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Permit v CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT II 2 . .• COMMUNITY DEVELOPMENT Permit #: FPS2012 -00071 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2012 Parcel: 2S113AB01201 Jurisdiction: Tigard Site address: 16260 SW UPPER BOONES FERRY RD Project: Game Day Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30 Project Description: Add (9) fire sprinkler heads for TI 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: 503- 624 -6300 FAX: 503 - 657 -5182 FEES Description Date Amount Specifics: Permit Fee - COM 05/03/2012 $102.20 12% State Surcharge - Building 05/03/2012 $12.26 Type of Use: COM Plan Review - Fire Life Safety - COM 05/03/2012 $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: $0.00 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 q ions to ► UNC by calling 503.232.1987 or 1.800.332.2344. // Issued y: /, t � Permittee Signature: f�. 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 Building Permit Application F012 OFFICE USE ONLY City of Tigard CIE Date /B d ©A/ Permit No.: i a«� 7 l 13125 SW Hall Blvd., Tigard, OR RECEIVED PSP�� ' g Plan Review 6 n , `g - 0 � Phone: 503.639.4171 Fax: 503.598.1960 u /r/[w �� Date /B : Other Permit: Inspection Line: 503.639.4175 MAY - 3 2012 e..11 Date Ready /By: Juris: E1 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information CITY OF TIGARD BUth4INl81ON 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 ® 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: 16260 SW UPPER BOONES FERRY ROAD New dwelling area: square feet City /State /ZIP: TIGARD, OR 97224 Garage/carport area: square feet Suite/bldg. /apt. no.: 100 I Project name: GAME DAY MEDIA Covered porch area: square feet Cross street/directions to job site: SW UPPER BOONES FERRY ROAD & DURHAM 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 9 NEW HEDS IN SUITE 100 BUILDING 'E' Valuation: $$2,751.00 THIS IS A OVER THE COUNTER PERMIT, NO PLANS WERE SUBMITTED 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: ® 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 Phone: (503) 657 -5155 Fax: (503) 657 -5182 Amount received CCB lie.: 104570 , f Date received: . /55, 3-T Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: TODD CRIVELLONE Date: 5/3/20122 • Fee methodology set by Tri- County Building Industry Service Board. is \ Building \Permits \FPS - PermitApp.doc 12/03 4404613T(II/02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler 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: $ $2,751.00 B.) Type I - 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: • 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. C: \WSFP_OregonCity \LS2599 _Remington \TigardPermit.doc 2