Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
e COMMUNITY DEVELOPMENT Permit#: FPS2014-00022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2014
Parcel: 2S110DB01300
Jurisdiction: Tigard
Site address: 15298 SW ROYALTY PKWY
Project: EyeHealth Northwest Subdivision: 1996-010 PARTITION PLAT Lot: 2
Project Description: Add(1)sprinkler head to new restroom
Contractor: CROSSFIRE SPRINKLER CO Owner: TIGARD INVESTMENT PROPERTIES LLC
17400 SE 82ND DR 11086 SE OAK ST
CLACKAMAS, OR 97015 MILWAUKIE,OR 97222
PHONE: 503-210-5506 PHONE:
FAX: 503-210-5538
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/06/2014 $75.30
12%State Surcharge-Building 02/06/2014 $9.04
Type of Use: COM Plan Review-Fire Life Safety-COM 02/06/2014 $30.12
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 $114.46
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,400.00
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 qu ns to ON C b calling 503.232.1987 or 1.800.332.2344.
Issu d By: /
r _ Ad e„ Permittee Signature:
If--e-,-Ar -
Call 503.639.4175 by 7:00 a.m.for the next available ins.: ion 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.
02/05/2014 23:32 5032105538 CROSSFIRE PAGE 01/05
Building Permit Application
Fire Protection System dECEIVED l.tlktul-l.lt I.. L.SF.1711.1"
Received / Pen°tho.:, "old jtt_0[k')J..1+
City of Tigard nateft: It - --� -
13125 SW Hall Blvd,,Tigard,OR 9 Fta —6 2014 Plan Revievt other Permit 4,144,6/e/00000
_. Phone; 503.639.4171 Fax: 501.598 1960 natelt3y:
CITY OF TIGARD Dace Reaay/sy: lessee Page 2 for
i - ,\1,C� Inspection Line' 503.639.4175 Supplemental tnrartuadoa
Internet: www.tigard-or-goo Notifiul/Mathod:
• IN IV 10P'
Indicate the va
❑Demolition Permit fees*are based on the value of the work performed.
❑New construction value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
_.. •--7- -,- -P- -- =4 work indicated on this application-
Valuation:
❑1-and 2-family dwelling Commercial/industrial Number of bedrooms:
❑Accessory building ❑Multi-family
Number of bathrooms:
0 Master builder I=1�"� ,
- + -c! Total number of floors:
Job site address:15298 SW Royalty Pkwy New dwelling area: square feet
City/State/Z1P:Tigard,OR Garage/carport area: square feet
Suite/bldg-/apt.no.: Project name:Eyeilcalth NW Remodel Covered porch area: square feet
Cross street/directions to job site: Deck area square feet
Other structure area: square feet
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
— .. „.
— = indicated on this• - ,� work ind la app tcauon.
W . - Valuation: $$1,400.00
Add(1)Sprinkler Head in New Rest Room
Existing building area: square feet
New building area: square feet
stories:
... - Number of s
Name Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing
Phone:( ) Fax:( ) New
All contractors and�� be
,,--s •�!_, subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: apply:
Phone:( ) Fax::( )
E-mail:
Business name:Crossfire Sprinkler Company Permit fee:
Address:17400 SE 82n°Drive
State surcharge(12%of permit fee):
City/State/ZIP:Clackamas,OR 97015 FI.S plan review(40%of permit fee):
Phone;(503)210-5506 Fax:(503)210-5538 {Due upon application.)
CCB lie.:174746 ' Total permit tees:
ri/A Amount received:
Authorized signature: 1°P
-I permit appligtioa expires if a permit is not obtained
Date:2/6/14 within 180 days after it has been accepted as complete.
Print name:Timothy A Bishop ' Fee methodology set by Tri-County Building Industry
Service Board.
t: il0iegl,PermitslFPS-PcnclitA PD.4a 1091!09 440-4613T(1If02/COM/B)
02/05/2014 23:32 5032105538 CROSSFIRE PAGE 02/05
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
– � —� New 2.) Modification to sprinkler heads only:
O Addition ® 1-10 heads: No plan review required.
® Alteration ❑ 11-4-heads: Plan review required.
❑ Repair
Number of sprinkler heads: 1
Additional description of work: •
_
® Wet ❑ Dry —
Additional Stan t tit es
Information: Hazard Group Light Hazard —
Density .10
Design Area 1500
K Factor 5.6
Sprinkler Project Valuation: $ _ 1400
Hood Project Valuation: $ -
.1.1r A.... • '� ";.�-•� ..
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
Square Footage: Permit Fee:
0 to 2,000 $198.75 -
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.
Project valuation subtotalSsee A,B &C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footageSsee 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"
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