Permit 'CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit# FPS2012 -00143
Date Issued 09/19/2012
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 2S113A600500
Jurisdiction Tigard
Site address 16083 SW UPPER BOONES FERRY RD 300
Project Therapeutic Associates Subdivision FANNO CREEK ACRE TRACTS Lot PT 37
Project Description Add fire sprinklers below ceilings for TI
Contractor FIRESTOP CO Owner G &S FC LLC
3203 NE 65TH ST #2 16083 SW UPPER BOONES FERRY RD,
VANCOUVER, WA 98663 STE
TIGARD, OR 97224
PHONE 360 - 718 -8604 PHONE
FAX 360 - 718 -8603
FEES
Description Date Amount' .,
Specifics Permit Fee - COM 08/29/2012 $112 96
12% State Surcharge - Building 08/29/2012 $13 56
Type of Use COM Plan Review - Fire Life Safety - COM 08/29/2012 $45 18
Class of Work ALT Type of Const IIIB Info Process /Archiving - Lg $2 00 (over 08/29/2012 $2 00
Occupancy Grp B Height ft 11x17)
Stories 3 Info Process /Archiving - Sm $0 50 (up to 09/19/2012 $6 00
11x17)
Commercial Sprinkler System
Sprinkler Required Yes Sprinkler Type Wet
Standpipe Required Hazard LT
Density 10 Design Area 1600
K Factor 11 2
Commercial Fire Alarm System
Fire Alarm Required Alarm Type
Pull Station Required Smoke Detectors Req
Battery Calcs Provided Cut Sheets Required
Total $179 70
Valuations Required Items and Reports (Conditions)
Sprinkler Valuation $3,950 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 Notificat 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 q Lions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued y Permittee Signa • re '
Call 503 639 4175 by 7 00 a m for the next available inspec on date
This permit card shall be kept in a conspicuous place on the job site unt completion of the project
Approved plans are required on the job site at the time of each inspection
Building Permit Application
9f x.. ,•? .yncir ? �Y y �: sir1�7 "3' t �F T ?. _mac.
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Fire Protection System Y • EY'V ED °- fi "' rg OR OFIEIC- FUSEz -tvgx - ` -t
�,7 [ City of Tigard Received v(/ J J
b Dated3y of ,"1// Penmt No 4Q S Aot .)' T
-E r" '. 13125 SW Hall 131%d heard OR 97223' ii 2 9 1012 Plan Review Q �7 r Oi hcc Peimn _ oo /s
y - Phone 503 7182439 Fas 503 598 1960 Date/13v ` � l
tnccr,. , Inspection Line 503 6394175 CITYOFTIGARD Dace Read\ /By / Al / '� S See Page for
-.:: Internet wwotrgard -orgov BUILDING DIVISION our' d /Method i/if Supplemental lnfoi manor]
0 ,Rre,MY 4,010
TYPE OF WORK REQUIRED DA FA 1- AND 2- F.1i1IIL1 DWELLING
Pet nut fees ate based on the value of the wort. pet formed
111 Nesv constr uctruu Ili Demolition
Indicate the value (rounded to the neatest dollar) of :11
Cg. Addttion /altet attonheplaccment ❑ Other equipment materials labor o0. erhedd and the i )lit lot the
CATEGORY OF CONS RUC l ION work 111 hated on Ihis application
valuatroi s 3 , cce
❑ 1- and 2- family dwelling CommeiLicit /industrial / S r
❑ Acccssoi) building ❑ Multi- family Number o cdi ooms
111 Mastct buildei 111 Othci Numhct of bat Dons
JOB SI FE INFORM - A1 ON AND I OC4I ION I ota) 'writhe' of Il is
lob sitc address ' 6 $ 3 Sr w v PPe2 12,6.0c s F6a -42-r ge. Ness dwelling ea squaic feet
Ca)/State/ZIP T I &Al / a 2 , Garage /ca ,. rt area square feet
Suit , ta.•, /apt no Ry c I Prolcctname -CsT Fir_ ERA pewn t- Covet poi chaiea quaicfeet
Cross stieet/directions to job site A SS IATES Dc c area square feet
tier slruclwe area square feet
REQUIRED DA I A ( OMi11ER( IAL CHECKLIST
Subdivision Lot no Permit tees* ate based oil the value of the wor perfoimcd
I a\ map /parcel no Indicate the value (iounded to the nearest dollar) of all
equipment matcnals labor overhead and the profit for the
DESCRIP HON OF WORK work indicated on this application
ADD F(ILE s P a-I N K LE 2 S BE (-0 w e--e I Nis Valuation S 3/ 1 5-0 .
To /keeoMo DATE - ENA N 1 _ T-i iP IZOUeMEIV I F istutgbuddin square feet
New building area square feet
❑ PROPI In 1' OWNER ❑ I E N4N I Number of stones 3
Name Type of construction
Address
Occupancy groups
C ity /State /ZII'
E\isting D Fp c—
Phone ( ) I a\ ( )
�,/ New O FFI c
APPLICANT CON VAC f PERSON
NOTICE
Business name F (/LEs P o . LLB
All tontractois and subcontractors arc required to be
Contact name go 6.-12_6-E M licensed with the Oregon Construction Contractors Boaid
under ORS 701 and ma) be required to be licensed in the
Address 32-O 3 N . E . G S A S SP. Z f ur indiction in x‘ Inch work is being pci for med It the
Cit\ /State /LIP A N Co t/U ER twth , q 8 6 3 3 applicant is evempt from licensing the following reasons
apply
Phone ( 360) 71 8 — 9 60 4 Fa\ (36 0) r11 $ ' $ b o 3
E-mail voE 9 ve evr< co, F've sto p c--6. CoNt
CONTRACTOR BUILDING PERM! F FECS%
Business name SA 4 E A- S /`e 13 o U (Please refer to fee schedule)
Address Permit fcc
Cit_s /Slate /ZII'
State surcharge (12% of permit fee)
1LS plan ieviess (40% ol permit lee)
tone ( ) Fas ( ) (Due upon application )
i ,CB lie 1 13 - 7 9 g(/ total permit fees
Autho iized sig " Amount ie�eived
I Ills permit .ppIle,mo„ e.pu ks .r . p ,, Intc ,> not obtannka
I
Print name p art 0iihin IS() d.ivs alter a has been accepted as tumptetc
r I cc mcthodolovv set by To- County Building IndustrD
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) El 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 Ab 0 FILE SP1 -1 A k LE P-s B ELe (n) GE l Lt ,J
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
DK Wet ❑ Dry
Additional Standpipes O
Information: Hazard Group (,I G H T
Density , a
Design Area I G o d
K Factor I U ' -
Sprinkler Project Valuation: $ 3 S o
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.
http / /www tigard -or gov /city_hall/ departments /cd /dots /FPS- PermitApp doc Rev 01/25/2012