Permit 114 u CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
c COMMUNITY DEVELOPMENT Permit#: FPS2013 00158
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/31/2013
Parcel: 1 S136DD03400
Jurisdiction: Tigard
Site address: 11740 SW 68TH PKWY 250
Project: Oregon Health Care Association Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Adding(2)sprinklers to second floor offices.
Contractor: PATRIOT FIRE PROTECTION INC Owner: HEALTH CARE ASSOCIATES LLC
4708 NE MINNEHAHA ST 11740 SW 68TH PKWY
VANCOUVER,WA 98661 TIGARD,OR 97223
PHONE: 360-699-4403 PHONE:
FAX: 360-699-4485
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/31/2013 $51.09
12%State Surcharge-Building 10/31/2013 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 10/31/2013 $20.44
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: B Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .1 Design Area: 225
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 $77.66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $400.00
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 copy of the rules
or direct stions UNC by calling 503.232.1987 or 1.800.332.2344.
lssu d By: Permittee Signature
Call 503.639.4175 by 7:00 a.m.for the next available insp: ion 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.
2IECE7_VED
Building Permit Anulicatio.'
Fire Protection System 1 (IR 01•11( I.( ,,i 0%11
OCT 3 0 2013
City of llgard Received
Date /6 3/ (3 arr- Pant'INa' fi-s-aa13—oc)Lse
Iii•- }I3tto2nSc SW Salim Blvd, Plan Review
9 Ird... 503C4t3M01/OF TIGARD D2wEly
" ILnlaectio n w Lwiwe.t ip5or3
doiar9gAov n s II M se Page 2 for
ma - _ BUILDING DIVSON
729* I Supplemental Information
:,..':'':, .;'.T1/1*.0.WilRIC::: :',....... ::. ,t,'
0 New conmuction D Donation Permit fees*are bawd on the value of the work performed.
indicate the value(zotmdad to the nearest dollar)of all
Cil Additionlakeratien/replecement 0 Other: emlipment.materials,lab ,ovahead,and the profit fbr the
,;rido.43.,,A.g.:s,;,... .;i,,e,A:,,:e.,,,p4..,,i'j;*:', .'7^;;.,7:t:,:,V,j,,Ai7,.1t, work intik:act!on this applieatim_
•.',,,,,'A +'.,•,',:•ot -:1..k'!:'?,,;•:,,..,I,,..:'..';`,: 1,Y.:"..'":;..•-•.?..7..',•sst.f,4'i.ls,.:.t.P.',1, -ts..;■',,J'e,,-;,z-,:‘,re,;',;,:.-:
•
Dl-and 2-family dwelling EgiCoramercialimdasbi Valuation: S al
Nmrther of bakoonam
O AccessaybuDding 0 Muhi-fanagy
El Master builder 0 Othen Number of bathrooms:
. .
411*.'42ri0.001,00i,;,;;i:T'4'APC:#‘0,1F,: ::"4;`,P .:. : ',..:;," Total number dawn: -
Job site address:11740 SW 6111hFicay New dwelling an= square feet
cmy/StrderZIP:Tigard,OR 97223 Garagelcuport area: square foci
Suiteibldg2apt.no.:250 I Project name:OUCA Covered porch area square Ibet
Cross street/directions to job sites SW ablaut Street Deck ave= square feet
. .
Other structure area: square feet
Subdivision: 1 Lot no.: Permit fees"are based on the value of the work performed.
Indicate the value(rottuded to the nearest dollar)of all
TM(Rnal3/PIXtet no.: equipment,materials.labor,overhead,and the profit for the
": U , 010z,g,;0:0,:#00{.a::.',:: 'Kr.,:;y:hUrti ),.;,,W, ,, work indicated on this !,•lication.
Wind 0,om S4000
add spinlders for new walls
Existing building area: same square feet
, ..
