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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 111111 ° COMMUNITY DEVELOPMENT Permit#: FPS201300123 • TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2013 Parcel: 2S113AC00102 Jurisdiction: TIGARD Site address: 7250 SW DURHAM RD, STE#900 Project: Universal Tea Co Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 25-27,2; Project Description: Relocate(5)fire sprinkler 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 08/28/2013 $56.47 12%State Surcharge-Building 08/28/2013 $6.78 Type of Use: COM Plan Review-Fire Life Safety-COM 08/28/2013 $22.59 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 $85.84 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $700.00 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 Notif • enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain - copy of the rules or dire questions to N y calling 503.232.1987 or 1.800.332.2344. lss ed By: A Permittee Signature: `\ 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 OV Y FOR OFFICE USE ONLY Received e r/ j, - City of Tigard 3013 Date/By: b �b I J '/ Permit No.: � i3—QU/� " 13126 SW Hall Blvd.,Tigard,OR 97223 1+% Plan Review Phone: 603.639.4171 Fax: 603.698.1960 p, .) �'` Sate/By: Other Permit: PaU42- O .' 3 TIGARD Inspection Line: 503.639.4175 cx,,'W `"..til ate Ready/Ey: Juris: 0 See Page 2 for Internet: www.tigard-or.gov V' Vt) Notified/1\4ethod: Supplemental Information TYPE l� VV ��g 1 OG.WORiw : REQUIREI):DATA:1;.ANll 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 ag,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 to mmercial/i.ndustrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: :JOB SITE INFOR119ATION AND LOCATION Total number of floors: Job site address: 72 bV721i 'n"�%b, New dwelling area: square feet City/State/ZIP: -0(A-gt), ©12._ 9-72_Z(`- Garage/carport area: square feet Suite/bldg./apt.no.: 9 D Project name:u/J)VE:" ° L 7 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. !� ' b 7C 5 �^�/2 57)R,+ k � 141) Valuation: $ OD. _ F�M /� C�� l� Li %zL'A=1/�,/P/D� & > �S�PT4� Existing building area: square feet �iK/ 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: � -iC 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.lithe City/State/ZIP: applicant is exempt from licensing,the following reasons apply: Phone:( )• Fax::( ) E-mail: "` CONTRACTOR S,, `'•B�.1ILDIN.G PERIVILT FEE , Business name: f/`wi—�'f/� ��� / ��� (Pleaserefcraofeeschedulel- - Address: 90,9`5— 5 L(1 U� ), 9 �° — Permit fee: City/State/ZIP: -G/� �� q"7zZ State surcharge(12%of permit fee): / FLS plan review(40%of permit fee): Phone:(�73 6.,94. —ZqZ 8 Fax:LT' 6 — 96:. 7 (Due upon application.) CCB lic.: &461-77 Total permit fees: (� Amount received: e '5- ` Authorized signature: (?�,�PiL2� This permit application expires if a permit is not obtained Print name:��� f�—� Date:8—27 j within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. t:tBuilding\PermitaFPS-PermitApp.doc 03/23/06 440-4613T(I1/02/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 4-10 heads: No plan review required. Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: 5 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 Fire Alarm Project Valuation: $ 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 (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/dots/FPS-PermitApp.doc 2