Permit ' 'v CITY OF TIGARD
FIRE PROTECTION SYSTEM PERMIT
i a "' COMMUNITY DEVELOPMENT Permit #: FPS2009 00118
,,6` Date Issued: 01/13/2010
T f (;A 1) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S113AA00700
Jurisdiction: Tigard
Site address: 16600 SW 72ND AVE B10
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: Benchcraft
Project Description: Extend and modify existing wet fire sprinkler system.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - COM 01/13/2010 $166.76
PORTLAND, OR 97224 12% State Surcharge - Building 01/13/2010 $20.01
PHONE: 503 - 624 -6300 Plan Review - Fire Life Safety - COM 12/29/2009 $66.70
Contractor:
FIRESTOP CO
3203 NE 65TH ST. #2
VANCOUVER, WA 98663
PHONE: 360- 718 -8604
FAX: 360- 718 -8603
Type of Use: COM
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: B Height: ft
Stories: 2
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: ORD1
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $253.47
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 8500
Residential Square Footage:
Fire Alarm Valuation:
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 sta -d within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the :dopt-d by the Oregon
Utility No ' ion Cen . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You . stain .: copy of the rules
or dir questions to OUNC, Ilin 503.246.6699 or 1.800.332.2344.
lss ed By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 RECEIVE ( 2 7
Fire Protection System O C 2 9 2009 : `- � ' ' - � � �� z - u , r o ryt - ,
KIT City of Tigard Received _ %1� Permit Nu.: 13 ,,, . $
`� b D /B
fo { � v 13125 SW Hall Blvd.. Tigard. OR 9722 CITY OF TIGARD P lan Review . 2
I ii • ��� Other Permit J p •_�9 . �,�
a' Phone: 503.639.4171 Fax: 5o3.59s ILDING DIVISION Date %B ��
a���� �""i��h�h�h Inspection Line: 503.639.4175 Date Ready /t � El See Page 2 for
�i� T61 G�AiRD� p No ified /Meth r dIP Supplemental Information
lala itaiv 4 Internet: www.tigard- or.gov /� . __®
t.w /. ! _ , /
TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELI.INC
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
E Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead. and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
DI 1- and 2- family dwelling Valuation: $
® Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16600 SW 72 " Avenue New dwelling area: square feet
City /State /ZIP: Portland, OR Garage /carport area: square feet
Suite /bldg. /apt. no.: Project name: Benchcraft 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor. overhead. and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Extend and modify the existing Wet fire sprinkler system. Valuation: 888,500.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑TENANT Number of stories:
Name: Pac Trust Type of construction:
Address: 15350 SW Seqoia PKWY Occupancy groups:
City /State /ZIP: Portland, OR Existing:
Phone: (503)6241 -6300 Fax: (503)624 -7755 New:
►.1 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Firestop Co. All contractors and subcontractors are required to be
Contact name: Alec Baker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3203 NE 65 Street, #2, jurisdiction in which work is being performed. If the
City /State /Z_IP: Vancouver, WA 98663 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 718 - 8604 Fax: : (360) 718
E -mail: alec a?firestopco.com
• CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
1usiness name: SAME
Permit fee:
Address:
State surcharge (12% of permit fee):
City /State /ZIP: o
FLS plan review (40% of permit fee): -I 7 a
Phone: ( ) Fax: ( ) (Due upon application.) lQ
C lic.: 183279 Total permit fees: a 53 , l.\ l
Amount received: pp 11 J Al
Authorized signature:K - 1 L
1 - This permit application expires if a permit is not obtained
Print name: LY /I ����/ Date: within 180 days after it has been accepted as complete.
1 ����� * Fee methodology set by Tri- County Building Ind stry
/t3 a
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe .work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition El 1 -1 0 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 59
Additional description of work:
Type of System (Complete A, B, C or.D as applicable): • -
A.) Commercial Sprinkler. •
.
