Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 4 s COMMUNITY DEVELOPMENT Permit #: FPS2012 -00165
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2012
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 150
Project: RTM Investments Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: Modification of fire sprinkler heads for TI
Contractor: FIRESTOP CO Owner: PACIFIC REALTY ASSOCIATES LP
3203 NE 65TH ST #2 ATTN: N PIVEN
VANCOUVER, WA 98663 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 360 - 718 -8604 PHONE: 503 - 624 -6300
FAX: 360 - 718 -8603
FEES
Description Date Amount
Specifics: Permit Fee - COM 11/08/2012 $102.20
12% State Surcharge - Building 11/08/2012 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 10/24/2012 $40.88
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 11/08/2012 $2.00
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 $157.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $3,000.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 'pecialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work noJstarted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow e Fes adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. Y. m. obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
RECEIVED 4. ,y FOR OFFCE: USE Oi\Llu � ' � `*- .
Fire Protection S 1l �Y �I.� � , 1 � ;� � �" °�'
i<.. :: „?^.a'`�. FY'v$_`.,.:- L�r -. �__ u'�:, i:.i „_ -- ., ..te r,-.�,a;
: — 0 . 'l City of Tigard Receive f/ / , j, ^—/ A -G. /65
`- Date /By:
13125 SW Hall Blvd., Tigard OR 972 (' T 2 4 '1'� Plan Review
u ' ` Othe Perm a
� ` Phone: 503.718.2439 Fax: 503.598.19(10 Date /B tn ��� f � 'J �u�o�0 /pZ ���7�
ip.:::, cction Line: 503.639.4175 Date Read niris:
ia �RIDJ p b CITY OFTIGARD Y y / a/9 / 0 1 Ice Page 2 fur
` Internet: www.liaard or.e.ov Notified/Method: a0 �� Supplemental lemental Information
BUILDING DIVISION _ w (f
TYPE OF WORK REQUIRED DATA: I- 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.
III I- and 2- family dwelling K Commercial /industrial
Valuation: S
❑ 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: 14ci 45- 5,w. S6 el uo 1 A Pkw `j 11 New dwelling area: square feet
City /State / ZIP: P (Z T LA N b o 6 1 - 1 22- 4 Garage /carport area: square feet
Suite /bldg. /apt. no.: 1 S 0 Project name: IZT M 1 Nil £ STM EN TS Covered porch area: square feet
Cross streeUdirections to job site: Deck area: square feet
S. w. 1- A R p 1 N A L LA N C Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: 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
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
fLELocAl E PL
/ A N UG- F1 rLE RINKLES
R
Valuation: 3 , 41 ed
AcGOMb b Al E T-E NA NT Or) Q'1z -o V EN).E NT Existing building area: ti 846 square feet
New building area: square feet
J%f PROPERTY OWNER ❑ TENANT Number of stories: i
Name: P /V - \F 1 e SEA (.1`{ Assoc \A"1"." L.P. Type of construction: 11 _B
, J J. I
S EC,1V 6 I A Q {� 1n/�
Address: is 3 So S 4t 36 O Occupancy groups: B
City /State /ZIP:
Pa RT LA ' j 6 i2 4- _ Existing:. $
Phone: (So 3 624 - 6 3 Q o Fax: (5, 3 ) 6 2 4 - ">7 S 5 New: 6
X1 APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: E1 AZ Sib p arm PA NY LLL- All contractors and subcontractors are required to be
/
Contact name: g o 612_6 E licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: .32 0 3 N, E t G 5 s SPALE 'Z jurisdiction in which work is being performed. If the
City /State /ZIP: VRA1(4 U U C. (L i WA / c l 6 !O 3 applicant i exempt from licensing, the following reasons
apply:
Phone: (360 ) -7 IS—S 6,' Fax:: (360 ) `71$ -6603
E -mail: b d 6 , 9Yeeh cd6) siop . CaM
CONTRACTOR BUILDING PERMIT FEES* Ade-C t16”
Business name: SR Nl E S A V (Please refer to fee schedule, a o 0
permit fee: /0? , 2.0
Address:
State surcharge (12% of pennit fee): /?.. 4'
City /State /ZIP:
FLS plan review (40% of permit fee): VO. a 'hone: ( ) Fax: ( ) (Due upon application.) d U C
.2C13 lie.: 18 3 y'7 Total permit fees: X5'7. J 7
G
i 1
Authorized signature: ---x n /` Amount received: 1 � 0, �� .�w��/l p This permit application expires if:, Permit is not obtained
Print name: p_ g€ ILT D � �,E Date: 1 d/2 3 I 1 2 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry