Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IN . COMMUNITY DEVELOPMENT Permit#: FPS2022-00062
T I c;A iz D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/8/2022
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY K
Project: Tigard Town Square Subdivision: 1994-028 PARTITION PLAT Lot: 2
Project Description: Add and relocate sprinklers and replace existing pendent sprinklers with new quick response.
Contractor: VIKING AUTOMATIC SPRINKLER CO Owner: SN PROPERTIES PARTNERSHIP
3245 NW FRONT AVE 1121 SW SALMON ST
PORTLAND, OR 97210 PORTLAND, OR 97205
PHONE: 503-227-1171 PHONE:
FAX: 503-227-1552
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/20/2022 $134.48
12%State Surcharge-Building 05/20/2022 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 05/20/2022 $53.79
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 05/20/2022 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 05/20/2022 $3.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No 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 $209.41
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $5,100.00
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 a - • forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: _+'/ j/ Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
Th'. 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.
41
Building Permit Application
Fire Protection System R ECE I v •
FOR OFFICE USE ONLY
City of Tigard APR 2 6 ; RDeacteeByed: C q!II aa, ,i Permit No.: [n SaGaa "CX,G(p Ol
IN 't 13125 SW Hall Blvd.,Tigard,OR 97223 elan Review
Phone: 503.718.2439 Fax: 503.598.1960 CITY OFTIGAI� ateBy: ��� Z2. } Other Permit:
I'I G A R D Inspection Line: 503.639.4175 S U J LD I NN('IVI S I Akde Ready/By: Juris: I Ed See Page 2 for
Internet: www.tigard-or.gov �ed/Metho 12 - Supplemental Information
TYPE OF WORK REQUIRED DATA:i-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
IN Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
Eli-and 2-family dwelling ®Commercial/industrial _
❑Accessory building ❑Multi-family Number of bedrooms:
—
❑Master builder CIOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16200 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: K Project name: Tigard Town Square 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.
Add/relocate sprinklers as needed for tenant improvement. Valuation: $ 5,100.00
Replace existing pendent sprinklers with new quick response. Existing building area: square feet
New building area: square feet
INI PROPERTY OWNER ❑ TENANT Number of stories:
Name: Neville & Butler Commercial Real Estate Type of construction:
Address: 900 SW 13th Ave Suite 210 Occupancy groups:
City/State/ZIP: Portland, OR 97205 Existing:
Phone:( ) Fax:( )
New:
( (E APPLICANT J CONTACT PERSON
NOTICE
Business name: Viking Sprinkler All contractors and subcontractors are required to be
Contact name: Dave Bateman licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3245 NW Front Ave jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: Portland, OR 97210
apply:
Phone:(503)227-1171 Fax: :( 503)227-1552 .x.-
E-mail: dave.bateman@vikingsprinkler.net
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Viking Sprinkler
Permit fee:
Address: 3245 NW Front Ave
State surcharge(12%of permit fee):
City/State/ZIP: Portland, OR 97210 FLS plan review(40%of permit fee):
Phone:( 503)227-1171 Fax:( 503)227-1552 (Due upon application submittal.)
CCB lic.: 64837 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: Dave Bateman Date:4/26/2022 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/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:
El New system Number of sprinkler heads: 26 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
El 11+heads: Plan review required and El 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 [N Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes El No
Hazard Group Ordinary Hazard
Density
Design Area
K. Factor 5.6
Sprinkler Project Valuation: $ 5 ,100.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El 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): $
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\Pemuts\FPS_PermitApp_031016.doc 2