0 . Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I" I G A It D Inspection Line: 503.639.417 CITY OF TIGARD Date Ready/By: rurir ® See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
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: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling CommercialJindustrial Valuation: $
,
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
et C20 JOB INFORMATION AND LOCATION Total number of floors:
Job site address: S 7.>n to . Z J New dwelling area: square feet
City/State /ZIP: 5 ,„.. - `(> ,n... 9 1 Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: ? h ,... ) t c GA.,■...c -L Covered porch area • square feet
Cross street/directions to job site: Deck area: square feet
• 'Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST .
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.
�-� () \ A. c.,. ��■i -S :. -•S Lb pc- �.] : k. 1V C..J Valuation: $ S ( ( p
(AA%\ \ <s.•�S - 3 S6 AAA oS. Existing building area square feet
New building area: square feet
'PROPERTY OWNER I ❑ TENANT Number of stories:
Name: p Type of construction:
Address: ( 6 S ,► 1 0 ti ` Ir ' eta, fLJ - Occupancy groups:
City/State /ZIP: 0"T"; S ) % t o— Q l - .VA Existing:
Phone: (.5)'N) L . ( J Fax: (5=4) (039 - el L 39 New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Q ,‘,/.._ A L - S`X t . c r All contractors and subcontractors are required to be
Contact name: /!h► TtC� ..-i74' . t,•„i licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be Ikensed in the
Address: �'L c- - N i c . = (, j - k jurisdiction in which work is being performed. If the
City /State/ZIP: ?el t Lt ,,,,.........) r) ,0L 9- 'Z.1 applicant is exempt from licensing, the following reasons
._ apply:
Phone: 53) 1.1,-, . t,-1 1 Fax: : (5,13) 1,1,'7' 1 S'
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: S ra v _. . n t IN y 664-c. Permit fee:
Address:
City/State /ZIP: State surcharge (12% of permit fee):
FLS plan review (40% ofpermit fee):
Phone: ( ) Fax: ( ) (Due upon application.)
CCB lie.: (pm e., " /< (/ Total permit fees: / /
Authorized signatu Amount received: $a 4 t `
r, � .. . r This permit application expires if a permit is not obtained
Print name: N, ;? "� C- ate: 3. / 1 / ('L , within 180 days after it has been accepted as complete.
Fee methodology set by Tri -County Building Industry
Service Board.
I1Building \Permia\FPS- PermitApp.dac 02/01/2011 440-4613T(11/02/COM/WEB)
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:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet , ❑ , Dry
Additional Standpipes
Information: Hazard Group ' • r-
Density ,
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: - I $
C.) Fire Mann -
Submittal shall ' Battery Calculation r • : - ' ❑ - Ye's . • -
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 V . $404.39 • ' ••
Sprinkler Project Squ Footage: sq. ft. • -
Fire Protection Permit Fees
Project valuation subtotal (see A, 13'& 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): $- -° ' ' v
FLS Plan-Review (40% of pertriit- $
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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