Permit (198) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00099
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/26/2019
Parcel: 2S111ACO2901
Jurisdiction: Tigard
Site address: 9500 SW MURDOCK ST
Project: Templeton Elementary School Subdivision: None Lot: None
Project Description: Install kitchen fire suppression system into Type 1 exhaust hood,Ansul R-102.
Contractor: SANDERSON FIRE PROTECTION INC Owner: TIGARD-TUALATIN SCHOOL
1101 SE 3RD AVE DISTRICT 23J
PORTLAND, OR 97214 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-889-3110 PHONE:
FAX: 503-889-3192
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/06/2019 $91.44
12%State Surcharge-Building 08/06/2019 $10.97
Type of Use: COM Plan Review-Fire Life Safety-COM 08/06/2019 $36.58
Class of Work: NEW Type of Const: VB Info Process/Archiving-Sm$0.50(up to 08/06/2019 $4.50
Occupancy Grp: E Height: ft 11x17)
Stories: 2
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 $143.49
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Feeta9r $
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:
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
•
Are Protection System FOR OFFICE USE ONLY
City of Tigard "" ` °' Received•
g Mme'�� 1LV Date By: Permit N
III13125 SW Hall Blvd.,Tigard,OR 97223 (b 'i
,..,.‘(:\
: Plan Review '
I Phone: 503.718.2439 Fax: 503.598.1960 } '\t Date By: - )^ Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 a Date,Ready By: Jens. ® See Page 2 for
Internet: www.tigard-or.gov fied'Meth . /f Supplemental Information
TYPE OF WORIII‘" gP REQU1 DATA.. 1-ANI}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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
0 Accessory building 0 Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9500 SW Murdock St New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Templeton Elementary Sch 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: 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
DESCRIPTION OF WORK work indicated on this application.
Install Kitchen Fire Suppression system into type 1 exhaust hood,Ansul R-102 Valuation: $2000.00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ® TENANT Number of stories:
Name:Templeton Elementary School Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
►� APPLICANT 121 CONTACT PERSON NOTICE
Business name:Sanderson Fire Protection All contractors and subcontractors are required to be
Contact name:Geoff Spahr licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:see below jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
appy:
` one:( . )_ -Fax: :( )
E-mail:geoff@sandersonfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Sanderson Fire Protection (Please refer to fee schedule)
Permit fee:
Address: 1101 SE 3rd Ave
State surcharge(12%of permit fee):
City/State/ZIP:Portland,OR 97214
FLS plan review(40%of permit fee):
Phone:(503)8893110 Fax:( ) (Due upon application submittal.)
CCB lie.:208652 ,��/9 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:Geoff Spahr Date:7/22/19 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:1 Building PermitsFPS-PermitApp031016.doc 440-4613T(11 X02:COMi WEB)
1
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:
❑ 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: Ansul R-102 Kitchen fire suppression system. New system install
Type of System (Complete A, B,C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ 2000.00
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: Permit Fee:
0 to 2,000 $198.75
2,001 to 3.600 -524().-45 �';.. �� r, __ . ..
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: $
C:AUsers\sanderson fs\Downloads\FPS_Permitllpp.doc 2