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Permit �, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 11 4 COMMUNITY DEVELOPMENT Permit #: FPS2010 -00160 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/16/2010 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 15350 SW SEQUOIA PKWY 300 Project: Pacific Realty Subdivision: PACIFIC CORPORATE CENTER Lot: 0 Project Description: Adding and altering a total of (7) sprinkler heads for TI. Contractor: DELTA FIRE INC Owner: PACIFIC REALTY ASSOCIATES 14795 SW 72ND AVE 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PORTLAND, OR 97224 PHONE: 503 -620 -4020 PHONE: 503 - 624 -6300 FAX: 503 - 620 -1058 FEES • Description Date Amount Specifics: Permit Fee - COM 12/16/2010 $64.54 12% State Surcharge - Building 12/16/2010 $7.74 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Height: ft Stories: Commercial Sprinkler Svstem: 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: $1,000.00 Residential Square Footage: 0 Fire Alarm Valuation: $0.00 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 -0090. You may tain a copy of the ules or direct questions to OUNC by calling 503.232 • • • Issued By Permittee Signature: 4 A ' Call -' .175 by 7:00 a.m. for the next available inspection date. , 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. Fire Protection System Building Permit Application Received 14 ., , FOR O FFICE USE ONLY y am+ City of Tigard : O Date /B , 0 Permit No.: '- . Oa 1( " 13125 SW Hall Blvd Tigard OR 9 ` , Ptan Review l Phone: 503.639.4171 Fax: 503.598 9.0 \.% e n , Date/B : Other Permit: ;` • .10.....00 G2 T 1 GA RD Inspection Line: 503.639.4175 O� j cp ` 4 Date Ready /By: ® See Page 2 for Internet: www.tigard-or.gov ` �� ` `\C� \� Notified/Method: �/ Supplemental Information .. o ` .a0 \ TYPE °OF WORK REQ IREDDAT I AND2 FAMIL YDWELIN • ,� �i .,��° _ J-,..:—!:-.. ;�� , � *�a „��,.: - . � � �.� ,..: ... �,� , _ � ' :« ❑ New ❑ Demolition � ` `�... � Perm 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 r F - CTION ” work indicated on this application. ▪ 0,„ CA , T EO GRY O ,CUNSTR „ ,'" , ❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $1,000.00 ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: 1r-, ' 'JQB` S1Ti 1NFORMATI ©N AND LOCATION; `�` Total number of floors: 9- Job site address: 15350 SW Sequoia Parkway Building 17 New dwelling area: square feet City/State /ZIP: Portland, OR 97224 Garage /carport area: square feet Suite/bldg. /apt. no.: #300 Project name: Pacific Corp. Center • Covered porch area: square feet Cross street/directions to job site: PacTrust Deck area: square feet Other structure area: square feet REQUIRED D ATA COMMERCIAL' USE C HE ® ST 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 �4 s rr, ,E i + DESCRIPTIO O F WORI{ �� E work indicated on this application. Demo 3 heads, Add 1 Sprilker Head, and Relocate 3 Sprinkler Heads for T.I. Valuation: $ Existing building area: square feet New building area: square feet fW 0 ❑ PROPERTY' O '�i ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: -: • ® A PPLICANT � ..r... , y ,6.,, » , % , 4:r t o o .v,.. wow CT r ,� �. .. „ ,.._.. x> � � » NOTICE � � � Business name: Delta Fire, Inc. All contractors and subcontractors are required to be Contact name: Heidi Scarbrough licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 14795 SW 72 " Ave. jurisdiction in which work is being performed. If the City/State /ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons apply: Phone: (503) 620 -4020 Fax: : (503) 620 -1058 E -mail: heidis @deltafire.com » rgl, �., CONTRACTOR, d ',_ ,,, , j h % BUILDING PERMIT FEES � /, Business name: Delta Fire, Inc. . ' ( Ptease .refer`i'o ree£scheddlips., ,., ,. Permit fee: Address: 14795 SW 72 Ave. State surcharge (8% of permit fee): City/State /ZIP: Portland, OR 97224 FLS plan review (40% of permit fee): Phone: (503) 620 -4020 Fax: (503) 620 -1058 (Due upon application) CCB lic.: 64174 i Total permit fees: I Amount received: Authorized signature: jJ�,� l /�1/�, This permit application expires if a permit is not obtained Print name: Heidi Scarbrough r , te: 12 -16 -10 within 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(I I/02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information 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: 7 Additional description of work 'T a of S stem tom lete B C or, D ash ap , hcable A.:) CommerctaFSprtnlder T ® Wet ❑ Dry Additional Standpipes NA Information: Hazard Group Light Density 0.10 Design Area 1500 K. Factor 5.62 Sprinkler Project Valuation: $ 1,000.00 B) Type I Hood Floe S pp "ressioti System,. ... .� j z N . Hood Project Valuation: $ Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ i '"' z4 1 1", $%,i / 'Eat'^ i ) Residential Spnn1der (Stand Alone = System) i 3 Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 �ayst�ri 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 (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 03/23/06 440- 4613T(11 /02 /COM/WEB)