Permit Apr''' CITY OF TIGARD
FIRE PROTECTION SYSTEM PERMIT
2 COMMUNITY DEVELOPMENT Permit #: FPS2010 -00067
T f G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/15/2010
Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15333 SW SEQUOIA PKWY, STE# 150
Subdivision: PACIFIC CORP CENTER Lot: 0
Project: OnOne Software
Project Description: Relocate (13) sprinkler heads and add (5) sprinkler heads for TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - COM 06/18/2010 $102.20
PORTLAND, OR 97224 12% State Surcharge - Building 06/18/2010 $12.26
PHONE: 503 - 624 -6300 Plan Review - Fire Life Safety - COM 06/18/2010 $40.88
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:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: No Hazard:
Density: 0 Design Area: 0
K Factor: 5.6
Commercial Fire Alarm Svstem:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $155.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 2300
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 •regon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy o the rules
or direct questions to • C by calling 503.246.6699 or :11 .2344.
���. .
Issued B / y • Permittee Signature: / ( J
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 REcr 4 p. , F i fl
Fire Protection System 3' FOR OFFI(`E USE O \LY
Ill City of Tigard JUN 1 8 2010 Received Z I �� /0
° 13125 SW Hall Blvd., Tigard,OR 97223 Datei
OF ^ Bv: �Jr ie. J Pernutho/ ... :s We p 4 00 67
'.' : _ r A R D Plan Revie (l l 0 t4 I/ /!/ --Milt/
Phone: 503.639.4171 Fax: 503.598.1960 CITY � ILa, r'� Daie;B � ♦ OtherPermir
i i G n x . Inspection Line: 503.639.4175 I rra�t r` Bv:
Internet: www.ti and -or. ov �UILUiN L1Vi�6 Date Read /Notifie luris: f /0 in" /er ® SeePent l for
g g 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
Addition/alteranionireplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
CATEGORY OF CON aPp
❑ I- and 2- family dwelling ommercial/industrial
Valuation: $
Accessory building Number of bedrooms:
ID Accessory ❑ Multi- family
❑ Master builder ❑ Other: Number of bathrooms:
JOB_ SITE I\NFOR1MATION';AND LOCATION Total number of floors:
Job site address: 1,53 6u3 < �7 �U � ii �` `J t New dwelling area: square feet
City /State /ZIP: Th`M� , n P 91 f CA. �1 Garage /carport area: square feet
S uite Idg. /apt. no.: Project name: on one, : , ,4. 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 ( rotnded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION
I .OF WORK ^' work indicated on this application. �
Q(�GL r LILL�C� �J and acid Valuation: $ a, t , Q(3
,/� n �. _' . Existing building area square feet
`'� New building area: square feet
❑ PROPERTY OWNER ❑ ' TENANT Number of stories:
Name: • Type of construction:
Address: Occupancy groups:
City /State /ZIP:
Existing:
Phone: ( ) Fax: ( ) New:
•
rti APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: 'De1 -) V (P III /C. All contractors and subcontractors are required to be
L
Contact name: j- V ' ° °rcrkrtpro h. /"❑ Carpe,h. under with 701 the Oregon be required to Contractors Board
• 'P tV"` �J , ` -1 v�/ 1J '"'''� -�� 11 ��`"'�� �� under ORS 701 and may be required to be Icensed in the
Address: I [,I,G 5 € /a net '&Ve. jurisdiction in which work is being performed. If the
!, }a , . C fe j I o (� 9.90 applicant is exempt from licensing, the following reasons
City /State /ZIP: j ' U 1'L "1 cr-1
a pp Iv
Phone: ( 3)(M - C ` ,' 0� Fax:: 603) (0 9 _ 106 5
E -mail: I eiri 1 6 ect.T e1- r 11 / e. corn
• CONTRACTOR BUILDING PERMIT FEES*
Business name: l i e +� 'r Mr (Please refer t
P fe
Address: I 147°1-6 " `' nc Ave.
cun� 7 � State surcharge (12% of permit fee):
City/State/ZIP: �.(`y `-' ��
i FLS plan review (40% of permit fee): ��v//
Phone:64 (0 ) (10,30 Fax: ( ) 3 6,6). - lob& (Due upon application.)
CCB lic.: /„4 '"1 4 v Total permit fees: ,
�d s �n Amount received:
Authorized signature: -
This permit application expires if a permit i of obtained
Print name: liele� ,� ,i 0 Date: 6 • within 180 days after it has been accept, as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
(!BuildingPermits \FPS- PermitApp.doc 03,2306 440- 4613TO I iC2iCOALWEB)
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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 1"1 1-10 heads: No i 11
SIUlLL L1VI�i U 1-1V LLC4UJ. 1VU plat, review LCq LLLLCC7.
,1 Alteration rg, 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: I g
Additional description work:
Type of System (Complete A, B, -C or. D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group L
Density 0
Design Area C
K. Factor b,0) 9
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ Agik-
C.) Fire Alarm
•
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ A"
D.) Residential Sprinkler (Stand Alone System)
•
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.30
3,601 to 7,200 $292.50 • •
7,201 and greater $381.50
Sprinkler Project Square Footage: A /, 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°,'o 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 NICET level "3" technicians.
[:', Building Per:Tuts FPS- PermicApD.doC 2
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