Permit (11) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
_ COMMUNITY DEVELOPMENT Permit#: FPS2021-00038
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/3/2021
TIGARD 9 Parcel: 1S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 450
Project: Highkey Subdivision: ASHBROOK FARM Lot: 5
Project Description: Fire sprinkler permit-install complete sprinkler system(30 sprinklers)in new lab space on 4th fir.
Contractor: CENTURION FIRE PROTECTION LLC Owner: KING CAPITAL INVESTMENTS LLC
PO BOX 1705 ATTN KING,THOM
OREGON CITY, OR 97045 19250 NE PORTAL WAY
PORTLAND, OR 97230
PHONE: 503-593-9791 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/14/2021 $145.24
12%State Surcharge-Building 05/14/2021 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 05/14/2021 $58.10
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 05/14/2021 $4.00
Occupancy Grp: B Height: 55 ft 11x17)
Stories: 4 Info Process/Archiving-Sm$0.50(up to 05/14/2021 $50.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: 0.1 Design Area: 900
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Reg:
Battery Calcs Provided: Cut Sheets Required:
Total $275.27
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $6,500.00
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
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: 0 Aph. �n
HollyVGiNV"DPi�t1 f
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 3-'q-(0-2
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City Tigard Ti and ReceiDate/By: 04 102l Permit No.:ved Fps242/-00036
13125 SW Hall Blvd.,Tigard,OR 97223 APR 6 all ievL I 7
ita Phone: 503.718.2439 Fax: 503.598.1960 Datep]aaBRevy: �/ ^oZ.) - 2) Jy Other Permit730/02Q2/—av'az0
I'1 GA R u Inspection Line: 503.639.4175 CITY OF TIGARD Date •Ready/By: m H See Page 2 for
Internet: www.ti and-or. ov SIOP onfiedlMethod. Supplemental luformadon
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TYPE OF WORK ; REQUIRED DATA: t-AND 2-F-AMILY 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
r '' work indicated on this application.
CATEGORY OF CONNTRI CTION
❑ 1-and 2-family dwelling ® Commercial/industrial Valuation: $
ElAccessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9600 SW Oak St. New dwelling area: square feet
City/State/ZIP:Tigard, OR 97232 Garage/carport area: square feet
Suite/bldgJapt.no.: Project name:HighKey Lab Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COM1tiIAt: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
DESC RIP`1'ION OF WORK work indicated on this application.
Install complete sprinkler system (30 sprinklers) in new lab space on 4th fir. valuation: $ 6,500.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stones 4
Name:King Capitol Investments, LLC Type of construction:
Address:19250 NE Portal Way Occupancy groups:
City/State/ZIP:Portland, OR 97230 Existing:
Phone:( 310)963-5802 Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
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 —
' 1 ;� _ ,' BUILDINGPER.WITI:EES*
Business name:Centurion Fire Protection (Please.refer i¢fee;Schedale
Permit fee:
Address:PO Box 1705
City/State/ZIP:Oregon City, OR 97045 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503) 894-0563 ( ) (Due upon application submittal.)
CCB lie.:204812 k Total permit fees:
Authorized signature: - -- Amount received:
This permit application expires if a permit is not obtained
Print name: Bre h t q r')/4 Date:4/5/2021 * within 180 days after it has been accepted as complete.
Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\FPS-PermitApp 031016.doc 440-4613T(11/O2ICOM/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: 30 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:
T se of S stem Com.lete A B C or D as a r •licable :
ate,
A.) Commercial Sprinkler 3 °
Sprinkler Type ® Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes D No
Hazard Group light
Density .10
Design Area 900
K. Factor 5.6K
Sprinler Project Valuation: $6,500.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
3 k
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 ries
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_PemutApp_031016.doc 2