Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a COMMUNITY DEVELOPMENT Permit #: FPS2009 -00086
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/16/2009
Parcel: 2S113AD01900
Jurisdiction: Tigard
Site address: 16600 SW 72ND AVE B10
Subdivision: OREGON BUSINESS PARK I Lot: 9
Project: Spec Space
Project Description: Cap 1 -10 sprinkler lines for interior demo of office space.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY
Permit Fee - COM 09/16/2009 $62.50
#300 12% State Surcharge - Building 09/16/2009 $7.50
PHONE:
Contractor:
FIRESTOP CO
3203 NE 65TH ST. #2
VANCOUVER, WA 98663
PHONE: 360 - 718 -8604
FAX: 360 - 718 -8603
Type of Use: COM
Class of Work: FPS Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard:
•
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
PuII Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $70.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 3000.00
Residential Square Footage:
Fire Alarm Valuation:
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 : 'opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You ma o6tain . copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
��'lIIYYY 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.
finfiding Permit Applicatio ,
Fire Protection System FOR OFFICE USE ONLY
City of Tigard S EP 16 2009 Date /B : P No
�� o _, i�s a 9
IN '
o� —aoa��
■ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 13u�o?QO `� Dory/
11 . Phone: 503.639.4171 Fax: 503.598.1 Date/By: Other Permit
I - I �_ A IZ D Inspection Line: 503.639.4175 G� �9Y OF TIGARD Date Ready /By: Joris: ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: n 6-- 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/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: o p S• 0 1E4 /, New dwelling area: square feet
City /State /ZIP: eD „,,..t-1 , , O p 9 7l Z L..� Garage /carport area: square feet
Suite/bldg. /apt. no.: O Project name: /` L De...-.-,0 Covered porch ar :.: square feet
Cross street/directions to job site: Deck area: square feet
Other s cture area: square feet
REQ 11' D 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.
(- 1 ,f it ) es A Valuation: $ 3
e ' I e •e S , Existing building area: square feet
New building area: square feet
7ROPERTY OWNER I ❑ TENANT Number of stories:
Name: P G L t (.t-5 fe- Type of construction:
Address: t 'JS ( , J 5 , ,_ p Lw / -it .27 Occupancy groups:
City /State/ZIP: D✓kt a-Ncl oe. 9 - 7Z2 ( 4 Existing:
Phone: Goa 6, Z•(_ ( • Fax: F )6,-2.1 - -1-15c New:
tE2APPLICANT ❑ CONTACT PERSON NOTICE
Business name: F, f e54p . C . All contractors and subcontractors are required to be
Contact name: - a /- licensed with the Oregon Construction Contractors Board
ex under ORS 701 and may be required to be licensed in the
Address: '7) , to �•--- jurisdiction in which work is being performed. If the
City /State /ZIP: �� (,J applicant is exempt from licensing, the following reasons
apply:
Phone: ( Q) - 7 ( g - gam Fic:: (' -b ! 8 - FMn63
A J �
E E-mail: . .^,�S�D 6 2 - ? -- � '
�� CONTRACTOR BUILDING PERMIT FEES*
i (Please refer to fee schtduk)
Business name: ',_)
Permit fee: r 1. . 5-6 Address: °
State surcharge (12% of permit fee): 7 ...5-a City / State/Z[P:
FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application.)
CCB lic.: Total permit fees:
Amount received:
Authorized signature: 120 ,
This permit application expires if a permit is not obtained
Print name: A `L L l j P v--_ Date: 1 3 _ t CI -0 9 * within 180 days after it has been accepted as complete.
Fee methodology set by Tri-County Building Industry
Service Board.
I: 1Building \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:
1.) ❑ New 2.) Modification to sprinkler heads only:
El Addition N1 -10 heads: No plan review required.
Alteration ❑ 11+ heads: Plan review required.
El Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
El 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 (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.
I:\ Building \Permits \f PS- PetmitApp.doc 2
• Commercial Fire Protection System Permit Fees
State FMS Total
Project Valuation Permit Fee Surcharge Review Fire Protection
From: To: 12% 40% Fees
1 2,000 62.50 7.50 25.00 95.00
2,001 3,000 69.65 8.36 27.86 105.87
3,001 4,000 76.80 9.22 30.72 116.74
4,001 5,000 83.95 10.07 33.58 127.60
5,001 6,000 91.10 10.93 36.44 138.47
6,001 7,000 98.25 11.79 39.30 149.34
7,001 8,000 105.40 12.65 42.16 160.21
8,001 9,000 112.55 13.51 45.02 171.08
9,001 10,000 119.70 14.36 47.88 181.94
10,001 11,000 126.85 15.22 50.74 192.81
11,001 12,000 134.00 16.08 53.60 203.68
12,001 13,000 141.15 16.94 56.46 214.55
13,001 14,000 148.30 17.80 59.32 225.42
14,001 15,000 155.45 18.65 62.18 236.28
15,001 16,000 162.60 19.51 65.04 247.15
16,001 17,000 169.75 20.37 67.90 258.02
17,001 18,000 176.90 21.23 70.76 268.89
18,001 19,000 184.05 22.09 73.62 279.76
19,001 20,000 191.20 22.94 76.48 290.62
20,001 21,000 198.35 23.80 79.34 301.49
21,001 22,000 205.50 24.66 82.20 312.36
22,001 23,000 212.65 25.52 85.06 323.23
23,001 24,000 219.80 26.38 87.92 334.10
24,001 25,000 226.95 27.23 90.78 344.96
25,001 26,000 232.54 27.90 93.02 353.46
26,001 27,000 238.13 28.58 95.25 361.96
27,001 28,000 243.72 29.25 97.49 370.46
28,001 29,000 249.31 29.92 99.72 378.95
29,001 30,000 254.90 30.59 101.96 387.45
30,001 31,000 260.49 31.26 104.20 395.95
31,001 32,000 266.08 31.93 106.43 404.44
32,001 33,000 271.67 32.60 108.67 412.94
33,001 34,000 277.26 33.27 110.90 421.43
34,001 35,000 282.85 33.94 113.14 429.93
35,001 36,000 288.44 34.61 115.38 438.43
36,001 37,000 294.03 35.28 117.61 446.92
37,001 38,000 299.62 35.95 119.85 455.42
38,001 39,000 305.21 36.63 122.08 463.92
39,001 40,000 310.80 37.30 124.32 472.42
40,001 41,000 316.39 37.97 126.56 480.92
41,001 42,000 321.98 38.64 128.79 489.41
42,001 43,000 327.57 39.31 131.03 497.91
43,001 44,000 333.16 39.98 133.26 506.40
44,001 45,000 338.75 40.65 135.50 514.90
45,001 46,000 344.34 41.32 137.74 523.40
46,001 47,000 349.93 41.99 139.97 531.89
47,001 48,000 355.52 42.66 142.21 540.39
48,001 49,000 361.11 43.33 144.44 548.88
49,001 50,000 366.70 44.00 146.68 557.38
1:\Building\Fee Schedules \Fees COM -FPS 01 -0 1 -08.doc 1