Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
g COMMUNITY DEVELOPMENT Permit #: FPS2012 -00006
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012
:TIGARD Parcel: 2S112DA00700
Jurisdiction: TIGARD
Site address: 7000 SW REDWOOD LN
Project: Northwest Engineering Service Inc Subdivision: PACIFIC CORPORATE CENTER Lot: 3
Project Description: Fire suppression system under new mazzanine.
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES
9095 SW BURNHAM ATTN: N PIVEN
TIGARD, OR 97223 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 684 -2928 PHONE: 503 - 624 -6300
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 01/19/2012 $67.23
12% State Surcharge - Building 01/19/2012 $8.07
Type of Use: COM Plan Review - Fire Life Safety - COM 01/19/2012 $26.89
Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg $2.00 (over 01/19/2012 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 01/19/2012 $2.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
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 $106.69
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,040.00
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 not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow e rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -0'1 0090. ou ma, obt.in a copy of the rules
or direct questions to OUNC b calling 503.232.1987 or 1_8" "
Issued By: �_ u - Si. nature: , I �
1� 1 VI
Call 503.639.41 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.
y • Building Permit Application •
Fire Protection System :FOR OFFICE USE. ONLY
C1 of Tigard Received ::: ' + ` l T, t`, Plan Review • `i 1 a` ♦ 0 : / )---
Date/By: t�A►�FJ[� D _ 1,
TIGARD
Inspection Line: 503.639.4175 P� \� . A� B : Date ReadyB� Imo: 8 See Pave z for
Internet: www.tigard- or.gov , Q \k Notified/Method: � .. / Supplemental Information
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- x.�:�;>r�r ' - a ,.�- M aL i. - TIFE x,s�:.- iOF W x " %r _ � �\ °:ate': te "``"f"i" REQUIRED -�a s€ - nU'�*... : .•xve:: "a� „�”- .:- ��v't;..':y�:- DWEL'L1NG
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DATA 1 S AND 2 FANL LY
❑ New construction jb emolition 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 • ii , � .;r „�=�; - CATEGORY C(�NSTI2IIGTION � work indicated on this application.
, ,. , ,. OB=
❑ 1- and 2- family dwelling Commercial/industrial Valuation: $
II] Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ,E1 Other:
Number of bathrooms:
:'.bra” ,b::,, , :.,i�F3r?: c.: .'r,; ..� . ;, T ,k,,,, , ,4 ',;y "A ,'_ .,
; '1 " , Total number of fl
>',.n.: - " -_� ' °r °' - ° "_ � ota mum er o floors:
•,, .. q : t o� ; •" :1.OB , 'SITE INFORMATION .I -e ' 10 " - -, : ,,' `,,' =;.,,
',k"'.,a:. z',:_, :: ': ks' ^ :F`. ,, i. °.: -', -. �n�, .,H %"#�x� �` : 5 .- + � - `., ,tom r 5 ,,. - , �Eac �'" i..�'.
�,,, r
Job site address: '7 7 l f " � 7 q �49 p "s New dwelling area: square feet
City/State /ZIP: �j £ / ) I C) J 9 "7ZZ -4 Garage carport area: square feet
Suite/bldg. /apt. no.: Project name:» kl itiaiAli 2_ Covered porch area: square feet
Cross street/directions to job site: gro 6 MG Deck area: square feet
Other structure area: square feet
W LEODIRiu ibATA COlVI14Itlie- AI USE C HECKLIST
"
. Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
rm
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
R . # , $(" „ rx equipment, materials, labor, overhead, and the profit for the
x I ` DESII' l iOt o WORTC k . N ._ , '' ' work indicated on this application.
+�' 4.A s. ,.,,.,,1. ,- ,,, 5 -. F. - n _ ., . - ,, - , , -.:•,...;"14; , , ,, ,r , -, . . - 'a�':�whrm;w, =' :( . ,,,..v,.1 ,.n: c'.,, ,x,: 3• E• _•x a•.M.
•7 Vii) fi t - A. A)g.. .- p/777 Valuation: $ j L� n ,
/
I
P D - / / 9f fi1 , i,�s (251Al2-L69 Existing building area: square feet
� f Ci t�l r 7 New building area: square feet
ROPEItT1 �V1VE12 ' `" ANgT' k: t. k . f, - :.,,,- Number of stories:
��0; ;gin � , + 0, �� �xh. .g ,� ,
ml�� �( �- .�� fi
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Name: Type of construction:
Address: Occupancy groups: .
City/State /ZIP:
Existing: 1,1141• . 05 •
Phone: ( ) Fax: ( )
New: I I
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Business name: 4N' � b,4_ All contractors and subcontractors are required to be '
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: ( ) ' Fax:: ( )
E -mail:
A'
CO ACTOR ;. 'x * - ,:
x +
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Business name: ''� ,e,,,,,,, o "w= "...,,,, ,,,,Blease;refcr %tn fee'schedndet :%
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Address: 9095— , E3L), }(, Yn Permit fee _
City/State /ZIP: �1a4g� n 1a - q 7 22_3 State surcharge (l2% of permit fee) —
! �/ FLS plan review (40% of permit fee):
Phone: ("�3) a, _2'9Z Fax: (5D 3) &e7 - 9 57 (Due upon application.)
—
CCB lic.: b 4 7 Total permit fees_
Authorized signature: Amount received
`N This permit application expires if a permit is not obtained
Print name: ..C.) /14/17"--) Date: ( -� -1z_ within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1:1Building\Permits \FPS- Permi1App.doc 03/23/06 440- 4613T(1 I /02 /COMN✓EB)
I- :f
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
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,'Describe -work to�be..done•�� _ � ,� '� � � �° �' ��» �-
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration -1+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
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❑ Wet ❑ Dry
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 Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
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a. `"2t ,:. ,$„ <`:��' �'�.;- .`�.. , ,�.... .�s '�' "r.;,<�1�' ° b',
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es den 1 ` "rim l Al , ri � .,,_. ,� ; `.., u.
ti:a 'S` er; SVR.gk o e 'iS-'.stem� - ,
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S quare Footage: Permit Fee: �a s: ..vT ..w •.^? F� :, ?. �s' ru<s" vvk".",%= ?�::3sn:� "i5�a�:�i „tn'.%=rt��t �,.= xr;,.' �'' �sz . *.. *k - # ^a
0 to 2,000 $187.50
.a `kR, : 1? , =,' ;r, x.: < si W3
2,001 to 3,600 $232.50 - :i3::� t
.<, < <: v
',_ = 'i, „K
3,601 to 7,200 $292.50
. 7,201 and greater $381.50 reg:r o`F':-;'e =, r::<,,...”
Sprinkler Project Square Footage: sq. ft.
rz 's�''r • . , F•n
t ti n <.;P
pro ec o ermttSF.ees:::F `E�;�� °r
- . . . ,5, , ax¢g3'dy'd � �:��a. -< ':Z %;r. . ! ;;`;ti
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