Permit :`t ;, CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00230
COMMUNITY DEVELOPMENT DATE ISSUED: 4/24/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 .
PARCEL: 25101 DA - 00102
SITE ADDRESS: 13221 SW 68TH PKWY 401 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
PROJECT: HEALTH NET
Project Description: Modification of (6) fire sprinkler heads.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FR sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 18 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,700.00
Owner: Contractor:
TIGARD TRIANGLE I LLC ALPINE FIRE PROTECTION LLC
4650 SW MACADAM AVE STE 220 21410 NE 174TH ST
PORTLAND, OR 97201 BRUSH PRARIE, WA 98606
Contact #: PRI 360 772 - 4199
Phone:
Reg #: LIC 168077
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 4/24/2007 $62.50
[TAX] 8% State Surcha 4/24/2007 $5.00
Total $67.50
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 than 180 days. ATTENTION: Oregon law requires you to follow the rul:dopted by the
Oreg 11 y o' 'cation Center. Those rules are set forth in OAR 952 - 001 -0010 through O' ' •52- 001 -010• may obtain a copy
of ese rules or dir- .t q • tions • OUNC by calling 503.246.6699 or 1.800.332.2344.
I sued By: I IL�L/, Permittee Signature: i �
rI /
Call 503.639.4175 by 7:00 a.m. for an inspectio , •t business day.
This permit card shall be kept in a conspicuous place on the j •� ite until completion of the project.
Approved plans are required on the job site at the time of each inspection.
jldina Permit Application
,i Fire Protection System FOR OFFICE USE ONLY
City g of Tigard Received a ® 7 n Permit No.: ! J',.�,
II III ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Date/By: . Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: Juri • 81 See Page 2 for
T 1 Ij D N otified/Method: Supplemental Information
Internet: www.tigard- or.gov / b PP
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/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 - Commercial/industrial Valuation: $
❑ 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: 1 )7_2, 1 5(,v keg �� 1-gtr New dwelling area: square feet
City /State /ZIP: 1 _ t &l/1t 0 X. l ?Z Zj Garage /carport area: square feet
Suite/bldg. /apt. no.: l f sn Project name: 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 application.
01-0dt. T 5 r � w kC vS t n Cr/5 II �`� Valuation: $ 17 (�D
Ft ✓ SP / RUC v S y5t� !ti /j' Existing building area: 1()0 (-- square feet
New building area: square feet
❑ PROPERTY OWNER graENANT Number of stories:
Name: , ( tea, ( t- I ✓) -t Type of construction:
Address: 13 2..--t( 5 6 S " cute k v�/ Occupancy groups:
City /State /ZIP: Tv ,,. j 0 'f 7 2- Z) / Existing:
Phone: ( ) Fax: ( ) New:
Jit APPLICANT ❑ CONTACT PERSON NOTICE
Business name: IA- if , ,,, e Ft de PA„ (eL1-1 Ut^ LL-C-- All contractors and subcontractors are required to be
Contact name: " SU "� licensed with the Oregon Construction Contractors Board
&-.-- rMfi under ORS 701 and may be required to be licensed in the
Address: 2 I La, a� A) (7 Lf 5J- jurisdiction in which work is being performed. If the
City/State /ZIP: 3 f ,„ S k �U,✓c-e to 14- 9 G o6 applicant is exempt from licensing, the following reasons
/// apply:
Phone: MO ) — 72 2_ - ri y'l ' / Fax:: (7 2 5`% "- ( 7 /3
E-mail: t/ — if t i CZ tt! 'e pro w C i l . €4.4.-.... t ` CONTRACTOR BUILDING PERMIT FEES*
Business name: (P�referto fee schedule)
Permit fee: (.0 21. so
Address: SA-7471 JI State surcharge (8% of permit fee): 5.4'0
City /State /ZIP:
FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application.)
CCB lic.: b (9 8 Q 7 Total permit fees:
Authorized signal Amount received: 07.5-0
This permit application expires if a permit is not obtained
Print name: oysi Vs.-v./N. u✓N. Date: '- f �- 2 V--0
within 180 days after it has been accepted as complete.
*
�U Fee methodology set by Tri -County Building Industry
Service Board.
l:\B m
uilding\Pnits\FP e rmitApp.doc 03/23/06 440-46I3T(1I /02/COM/WEB)
7
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 -10 heads: No plan review required.
❑ 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
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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 $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.
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 (8% 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.
I: \Building \Permits \FPS - PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00230
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/24/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .' ill..
INSPECTION WORKSHEET FOR DATE: 6/6/2007 TIME: 7:01AM PAGE: 48
SITE ADDRESS: 13221 SW 68TH PKWY 401 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HEALTH NET
DESCRIPTION: Modification of (6) fire sprinkler heads.
OWNER: TIGARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: ALPINE FIRE PROTECTION LLC PHONE #: 360-772-4199
Inspection Request Scheduled For: Date: 6/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinlder rough -in /test 049681-01 360- 772 -4199 Y
Corrections/Comments/Instructions:
C)4- *4 fl 49
C 1
'0 ' 4A : G / i ii 0 /
I 1 k ! 4 - <4 i
0
PASS El PARTIAL APPROVAL El CANCEL El NO ACCESS
�` ❑ FAIL 111 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: L 0 Phone #: (503) 718003 i1)