Permit •
•
CITY OF TIGARD
FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 -00162
- TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/25/2012
Parcel: 25101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 310
Project: Cascade Management Subdivision: VARNS ACRES Lot: 9
Project Description: Fire sprinkler modification for TI
Contractor: T & L COMMUNICATIONS INC Owner: GK TRIANGLE CORPORATE PARK III L
PO BOX 87387 BY THOMSON REUTERS INC
VANCOUVER, WA 98687 -7387 ATTN: MEGAN DOWLING
• PO BOX 130174
CARLSBAD, CA 92013
PHONE: 360 - 737 -9725 PHONE:
FAX: 360 - 737 -9648
FEES
Description Date Amount
Specifics: Permit Fee - COM 10/25/2012 $102.20
12% State Surcharge - Building 10/25/2012 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 10/18/2012 $40.88
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Sm $0.50 (up to 10/25/2012 $5.50
Occupancy Grp: B Height: ft 11x17)
Stories:
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 $160.84
Valuations: Required Items and Reports (Conditions) •
Sprinkler Valuation: $3,000.00
•
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 Notific ' enter. 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 estions to O C by ca • g 503.232.1987 or 1.800.332.2344.
Issued y: 0 Permittee Signature: �i� ��
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 Applicati IV FOR OFFICE USE ONLY
� /�
City of Tigard Permit No.: S f 2 -•d0/ /
IN
• 131 SW Hall Blvd., Tigard, OR 9722 18 20 1' DReceived a an R v i ew Q � � / ,.,/.
2 O Review / Other Permit: f (PNf �►^LS
Phone: 503.639.4171 Fax: 503.598.1990+ Date/B
Inspection Line: 503.639.4175 Date Ready /By: tuns: El See Page 2 for
TIGARD Internet: www.tigard- or.gov (1YOFTIGARD Not ied/Method: f #/ 0s i� S Information
QuILDING D1v S ON O 0 G I w/ ✓� ' "-'
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
El 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.
❑ 1- and 2- family dwelling ® Commercial/industrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13221 SW 68th Parkway New dwelling area: square feet
City /State/ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: No Project name: Cascade Management Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Fire sprinkler tenant improvement Valuation: $ 3,000.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
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:
y:
Phone: ( 360 ) 737 - 9725 Fax: : ( 360) 737 - 9648
E - mail: office @tl communications.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: T &L Communications, Inc.
Permit fee:
Address: PO Box 87387
City /State/ZIP: Vancouver, WA 98687 State surcharge (8% of permit fee):
FLS plan review (40% of permit fee):
Phone: ( 360) 737 - 9725 Fax: ( 360) 737 - 9648 (Due upon application.)
CCB lic.: 67787 9 //y /ey Total permit fees: erg
Authorized signature: A
Amount received: • t b
cv2-4---, t, Th is permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Larry Bushaw D ate: r U Q ' * Fee methodology set by Tri- County Building Industry
Service Board.
I:\ Building \Permits\FPS- PermitApp.doc 03 /23/06 440-4613T( I 1/02/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:
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
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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: $ 2,175.00
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.
Fire Protection Permit Fees
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 (8% 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.tigard- or.gov/ city_ hall/ departments /cd /docs /FPSPermitApp.doc 2