Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111
COMMUNITY DEVELOPMENT Permit#: FPS2022-00045
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/27l2022
Parcel: 2S101DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 460
Project: Cetera Subdivision: None
Lot: None
Project Description: Fire sprinkler permit-relocated(12)and add(1)pendent heads due to new walls and lighting.
Contractor: FIRE ONE FIRE SYSTEMS INC Owner: G&I X TRIANGLE CORPORATE PARK LLC
PO BOX 734 BY DRA ADVISORS LLC
OREGON CITY, OR 97045 ATTN TAX DEPT
575 FIFTH AVENUE 38TH FL
NEW YORK, NY 10017
PHONE: 503-557-9050 PHONE:
FAX: 503-557-9268
FEES
Description Date Amount
Specifics:, Permit Fee-COM 03/23/2022 $112.96
12%State Surcharge-Building 03/23/2022 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 03/23/2022 $45.18
Class of Work: ALT Type of Const: IB Info Process/Archiving-Sm$0.50(up to 03/23/2022 $17.50
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 0.1 Design Area: 1500
K Factor: 8.0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $189.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,635.00
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: /! � ittee 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 RECEIVED (731
Fire Protection System MAR 3 Z022 rout t)I I I('l: 1.SF OvI.1
City of Tigard w Receiv />�02222_ �i� Permit No.:rPS20�-000
Date/By!,./
13125 SW Hall Blvd.,Tigard,OR 97223 V i l Y OF i IUpRU Plan RevievQ
* ; Phone: 503.718.2439 Fax: 503.598.196 I Date By �7�' - Z Other Permit:
Inspection Line: 503.639.4175 °BUILDING DIVISION Date Read/B / J
T 1(;A h E7 Internet: www.ti and-or. ov Notified/Metho S See Pagel for
g g 3 �,_i �1 Supplemental Information
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
3 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
0 1-and 2-family dwelling 3Commercial/industrial Valuation: $
0 Accessory building El Multi-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
N c Total number of floors:
Job site address: 1527.% 45\A) (Deb. , i►- ,...,y New dwelling area: square feet
City/State/ZIP: Ts(iA174) , otemetA( 4722.3 Garage/carport area: square feet
Suite/bldg./apt.no.: 6i lob Project name: CSC Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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
:rf,, $ n ,f.. ,'�`' , '".lt#!] C , , f-. work indicated on this application.
AUD f'��iLAC.ATE Dc/.1-r i+EAN+D5 Valuation: $ �3Z D
1!J lei 1 D xlc.A.,> W 144-LS PirOD L141 1 44) Existing building area: square feet
New building area: („$Z� square feet
Q �-� r w r y s s �. � { a Y
.<,:.*,. .} OW g. AI .. _ s�.: . u i y .tIefA Number of stories: Z4
Name: Ce.ri a a Type of construction: Ti ff . 1„Q (Tx)
Address: rb MI 5uo 6 e. two)�. Occupancy groups:
City/State/ZIP: -6/�7_Act ( p 72 is Existing: IS
Phone ( ) Fax ( ) New: S
< �" i W
Business name: vi'trz.� b►S+L vrt21i c .- o. ,. subcontractors
co e,w, b �. ..
SY'�"jEf✓13, JAIL All contractors and subcontractors are required to be
Contact name: M I p�MHeT� licensed with the Oregon Construction Contractors Board
�+ under ORS 701 and may be required to be licensed in the
Address: ?D �Dtt -�3s.1 jurisdiction in which work is being performed.If the
City/State/ZIP: raj C. ! bet- 97045 applicant is exempt from licensing,the following reasons
a 1
Phone:6t 557(Ib5o Fax::( )
E-mail: te\' Im i .0
�jQ
Business name: 5 e As A6Dl fi . . .� . ,_. . ,.. r x
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lie.: f ea K D Total permit fees:
Authorized signature: Q Amount received:
This permit application expires if a permit is not obtained
Print name: )iJ 5. ZuGG.E� n Date:v'3 M 47.2._ within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Bui(ding\Permits\FPS-Permit App_031016.doc 440-4613T(I 1/02/COM/WE.B)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
.'-�.,.� .��a...,ttt*** ,..� nttM.. ee,,n>#.atlle.>nksj.,._. ta.,<__w _v....��';s...... �.,< ae �.4 .-.,_...tz"`''.T.,r:;�j 5.'.�-
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: I3 Number of alarm devices:
IN 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 [K] Wet ❑ Dry
Additional Standpipes Nib
Information: Sprinkler Supply Line ® Yes ❑ No
Hazard Group LtclfWr 14#tZARD
Density ,1 c,
Design Area 1560
K. Factor g.p
Sprinkler Project Valuation: $
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 Fcc:
0 to 2,000 $198.75
;f
t 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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2