Permit Y CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
71 t ' a
COMMUNITY DEVELOPMENT Permit #: FPS2010 00023
T 1 AR L� 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/16/2010
Parcel: 2S 112 DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 210
Subdivision: Pacific Corporate Center Lot: 0
Project: NuScale
Project Description: Relocate (3) heads and add (3) heads for TI.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - COM 03/16/2010 $61.85
PORTLAND, OR 97224 12% State Surcharge - Building 03/16/2010 $7.42
PHONE: 503 - 624 -6300
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:
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 $69.27
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 900
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 rule
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By:
(VAIL 'n i1 r Iv /� Permittee Signature: // / — .4 1 ,_
1 1 � 1
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
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard Received f(�\
` g 1 Date,Bv: J� PermitNo. 00 23
° 13125 SW Hall Blvd., Tigard, OR 972 MAR 16 L 3 J. Plan Review L7�
Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
Permit
TIGARD Inspection Line: 503.639.417 5 CITY OF TIGARD Date Ready /By: Juris: ® See Page 2 for
Internet. www.tigard- or.gov BUILDING DIVISION Notified/Method: 1 1 C Supplemental Information
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
Igt /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /industrial Valuation: S
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE ENTORMATION AND LOCATION Total number of floors:
Job site address:6k 'a,.. La New dwelling area: square feet
City/State /ZIP: _ ` • + "l. 1 Garage /carport area: square feet
Suite .Idg. /apt. no.: a10 (Project name: j , '1 Copp. C'enkeX AJf aA Covered porch area square feet
Cross street/directions to job site: V`^'r `t►'"' 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.
Wtoca,1e 3 lneaas ay. odd SInerAr I ` {' Valuation: S C106.00
ra tio Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER j ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP:
Existing:
Phone: ( ) Fax: ( ) New:
X APPLICANT ❑ CONTACT PERSON
NOTICE •
Business name: T ITa. T t e. - on e _ All contractors and subcontractors are required to be
Contact name: j � � / licensed with the Oregon Construction Contractors Board
1-le ill t ` ' osi , ro " / ' �, / ( Ere- 0 ,3 CX under ORS 701 and may be required to be licensed in the
Address: I LI 7 5 3 W Tan , e • jurisdiction in which work is being performed. If the
City/State/ZIP: � O fma 09, 97.90-1-1 applicant is exempt from licensing, the following reasons
apply:
Phone: �3) Goo oar Fax: : 6�13� - 105g
E -mail: heldt c:tel-i-c,t. lye.. Corn
CONTRACTOR BUILDING PERMIT FEES*
Business name: T9I4 1 re ,/ (Please refer w fee schedule)
.r ire, ` Permit fee:
.Address: IL 7c 5 3 L3 '- n Ave. /�V
City /State /ZIP:por�a , 7aa.L'
State surcharge (12 ° %of permit fee):
( P FLS plan review (40 %ofpermit fee):
Phone: ( • - • ti . — L • ad Fax: s f ) , ip i - I oS I. (Due upon application.)
CCB lic.: , I Total permit fees:
Authorized signature: / Amount received:
4 .� / Z /A. ; This permit application expires if a permit is not obtained
Print name: � ' * • • . I, / Date: . d within 180 days after it has been accepted as complete.
• * Fee methodoloav set by Tri- County Building Industry
Service Board.
1 BwldingPermits /FPS- PermitApp. doc 03.23/06 440- 4613T(11:02CO:MLWEB)
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 M1-10 heads: No plan review required.
2 Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, ,C or D as applicable):
A.) Commercial Sprinkler
N. Wet ❑ Dry .
Additional Standpipes A) /A
Information: Hazard Group L.,0*
Density) 10 • •
Design Area j WO r}
K. Factor 5. (0 8-
Sprinkler Project Valuation: $ q'CO
B.) Type I - Hood Fire Suppression System--.
Hood Project Valuation: $ )411A
C.) Fire Alarm
•
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ /V /A
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.0
2,001 to 3,600 $232.50
1 3,601 to 7,200 $292.30
7,201 and greater $381.0 •
Sprinkler Project Square Footage: n1 sq. ft.
Fire. Protection Permit Fees •
Project valuation subtotal (see A, B & C above): $ Ci0a00 •
•
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.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or \ICET level "3" Technicians.
L \ Building `. Pe ^Tics'v, FPS -Pe_r niLA? pp.doc 2