Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2010 -00086
T I G 1t R. o 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/06/2010
Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72ND AVE 200
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Sunset Mortgage
Project Description: Add /relocate approximately (6) sprinkler heads as needed for TI.
Owner: FEES
PACTRUST Description Date Amount
15350 SW SEQUOIA PKWY SUITE 300 Permit Fee - COM 08/06/2010 $64.54
PORTLAND, OR 97224 12% State Surcharge - Building 08/06/2010 $7.74
PHONE: 503 - 624 -6300
Contractor:
WYATT FIRE PROTECTION INC.
9095 SW BURNHAM
TIGARD, OR 97223
PHONE: 503 - 684 -2928
FAX: 503- 684 -9657
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 $72.28
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 980
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 r
or direct quest' • • • 4 - C by •: 'ng 503.246.6699 or 1.800.332.2344.
Issued B : I ,f/o , / Permittee Signature: = �
Call 503.639.4175 by 7:00 a.m. for an inspection that business : ay.
This permit card shall be kept in a conspicuous place on the job site until co pietion of the project.
Approved plans are required on the job site at the time of each inspection.
r
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard DateB , _20 Permit No.: ‘ ,„/ 6006V,
1 ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: At t.PaDko -‘49/7 „..
TIGARD Inspection Line: 503.639.4175 Date Ready/By: ]uric: 0 See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
' - WORK TYP OF WK: = 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
y ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION`.,." wor indicated on this application.
ap
❑ 1 - and 2- family dwelling Commercialindustrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SIT E INFORMATION AND LOCATION Total number of floors:
Job site address: / , 0/ 67 '77A New dwelling area: square feet
City/State /ZIP: / / , 4 ; �7 f /9 9 -2_7_4_ Garage/carport area: square feet
Suite/bldg. /apt. no.: 2_6)62 I Project name: 6Did i mm t 5 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.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
- DESCRIPTION OF WORK >' - `. - , work indicated on this Fz Y e
application
A--bb / . fi, i
_ i1 _T ,/ / 1J /��? o / ? t�f Valuation: $ (/®,
--/- ,4
, 446' A//1--/ 6 � ` _ /t / Existing building area: square feet
wi /1, 7 New building area: square feet
❑y PROPERTY ' OWNER.. - , ❑, TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON ',
NOTICE =.�
Business name: 'C: �DN�� C...- - TZWL All contractors and subcontractors are required to be '
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax: : ( )
E -mail:
, ., : - CONTRACTOR BUILDING PERMIT FEES*
� l jL TT -- �� ,0 � ,. (Please refer to fee 'scliedule) , -
Business name:
A pe �i / �� j3 �) A � [ Permit fee: 69[i, S
ddress: 0 S � , 0 -/U'1��� -7n C,l
City/State /ZIP: ! l 4j,(�% 0 `7 2 Z State surcharge (12% of permit fee): 7. 7 [
` l / FLS plan review (40% of permit fee):
Phone: (5) 6; �9z g Fax: (5O $) 6E4.._ 965.7 (Due upon application.)
CCB lic.: ( 0 7. 7 L Total permit fees: 72. Ace
4 Amount received:
Authorized signature:
�/L�C /:. This permit application expires if a permit is not obtained
Print name: 6 Ll r�� Mt) Date: e -- -/D 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\ Building \Permits \FPS- PermitApp.doc 03/23/06 440 -4613T(11 /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done; k `;
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition `1 -10 heads: No plan review required.
- alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
• Additional descri tion of work:
Type o£System _(Complete,A, B C or D „as applicable) _ ...; - , .,.. ',.u: d r 's.
i 's N xa ' d ` 'fi fl r ¢. �'P s a''r 4z w.” S �'i -.
A. Comrnerclal S rttlkler � � a v3 e
• ❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density •
Design Area
K. Factor
Sprinkler Project Valuation: $
B) Typ I` k Hood ==Fire Supprs:ston Systm:.i,r k_ 3V, . ti r' ira t, ,t flOa
Hood Project Valuation: $
C F1re Alarm a � s �� xi O Ai i
..:' +:. k.k' i, yY. . "�`t., i_,_e .: L.� q�4�. ,1 y,. .i � 6,.... .�, ., -.r S��.�, ' ,. _ ,.. s <� `:.' .. _. ��, ...�:?•- _ .. .vvC`v'. .. .... �,,. �. .we. � ��'a .
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprtnkker (Stand Alone System) ; _ ` 1 : . r
Square Footage: Permit Fee: x. RM A
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
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.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
http: / /www.ci.tigard.or.us /city_ hall/depart ments /cd /dots /'FPS - PermitApp.doc 2