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Permit Building Permit Applicatiof ECEIVED Fire Protection System 1 FOR OFFICE USE ONLY NOV 2 2 2022 Received �t l '/� City of Tigard Date/B : I aA. , 9,, Pemut No.: ' All". W • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review. l Phone: 503.718.2439 Fax: 503.598.1'(i TV OF TIGARD Date/B : " ill Other Permit: TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready:y: luris: ® See Page 2 for Internet: www.tigard-or goy Notified/Method'. Supplemental Information '' ft TYPE OF WORK REQUIRED 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. El1-and 2-family dwelling IN Commercial/industrial Valuation: $ ElAccessory building ❑Multi-family Number of bedrooms: ❑ Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 16655 SW 72 N D AVENUE New dwelling area: square feet City/State/ZIP: PORTLAND, OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: 200 Project name: WALEN OFFICE T. I 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.: 2 S 113AC 0 0101 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 (15) , RELOCATE (26) , DEMO(3) sprinkler Valuation: 4927 $ heads to accommodate office T. I Existing building area: N/A square feet New building area: SAME square feet M PROPERTY OWNER 0 TENANT Number of stories: 1 Name; PACTRUST Type of construction: III-B Address: 15350 SW SEQUOIA PARKWAY SUITE 300 Occupancygroups: OFFICE City/State/ZIP: PORTLAND OR 97224 Existing: B Phone:(5 0 3) 6 2 4-7 7 8 7 Fax:( ) New: NO CHANGE ® APPLICANT ® CONTACT PERSON NOTICE Business name: PATRIOT FIRE PROTECTION _ All contractors and subcontractors are required to be Contact name: STEVYN STUART licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 4708 NE MINNEHAHA ST jurisdiction in which work is being performed.If the City/State/ZIP: VANCOUVER WA 98661 applicant is exempt from licensing the following reasons apply: Phone:(360) 699-4403 Fax::(360) 699-4485 E-mail: STEVYN-STUART@PATRIOTFIRE.COM CONTRACTOR BUILDING PERMIT FEES" Business name: SAME AS ABOVE (Reuse refer to fee schedule) Permit fee: Address: City/StatefZIP: State surcharge(12%of permit fee): FLS plan review(40%of permit fee): Phone:( ) Fax:( ) (Due upon application submittal) CCB lie.: 70822 Total permit fees: Authorized signature: 1 , I Amount received: ii'i="�- This permit application expires if a permit is not obtained Print name: s-ra- 'ropti2 Date: 10/10/2 2 within 180 days after it has been accepted as complete. AlNI( I -T' * Fee methodology set by Tri-County Building Industry Service Board. I:1Budd,nglPermils1FPS-PermilApp_031016.doc 440-4613Tti 1/02/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: ❑ New system Number of sprinkler heads: 41 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 ❑X 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 NONE Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group LIGHT HAZARD Density 0 . 1 GPM/FT".2 Design Area N/A K.Factor 5 .6 Sprinkler Project Valuation: $ 4 9 2 7 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: $ I:\Building\Permits\FPS_PermitApp 03 1016.doc - 2