Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' COMMUNITY DEVELOPMENT Permit#: FPS2021-00020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/8/2021
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD, STE#301
Project: Embassy Center#301 Subdivision: None Lot: None
Project Description: Add and relocate sprinklers
Contractor: SPRINKIT FIRE PROTECTION INC Owner: LITHIA REAL ESTATE INC
PO BOX 2227 ATTN DEBOER, MARK
OREGON CITY, OR 97045 150 N BARTLETT ST
MEDFORD, OR 97501
PHONE: 503-272-6650 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/04/2021 $134.48
12%State Surcharge-Building 03/04/2021 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 03/04/2021 $53.79
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 03/04/2021 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 03/04/2021 $12.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: 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 $218.91
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $6,000.00
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: V..\.0\il ` 61 n 1eey. Permittee Signature:
s.
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.
j Building Permit Application 13.- 211(0 I21
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard Received ,t�` , r a
Date/By: 2 1 , Z, { 'V Permit l;o.: p:-` S'1� -Q��
• 13125 S W Hall Blvd.,Tigard,OR 97223 (? ���I plan Review ^ ,
C Phone: 503.718.2439 Fax: 503.598.1960f'� DateBy: '3 Other Pern>ir.
t i t,n it U Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By:• /`� m.,1. Fl See Page 2 for
Internet: www.tigard-or.gov , I_III_DI(JG DIVISION Nor /Method: J e- Supplemental Information
TYPE OF WORK QUIRED DATA:1-AND 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9020 SW Washington Square Rd. New dwelling area: square feet
City/State/ZIP: Tigard Garage/carport area: square feet
Suite/bldg./apt.no.:301 Project name:Embassy Center#301 TI 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.
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.
Valuation: $6,000
Add and relocate fire sprinklers for TI
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON _ _ NOTICE
Business name:Same as below 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:
Phone:( ) FFax::( )
E-mail:-r .Sch LISP C'E'Z,eyr "cJ Sen n k.1+-fj • Ca
CONTRACTOR BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
Sprinklt Fire Protection Inc.
Permit fee:
Address: PO Box 2227, Oregon City, OR 97045
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( )503-272-6650 Fax:( ) (Due upon application submittal.)
CCB lie.:211320 Total permit fees:
� .d / 0 Amount received:
Authorized signature 4_ G
This permit application expires if a permit is not obtained
Print name:Travis Schweitzer Date:2-15-21 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building'PermitsTPS•PemdtApp_03 I 016.doc 440-4613T(1 l/02/COM/WEB)
N
• 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: 41 Number of alarm devices: NA
® 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:
T j e of S stem (Complete A, B, C or D as ap.licable :
A.) Commercial Sprinkler
Sprinkler Type ® Wet ❑ Dry
Additional Standpipes No
Information: Sprinkler Supply Line ❑ Yes ® No
Hazard Group Light Hazard
Density
Design Area
K. Factor 5.6k
Sprinkler Project Valuation: $6,000
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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