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Permit
q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT '1 _ COMMUNITY DEVELOPMENT Permit #: FPS2012 00161 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/17/2012 Parcel: 2S112AC01500 Jurisdiction: Tigard Site address: 7319 SW KABLE LN 500 Project: Quality Custom Distribution Services Inc Subdivision: FANNO CREEK ACRE TRACTS Lot: 23, PT 2 Project Description: Add (2) sprinkler heads and relocate (1) head for TI Contractor: DELTA FIRE INC Owner: PACIFIC REALTY ASSOCIATES 14795 SW 72ND AVE ATTN: N PIVEN PORTLAND, OR 97224 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 620 -4020 PHONE: FAX: 503 - 620 -1058 FEES • Description Date Amount Specifics: Permit Fee - COM 10/17/2012 $83.37 12% State Surcharge -.Building 10/17/2012 $10.00 Type of Use: COM Plan Review - Fire Life Safety - COM 10/17/2012 $33.35 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 $126.72 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $1,610.00 • 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 ■ : "ca ion . - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may o.tain a copy of/ he rules or . ect questions to 0 by . ng 503.232.1987 or 1.800.332.2344. ued B y: 9 1i Permittee Signature: !l / I 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 ApplicationR. r Fire Protection System . Q!'T 17 • -2bi Received FOR OFFICE USE ONLY City of Tigard / % 7X .2. rah PermitNo.: ,CPSA24,1�0 /6/ 13125 SW Hall Blvd., Tigard,O• T� G Plan Review ' 1I Phone: 503.639.4171 Fax: 503 :. JING DN IS ON Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: turis: ® See Page 2 for Internet: www.tigard - or.gov 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 (rotnded 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 CommercialIindustrial Valuation: S Accessory building Number of bedrooms: ❑ rY g ❑ Multi - family ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 7319 g '� � Q v , New dwelling area: square feet City /State /ZIP: T , O - { `l a`5 " Garage /carport area: square feet Suite/bldg. /apt. no.: dIC5 0 Project name: ()fp�nn. "Ea), Tack Covered porch area square feet Cross street/directions to job site: ()fern, 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. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the • 'I 5 and. OF WORK I 1 ( work indicated on this application. MCI a ,-, (INer ho4 (4nd. re lnca J ,, 'T�.� 1 r Valuation: S I , (010. T . ' "r Existing building area square feet New building area: square feet ❑ PROPERTY OWNER I ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New X APPLICANT ❑ CONTACT PERSON NOTICE . Business name: J P ( , :: , :, All contractors and subcontractors are required to be Contact name: � �� licensed with the Oregon Construction Contractors Board I " 7�nGl / � e, under ORS 701 and work is required !tensed in the Address: ` � . y� ^ � jurisdiction in which work s being ing performed. If If the City/State /ZIP: OF& k IG� 0 G7 y applicant is exempt from licensing, the following reasons v' apply: Phone: 'N Goo - - Fax: : � v (0 — 105 8 E -mail: heat s ay . corn CONTRACTOR BUILDING PERMIT FEES* Business name: ')�/I I I C Inc • (Please refer to fie schedule Address: I JJ ` ci 5 , ,t! v1 , gon 1 Permit fee: 8 3. 7 City /State /ZIP:("�`-�(� � f �+ � ©� AR State surcharge (12% of permit fee): /0 .00 FLS plan review (40 % of permit fee): ;. 2 (I Co Phone: i 0 _ 1401Q-0 Fax: ( 1 Q _ 105'g (Due upon application.) 7 7 CCB lic.: �� / Total permit fees: 4076 ,7p Authorized signature: Amount received: /P4. de li( This permit application expires if a permit is not obtained Print name: •- r (Date: ! within 180 days after it has been accepted as complete. B ' I a it 1 ' Fee methodology set by Tri -County Building Industry C j Service Board. I \Building\Permits \FPS- PermitApp,doc 03/23/06 440- 4613T(1I /02 /COMVWEB) • 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: Acka a i11k1er'h t6 in refircoorn_ - andl - relocate- had _QT NO3 On1k. Type of System (Complete A, B, .0 or D as applicable):' . A.) Commercial Sprinkler . Wet ❑ Dry Additional Standpipes NAt Information: Hazard Group 1.2i ht- Density , ( • Design Area •1 K. Fielor 5. Oa Sprinkler Project Valuation: $ B.) Type - Hood Fire Suppression System - - Hood Project Valuation: $ /VA C.) Fire Alarm, Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ AJf D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $187.50 • 2,001 to 3,600 $232.50 • • 3,601 to 7,200 $292.50 • 7,201 and greater $381.50 Sprinkler Project Square Footage: AJA 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 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. I: \Building \Permits \FPS - PermitApp.doc 2