Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• COMMUNITY DEVELOPMENT Permit#: FPS2014-00069
T I G AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/07/2014
Parcel: 25101 AA09100
Jurisdiction: Tigard
Site address: 12447 SW 69TH AVE
Project: Capital One-Building C Subdivision: WEST PORTLAND HEIGHTS Lot: A
Project Description: Adding,removing,and relocating fire sprinklers for existing TI.
Contractor: FIRE SYSTEMS WEST INC Owner: TIGARD CORPORATE CENTER LP
600 SE MARITIME AVE#300 15325 SW BEAVERTON CREEK CT
VANCOUVER,WA 98661 BEAVERTON, OR 97006
PHONE: 253-833-1248 PHONE:
FAX: 503-289-2208
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/07/2014 $75.30
12%State Surcharge-Building 05/07/2014 $9.04
Type of Use: COM Plan Review-Fire Life Safety-COM 05/07/2014 $30.12
Class of Work: ALT Type of Const: IIIB Info Process/Archiving-Lg$2.00(over 05/07/2014 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 ,Info Process/Archiving-Sm$0.50(up to 05/07/2014 $7.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 1500
K Factor: 8
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $125.96
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,345.00 '
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: /
...zilt4; ______
Call 503.639.4175 by 7:00 a.m.for the next available ins";-ction date. ,
This permit card shall be kept in a conspicuous place on the job sit ntil compley i-of the project.
Approved plans are required on the job site at the ti a of each ingPzection.
Building Permit Application
Fire Protection System RtetiN FOR OFFICE USE ONLY
City of Tigard "" Received Date/By: r( mit gam- Permit No.: ! _����
13125 SW Hall Blvd.,Tigard,OR 97223 % \k ! _ /� `, Y
q Plan Revi
Phone: 503.718.2439 Fax: 503.598.196? fl Date/By: 44 t her Permit: O.,.�/Y_culses
TIGARD Inspection Line: 503.639.4175 A�D Date Ready/By: .1uris See Page 2 for
Internet: www.tigard-or.gov r(�NO T►G A" Notified/Method: ...51//01 t Supplemental Information
12 r-.1 Pac e -- t�trst l ll\ / c'M i./'7It ii-eL 111 Av-? i
TYPE OF P l' 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.
❑ l-and 2-family dwelling XCommercial/industrial Valuation: $
❑Accessory building El Multi-family
Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORl►IATION AND LOCATION Total number of floors:
Job site address: I . •14 7 5(A.) 6 ej 7J.t i4 v[S New dwelling area: square feet
City/State/ZIP:- I A Abeip 0g- 9) 2 2.3 Garage/carport area: square feet
Suite/bldg./apt.no.: C Project name:C ?CIL- ONg" Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:CONIMEKCLAL USE CHECKLIST
Subdivision: 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.
ti 912, SL ov - Fz6z.c>6 -R5 i ,r__,5: SPR_tNKQ,c-S F
Valuation: S c.
C t ST(Nit T�iv, rr (m Pl w i"�wwr'r
Existing building area: square feet
New building area: square feet
*PROPERTY OWNER ❑ TENANT Number of stories:
Name: T/4 4 A Cc:t.RP61-Ct c-Lsvvrb,c— L P Type of construction:
Address: 154Oc Ai(LL 1 i<prAl AM/ Occupancy groups:
City/State/ZIP: VSil-.'ja,\l/ 012- 7 7 0 0 6 Existing:
Phone:(Sb ) (.„el- .-2 Z_o 2, Fax:( ) New:
&APPLICANT ❑ CONTACT PERSON NOTICE
Business name: F'(i2t 5 of 7ayti S 4i63T All contractors and subcontractors are required to be
Contact name:J DT./ s,41,4∎1 'Sv�/ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:6,pr> 56 /i / -(1._1 ips1( /.)4--- 1_7 DA jurisdiction in which work is being performed.If the
City/State/ZIP: ^^ gJ���/ applicant is exempt from licensing,the following reasons
V/bjCOUv67L /Lf 4 apply:
Phone:(f k,0) 6 5 7 q%Q 6 Fax: :( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
` (Please refer to fee schedule)
Business name: F-5 C14 etS erZll,f) - Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lie.: 4' `3 -L Total permit fees:
Authorized signature - .
: Amount received:
��- This permit application expires if a permit is not obtained
Print name: Date: within 180 days after it has been accepted as complete.
JAso4p,Hes e q- z ►-► 9
• Fee methodology set by Tri-County Building Industry
Service Board.
I\Building\Permiti\FPS-PermitApp.doc Rev 01/05/2012 440-46131(1 1/02/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 ,J 1-10 heads: No plan review required.
Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 10
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 Li.11 .-41--
Density Q, (O
Design Area /
K. Factor 8, Ot<
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component 1:1 Yes
Ay
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
Arl 44,
0 to 2,000 $198.75 J
2,001 to 3,600 (v
$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/eity_hall/departments/cd/dots/FPS-PermitApp.doc Rev 0115/2012
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12447 SW 69TH AVE, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2014-00069
Jeff Grove
Violation Summary:
Inspector Contractor