Permit (45) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
Permit#: FPS2014-00104
• COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/10/2014
TIGARD Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 325
Project: Carter Counciling Subdivision: ASHBROOK FARM Lot: PTS 5&
Project Description: Add(1)new fire sprinkler head in new corridor.
Contractor: PATRIOT FIRE PROTECTION INC Owner: SUN LIFE ASSURANCE CO OF CANADA
4708 NE MINNEHAHA ST BY NORRIS BEGGS&SIMPSON
VANCOUVER,WA 98661 121 SW MORRISON ST#200
PORTLAND, OR 97204
PHONE: 360-699-4403 PHONE:
FAX: 360-699-4485
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/10/2014 $51.09
12%State Surcharge-Building 06/10/2014 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 06/10/2014 $20.44
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $77.66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $400.00
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 Notifica'on 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 stions to NC ailing 503.232.1987 or 1.800.332.2344.
Issued By: 1 a4T-4k4-V1 Perm ittee Sig •ture:
Call 503.639.4175 by 7:00 a.m.for the next available insp= ion 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.
JUN. 10. 2014 7: 21AM PATRIOT FIRE VANC NO. 5507 P. 2
Building Permit A.pplicillCElVEp
Fire Protection System FOR OFFICE USE ONLI'
City of Tigard JUN 0 2014 Received .riM� PcrmitNo., 'I ; Al/ �/j ,
13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
Other Permit:
' � Phone: 503.718.2439 Fax: 5¢� 98 O Dstc/Bv: Judi: G3 Scc Pngc 2 for
TIGARD Inspection Line' 503.639.41b&l 1 ( TIGARD Dale 1Zeady By:
Internet: www,t'and or.pUILDIN NotifcdiMcthod: RI Sec Supplemental Information
r� G DIVISION __
❑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
Ins:1 . w yize c t° work indicated on this application.
valuatron: s
❑1-and 2-family dwelling ®Commercial/industrial
❑Accessory building ❑Multi-family
CIbedrooms:
❑Master builder ❑Other: Number of bathrooms:
W r g t ,, ;V,: " Total number of floors:
Job site address:9600 SW Oak Street New dwelling area: square feet
City/State/ZIT':Tigard, OR 97223 Garage/carport area• square feet
Suite/bldg./apt.no.:325 ` Project name:Carter Counciliug Covered porch area: square feet
Cross street/directions to job site:SW 95h1 Ave Deck area: square feet
Other structure area: square feet
�±� :
REQ XIt * e0-1. irs` 5
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
ic, .Cut 0 0 > `4tyl� Y 5J`µ , work indicated on this application.
1 1 ,e'..�.rrn pJr.,. .'-h iger,r t^'A. . bri Nv
add (1)sprinkler in new corridor Valuation: $$400.00
Existing building area: same square feet
a� ; New building area: same square feet
r- o 4's `• , g.'' .e 77. r� r ,��^^,,���t����rr Number of stories: S
Name:Carter Counciling Type of construction: 3-B
Address:9600 SW Oak Street,suite 325 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing: B
Phone:( ) Fax( ) New: )8
• �,�;`x:� �,�..1m���R��''i,.v 4�i i ii")mr—.egN`�e±y'x „7., $Y,., '%�+ ��'�:P��''�o �i,.i`:"M�::-!ti..,,r
tYr .ir. .�'��ySra ,�^'•+�Pfi•A
Business name:Patriot Fire Protection,Inc All contractors and subcontractors are required to be
Contact name:Ted Baker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:4708 NE Minnehaha Street 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 I Fax::(360)699 4403
E-mail:ted.baker@patriotfire.com /
a.cUikxR4,C �y, , t••r,d". Asti _ ., �,.� �`+ �:
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:;rant[ ,fPlrUSC refer Iee•schee, .1/4 iN �
Business name:same as above
Permit fee: �j .0/
Address:
State surcharge(12%of permit fee): 4p. l3
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) _- (Due upon application.) "' ��
CCB lie.:70822 Total permit fees: '7 7, 66
Authorized signature
AM Amount received: 7 7 t
This permit application expires if a permit is not obtained
Lint name:Ted Baker Date:6-5-14 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:''Building,Permir\FPS•Penri;App.doe C2101/11 44O-4613T(11/021COMJWEB)
JUN. 10. 2014 7: 21AM PATRIOT FIRE VANC NO. 5507 P. 3
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
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1.) ❑ New 2.) Modification to sprinkler heads only.
❑ Addition ® 1-10 heads: No plan review required.
® Alteration ❑ 11+heads: Plan review required.
El Repair
Number of sprinkler heads: 1
Additional description� VOW.
l t n of work:
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® Wet ❑ Dry
Additional Standpipes no
Information: Hazard Group _ light
Density -1
Design Area 225
K..Factor 5.6
Sprinkler Project Valuation: $ 400
Hood Project Valuation: _1 $
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Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
,wN" "t :`'4:967,.,L';„4`:' >:St;'r r'",'-"� ? 142#.`. .! `qi.:‘: ,�;�'r:f�.-V%45t';...ti''%. ',11f., :.n,:
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Square Footage: Permit Fee: `is ; : • ' : .1,,.”
g` 1 `
0 to 2,000 $198.75 �:, . � ,'� ;
2,001 to 3,600 $24645
— r.z; � .)• a
3,601 to 7,200 $310.05 - ' �`' `:``1 ti } t
7,201 and greater $404.39 «a•:.,'
Sprinkler Project Square Footage: sq,ft.
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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% ofpermit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
C:\zztellsl ocalstosagc\pemirpending\CarterCounaling32-11961\submittal\TigardTtAffidavitsee page 2.doc 02/01/11