Permit y
114 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' : " COMMUNITY DEVELOPMENT Permit#: FPS2022-00059
Date Issued: 5/4/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15333 SW SEQUOIA PKWY, STE#100
Project: Bridgetown ER and Veterinary Subdivision: PACIFIC CORPORATE CENTER Lot: 3
Project Description: Fire sprinkler permit:Adding(109)new sprinklers to existing system.
Contractor: CENTURION FIRE PROTECTION LLC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 1705 ATTN: N PIVEN
OREGON CITY, OR 97045 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-593-9791 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/04/2022 $338.92
12%State Surcharge-Building 05/04/2022 $40.67
Type of Use: COM Plan Review-Fire Life Safety-COM 05/04/2022 $135.57
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 05/04/2022 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 05/04/2022 $48.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 0.1 Design Area: 0
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 $569.16
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $24,500.00
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
Issued By: � A.� Permittee Signature: ge t'. � 2'
Call 503.639.4 75 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 I.OR on.I(.1.:I SI.ONI.I
City of Tigard11 _ VED
J1/ D e �1 / .'' / :':7 -;Plan Review /yeB �ZInspection Line: 503.639.4175 AR 1 y 22�} Date ReadyBy: �fJuris: ee Page 2 for
Internet: www.tigard-or.gov A F Notified/Met d:^�3-22- _ ('Z..c, Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FA!111LY 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.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑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:15333 SW Sequoia Parkway New dwelling area: square feet
City/State/ZIP:Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:100 Project name:Bridgetown Veterinary Clinic Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
CAP' /� /' �r •. ,f y q; bit, 4`/,ii,1.- (_ Other structure area: square feet
' ETA` *ItOCEUS1
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.
Add 109 new sprinkler drops to existing system. Valuation: $ 24,500.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:1
Name:Bridgetown Veterinary Clinic Type of construction:
Address:15333 SW Sequoia Parkway Suite 100 Occupancy groups:
City/State/ZIP:Tigard, OR 97224 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON
= 1 ,:
Business name:Centurion Fire Protection All contractors and subcontractors are required to be
Contact name:Brent Barker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:PO Box 1705 jurisdiction in which work is being performed.If the
City/State/ZIP:Oregon City, OR 97045 applicant is exempt from licensing,the following reasons
apply:
Phone:(503) 894-0563 Fax: :( ) Metro License#11876
E-mail:brentbarker@centurionfirepro.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:Centurion Fire Protection
Permit fee:
Address:PO Box 1705
State surcharge(12%of permit fee):
City/State/ZIP:Oregon City, OR 97045 FLS plan review(40%of permit fee):
Phone:(503 ) 894-0563 Fax:( ) (Due upon application submittal.)
CCB lic.:204812 Total permit fees: j, 4
f "�— Amount received: V�
Authorized signature: ..�(!�
This permit application expires if a permit is not obtained
Print name:B
A,1� 7 J- IF Ar-Ae j-.-- Date:4/7/2022 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
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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: 1 09 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 Ea Wet
El Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes El No
Hazard Group light
Density .10
Design Area 1007
K Factor 5.6K
Sprinkler Project Valuation: $24,500.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El 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): $24,500.00
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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