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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2013 -00061 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2013 Parcel: 2S101CA00200 Jurisdiction: TIGARD Site address: 7904 SW HUNZIKER RD Project: Agilyx Subdivision: 1994 -025 PARTITION PLAT Lot: 2 Project Description: Install supply line to mobile foam cart Contractor: SIMPLEXGRINNELL LP Owner: AGILYX CORPORATION 6305 SW ROSEWOOD ST. 7904 SW HUNZIKER ST LAKE OSWEGO, OR 97035 TIGARD, OR 97223 PHONE: 503 - 683 -9000 PHONE: 503 - 217 -3160 FAX: 503 - 675 -6521 FEES Description Date Amount Specifics: Permit Fee - COM 05/15/2013 $145.24 12% State Surcharge - Building 05/15/2013 $17.43 Type of Use: COM Plan Review - Fire Life Safety - COM 05/15/2013 $58.10 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 $220.77 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $6,303.00 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 No • - ion Ce Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dire questions to OUN• • ca ling 513.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available in - section d. te. This permit card shall be kept in a conspicuous place on the job site un ' co - etion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Fire Protection System ilicei,\IED FOR OFFICE USE ONLY City of Tigard Received 5 - Permit No. , a 13125 SW Hall Blvd., Tigard, OR 9 •" Y 1 2013 Date/By: / 3 �O r D D j Plan Review ' Phone: 503.718.2439 Fax: 503.598. ' .0 Date/By: Other Permit: P,90//1. -003 Z TIGARD Inspection Line: g 03.6394 l� 175 c o riG�►') Date Ready /By: Juris: El See Page 2 for Internet: www.ti and -or. . ov 1 D��1�I i ,, Notified/Method: Supplemental Information BUILDING TYPE OF WORK REQUIRED DATA: 1 - AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work perfored. Indicate the value (rounded to the nearest dollar) of all m Addition/alteration/replacement ID Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El I- and 2- family dwelling Commercial /industrial Valuation: $ ❑ Accessory building ID Multi-family Number of bedrooms: El Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 7 y J, n �, Nu(ZZLLrrnty Sfr�f New dwelling area: square feet City /State /ZIP: 77 r6(� .0e • 7 n 72.23 Garage /carport area: square feet Suite /bldg. /apt. no.: Project name: Aityx 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: 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 DESCRIPTION OF WORK work indicated on this application. IktSf4Lll Suppl /. k e to A 14r_LQ. alkyl ( l- Valuation: $ 60, 3 03 Existing building area: 28 square feet New building area: square feet ❑ PROPERTY OWNER g TENANT Number of stories: Name: 49i lay COrport LoK_ Type of construction: Address: ! 9‘60 A. G J. 41446.1s i Occupancy groups: City /State/ZIP: geolib{4 UL r O. 9760g Existing: Phone: ( ) Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: SG iee Clralutel/ All contractors and subcontractors are required to be �1' licensed with the Oregon Construction Contractors Board Contact name: do� Aid S‘1/' - under ORS 701 and may be required to be licensed in the Address: (6,363- . W. pa ce(A)Oen( st jurisdiction in which work is being performed. If the J ►` /� applicant is exempt from licensing, the following reasons City /State/ZIP: �kP 054)646, (/ P. 4'7O p apply: Phone: (5b 60 3) 83 • 9000 Fax: : ( S 03) 1075' ( 5 2. 1 E -mail: Jvl.UIAS0V6 S 44.pt entetvutti (,COVVk. CONTR &CTOR BUILDING PERMIT FEES* t • i. (Please refer to fee schedule) Business name: Sukte As d �pitca. Per fee: ,�j . 2 q Address: `�' State surcharge (12% of permit fee): 17• 4 3 City /State /ZIP: FLS plan review (40% of permit fee): 1 O Phone: ( ) Fax: ( ) (Due upon application.) CCB lic.: /q99_/ Total permit fees: fa.0 .7 Authorized sig (...,%.../......___ Amount received: t / �� This permit application expires if a permit is not obtained Print name: d gel SOl/� Date: * within 180 days after it has been accepted as complete. Fee methodology set by Tri- County Building Industry Service Board. I: \Building \Pcrmus \FPS- PcrmitApp.doc Rev 01 /05/2012 440- 4613T(t /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 tgl, 1 -10 heads: No plan review required. Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: - arsfrtlf Supptif fuze tv ktoto.t.te foam,. Calf Type of System Complete A, B, C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ • • • 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: / /aww.tigard- or.gov /city_ hall /departments /cd /dots /1 PermitApp.doc Rev 01 /25/2012