Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
t: COMMUNITY DEVELOPMENT Permit #: FPS2013 00087
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 06/25/2013
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 120
Project: Meridian Tech Subdivision: WEST PORTLAND HEIGHTS Lot: 9 -25, PT
Project Description: Relocate (1) fire sprinkler head and add (4) heads for TI
Contractor: WYATT FIRE PROTECTION INC Owner: PACIFIC REALTY ASSOCIATES
9095 SW BURNHAM ATTN. N PIVEN
TIGARD, OR 97223 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 684 -2928 PHONE' 503 - 624 -6300
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 06/25/2013 $64 54
12% State Surcharge - Building 06/25/2013 $7 74
Type of Use: COM Plan Review - Fire Life Safety - COM 06/25/2013 $25 82
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 $98.10
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation $940.00
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 No • ation C - er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a c•py of the rules
or direr questions to OU by c. ling 503.232 1987 or 1.800 332 2344. _ ��
Issue By: ' /, Permittee Signature: % �
� ,
Call 503.639.4175 by 7:00 a.m. for the next available inspecti. 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
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard Dat: /B : 'M ►s PernutNo: / ∎ 5-e9687 Received
' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
JUN 2 5 2013 Other Permit: Phone: 503.639 4171 Fax: 503 598.1960 Date/By:
TIGARD Inspection Line 503 639.4175 CITY O� 11 G Date Ready/By. Jura- El l See Page 2 for
Internet: www.ttgard -or gov l �l l UC►luJ Notified/Method. Supplemental Information
BUILDING DIVISION
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
0 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: $
111 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: /2. 9t79 ,ki 6er-A pKki L New dwelling area: square feet
City/ State/ZIP: 4 ^
`8 l 2.0 1 og_ Z
9-7 Z 3 Garage/carport area: square feet
Suite/bldg. /apt. no.: ` 2c:3 Project name: MM•)) `r-, ( a/ZP 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
?(.'"(261"----r- y74-1.1) DESC PI RIPTION WORK I I � /, work indicated on this application.
/ / ,t 4 ' SPP-V L s _ Valuation: $ 94-0, .2
"Ai e7D A-12---Al- 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:
PPLICANT ❑ CONTACT PERSON NOTICE
Business name: - j -- e_o,o• r, r o,e_. All contractors and subcontractors are required to be '
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be 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: ( ) ' Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
yky / pi 7:),477--------C:77 D (Please refer to fee schedule)
Business name:
qVS 6 i i � J � Permit fee:
Address: -
City/State/ZIP: --pan-yip 0, 97 2 Z3 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (5 � Z Fax: ( j G 0 3 03 -9z:6 7 (Due upon application.)
CCB lic.: 6 4 ,P 7 7 Total permit fees:
Amount received: as98 • /D — Authorized signature: � /—
This permit application expires if a permit is not obtained
Print name: �(-,a,,,,t,-,-, Date: (p --W- /') within 180 days after it has been accepted as complete.
• * Fee methodology set by Tri-County Building Industry
Service Board.
1 \Building\PermitsTPS -Perm itApp doc 03/23/06 440- 4613T(I1 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
, De's6i . ib l wO'rk to be' do'
1.) New 2.) Modification to sprinkler heads only:
fl Addition i0.1.-10 heads: No plan review required.
- 0..Alteration 11+ heads: Plan review required.
n Repair
Number of sprinkler heads:
Additional description of work:
:
A tini
),'1Ciiiefeiat riitikteKCY ,:`
Wet 11 Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B) Type 14 49.d.Fiie Sitopressio4Sysieto; ,
Hood Project Valuation:
C) FireAilarm
Submittal shall Battery Calculations Yes
include: Individual Component LI Yes
Cut Sheets
Fire Alarm Project Valuation: $
. 4 404'
— ,
D:),Ateiktelitia A10,110
Square Footage: Permit Fee: , 4.
. ,‘I3 "■'"'
0 to 2,000 $187.50
2,001 to 3,600 $232.50
;•„. ,L; 4
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
• 1;Z:
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.us/city_hall/departments/cd/docsrFPS-PermitApp doc 2