New building mem lame square feet
17.4***.,#.. F.*....2: :::::;':‘,71:1 ,.::,,'..:•:;;:i,J. .'.:.,, ,;..42,),;.„'.:,',: !' Numba of atones. 2
Name:Oregon Beak Care Assoc. Type ofoanstruction: 3-B
Address:11740 SW figh Play,sake= Occupancy grcuPa:
City/State/71P:Tigard,OR 97223 Existing. B
Phone:( ) Fax:( ) New: B
1;!:...C7Tri*E-9,1T:",',`:,1'ils
- ' •‘ '" ;.,,,L'A.,::1.,-:- ..i.hg,,,,,e,,g1,,—„..:rii:*,,t'..;v4,6. :4,,,,,,Ab‘
Business name:Parka Fire Protection,Inc AB contactors andsubeontractors are required to be
licensed with the Oregon Construction Coln/actors Board
Contact name:TM Balm
under ORS 701 add may be requited In be licensed in the
Addrrae:4708 NE bilmtaltabw Street jurisdiction,ill which wotk is being performed.If the
amlicamtis masaptfraut licuasitg,the following reasons
City/StakIZIP:Vasenaver,WA 90661 MA,:
Phone:(369)699 4403 Fax::4360)-6MAIII3 -31o0"-Gq q-iiii6 .
Dismal:ted.bskerapattiotOre.ana
-,:',;,:2, :',,Ilt:',.:N.''.',11r.t.),-...i,s.Aig;6. 4.4?*":4:ifY,;,taS;::?`1144Airriitg:V.-0
Business name:same as above
Penult fee:
Ackkess:
State surcharge(12%°foment fee):
City/State/ZIP: .. .
— FLS plan review(40%of permit fee):
Phone:( ) ,z,---- I Pmc( ) aDu e von application.)
CCI4lic_z 70022 Total Funk fees:
Authorized sisal:darer 0;L— Amount received: 77.6*
This permit application expires if Is permit is not obtained
Print name:Ted Baker I Dam 10-28-13 1 within indays after it has been accepted as complete
• .
Fee meihodolosy=thy Si-Comity Building Industry
Service Board.
takarbralPeanitAPPS-Peacitivp.doe 02/01/11 44044132(11A32/0014AVP10
'cl 96 'ON ONVA hld 101E_Vd AV17 :8 Eli(,) '0, '100
City of Tigard: Fire Protection Permit Checklist
Page 2 Supplemental Information
1.) 0 New 2.) Modification to sprinkler heads only:
Addition El 1-10 heads: No plan review required
Alteration El 11+heads: Plan review required.
CD RePair
Number of sprinkler heads: 2
Additional description of work:
ypofen (CDmpLAi •• • • • • • •
n•,. . ,‘•
Additional Stancipes no ______
Infi7rmsuion: I-Iazard Gnotry ght
—Density .1
Design Area 225
K.Factor 5.6
Sprinlder PEject Valuation: $ 400
Typr-___$ood Fire SppeioiSysteifl . : •
Hood Project Valuation;
, S; •
), • c!, ,• . ;•,.• ,,,•.•• • • • • " •
Submittal shall Battery Calculations 0 Yes
Include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Projer-t Valuation: $
Square Poomge: Pewit Pee;
0 to 2,000 $198.75
2,001 to 3,600 $24645
3,601 to 7.200 1310.05 ;
7,201 and greater 404.39
Sprinkler Project Square Footage: sq.ft.
'.Fire,PicitectiOnTeitinnitfeittl.'s. .„ , • ,•
Project valuation subtotal(see A,B&C above): $
Permit fee based on project valuation(see fee schedule): $ —
Permit fee based on s e see D above: $
State Surcharge(12%of permit fee) $
FLS Plan Review(40%of permit fee): $
TOTAL: $
Plan review requires a completed application and2 sets of plans at submittal. Plan review fees are required at submittal
C\Dou erds awl Setif'1gs teelbakar\Desktop OHCA Remodel 3241 581\119ud 12.4fiekvit see page Mee 02/01/11
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OHCA -\
U74 0 SW 68 Overall Second Floor Plan
1168th Pkwy, suite 2S0 r ,
-- Tigard, OR 97223 ' No scoit
°O 32-11851 '____„,
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