Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a • COMMUNITY DEVELOPMENT Permit #: FPS2012 -00038
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2012
Parcel: 2S 112 DD00200
Jurisdiction: Tigard
Site address: 15862 SW 72ND AVE 100
Project: Remmington Center Clothing Subdivision: 1994 -006 PARTITION PLAT Lot: 2
Project Description: Add (4) sprinkler heads, relocate (5) heads and plug (1) head.
Contractor: WESTERN STATES FIRE PROTECTION Owner: PACIFIC REALTY ASSOCIATES LP
13896 FIR ST STE B ATTN: N PIVEN
OREGON CITY, OR 97045 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 657 -5155 PHONE:
FAX: 503 - 657 -5182
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/09/2012 $102.20
12% State Surcharge - Building 03/09/2012 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 03/09/2012 $40.88
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $155.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,363.00
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 • ' . - '• 1 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 • - ct questions to ∎ U - • . calling 503.232.1987 or 1.800.332.2344.
1 tied By: = I / ,, / Permittee Signature: x ,
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.
Fire Protection System ��ISINQoNIa'II116
Building Permit AnnlicatiogiV011a X IIO FOR OFFICE USE ONLY
6
City g Z ` of Tigard 1 QZ 11T 1• Date /B . i : P Received Permit No.: .5a: r7� y /p' X6 �/y� x
) 3g
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 4,--0016' 9. tl; + Date /By: Other Permit: u Pgp/A. 40/0
Inspection Line: 503.639.4175 ,.J04. e_ L Date Ready /By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/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
0 Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- 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: 15862 SW 72 AVE New dwelling area: square feet
City/State /ZIP: TIGARD, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 100 I Project name: REMINGTONS - PACIFIC CORP CNT Covered porch area: square feet
Cross street/directions to job site: SW UPPER BOONES FERRY ROAD & SW 72ND Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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 4 HEADS, RELOCATE 5 AND PLUG HEAD IN NEW OFFICE BUILDOUT Valuation: $$2,363.00
ALL WORK TO BE DONE FROM EXISING SYSTEM AND TO MEET NFPA 13 Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name: PACTRUST PROPERTY Type of construction:
Address: 15862 SW 72 AVENUE Occupancy groups:
City/State /ZIP: TIGARD OREGON 97224 Existing:
Phone: (503)956 -6290 Fax: ( ) New:
0 APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: WESTERN STATES FIRE PROTECTION Co. All contractors and subcontractors are required to be
Contact name: TODD CRIVELLONE licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13896 FIR STREET, SUITE B jurisdiction in which work is being performed. If the
City/State/ZIP: OREGON CITY, OREGON 97045 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 657 -5155 I Fax: : (503) 657-5182
E -mail: todd.crivellone @wsfp.us
CONTRACTOR
Business name: WESTERN STATES FIRE PROTECTION Co. BUILDING PERMIT FEES*
Address: 13896 FIR STREET, SUITE B
Please refer to fee schedule.
City/State /ZIP: OREGON, CITY OREGON 97045 -
Fees due upon application $155.34
Phone: (503) 657 -5155 I Fax: (503) 657 -5182
Amount received
CCB lie.: 104570
Date received:
Authorized signature:
c _V
This permit application expires if a permit is not obtained
s• within 180 days after it has been accepted as complete.
Print name: TODD CRIVELLONE Date: 3/9/20122 * Fee methodology set by Tri-County Building Industry
Service Board.
i:\Building \Permits \FPS- PermitApp.doc 12/03 440- 4613T(IIIO2 /COM/WEB)
•
i c
City of Tigard: Fire Protection Permit Checklist ,
- 'Page 2 - Supplemental Information
Describe work to be done:
1 ❑ New 2.) Modification to sprinker heads only:
❑ . Addition ® 1 -10 heads: No plan review required.
® Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 10
•
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
®. Wet ❑ Dry
Additional Standpipes
Information: Hazard Group LIGHT HAZARD - ORD
Density
Design Area
K. Factor 5.6
Sprinkler Project Valuation: $ $2,363.00
B.) 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.
Project Valuation Subtotal (A, B & C): $ 2,363.00
Permit fee based on valuation .(see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $,
FLS Plan Review 40% of Permit Fee: $
TOTAL: $
Plan review'requires a completed application and 3 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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