Permit 111 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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COMMUNITY DEVELOPMENT Permit #: FPS2011 -00074
TI R. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/17/2011
Parcel: 2S 112AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 110
Project: Sterling Communications Subdivision: PACIFIC CORP CENTER BLD 9 Lot:
Project Description: Pipe and sprinkler demolition in computer room. Tying new piping to grid.
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES LP
9095 SW BURNHAM ATTN: N PIVEN
TIGARD, OR 97223 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 684 -2928 PHONE:
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 06/17/2011 $102.20
12% State Surcharge Building 06/17/2011 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 06/17/2011 $40.88
Class of Work: ALT Type of Const: Info Process /Archiving - Lg Sheet (over 06/17/2011 $2.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process /Archiving - Sm Sheet (up to 06/17/2011 $4.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Hazard:
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 $161.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,187.00
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 : ° cosy of the rules
or direct questions to • NC by calling 503.232.1987 or 440g4.32.2.114.
Issued By: Permittee Signature:
//6 ✓r �/ _ iv mss-
Cal fi • 175 by 7:00 a.m. for the next available inspec ' n date.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Building Permit Application
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Fire Protection System FOR OFFICE USE ONLY -
City of Tigard 40t Received
( Air/ th b Date/By: � Permit No.: ,/ / 1 Li
'! 13125 SW Hall Blvd. Tigard, OR 972 ��
I
rilfilli
gar 'n Pl an R evue rJ
Phone: 503.639.4171 Fax: 503.598.1%:. . r ' - ��11 Date/By: 1 e , Other Permit:
TIGARD Inspection Line: 503.639.417 I. `^ 'j Date ReadyBy: Ions: RI See Page 2 for
Internet: www.tigard - or.gov \ vN Notified/Method: Supplemental Information
TYPE OF FORK Oktw
, ,.,. : ,,,. ; : ' ,,, ,; :, :, r. x , RE DA TA 1 AND 2 FAl D
❑ New construction ❑ Deg
Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY: OF CONSTRUCTION work indicated on this application.
ap
1:11 1- and 2- family dwelling mmercial/industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
,.. ;:<: �- s<:< �-,:: �>: � >,�M ��::.:: =s;;'';;,; >;;�;> >:i Total number of floors:
; :' ...:' - <` , RQT211 :A1VD - LOCATION
Job site address: l49 4 ;.. ii,/ s' (f o 0 ) A. - pit .) Y. New dwelling area: square feet
City /State /ZIP: --"O(4— O 9' 7 � 2_4 Garage /carport area: square feet •
. Suite/bldg. /apt. no.: Project name: S'"� n q )).4 ),, , Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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::RE. < U:<I1 .. b. , <T 1�:=::CO 1?L1V. Egd;•*t SE�C1 'EC; I:'_t$: V
Subdivision: I Lot no.: _Permit fees* are based on the value of the `„.,., _
-- - _ — performed.
Tax map /parcel no.: Indicate the value (rounde he nearest dollar) of all - _
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” "``" ' ' "`` °`<'� �� •� ' ° °� <���" work indicated on this application.
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pi pE ; :5pibt , l to d v 5 'm „ �ilipi' r e ps Valuation: . $ 2
R oom t i 1 Existing budding area: square feet /Li New building area: square feet
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. ..� >.....,......., ... ,I'ROP.,ERTI�. _OWNElL2,,.,_... ..., :.. r >.. : <,. <.�.,,.1.,.......::.�. ,..,::. Number of stories:
Name: S '�� `Ai q mit 1 i - 0 jvs Type of construction:
Address: /4 5 k/ : 5 0 0 t 4 ' K ut-, ) Occupancy groups:
City /State /ZIP: ' a,4-49 / r ie._ 22.
9 7 -4 Existing:
Phone: ( ) Fax: ( ) New:
` ,s
j �''rf� g„ All contractors and subcontractors are required to > be ,, •... ”
Business name: ---,- '�
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) • I Fax: : ( )
E -mail:
,
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Business name:
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`��� ..; � ::: < >::- <;:;�.;- ::; >t::(Plense efer.. fee sc eJ clef
0 95 . r W � Q) `1 � n Permit fee:
Address: �L
City /State /ZIP: ��� D �' � � � State surcharge (12% of permit fee):
( - l `- - FLS plan review (40% of permit fee):
Phone: (5C3) , ( 54 _ -2_9 2 _6 I Fax: (GD3) 6 . -- %, 57 (Due upon application.)
CCB lie.: (, 4-n77 _ Total permit fees: �I/ �j 3/ Authorized signature: Amount received: e
This permit application expires if a perm' is not obtained
Print name: i fJ � ,,,4-��L Date: 7 w ithin 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(11 /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
b wo to be d
:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Rep
Number of sprinkler heads:
Additional description of work:
,, . C of D as appllcab�.e)
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Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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Hood - Project Valuation: — $
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— -- Submittal_shall-- — __, Batter -y_ Calculations -- - - ❑ -- Yes- -- -- — - - - - -" - --
include: In dividual Component El Yes
Cut Sheets •
Fire Alarm Project Valuation: $
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"'£';, iii: " ";:tm�3�i��:':,: `i:a ^ ° •c �::'r,; �Aii:
Square Footage: ^ L: •
e: Permit Fee: = r �F;F .,, �' {�.: :_":;'.:;,<
111111111imismagSW :ity:A,., b..: >�::�:;: :%> si�3k::.: 0> 5�% 3� ,'^.xt".£; {ti5:,4s: »�.0 >i AS ^1, :u�•'o£, k' m, ?'.��; d3i; y .',z y : ; ::' X it.:[ t:?itY 'r A .::...:.,, ', .. ; ?: !fE0 to 2 000 $ 187.50
2,001 , �;.; �.3�E::,.
to 3 600
32.50 �... �.:
,.. � ? ?f ' a'� ''` � `; .< '.� �; .� ....;, ":v:r r3 n .. a s ,r..
r1 $292.50
3,601 to 7 �00
> >
M!v:: >: n.:: "::E::ra :1 :�:`1�"i' ^ � »' in•se.'
L`n
.. it
7,201 and 01 n greater x x }=
3 .
81 5
0
Sprinkler Project Square Footage: sq. ft.
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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.
http: / /www.ci.tigard.or.us/ city_ hall/ departments /cd /dots /FPS- PermitApp.doc 2
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