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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2010 -00159 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/16/2010 TIGARD Parcel: 2S113AB01400 Jurisdiction: TIGARD Site address: 7312 SW DURHAM RD Project: Protection One Subdivision: Lot: 0 Project Description: Relocate (6) 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 $83.37 12% State Surcharge - Building 12/16/2010 $10.00 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 $93.37 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $1,700.00 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 No - enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You may obti a copy of t - rules or di - t questions to 01 C b ailing 503.232.1987 or 1.800.332.2344. Is - ued By: p / "e0 / Permittee Signature: '� � / -�� Call 503.639.4175 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 ApplicationRECEN FOR OFFICE USE ONLY City Of Tigard DEC 1 6 2010 Date /By: �a / s, /0 (30 Permit No.: 8o?a�o +o • III to 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review - COQ Phone: 503.639.4171 Fax: 503.598.19 Date /By: Other Permit: 020/0 a!O-3 Inspection Line: 503.639.417 OF TiGARD Date Ready /By: Juris: lia See Page 2 for TIGARD g g B U I LDING DIVISION Internet: www.ti and - or. ov Notified Method: Supplemental Information : . "Y P E OF WORK t REQU DATA 1 AND2 FAMILY WELLIN z ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 0 Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the y c w ork indicated on this application. A ! :0, - 'GORY [?F CONSTRUCTION , z „ PP ❑ 1- and 2- family dwelling ® Commercial/industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: r JOB SITE `INFORMATION AND tLOCATI ©N r Total number of floors: Job site address: 7312 SW Durham Rd New dwelling area: square feet City/State /ZIP: Portland, OR 97224 Garage /carport area: square feet Suite/bldg. /apt. no.: Bldg H Project name: PacTrust Business Center Covered porch area: square feet Cross street/directions to job site: Protection One Alarm Deck area: square feet Other structure area: square feet QUIRED 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 z o indicated on this application. �� ? D OF WORK,' A; t work indi appy t' Relocate 6 Heads for New T.I. Valuation: $$1,700.00 Existing building area: square feet New building area: square feet a Y OWNE R ` E �� TE ` s ,,•.„,„„. Number of stories: O, 0PROPER . Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: �r ® LAPP CANT` " i s ❑ NTACT PE � , Flair, t z �a� - 1 , :-V - ' - ' , °‘ A E . _ / t,..,, >�,,., CO ` ,. y ,.. , 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 CONTRACTOR e ' l� ` ,A .6111),:,'0.o., „ " t ` 41C , � BU ILDING PERNIIT FEES - .. 4 1�S.n..,,,Z. ,fie., , „�.: ,,,.� -�. .., 5'ff „ �„ m a ,,. .. h ('Pl ease refe to fe se hed u teT F„ %! ,... &:” Business name: Delta Fire, Inc. Permit fee: Address: 14795 SW 72 Ave. State surcharge (8% of permit fee): City/State /ZIP: Portland, OR 97124 " FLS plan review (40% of permit fee): • Phone: (503) 620 -4020 Fax: (503) 620 -1058 (Due upon application.) CCB lic.: 64174 Total permit fees: Authorized signature: hat / Amount received: �j This permit application expires if a permit is not obtained Print name: Heidi Scarbrough Date: 12/16/2010 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 /23/06 440-46 13T( 1 1/02/CCM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information scribe wor =ta b e lane : , ! , , 1.) ❑ New 2.) M odifica tio n to sprinkler heads only El Addit ® 1 10 heads: No Plan plan review required ® Alteration El 11 + heads: review required. ❑ Repair Number of sprinkler heads: 6 Additional description of work Typ Syst „ (Comp l et e A $, ° \ C of D as apgh '.., : ...,, • , C9j ercial Sprinkle 3 ” ' ® Wet ❑ Dry Additional Standpipes NA Information: Hazard Group Light Density 0.10 Design Area 1500 K. Factor 5.62 1,700.00 Sprinkler Project Valuation: $ B } Y �Type I„ Hood '"Fire Suppression Sy rn y ,' ste Hood Project Valuat $ iii \v; `� . C F Alarm ,�y7 r 3 �, o " Su shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ €`pax �� D . Resl den i nal S nnkler (Stand Ala`eSy'ste , Square Footage: Pe Fee: 0 to 2 000 $187.50 6 2,001 to 3,600 $232.50 s , 3 601 to 7,200 k $292.50 • 7,201 and greater $381.50,. Sprinkler Project Square Footage: sq. ft. Fire; Protection Ferrnit Fees X., =,r'' 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 sea of an Oregon licensed fire suppression engineer, or NICFT level "3" technicians 440- 4613T(Il /02COM/WEB) L \ Building \Perm its \FPS- PermitApp.doc 03/23/06