Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
° COMMUNITY DEVELOPMENT Permit #: FPS2012 -00144
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/29/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Triangle Point Subdivision: VARNS ACRES Lot: 9
Project Description: Relocate 10 heads in new ceiling ground floor elevator lobby and restroom
Contractor: PATRIOT FIRE PROTECTION INC Owner: TRIANGLE POINTE LLC
4708 NE MINNEHAHA ST 901 NE GLISAN ST, #100
VANCOUVER, WA 98661 PORTLAND, OR 97232
PHONE: 360 - 699 -4403 PHONE:
FAX: 360 - 699 -4485
FEES
Description Date Amount
Specifics: Permit Fee - COM 08/29/2012 $102.20
12% State Surcharge - Building 08/29/2012 $12.26
'Type of Use: COM Plan Review - Fire Life Safety - COM 08/29/2012 $40.88
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .1 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 $155.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,500.00
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 1.800.332.2344.
Issued By: Permittee Signature: Deld ,/1 GY' to f 1
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 'T 1 P�C/ (� /J M/� � �f �.+
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.
AUG. 29. 2012 2:13PM PATRIOT FIRE VANC NO. 0510 P. 2
Buildine Permit Application
Fire Protection System 10« oily I I '.I 0.1
City of Ti and '°�
13125 SW Hall Blvd., Tigard, OR 97223 AUG 2 9 2012 lie s / penmt No.: t l e/A s � /a 017/40 ' • Phone: 503.718.2439 Pas 503.598.1960 DaterBy Other P P � a- pot 33
, , < , n „ ,, Inspection line: 503.639.4175 � Date Ready/liy: : . leas Rf See page 2 rep
Inter: www.tigard -oagov CITY OF TIGARD d1 KD S e)12/ upplemental Iatereaden
Buggincosta ` , ,, i. , . t YPE OF WORK REQUIRED DATAi 7- liND 2-I+ .Y,DWELLING '
❑ New construction ❑ Demolition Permit fees* are based on the value ofthe work performed.
�Addition/altorati �rP lsccmeat ❑ Other. Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
+ ; ` 'r '+ ,6XECO1RY Or ,CONN61RIIC1fION work indicated on this application_
0 1- and 2- family dwelling (7cCommetcinlrindnstrial
Valuation_ $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Otha: Number of bathrooms:
;• ,) • : , . , : ' ,'4T0 ,, SITE, INFORMATION, AND LOCATION - Total number of floors
lob site address: % ,33 S S'M 62714 v. Ut f New dwelling area: square feet
city /st I P: 'r\Cq aD, �D e_ all 2Z ' 1 ego/ square &et
Suite/bidgJapt. no.: I Project nemeTRGt.3 t ,,,,, +{ Covered porch area' square feet
Cross street /directions to job site: 1 Deck area: square fcct
. Other stmcmre area: square feet
Subdivision: I Lot no.: Permit foes' an 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 profs tbr the
" , " ( 'DESCRIPTION'OF+ WORK work indicated on this application.
X j() ' Ilea (-X3 x IM sr-- ME? rl f� tit lfOLVI D Vibration S
1 cLOti aS/1"4 l ot�$`f i Evir gem im--1 Existing building area: square feet
New building arcs: square feet
' r ppg y ")5 :: j riturrAra Number of stories:
Name ‘ l(r. e t 0. g Type of construction: `
Address: 113320'; Int:014 T \UN Occupancy group"''
City /staOel�IP: (� �) e& '"�72 — Existing: .
Phone: ( ) Fax: ( ) New:
, : I :APO4CANT ❑ CONTACT PERSON • , ' NOTICE. ' ' '
Business name: ?4S1ZItteIh ( p pry , L _. _ All contactors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact mime:
mO ea p31 under ORS 701 and may be required to be licensed in the
Address: A103 as niti 1A► ST. jurisdiction in which work is being performed. If the
applicant
City/State/ZIP: W a. Q� $fib I is exempt from licensing, the following reasons
Co u j1? ,
Phone. (160) to l 4443 . Fax : ) 6 4-46s
E-mail: r , M n • '' 1DT ILE. Cl1t i
„.,+ , ' cterrizApfoR BIIII•DII GPERMIi'FEES"' • .
Apka io*Tehedldsl
Business name: 7 Tatar t Pfaai iitN [tl L _ Permit fee:
Address: 4 O $ ere 1 t jigs v ST _
State surcharge (12'Yo of permit fee)
City /StatelZIP: q�{��vV z, VA. 1gb I FLS plan review (40% of permit fee): -
Phone• 4) . -,, , ,Log F3) 1 p l (Due upon application)
•' : lie.: `7022'., _ 1 Total permit fees:
Authorized aigaa 7 Amount received: 1 ( 5 5 3
19bie permit apportion expires Ha permit is not obtained
Print name: 173 � M e / Date: , cf , �� within 180 days after it has been accepted as complete.
• Pee methodology set by Tri-County Building Industry
AUG. 29.2012 2:13PM PATRIOT FIRE VANC NO.0510 P. 3
City of Tigard: Fire Protection Permit Checklist
Page 2 . Supplemental Information
escigi150i0kta lbe doge:
L) ❑ New 2.) Modification to spxinldex heads only:
❑ Addition � 1 -10 heads: No plan review required.
C, Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads; ILD
Additional description of work � WE ge 1 tam (1
Type if System (CompleteA,''B,-C or D, as`applicabxe):
A `.�Co pmn'er ial Sprinkler
a_ ❑ Dry
Additional Standpipes t..t t-
Information: Hazard Group Ltc 4 r w
Density . k -
Desigi Area Sao 5bf1
i Fa ctor 5
rinkler Pro ect Valuation: $ ` .11 —
, S ;� e;Y' - "Ho'od'Pi re Su I 'legged' :
Hood Project Valuation:
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
Sprinkler"(Stand System) •
•
Square Footage: Permit Fee: .
0 to 2,000 $198.75 , .
2,001 to 3,600 $24645 :
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. f
Fire Protection Permit,Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based o n p r oj ect valuation (see fee schedule): $
�' Permit fee based on square fie (see D above): $ -
State Surcharge (12% of permit fee): $
FIS Plan Review (40% of permit feel_ $
TOTAL $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal,
hop : / /v..45.1..ro, /dtv_A all /amdme ded/docs/FPrP.EitAppdoc Rev 01/95/2012
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
° COMMUNITY DEVELOPMENT Permit #: FPS2012 -00144
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/29/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Triangle Point Subdivision: VARNS ACRES Lot: 9
Project Description: Relocate 10 heads in new ceiling ground floor elevator lobby and restroom
Contractor: PATRIOT FIRE PROTECTION INC Owner: TRIANGLE POINTE LLC
4708 NE MINNEHAHA ST 901 NE GLISAN ST, #100
VANCOUVER, WA 98661 PORTLAND, OR 97232
PHONE: 360 - 699 -4403 PHONE:
FAX: 360 - 699 -4485
FEES
Description Date Amount
Specifics: Permit Fee - COM 08/29/2012 $102.20
12% State Surcharge - Building 08/29/2012 $12.26
'Type of Use: COM Plan Review - Fire Life Safety - COM 08/29/2012 $40.88
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .1 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 $155.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,500.00
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 1.800.332.2344.
Issued By: Permittee Signature: Deld ,/1 GY' to f 1
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 'T 1 P�C/ (� /J M/� � �f �.+
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.