Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
illi
y Permit #: FPS2012 -00011
COMMUNITY DEVELOPMENT
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/10/2012
TIGARD Parcel: 2S112DC00100
Jurisdiction: Tigard
Site address: 15605 SW 72ND AVE
Project: Consumer Cellular Subdivision:HERN PACIFIC TIGARD INDUSTRIAL Lot: 1 -2
Project Description: Adding (26) fire sprinkler heads for TI.
Contractor: T & L COMMUNICATIONS INC Owner: PACTRUST
PO BOX 87387 15350 SW SEQUOIA PKWY #300
VANCOUVER, WA 98687 -7387 PORTLAND, OR 97224
PHONE: 360- 737 -9725 PHONE: 503 - 624 -6300
FAX: 360- 737 -9648
•
FEES
Description Date Amount
Sp ecifi cs: Permit Fee - COM 01/26/2012 $91.44
12% State Surcharge - Building 01/26/2012 $10.97
Type of Use: COM Plan Review - Fire Life Safety - COM 01/26/2012 $36.58
Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Sm $0.50 (up to 01/26/2012 $5.50
Occupancy Grp: B Height: ft 11x17)
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 $144.49
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,000.00
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 1.800 344.
,,
Issued By' / Permittee Signature: �3 Ia ....a L_____ „or
Call 503.• • .4 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.
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
• City of Tigard Received ��
I PermitNo.: ;`� - at)t
�
.
" 13125 SW Hall Blvd., Tigard, OR + ;,' \I. DateB L Plan Review
I IIII
Phone: 503.718.2439 Fax: 503.59: ' ''.0 6 �� DateB : ` • her Permit: .e , I , —
_ /_. 7
TIGARD
Inspection Line: 503.639.4175 w\ Date Ready Juris: 5 ee 'age 2 for
Intemet: www.tigard- or.gov ,P\� ( � �G� Gi _ S I O� Notified/Method t �yc / / 2 /� s€�/ / � Supplemental Information
,. , ., „; , .. ,,.. TYPE OF W o1. :, RE U , :u. ., i 'A.1 ND.•
❑ New construction Pt) olition Permit fees* are based on the value of the work performed.
Indicate the value (rowded to the nearest dollar) of all
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
.- ',:a : - 7 work indicated on this application.
AC::: X „ OF r COIV S T -- ; OIS' '
CATEGOR %;. =
dwelling Valuation: $
❑ 1- and 2-family g ® Commercial /industrial
❑ Accessory building 111 Multi-family Number of bedrooms:
❑ Master builder 111 Other: Number of bathrooms:
'rRt JOB SITE :;' INFORMATION ''%AND.:- LOCATION-; : . Total number of floors:
Job site address:46595 72” Ave New dwelling area: square feet
City /State /ZIP: Tigard, OR Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Consumer Cellular Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIREI)DATA:GO LSECFIEIS °•
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rowded to the nearest dollar) of all
/ equipment, labor, overhead, and the profit for the
"�," „ < 9 � a ES D work indicated on this application.
„ CRIPT� ON';OE� WORK-, ; ,
Fire sprinkler tenant improvement Valuation: $2a (),
Existing building area square feet
New building area: square feet
'' Q y "'' PROPERTY:; OWNER , A ,” TNANT„ , %-`
: .air., . ogjs - .,.,� .:,; „,k, Number of stories:
;;
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
%.,,... ,... „ ,F� ;
APPl;1CANT � � CONTACT: PER �- 1�:;� %- �,. :
,.F, .,, ,: >,; - „.. �i,;.,:.:: .- ,..., ter,.. .., r < NOTICE �7% �=�?°
Business name: T &L Communications, Inc All contractors and subcontractors are required to be
Contact name: Larry Bushaw licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: PO Box 87387 jurisdiction in which work is being performed. If the
City /State /ZIP: Vancouver, WA 98687 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 737 -9725 Fax: : (360) 737 -9648
E -mail: office @tl- communications.com
CONTRACTOR:; r; %°,' `; . �...? . t' >:;” 5 ,�e•y.. / T
y �ia,% ,. a ,,, ..'�; ;BUILDINGePE MIT >F,ES..
