Permit 4 CITY OF TIGARD
FIRE PROTECTION SYSTEM PERMIT
a COMMUNITY DEVELOPMENT Permit #: FPS2010 -00106
T I G A Ft O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/17/2010
Parcel: 2S 112 DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 290
Subdivision: PACIFIC CORPORATE CENTER Lot: 0
Project: Fairway America
Project Description: Adding and relocating a total of (3) sprinkler heads.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - COM 09/17/2010 $64.54
PORTLAND, OR 97224 12% State Surcharge - Building 09/17/2010 $7.74
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: Yes 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: 0
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 Or- „on
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of t - ules
or direct questions to OUNC by calling 503.246.6699 or 1.81t ' .
Issued By: / Permittee Signature: 1 ■41/4
day
CaII 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 FOR OFFICE USE. OM.)
Received
City
of Tigard , �� DateiBv: �) 0 3 Permit No.: r. -• — 001
:� a 4 13125 SW Hall Blvd., Tigard, OR 9 i r \0
s Plan Review
Phone: 503.639.4171 Fax: 503. t: C 1 DateiBv: Othe Pe rmit P �(J U0� 1
]�
�
T 1 G A R D Inspection Line: 503.639.4175 „Q P Q x C\ Date Ready/By: Juris: E2 See Page 2 for
Internet: www.tigard- or.gov C' � `\�\O Notified/Method: 7 CL Supplemental Informat
TYPE OF WORK G \ � � \s V REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ DemOon Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
AAddition/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 ACommercial/industrial Valuation: $
A ccessory building Number of bedrooms:
❑ g ❑ Multi - family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFOORMATION AND LOCATION Total number of floors:
Job site address: (0(050 5() {(,��� ^^•�A( 1«Jlt New dwelling area: square feet
City/State /ZIP: To 1 .44 / t A ()•••R��� 4 7 931- Garage /carport area: square feet
Suite 1dg. /apt. no.: 9 Project n Covered porch area square feet
Cross street/directions to job site: rcA'1rUx'.LCQ /"�Che('ICL� Ili. Deck area: square feet
V 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
A m DESCRIPTION OF -�- work indicated on this applicatiionn.. /�
1ocrA.k, d- he a- odd d 1 �r ne , \ - 1. L r . Valuation: S I i 0 0 . 00
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:
) APPLICANT ❑ CONTACT PERSON
NOTICE
Business name:
>l�, r, re.,, Tr
� t. All contractors and subcontractors are required to be
Contact name: HP.•tr��r,� rt'x� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be liensed in the
Address: 7C - ha n d jurisdiction in which work is being performed. If the
City /State /ZlP: A -la n ON 7 a al. i n p� a a p pp p licant is exempt from licensing, the following reasons
Phone: (6a3)6a0- `1ot�fo Fax:: (5a3) 000.0 -105
E -mail: het I S d et i r s ire , corn
CONTRACTOR BUILDING PERMIT FEES*
Business name:7)&6 ri r'p _ (Please refer w fee schedule
Address: 1 [., ` an � � �V � � Permit fee:
: f'If'lQ ` 1 d '7 ft State surcharge (12% of permit fee):
City /StateiZlP U
� FLS plan review (40 %ofpermit fee):
Phone: a9C 1 . (,`O,9 j I Fax: 15o,3) roan 106 (Due upon application.)
CCB lic.: (441 1 V" �/" ' Total permit fees: 7 ... (4 1 .0.,4 6 0/ ( c‘......." G� , „I - Amount received:
ur
Authorized signature.
This permit application expires if a permit is not obtained
Print name: • t i k .„. Date: 9/ 11/ 10 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I. Building PermitsTPS- PermitApp.doc 03,23;06 440 -46 13T(1I, 02.COAtWEB)
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 Iequired.
Alteration ❑ 11+ heads: Plan review required.
i ❑ Repair
Number of sprinkler heads: ,3
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
N1 Wet ❑ , Dry
Additional Standpipes itA
Information: Hazard Group Lire,
Density .15
Design Area iv Oo •
K. Factor 5, ( Q , 9 .
Sprinkler Project Valuation: $1
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 5292.50
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 (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.
[:` B iidng \Permits \FPS - PermitApp.doc 2