Permit (2) . CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'' � '' COMMUNITY DEVELOPMENT Permit#: FPS2019-00143
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/30/2019
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY M
Project: Tigard Town Square Subdivision: 1994-028 PARTITION PLAT Lot: 2
Project Description: Fire sprinkler system and heads in exterior canopy for suites M and N(spec space and Planet Fitness).
Contractor: SPRINKIT FIRE PROTECTION INC Owner: SN PROPERTIES PARTNERSHIP
PO BOX 2227 1121 SW SALMON ST
OREGON CITY, OR 97045 PORTLAND, OR 97205
PHONE: 503-272-6650 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/03/2019 $156.00
12%State Surcharge-Building 12/03/2019 $18.72
Type of Use: COM Plan Review-Fire Life Safety-COM 12/03/2019 $62.40
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 12/03/2019 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 12/03/2019 $27.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Dry
Standpipe Required: Yes Hazard: LT
Density: 0.1 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $266.62
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $8,000.00
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 1.80 2344.
Issued By: e Signature: (,
Call 03.639.4175 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 RECEIVED FOR OFFICE LSE ONLY
Cityof Tigard Recet"ea / i4�►�gi )/ )
iI ■ 13125 SW Hail Blvd.,Tigard,OR 972 2019 Date/By: i /i f I �o(!//�/ 6 l r 3
g 21OV 2 Plan Revkw 11 /��
111 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: )) .1 J I'
T I ,n 1,0 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: l /7 /j,) 1u•rs m ,re,„re o ror
Internet: www.tigard-or.gov BUILDING DIVISION N d/Method: ` 1_ I Supplemental information
TYPE OF WORK " F x114D2-FAMILY,'
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
„12'."4-ddition/alteration ire placement E Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF coN 1 VcI s1 work indicated on this application.
,.«r-� Valuation: $
❑ I-and 2-family dwelling __I:I.-Commercial/iindustrial
❑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: i 6` 3 P466`L I-1 New dwelling area: square feet
City/State/ZIP: . 0_-�'rrik 2 Garage/carport area: square feet
Suite/bldg./apt.no.: " � Project name: '1-- mot- ` Covered porch area: square feet
,t 1 ILWSr� 'il�Lr�n ,,�Gj+�J�
Cross street/directions to job site: M di 0 t- ; t f' .4-;: I .:, L AiC r Deck area: square feet
__ yy i
QV S Cr-r` ('j-.4-i.`_ it /. Other structure area: square feet
A7/ -'//`y REQUIRED DATA:COMNIERCI .L- 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.
'g'w'l cA c,- 4-C.-4 yd e CS /` gPr'Viki2 r ��tg�C'" Valuation: $ g Q6�
Q�� g �>n t'1 Rthr10K 4,,,e U 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:( ) Pax: ( ) New:
Oar w 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: \_ 0 0�� jurisdiction in which work is being performed.If the
City/State/ZIP: �� K lf-Sapplicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax::( )
E-mail: T. Sr I,✓Z,t -2-4,jA £'�(1gIut
CONTRACTOR ItC1L11tl t "FEES*
Business name:
(Please refer to fee schedule)
�^ Pro �J. C_
pil ����� rl rC � ��� K Permit fee:
Address: 'f0 22 Z 7
City/State/ZIP: ez f C, 6 Q 6 70 11 State surcharge(12%of permit fee):
�G / FLS plan review(40%of permit fee):
Phone:(c}1( ) SIC) —d 19 Fax:( ) (Due upon application submittal)
CCB lie.: 2,11 ,5 2p / Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: T(�Jl�j ie,V zf� Date:Alb) UM * within 180 days after it has been accepted as complete.
1 -,� d Fee methodology set by Tri-County Building Industry
Service Board.
lieuaiding\PermitslFPS-PermitApp_031016.doc 440-4613T(1 I/01/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: 8 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:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet "Dry
Additional Standpipes no
Information: Sprinkler Supply Line ❑ Yes ® No
Hazard Group Light
Density
Design Area
K. Factor 5.6k
Sprinkler Project Valuation: $$8000
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
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 $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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