Permit (35) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I COMMUNITY DEVELOPMENT Permit#: FPS2019-00030
1[=AR f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2019
Parcel: 2S 111 ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: None Lot: None
Project Description: Fire supply line for a new two-story school.
Contractor: TRIPLETT WELLMAN INC Owner: UNION HIGH SCHOOL DISTRICT
PO BOX 160 NO. 3 JT
WOODBURN, OR 97071 00000
PHONE: 503-982-4188 PHONE:
FAX: 503-982-0390
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/13/2019 $285.12
12%State Surcharge-Building 06/13/2019 $34.21
Type of Use: COM Plan Review-Fire Life Safety-COM 06/13/2019 $114.05
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 06/13/2019 $114.00
Occupancy Grp: E Height: 41 ft 11x17)
Stories: 2
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Yes Hazard: UNK
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 $547.38
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $20,000.00
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. 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: - �� /
/ •ermiftee Signature: -„›Q
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 N\.0.-r..-..\2-(4,301.3D raiz()IFI( 1 l Sl: o'.Ll
Received Permit No.:
City of Tigard `.te/B : 11• ,.�_r ,� , l
13125 SW Hall Blvd.,Tigard,OR 97223 Received
Review
■ Phone: 503.718.2439 Fax: 503.598.1960 Date/BRECEIVE : ' Other Permit. f l
._. iii
ii,,A R D Inspection Line: 503.639.4175 MAR 5 2019 Date Ready/By: ® See Page 2 for
arimiInternet: www.tigard-or.gov Notified/Method. 1 , /1 t /T� pI Supplemental Information
CITY QF TIGARD t'M a f!--t-4
TYPE OF WORIGUILDINCta DIVISION REQUIRED DATA:s1-AND 2-FAMILYD'VV'ELLING
®New construction 0 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.
❑ 1-and 2-family dwellingValuation: $
0 CommerciaUindustrial
I=1Accessory building 0 Multi-family Number of bedrooms:
0 Master builder ®Other:School Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:14650 SW 97th Street New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Twality Middle School Covered porch area: square feet
Cross street/directions to job site:97th and Murdock Street Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CIIECI LIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S111ACO2700 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.
All underground work associated with the site fire protection system. Valuation: $ t�f
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
`"• Name:Tigard-Tualatin School District Type of construction:
Address:6960 SW Sandburg Street Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Q Phone:(503)431-4000 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON NOTICE
1 Business name:DayCPM
All contractors and subcontractors are required to be
Contact name:Shawn Christensen licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:6960 SW Sandburg Street
City/State/ZIP:Tigard,OR 97223 Phone:(971)727-4168
jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
apply:
Fax::( )
E-mail:shawn.christensen@otak.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Triplett Wellman (Please refer to fee schedule)
Permit fee:
Address: 1717 Mt Jefferson Ave
City/State/ZIP:Woodburn,OR 97071 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)982-4188 Fax:( ) (Due upon application submittal.)
CCB lic.:43496 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name:Shawn Christensen Date:3/5/2019 within 180 days after it has been accepted as complete.
* Fee methodology-set by Tri-County Bailding-i rd,.shy
Service Board.
1:\Building\Permits\FPS-Pe`mitApp_031016.doc 440-4613T(11/02/COM/WEB)
'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: Number of alarm devices:
El Addition or El 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
El 11+ heads: Plan review required and 0 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
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line 15\ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I- Rood Fire Suppression.System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
_Residential Spru tiler(Stand Alone Systemm)
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: $
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