Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
n Permit #: FPS2011 -00080
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/06/2011
Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 250
Project: Spec Space Subdivision: TIGARD TRIANGLE CENTER Lot:
Project Description: Modification of (32) fire sprinkler heads for TI
Contractor: DELTA FIRE INC Owner: PACIFIC REALTY ASSOCIATES
14795 SW 72ND AVE ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 620 -4020
PHONE: 503 - 624 -6300
FAX: 503 - 620 -1058
FEES
Description Date Amount
Specifics: Permit Fee - COM 06/28/2011 $134.48
12% State Surcharge - Building 06/28/2011 $16.14
Type of Use: COM Plan Review - Fire Life Safety - COM 06/28/2011 $53.79
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg Sheet (over 06/28/2011 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 4 Info Process /Archiving - Sm Sheet (up to 06/28/2011 $10.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 1500
K Factor: 5.62
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $216.91
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $5,450.00
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 questions to OUNC by calling 503.232.1987 or 1 • 4.
Issued By: / - - -. Ytee Signature:
Call 503.6 .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.
r
Building Permit Application_
.
Fire Protection System R4 1 FOR OFFICE USE ONLY
111 l City of Tigard /_ �� / '' � OS0
�/ Date e," ' L Permit No:' �� O
• 13125 SW Hall Blvd., Tiaard,OR 97223 ✓.M/ plan Revte.
. Phone: W Hal 9A 171 Far: X03.59 960 � ` p � ® DaieBv ( Other Permit: AO / �0 7
Inspection 503.639.4175 v
Ins • di '� 4u � / / `'/
TIGARD p �Q �� ��,, Date Rea. luris: Ea See Page: for
Internet: www.[igard- Or.gov 8, .1-47).0 �F Notified/Ivlethod: 7/j-/1 ( Supplemental Information
TYPE OF WORK : S /QA, j � REQUIRE D •DAT:• ;' 1- _AND S- FAt1IIL' DWELLING.
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (roinded to the nearest dollar) of all
AAddition/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 IACommercial/industrial Valuation: $
Accessory building Number of bedrooms:
❑ • g ❑ Multi - family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 9 l l l 1)3 W L L New dwelling area: square feet
City /State /ZIP: ' 44( tl Fl 0 ,0, 91.9-9-3 1 Garage /carport area: square feet
410,Idg./apt. no.: it zo (j f Project name:? a C 'Pa C r Covered porch area square feet
Cross street directions to job site: c (3( `tC.a tt1 * Deck area: square feet
Other structure area: square feet
REQUIREDDATr1 COMMERCIAL- USE,CHECKLIST . •
F. . .. .e.... .'.r . . ' : -. ..: . ':: r.r.....:: a • •.C..r ,r.�•:,yy. v' /.a.�::...t ... ..
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value rotnded to the nearest dollar) of all
Taff map /parcel no.: equipment, materials, labor, overhead, and the profit for the
` DESCRIPTION WORK work indicated on this application..
Aid /' 1crc 1e 1lQ,lJtki`s (�„� fin, T �h Valuation: $ 5 50 •
�t-t)1 ' yCM� l� l• 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:
Phone: ( ) Fax: ( ) New:
g APPLICANT ❑ CONTACT PERSON
., NOTICE- ,
Business name: Dek,r F re T in` . All contractors and subcontractors are required to be
Contact name: Q ` r,I ndm�r `�, licensed with the Oregon Construction Contractors Board
� I t `' l (y/ p under ORS 701 and may be required to be lensed in the
Address: 1 141;5 A ) 7 JL e - jurisdiction in which work is being performed. If the
Of d OP, ^ -7 f applicant is exempt from licensing, the following reasons
City /State /ZIP: to (� L �f ^r apply:
ti.J Phone: a3) (0 9 _ Fax :: (,mss (' (�� ' tos s he a , T alp
E -mail: �' ,t S .
CONTRACTOR • BUILDI\ GyPERi11TL,FEES*
Business name: ( r .( rP f rot.?
_ (Please refer to" fee schedule
Address: IL( v 5t \ u 7 of Ave. Permit fee:
City/State/ZIP: or �cl O � State surcharge (40% of permit fee):
of permit fee):
/r' t^ �� 2 � � FLS plan review (40%
Phone: (6aS (t�69,0 - Nl.A7� i Fax: `E .� ( — 106 I (Due u•on ar•lication.j
CCB lic.: w 17� ` t Total permit fees:
Authorized signature: . / f / Amount received:
` - . . _ r A ��; This permit application expires if a permit is not obtained MI
Print name: • ' . �� :�� �� . I within 180 days after it has been accepted as complete.
-� * Fee methodolog set by Tri- County Building Industry
Service Board.
440- 4613T(l li0 ? /COMJWEB)
I. Building 'Permits \FPS- PermitApp.doc 03/23/06
City of- Tigard: Fire - Protection Permit - Checkli
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
yam'
Addition r1 1 - 1 0 heads: � \ plan i
U 1-10 t1eGUJ: 1�U plan LCVLCW CCC.�UILC(1.
C Alteration Ili 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: ag`
Additional description of work: • -
•
Type of System (Complete A, B,:C or D as applicable): •
A.) Commercial Sprinkler
Wet ❑ Dry
Additional Standpipes Al
Information: Hazard Group (,,$4,E
Density , 10
Design Area
K. Factor 5 '
Sprinkler Project Valuation: $ 5 IM, 00
B.) Type - 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:
I 0 to 2,000 5187.50 ,
2,001 to 3,600 5232.50
3,601 to 7,200 5292.50 •
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.
[: \ Buiiding \ Permits \FPS- PermitApp.doc 2
D E Ern 14795 S.W. 72nd AVENUE
PORTLAND, OR 97224 LETTER OF TRANSMITTAL
F I R E I N C ■ CCB# 6 503 -620- 2
FAX 503
CU: Chi L
JUN 2 8 2011
DATE 6/24/2011 JOB NO. 11-4750
CITY OF TIGARD ATTENTION: BUILDING DEPARTMENT
• BUILDING DIVISION RE: Pacific Parkway Center
TO: City of Tigard Spec Work Suite #250 •
13125 SW Hall Blvd. •
Tigard, OR 97223
VIA: 'RA
COPIES I NUMBER I DESCRIPTION
3 Sheet 1 -1 of 1 Architect Approved Drawings
3 Pg 1 -21 of 21 Architect Approved Data Submittal
1 Pg 1 -1 of 1 Permit Application
1 Each Check Totaling $216.91 For Permit Fees
THESE ARE TRANSMITTED as checked below:
X For Approval For Review and Comment
For Your Use Approved
X As Requested Submit copies for distribution
•
REMARKS:
REPLY REQUIRED: OYES LINO BY DATE:
BY: Tim Carpenter /Heidi Scarbrough