Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2014-00011
Date Issued: 01/1512014
TIGARD 13125 SW Hall Blvd. Tigard OR 97223 503 718.2439 Parcel: 2S113AD01700
Jurisdiction: Tigard
Site address: 16940 SW 72ND AVE
Project: Mens Wearhouse Subdivision: ROSEWOOD ACRE TRACTS Lot: 26-34. P
Project Description: Adding and relocating (6)sprinkler heads for TI.
Contractor: DELTA FIRE INC Owner: BRIDGEPORT LAND LLC
14795 SW 72ND AVE 3939 NW ST HELENS RD
PORTLAND, OR 97224 PORTLAND, OR 97210
PHONE: 503-620-4020 PHONE:
FAX: 503-620-1058
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/15/2014 $102 20
12% State Surcharge-Building 01/15/2014 $12 26
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required Yes Sprinkler Type: Wet
Standpipe Required. No Hazard' LT
Density .10 Design Area. 1500
K Factor 5.62
Commercial Fire Alarm System:
Fire Alarm Required. Alarm Type
Pull Station Required: Smoke Detectors Req
Battery Calcs Provided Cut Sheets Required
Total $114.46
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 ob an a cop of the rules
or direct questions to OUNC by calling 503 232.1987 or 1.800.332.2344.
Issued By: Pe r mittee Signature:
Call •r • 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.
Fire Protection System
Building Permit Application FOR OFFICE USE ONLY
City of Tigard RecC1ved Permit No-: —
`J Tigard Date BY / /5 /y ✓!/ SaP IL�Jw 1
" 13125 SW Hall Blvd.,Tigard,OR 9 ‘'" ��t Plan Review /
• 2 Phone: 503.639.4171 Fax: 503.598. w, A.Fj�'� Date B : Other Permit /i. '„0
TI GA RD Inspection Line: 503.639.4175 ,p\`t v Date Ready By: lurk H See Page!for
Internet: www.tigard-or.gov Q�1\GA."Ne Notified Method: ... 36 2 Supplemental Inform:Mos
1. _
TYPE OF WO - 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.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16940 SW 72od Ave. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project n it Covered porch area: square feet
Cross street/directions to job site: Men's Warehouse 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.
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.
Adding and relocating 6 heads for Tenatn Improvemnt Valuation: 552,411.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ( 0 TENANT Number of stories:
Name:The Men's Warehouse Type of construction:
Address:40650 Encyclopedia Circle Occupancy groups:
City/State/ZIP:Fremont,CA 94538 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name: Delta Fire,Inc. All contractors and subcontractors are required to be
Contact name: Heidi Scarbrough licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 14795 SW 7snd Ave. jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97224 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)620-4020 Fax::(503)620-1058
E-mail: heidis@deltafire.com
CONTRACTOR BUILDING PERMIT FEES'
Business name: Delta Fire,Inc. tPteest►ejrrrojeeschedule)
Permit fee: I fjA
Address: 14795 SW 72i0 Ave.
State surcharge(8%of permit fee): J,
City/State/ZIP:Portland,OR 97224
FLS plan review(40%of permit fee):
Phone:(503)620-1058 Fax:(503)620-1058 (Due upon application)
CCB lic.:64174 Total permit fees: It f Li, r
Authorized signature: , Amount received:
,(, 1 '�� This permit application expires if a permit is not obtained
Print name: Heidi Scar rough Date: 1-1414 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry
Service Board.
I Building Permits FPS-PertnitApp-doc 0323/06 440-4613T(11,022COM/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.
►il Alteration ❑ 11+heads: Plan review required.
El Repair
Number of sprinkler heads: l
Additional description of work
T ji a of S stem Com.lete A, B, C or D as a• .licable :
A. Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes N/A
Information: Hazard Group Light
Density 0.10
Design Area 1500
K.Factor 5.62
Sprinkler Project Valuation: $ 2,411.00
B.) Type I - Hood Fire Suppression System
Flood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
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: 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 (8%of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $ 155.34
Plan review requires a completed application and 2 sets of plans at submittal Plan review fees are required at submittal.
"New" 6re protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer,or NICET level"3" technicians.
I-Building ennuslFY5•PermitApp.doc 03/23/06 440-4613T(II/02/COMIWEB)