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Permit (162) iI;IlCITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT llIll,, COMMUNITY DEVELOPMENT T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ®�� Date Issued: PS2016-00183 5/2016 Parcel: 1S135BC00700 Site address: 10831 SW CASCADE AVE Jurisdiction: Tigard Project: Rose City Futsal b None Lot: None Project Description: Interior remodel. 11/15/16 REPRINTED to correct project REPRSuINTED tto Fire Sprinkler modifications Contractor: AMERICAN SPRINKLERS INC 7950 N LONE PINE RD Owner: ICON IPC PROPERTY ONER POOL 2 L TERREBONNE, OR 97760 BY INDCOR PROPERTIES 2 NORTH RIVERSIDE PLAZA, STE 235 CHICAGO, IL 60606 PHONE: 541-948-0679 FAX: PHONE: Description ecifia Date Permit Fee-COM Amount S Type of Use: COM 12%State Surcharge-Building 11/15/2016 $231.32 Class of Work: ALT Plan Review-Fire Life Safety-COM 11/15/2016 $92 73 Occupancy Grp: B Type of Const: VB Info Process/ArchivingL $2.00(over 11/15/2016 Height: 9 11/15/2016 $92.53 Stories: 1 ft 11x17) $2.00 Info Process/Archiving-Sm$0.50(up to 11/15/2016 11x17) $7.50 Commercial S rinkler S stem: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: Density: .15 Design Area: 900 K Factor: 5.6 Commercial Fire Alarm Sstem: Fire Alarm Required: Pull Station Required: Alarm Type: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Valuations: $361.11 Required Items and Reports(Conditions) Sprinkler Valuation: $15,000.00 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. applicable law. All work will be done in accordance with approved appance, l .if work is k will bed for mnre tco 180 Aplans. This SpecialtytCodes and all other issuance, Notification Center. Those rules are set forth days.in OAR ATTENTION: Oregonon h OAR requires952-001-0090.uexpire if work is not started within 180hdays of through h law 0to follow the mayulob adopted copy the rules or direct qu- • OUNC by calling 503.232.1987 or 1.800.332.2344. 9 You obtain a of the rules Issue By: / I.: Permittee Signatud ,.e er2-1? i c_k__". ip Call 503.639.4175 by 7:00 a.m.for the next available inspe on 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. 714 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit#: FPS2016-00183 TEGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/15/2016 Parcel: 1 S135BC00700 Jurisdiction: Tigard Site address: 10831 SW CASCADE AVE Project: Rose City Futsal Subdivision: None Lot: None Project Description: Interior remodel. Contractor: AMERICAN SPRINKLERS INC Owner: ICON IPC PROPERTY OWNER POOL 2 L 7950 N LONE PINE RD BY INDCOR PROPERTIES TERREBONNE, OR 97760 2 NORTH RIVERSIDE PLAZA, STE 235 CHICAGO, IL 60606 PHONE: 541-948-0679 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-COM 11/15/2016 $231.32 12%State Surcharge-Building 11/15/2016 $27.76 Type of Use: COM Plan Review-Fire Life Safety-COM 11/15/2016 $92.53 Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 11/15/2016 $2.00 Occupancy Grp: B Height: ft 11x17) Stories: 1 Info Process/Archiving-Sm$0.50(up to 11/15/2016 $7.50 11x17) Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: Density: .15 Design Area: 900 K Factor: 5.6 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Gales Provided: Cut Sheets Required: Total $361.11 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $15,000.00 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. Spe Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work not s •d within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folio tie rul .opted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001 e:•o. `P,Io -,:y obt.in a copy of the rules or direct questions to OUNC by calling 503.232.1987 o :00.332.2344. Issued By: Permittee Signatur- r 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 Application Fire Protection System FOR OFFICE 1 S OMI.v q V �' Received / City IliW Tigard / 17 lG / Permit No.: f �� �a n ! DateBy: ! 1-=-12 „; �f tf� v 13125 SW Hall Blvd.,Tigard,OR 9722 PlanRevi ' Other Permit: eke rgO (, y s Phone: 503.718.2439 Fax: 503.598.1960 DateBy: 'i/ (** c i Inspection Line: 503.639.4175 Date Ready :y: Juris: Ei See Page 2 for TIGARD p r Internet: www.tigard-or.gov O C I 1 9 L.U i b Notified/Methodf//T fp .: rpep Supplemental Information TYPE OF MGM OF 1 IGARI) REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction INIBIAK DI VISION ION Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ilO `Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuatiur- 0 1-and 2-family dwelling ❑Commercial/industrial Number of bedrooms: ❑Accessory building 12Multi-family ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: / © '5/ e-) Gu G 4 S C fI j>/-� (i New dwelling area: square feet City/State/ZIP: 1-/ C, J2/? Garage/carport area: square feet Suite/bldg./apt.no.: Project name: ,Q.Gt C,7' nt.y-5-0.,..e 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. F/Xg c, 1 /V/-4/6-'75 Valuation: $ L 1 at Existing building area square feet New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed.If the City/State/ZIP: applicant is exempt from licensing,the following reasons apply: y: Phone:( ) Fax::( ) E-mail: CONTRACTOR BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) . . /1�.s�v2 1�:s()/� ,gip, K'/' ° Permit fee: Address: 9' S 6 A/ r P r 4) 7 �'`�� P � I State surcharge(12%of permit fee): City/State/ZIP: 7 R R G,j 7/- - er11 9�77C> FLS plan review(40%ofpermit fee): Phone:(ScI' ) F7 4 7 F, / ) Fax:( ) (Due upon application submittal.) CCB lic.: l., ""6) 6.7 t/' ii 7 Q Total permit fees: Amount received: Authorized signature: �/ C%- ("g/ This permit application expires if a permit is not obtained Print name: G h a c.76- E-lP Date: IG,_-� j within 180 days after it has been accepted as complete. lie q * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(11/02/COM/WEB) l City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information Describe,work to be done: 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: ❑ New system Number of sprinkler heads: 35 Number of alarm devices: K'Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and Alteration (3) copies of sketch showing area (3) copies of sketch showing area to existing of work within building structure of work within building structure system ❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work: Type of System (Complete A,B,C or D as applicable): A.) Commercial Sprinkler et ❑ Dry Additional Standpipes Information: Hazard Group Density /7 Design Area 9112 K. Factor 5, (p Sprinkler Project Valuation: $ /5-0,0 B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component 0 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: $ I:\Building\Permits\FPS_PemutApp_071514.doc 2