Permit i a
.M,Z � CITY OF TIGARD
" FIRE PROTECTION SYSTEM PERMIT
a COMMUNITY DEVELOPMENT Permit #: FPS2009 -00096 •
[ iGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 10/28/2009
Parcel: 2S112DC00500
Jurisdiction: TIGARD
Site address: 15895 SW 72ND AVE 200
Subdivision: OREGON BUSINESS PARK III Lot: 40
Project: CIDA
Project Description: TI relocate and add a total of 27 heads.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 Permit Fee - COM 10/14/2009 $69.65
12% State Surcharge - Building 10/14/2009 $8.36
PHONE: 503 - 624 -6300 Plan Review - Fire Life Safety - COM 10/14/2009 $27.86
Contractor:
DELTA FIRE INC
14795 SW 72ND AVE
PORTLAND, OR 97224
PHONE: 503 - 620 -4020
FAX: 503- 620 -1058
Type of Use: COM
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: B Height: ft
Stories: 2
Commercial Sprinkler Svstem:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No 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 $105.87
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 2200
Residential Square Footage: 0
Fire Alarm Valuation: 0
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:
oAa,tai `_/ , , r Permittee Signature: )A,
V
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.
BuAiling Permit Application
Fire Protection System RECEIVED - " FOR . OF F I(:E uSE ONLY.' •:
7,1 a 1 312 5 Of , OCT 1 2009 Da teB Plan v �1 . wild g. 2..• l `
(
•J 'Tigard Perttut No.: /
131_ SW Hall Blvd., Tigard, OR 97223 . - �
a R e v iew ` (J 1
Phone: 503.639.4171 Fax: 503.598.1960 Date I ' 1 Other Permit:
T I Ex K D Inspection Line: 503.639.4175 CITY OFTIGARD Date Ready :y: Juris: fd See Page 2 for
Internet: WWW. tigard- or.gov BUILDING DIVISIO ■ Notified/Method: f Supplemental Information
TYPE OF WORK .- . : , . REQUIRED DATA 1 AND 2- FA,NIILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rowded to the nearest dollar) of all
$. ddition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling *ommercial /industrial Valuation: 5
El Accessory building Number of bedrooms:
Accessory Multi- family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE LNFORRVIATION AND LOCATION Total number of floors:
Job site address: 1 CJ�9S � i)3 /Ana �t V le_ New dwelling area: square feet
City /State /ZIP: ' ` of.A /\ �
,(14 0 (k (i"79 Ga /carport area: square feet
.Id /apt. no.: Apo "` Project name: C c pr T Covered porch area square feet
Cross street/directions to job site: _t ,4 11 =tile.. Deck area: square feet
Other structure area: square feet
RE DATA.. COMMERCIAL -USE C
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION :OF WORK _ ( • work indicated on this application. / on
J J�
- I'� �'il.1C.�
� and Q d. l - lI- l'CtJI,\ M vierActej Valuation: S a art! *
.C'ef n e . '�'. T Existing building area square feet
l New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1i
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP:
Existing:
Phone: ( ) Fax: ( )
New
APPLICANT ❑ CONTACT PERSON
NOTICE,. ..
Business name: 1-ct_ .F1i Construction re Trnc - All contractors and subcontractors are required to be
Contact name: �1 licensed with the Oregon Construction Contractors Board
. I , . r,\ - y 1 e: .� ` �.'' under ORS 701 and may be required to be (tensed in the
Address: I LI7g u.,6 fa ■ �P_ jurisdiction in which work is being performed. If the
applic
City /State /ZIP: � Q` ( -. nd. ."9, q7 949.14
l �
� � �� aplv: is exempt from licensing, the following reasons
Phone: (ad '`�IOO,0 Fax: :' o3 C / 094 — JO
E -mail: 41'l6 -& eaciftY e.co y / 1
CONTRACTOR BUILDLNG PERh1IT FEES*
Business name: ci rh" ' (Please refer to fee schedule
`�` C i • ^^,,'' Permit fee: l I �� 6),
Address: /1.11 F land Aue. •1
CitylState / "LIP: d Q" (� State surcharge (12% of permit fee): Q
+ ++ I � ^
t � . 5 �� _ ` / 'A GpCJD � FLS p lan revi (40% ofpermit fee): v
Phone: (Q3 69 ..t/'LIJf I Fax: ) (/�� W
, (Due upon application.) a',
CCB lic.: CCU 1 ` l N Total permit fees: j 0 5 . 1
Authorized signature: y
itc/u., Amount received: f
This permit application expires if a permit is not obtained
Print name: �' ' Date: G within 1S0 days after it has been accepted as complete.
' - 1 , 6 � �� " Fee methodoloev set by Tri- County Building Industry
Service Board.
1' BuildingPermits \FPS- PermitApp.doc 03/23706 440- 4613T(I I/0_ CO\t,WFB)
■. 1
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information j
Describe work to be done:
' 1.) New 2.) lodification to sprinkler heads only:
Addition ❑ 1 -10 heads: No plan review required.
Alteration X 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 97
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet ❑. Dry
Additional Standpipes Al lk
Information: Hazard Group L'o -
1
Density • ' • vG`
Design Area • .
K. Factor ,r (
Sprinkler Project Valuation: $ 01 , ,. 00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ MIA
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 $187.50 .
2,001 to 3,600 $232.50
3,601 to 7,200 $292.30
•
7,201 and greater 8381.50 .
Sprinkler Project Square Footage: /WA sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 0)"9.9 .
1 Permit fee based on project valuation (see fee schedule): $ ( Q9 . W
Permit fee based on square footage (see D above): $ NA .
. State Surcharge (12% of pertnit fee): $ 15.34
FLS Plan Review (40% of permit fee): 1 $ , .7. Ve
I TOTAL: 1 $ " 105, 8.7 • ;
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
[: \13,,,i,- Per:*u:App.doc 2