Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2013 -00082
13125 S W Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/20/2013
T f G r\ R n 9 Parcel: 2S112AB02300
Jurisdiction: Tigard
Site address: 14150 SW MILTON CT
Project: Medical Teams International Subdivision: BONITA INDUSTRIAL PARK Lot: 5
Project Description: Add (2) fire sprinkler heads.
Contractor: AFP SYSTEMS INC Owner: MEDICAL TEAMS INTERNATIONAL
19435 SW 129TH AVE PO BOX 10
TUALATIN, OR 97062 PORTLAND, OR 97207
PHONE: 503 - 692 -9284 PHONE:
FAX: 503 - 692 -1186
FEES
Description Date Amount
Specifics: Permit Fee - COM 06/20/2013 $69.92
12% State Surcharge - Building 06/20/2013 $8.39
Type of Use: COM Plan Review - Fire Life Safety - COM 06/20/2013 $27.97
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: ORD1
Density: 0 Design Area: 0
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $106.28
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
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: , , / ! e 04 - - /
/ / 1T � G /1/
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.
•
JUN -19 -2013 WED 12:03 PM AUTOMATIC FIRE PROTECT FAX NO. 5036921186 P. 02
Buildin>? Per mit Appli cation
Fire Protection System RECEIVED l tttt (,I,,.I('I• I :.SIC ()NI.,
CI of Ti and kilrRly� �: E rb PemaitNo.
t3' g Daw ax Zo / 3 /� So?D /3 - D �ld��
n 13125 SW Hall Blvd., Tigard OR 97223, t t\1 1 9 2013 Plan Review
Phone: 503,718,2439 Fax; 503.598,1960 Date/iv: Other Permit:
I l t , .\ i , I , Inspection Line: 503.639.4175 CITY OFTIGARD (Ace Ire idynly: kith,: ,.. ld See Page 2 tor
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: to Supplemental Information
TYPE OF WORT( _ . . 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
I Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY 011. 'ca■isirivircriorsi `. work indicated on this application.
❑ 1- and 2- family dwelling ® Commercialfindustrial Valuation: $
—
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOl) SlTL INFORMAT'ION;:41SD .LQCATION. Total number of floors:
Job site address: 19150 Su) Ali { +o C.41./AT Now dwelling area: square feet
City/State /ZIP: 'it f3Aiki) OR 1 1 22.4 Garage/carport area: square feet
Suite/bldg. /apt. no.: J Project name: AO/ CAC Teaks 0ATtp,S/.{. Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA; COMMERCIAL -USE CHECia1ST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
fax 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.
Ir TA LI (6 15S . .+A JbAQD Res paa$c ARE 6f2tt�idee. i -46.4.D Valuation: $ f 'L DQ r Od
1114 ( E. t-t i R j-k- Existing building area square feet
New building area: square feel
EA PROPERTY 'OWNER : . I 0 7'ENAN7' Number of stories:
Name: 3 e,F1 L TA )4 11EAO TI OIJAC Type of construction:
Address: i t 150 SI,J )4t t CAVrz'T _ Occupancy groups:
City /State/ZIP: 1t t A AD Oca.. co z-2 "{ Existing:
Phone: ( ) Fax: ( )
New:
til APPLICANT Q CQNTACT PERSON .:
Business name: AF? 61 s•tEJ14S All contractors and subcontractors are required to be
Contact name: r.KtC S9..0Wls licensed with the Oregon Cbnstruction Contractors Board
under OILS 701 and may be required to be lrensed in the
Address: L C A 11 S 5 W ( 2. 9 Ave— jurisdiction in which work is being performed. If the
City/State/ZIP: `�UAI O 1 d6 applicant is exempt from licensing, the following reasons
Ati - apply:
Phone: (5'03) (At t i2eH J Fax:: ( )
E -mail:
' CONTRACTOR
!#UItDIIyC PERMIT FEES*
Business Hume: ,',16-1-_6/-1.$ . " . . ' (Please'reli'r (cc schedule
Address: S W E Permit fee
`� 3 ( Z V State surcharge (12% of permit fee):
City /State /ZIP: —r' A I Ai' N OQ - CO p to TLS plan review (40% ofpermit fee):
Phone: ( 5 Loci Z 42.09 Fax: ( ) (Due upon application.)
CCB lic.: ( 15 3 Total permit fees: y
Authorized signature: C Amount received: /06 . .4
{� T his permit application expires if a permit is not obtained
Print name: ( 3 1C. .Owj 1 3 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri County Building Industry
lttuilklloa \Ptrmita\FPS•ParmitApp.dnc Ray 01/0/2012
Service Baud, 440�ti 13T(I 1 /02/COMlIVED)
JUN -20 -2013 THU 03 :21 PM AUTOMATIC FIRE PROTECT FAX NO. 5036921186 P. 02
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
D ces nb ork to be' done:
1.) ❑ New 2.) Modification to sprinkler heads only:
QC Addition IZI 1 -10 heads: No plan review required
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: Z
Additional description of work:
of-S stem Cohn fete :A; $; C or D •as.. a livable
A.) Commercial' Sptinler
Wet _ ❑ D -
Additional Standpipes
Information: Hazard Group Vi r —A'
Density
Design Area
K. Factor 5. to
Sprinkler P_ roject Valuation: $ / Z oo . a 0
B:) Type I - Hood Fire Suppression 1on 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: 1 Permit Fee:
0 to 2,000 I $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05 -
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire' Protection Permit. Fees
Project valuation subtotal (see A, 13 & C aback_$
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (sec D
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.
I ;\ Building \Pcimiu \FPSPertmtApp,doc Rev 01/0r/2012 2
JUN -19 -2013 WED 12:03 PM AUTOMATIC FIRE PROTECT FAX NO. 5036921186 P. 01
r APP SYSTEMS INC
C IP---
19435 SW 129 Ave
Tualatin OR 97062
503- 692 -9284
i_ _:a`: 503 -692 -1186 Fax
FAX TRANSMITTAL SWEET
DATE: cUrU.. 1 t 5
COMPANY: ()c Uctd6 cr.-- T( ,rd
ATTN: 0 e-biaot -e._.
Fax # (5) scib - 1 %00
FROM: M' }e,iytN4 -_ -f77
RE: .at.3-a_, re—w e rava..\-. cold. ve. VWA.,
Number of pages: q (including cover sheet)
Please call 503 -692 -9284 if you do not receive all pages.