Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
g COMMUNITY DEVELOPMENT Permit #: FPS2010 -00163
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2010
Parcel: 2S1 01 AD03500
Jurisdiction: Tigard
Site address: 6600 SW HAMPTON ST
Project: Quest Diagnostics Subdivision: Lot: 0
Project Description: Modification of (14) 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 12/21/2010 $123.72
12% State Surcharge - Building 12/21/2010 $14.85
Type of Use: COM Plan Review - Fire Life Safety - COM 12/21/2010 $49.49
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Height: ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0 Design Area: 0
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $188.06
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $4,200.00
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 obtain a copy of the rules
or direct qu ' ns to OU • by calling 503.232.1987 or 1.800.332.2344.
Issued / Permittee ignature:
et'
■
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.
•
• Fine Protection System - • -Y. ''.:,'': -. , �:.. -,.:- .:...:. _:. • � ,r'F7tf
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• . $iiitdin2 Application` t.._ _ 1 ,2... FOR OFFICE USE ONLI'
- < ,.:_ __:..t - _ Received • .
Ci OfT and " - / Permit No.:
g - - Date l3 . /� 1 P tV, -0016 J
_�e:
,_ ° 131 $ S W Mall Blvd., Tigard, OR 97223 _ • - : Plat) Rgvie > � J Other Permit:
Phone: '30109.417V Fax: 503:598. C96D " • - . _ � pate/g ; • 4��y�d
• -. T I G A R D Inspection Lane: -503'.639.4175 _, • CITY OF '.OAR If Date Ready :'y: �..� h ® See Page 2 for
. Internet: www.tigard- or.gov - BUILDING nIVISI t' a otified/Method: / 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: 6600 SW Hampoton New dwelling area: square feet
City /State/ZIP: Portland, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: . Project name: Quest Diagnostics 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.
Add New Heads for New Mezzanine and New Ceiling Construction Valuation: $$4,200.00
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:
g
Phone: ( ) Fax: ( ) New:
e APPLICANT ❑ CONTACT PERSON 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:
CONTRACTOR BUILDING PERMIT FEES'
Business name: Delta Fire, Inc. (Please refer to fee schedule)
Permit fee:
Address: 14795 SW 72 Ave
City/ State/ZIP: Portland, OR 97224 State surcharge (8% of permit fee):
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: ' . /
Amount received:
T his permit application expires if a permit is not obtained
Print name: Heidi Scarbrough / Date: 12 -21 -10 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
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•
City of Tigard: Fire Protection Permit Checklist •
Page - Supplemental Information
Describe work to be done:
•
1.) • ❑ New • 2.) Modification to sprinkler heads only.'
(21 Addition • ❑ 1 -10 heads: No plan review required.
• ® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 14
Additional description of work
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes N/A
Information: Hazard Group
Density 0.10
Design Area 1500
K. Factor 5.62
Sprinkler Project Valuation: $ 4,200.00
3.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
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.
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