Permit - � . CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I I COMMUNITY DEVELOPMENT Permit #: FPS2013 00041
TIGARLD, 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/25/2013
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 355
Project: Spec Space Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: Relocate (1) fire sprinkler head and add (2) heads
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES
9095 SW BURNHAM ATTN: N PIVEN
TIGARD, OR 97223 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 684 -2928 PHONE:
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/25/2013 $51.09
12% State Surcharge - Building 03/25/2013 $6.13 •
Type of Use: COM Plan Review - Fire Life Safety - COM 03/25/2013 $20.44
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 $77.66
Valuations: Required Items and Repo rts (Conditions)
Sprinkler Valuation: $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 AO of the rules
or direct ques '. - • i • C by calling 503.232.1987 or 1.800.332.2344. . /
Issued B : I� = Permittee Signature: //
J\ _ l#62--l44-A1--k) /A/ /'
Call 503.639.4175 by 7:00 a.m. for the next available inspectio date.
This permit card shall be kept in a conspicuous place on the job site until c • pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System RED �u�p ; FoROFFieEusEOlvi.Y t
City of Tigard C
Re Date/By: a� i 3 Permit No.: /PSa /3 eo
' 13125 SW Hall Blvd., Tigard, OR 97223 MAR 2 5 2013 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: 4e,go < -WS-
7/7/PAR • Inspection Line: 503.639.4175 CITY OFTIGARD Date Ready/By: kris: El See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION 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
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 dwellingSommercial /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: (P t, 50 4 ?t)ve,49p� Z New dwelling area: square feet
City/State /ZIP: L aA2 / 97 Garage/carport area: square feet
Suite/bldg. /apt. no.: 3 Project name: ,5,2 )9 a'¢-r) -35S 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: 1 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.
' Valuation: $
1� O AO c) //L `ti s,/epti� �.
i�z S �, c- R � � �T�/ Existing building area: square feet
f/l �— 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:
AA PPL1CANT ❑ CONTACT PERSON NOTICE"
Business name: • �I �J riZjfC_.legZ— All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and maybe required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/ State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) • I Fax:: ( )
E -mail:
. ° CONTRACTOR " BUILDING PERMIT FEES*
Business name:,J m_-7--; F / /2.. p��� —�0� (Please refer to fee eschedule
� 93 f , /e A , , l� 5T, Permit fee
Address: ,l,I� =1C/
City/State/ZIP: 1 0 2� ' 7Z2. State surcharge (12% of permit fee):
/ FLS plan review (40% of permit fee):
Phone: (503) 4, —2 Z I Fax: (�3 6B4- 9b57 (Due upon application.)
CCB lie.: 64i9 7 Total permit fees:
i
Authorized signature: 7
� Amount received: #77,6(.0
----f----Ce.--- This permit application expires if a permit is not obtained
Print name: / v`r / Date: (/ O) -
� 1 it T� -26---/ within 180 days after it has been accepted as complete.
!2y �7 _
* Fee methodology set by Tri -County Building Industry
Service Board.
I:\BuildingkPermits \FPS - PermitApp.doc 03/23/06 440- 4613T(I I /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information •
,,• w;•
p
1.) El New 2.) Modification to sprinkler heads only
.Addition )g.1-10 heads: No plan review required.
Alteration CI 11+ heads: Plan review required.
0 Repair
Number of sprinkler heads: 3
Additional description of work:
4 Type of System (Complete A, B, C oiD as applicable)
-7;
; - •:‘ .
eotii Sprirdcler •
Wet 0 Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
Type f-1,464: Flie'S4pi5feWb,x).$y§tein
Hood Project Valuation:
C) Fire Alarm
, • , .
Submittal shall Battery Calculations 0 Yes
include: Individual Component El Yes
Cut Sheets
FLe Alauu Project Valuation; $
- -
•' =.4,= °:
Residential S"priliklOrf
Square Footage: Permit Fee:
0 to 2,000 $187.50
2001 , to 3,600 $23150
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Fir Protetion 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 (12% 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.ci.tigard.or.usicity_hall/departrnents/cd/docs/FPS-PermitApp.doc 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
6650 SW REDWOOD LN 355, TIGARD, OR,
97224
Commercial - Fire Protection System
999 Sprinkler Final
05/07/2013 00:00
FPS2013-00041
PASS - No C of O
Violation Summary:
Inspector Contractor