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Permit
q CITY OF TIGAR FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPME Permit #: FPS2013 00063 T i G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/19/2013 Parcel: 1 S136DA00100 Jurisdiction: Tigard Site address: 11308 SW 68TH PKWY Project: Comcast Tech Ops West Subdivision: PFAFFLE PLAZA CONDO Lot: 2 Project Description: Fire alarm replacement for TI. Contractor: COCHRAN INC Owner: BENENSON 68TH PARKWAY KEY LLC, T 7550 SW TECH CENTER DR #220 BY PROVIDENCE HEALTH SYSTEM TIGARD, OR 97223 ATTN: PROPERTY MANAGEMENT 1235 NE 47TH STE 160 PORTLAND, OR 97213 PHONE: 503 - 234 -6564 PHONE: FAX: 503 - 238 -2098 FEES Description Date Amount Specifics: Permit Fee - COM 06/19/2013 $610.36 12% State Surcharge - Building 06/19/2013 $73.24 Type of Use: COM Plan Review - Fire Life Safety - COM 05/22/2013 $244.14 Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg $2.00 (over 06/19/2013 $24.00 Occupancy Grp: B Height: ft 11x17) Stories: 2 Info Process /Archiving - Sm $0.50 (up to 06/19/2013 $23.00 11x17) 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: Yes Alarm Type: Automatic Pull Station Required: No Smoke Detectors Req: No Battery Cafes Provided: Yes Cut Sheets Required: Yes Total $974.74 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $62,350.00 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, . • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility otification Cen = . Th. e rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or di '-ct questions to OUN • • call g 503.232.1987 or 1.800.332.2344. Is ued By: I Permittee Signature: / Call 503.639.4175 by 7:00 a.m. for the next available ins, - tion date. This permit card shall be kept in a conspicuous place on the job s' • until completion of the project. Approved plans are required on the job site at the time of each inspection. BuiMt) Permit Ap plication F ri O I jF ,,� ` /� -e J Fire Protection System FOR OFFICE USE ONLY City of Tigard MAY 2 2 2013 Received 7i Permit No. ' tY g Dates•. — - 3- /3 •-A� S_ , 3 --eDD ° 13125 SW Hall Blvd., Tigard, OR 9722 fl n Plan Re i 111 0 . • Phone: 503.718.2439 Fax: 503.598.1 �F TIGA Dates : IP!•1 lj Other P • '_e 1.20 3 % / / -_ , r I Ci n k D Inspection Line: 503.639 BU DIVISION Date Readn - : r � �Cli Jana ® See Page 2 for Internet: www.tigard- or.gov Notified/Method:4 4 /3 � / / 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. Valuation: S ❑ 1- and 2- family dwelling NOommercial/industrial — ❑ 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: / /34g `3,72-//1 1/ New dwelling area: square feet 7 City/State /ZIP: ic #1 0 ©, 7 Garage /carport area: square feet Suite/bldg. /apt. no.: / D d Project name: rna 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. 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. .eZ ./ -�� ,t L Valuation: SZ 3) A'.1/2 /`� /l 5V- Existing building areAye square feet New building area: wi/ square feet ❑ PROPERTY OWNER TENANT Number of stories: Name: ) � , , Type of construction: 7M / .� �� Address: l `7d /-.4Oy F ?wA/4Oy IvD Occupancy groups: 8* -o City/State /ZIP:/P��[�Q �' Existing: �/ j4 ,7„¢ Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name• aLtir - All contractors and subcontractors are required to be Contact name: �,c licensed with the Oregon Construction Contractors under ORS 701 and may be required to be licensed in the Address: / 5 � 2 ��� ) jurisdiction in which work is being performed. If the 2P-7,47-2,0 O 97z 3 applicant is exempt from licensing, the following reasons City /State /ZIP: / !! apply: Phone: 9�3 ) 2e9 .� ---‘1:. X I Fax: ; ) 6' � �ag E- mail:., CTf7���:/ r 7 C /2/- t/I/fli ea~ � CO / NTRACTOR BUILDING PERMIT FEES* Business name: �i°T� t. / /./ ?. (Please refer to fee schedule! Address7' �� �/ ,) #224) Permit fee: City/State/ZIP: 7 t J ®g '912 — State surcharge (12 % of permit fee): FLS plan review (40% of permit fee): Phone:1. 2J 'Z 4 �/ Fax: ( * Z2 �7 '� (Due upon application.) � u yi �7 CCB lie.: 7Z94iT Total permit fees: Authorized signature: Amount received: a // This permit application expires if a permit is not obtained Print name: ; Date: / within 180 days after it has been accepted as complete. * Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \Permits\FPS- PermitApp.doc Rev 01 /052012 440- 4613T( 11IO2/COM/WEB) f City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) New/4 e2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. El Alteration ❑ 11+ heads: Plan review required. El 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: $ C.) Fire Alarm Submittal shall Battery Calculations Yes include: Individual Component Yes Cut Sheets 4"" Fire Alarm Project Valuation: $(pZ �j D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 7,201 and greater $404.39 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 (12% of permit fee): $ FLS Plan Review (40% of permit fee): $ TOTAL: $ Plan review requires a completed application and three (3) sets of plans at submittal. Plan review fees are required at submittal. http: / /www.tigard- or.gov /city_ hall /departments /cd /does /FPS - PermitApp.doc Rev 0115/2012