, l,a,a,.., ,,,> ..,..yi.r,.i ^.�; r••., ., :'•r „ { -r.r�. ,�w:- tea;.,. �'� '`�r� RR .. e
ter.<r /; _ a;5 "< "N ; r..
Business name: T &L Communications, Inc P1eas error eel ctie
Permit fee:
Address: PO Box 87387
City /State /ZIP: Vancouver, WA 98687 State surcharge (12 %ofpermit fee):
FLS plan review (40% ofpermit fee):
Phone: (360) 737 -9725 Fax: (360) 737 -9648 (Due upon application.)
CCB lie.: 67787 Total permit fees: 9 /'i il ,5-
Authorized signature: g (� - (1 x Amount received:
,J �QI�� This permit application expires if a permit is not obtained
Print name: Larry Bushaw Date: 1/25/12 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I: \ Budding 'Permits\FPS- PermitApp.doc Rev 01/ 05/2012 440- 4613T(11/02 /COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
4, ,„ Ive
g'1,„ ',Wi'V.' 'epl
illM , 4111115107:0% - W.Y.inkf:ir, ' ' ' IYI , t= ,, ,... '', k, 1,1 gv
1.) 0 New 2.) Modification to sprinkler heads only:
El Addition Li 1-10 heads: No plan review required.
IR Alteration El 11+ heads: Plan review required.
iii Repair
Number of sprinkler heads: P....(:)
Additional description of work:
Irfgof Wp (Ctr‘iiileii.A, Bt,tet6t1/1"Miiiitttleabli);', . iv7"'
,,.,,,,. - „ : ,/,----:',- ,r.:' ,- ;:lyzot ,3 ;.4;4.0-r' 7 ---1*1* -
0„.„„Ar„;;' ,:i„ ,,,,,.:„ :4.1i:W1::.M, -;-, )'.' -4 Y 4: riki: i '-r1,...; ' % O''%' ",,' '0Z'?
'V , „''''
'' , , -47471;7 ---- • r„
Wet ID Dry
Additional Standpipes
Information: Hazard Group L 0 ki
Density
Design Area
K. Facto . ( P
Sprinkler Project Valuation: $ 2... 0 c.3"
"
B 'I:
4 994 Fire Sitiii*:.4 ifa*§Ol04,- '::::!'"I''.:i::'[',
Hood Project Valuation: $
111 4.111 , ,, :: , :
..."( : -,,,, , .,"1 ,:,:,,.41,- , P ,Rvt., INV:4 :
Fite:Al u
ariy:1":::': „, : k-,:',; '::'' ,, '„It , '.:1111111111118111110:::::01 , .: , 1z , : - 1-- ''''-' 1 ' ' """'-',1%14'i'El li,,a
Submittal shall Battery Calculations El Yes
include: Individual Component III Yes
Cut Sheets
Fire Alarm Project Valuation: $
v antlarA
1
P:
ODINAt'Sidelitig":Spiiiikler
Square Footage: Permit Fee: ''. ,
0 to 2000 $198.75
111
2,001 to 3,600 $246.45 :kA2A75:11Arttittill
it :',' ,V,J„,•.,',ia'ri,%!
3,601 to 7,200 $310.05
7,201 and greater $404.3 raillLitt ;4W1V
Sprinkler Project Square Footage: sq. ft.
-P;t'dlaOKAIPiillAgttu:: FiiTraiNgai0,1Wle-hika4::;'::",t :: titIll,::SI-
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
http://www.tigard-or.gov/city_hall/departments/cd/docs/FPS-PermitApp-doc . Rev 01/25/2012
- ----......