® Wet ❑ Dry
Additional Standpipes NA
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 8,500.00
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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
http: / /www.tigard- or.gov /city_ hall; departments /cd /dots /ITS- PermitApp.doc 10 /01 /1)
r
EMERICK CONSTRUCTION COMPANY SUBCONTRACT
. ; P.O. Box 66100 ISSUE DATE: 12/09/09
Portland, Oregon 97290 -6100 COST CODE: 097 -2 -2100
EMERICK Tel: (503) 777 -5531 Fax: (503) 771 -2933 PAGES 1 OF 2
CONSTRUCTION CO.
SUBCONTRACTOR: PROJECT: OBP 1 — Building 10 Tenant Improvement
Firestop Company JOB NO.: 097 -2
3203 NE 65 St, Space 2 The following checked Attachments are incorporated by reference into this Agreement.
Vancouver, WA 98663 ATTACHMENTS DATE PAGES
I El Subcontract General Conditions 10/31/03 8 Pages
OWNER: II Q Insurance Requirements 03/16/09 2 Pages
PacTrust III El Contract Documents 12/21/09 9 Pages
1530 SW Sequoia Parkway IV El Billing and Payment Requirements 12/21/09 1 Page
Suite 300 V ❑ Subcontract Special Conditions 10/31/03 1 Page
Portland, OR 97224 VI ❑ Indemnification Addendum (WA) 10/31/03 1 Page
ARCHITECT: VII ❑ Performance and Payment Bond 10/31/03 2 Pages
Martin Hanson
15350 SW Sequoia Parkway #300
Portland, OR 97224
AGREEMENT
The Contractor has entered into a Contract with PacTrust pertaining to the Project. Effective December 1, 2009, the
Contractor and Subcontractor agree as follows:
Article 1 - SCOPE OF WORK
The Subcontractor agrees to furnish all supervision, engineering, management, labor, tools, equipment, materials,
supplies, facilities, and financing necessary to perform and fully complete the following described Work and all work
incidental thereto. The term "Work" includes, without limitation, the following:
Fire System Complete
As specified in:
Contract Documents
With the following Additions:
1. Pendant Sprinklers
With the following Deletions:
1. None
COMMON TEMPORARY SERVICES. The following "Project" common temporary services and/or facilities are
for use of all project personnel and shall be furnished as herein below noted:
By this Subcontractor:
None
By Others:
•
EMERICK CONSTRUCTION COMPANY SUBCONTRACT
P.O. Box 66100 DATE: 12/9/09
Portland, Oregon 97290 -6100 COST CODE: 097- 2 -2100
E M E R 1 C K Tel: (503) 777 -5531 Fax: (503) 771 -2933 PAGE 2 of 2
CONSTRUC1ION CO
SUBCONTRACTOR: Firestop Company
OTHER SPECIAL PROVISIONS.
Article 2 — CONTRACT PRICE
In consideration of the performance of the Work, the Contractor agrees to pay the Subcontractor the total sum of:
Eight Thousand Five Hundred Eighty Seven Dollars ($8,587.00)
Retainage: Ten (10 %)
This Agreement represents the entire and integrated agreement between the parties hereto and supersedes all prior
negotiations, representations, or agreements, either written or oral. No provision of this Agreement may be waived or
changed, except through a written Subcontract Change Order.
IN WITNESS WHEREOF, the Contractor and Subcontractor have executed this Agreement.
FIRESTOP COMPANY 144E ERICK CONSTRUCTION COMPANY
®t.
By: By:
Title: Title:
OR CCB #: OR CCB #: 10723
Expires: WA Contractors Registration #: EMERIC *379NT
Federal Tax ID #:
Entity Status: ❑ Corporation ❑ Sole Proprietor ❑ Partnership ❑ Other:
Registered minority subcontractor (check all that apply): ❑ MBE ❑ WBE ❑ ESB
® Please sign both copies of this Agreement and return to our main office within 15 days. A fully executed copy
will be returned to you.
For ECCO use only:
Logged Received:
I Reviewed by PM: