Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2014-00180
Date Issued: 11/25/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DA00800
Jurisdiction: TIGARD
Site address: 15115 SW SEQUOIA PKWY 200
Project: Sumner College Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: Adding(16)and relocating(10)sprinkler heads for TI.
Contractor: AFP SYSTEMS INC Owner: PACIFIC REALTY ASSOCIATES LP
19435 SW 129TH AVE ATTN: N PIVEN
TUALATIN,OR 97062 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-692-9284 PHONE:
FAX: 503-692-1186
FEES
Description Date Amount
Specifics:, Permit Fee-COM 11/10/2014 $123.72
12%State Surcharge-Building 11/10/2014 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 11/10/2014 $49.49
Class of Work: ALT Type of Const: IIIB Info Process/Archiving-Lg$2.00(over 11/10/2014 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 11/10/2014 $2.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .15 Design Area: 1500
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 $192.06
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $4,300.00
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 a copy of the rules
or direc .uestions to• NC by calling 503.232.1987 or 1.800.332.2344.
Iss =d By: / 4I /• Permittee Signature: }
IMOLA Call 503.639.4175 by 7:00 a.m.for the next available inspection 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 �`l� FOR t)l I It 1 I 'Nl O\I-ti
71 City of Tigard C �I Received !r/ Permit No.
a ` 13125 SW Hall Blvd.,Tigard,OR R V �yI -•a —s
Phone: 503.7182439 Fax: 503.598.1960 1°4 Dafe/g : li g& (I MiIll�a Other Permit:
'I-1 1.J A it D Inspection Line: 503.639.4175 `w 1 Q Date Ready runs: See Page 2 for
Internet: www.tigard-or.gov 1`► `� a] (� Notified/Method: / �i ��' Supplemental Information
TYPE OF '' , REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ' 0 o Aeon 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.
❑ 1-and 2-family dwelling El Commercial/industrial
Valuation: S
m
❑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: 15 I(5 Su" 5�,l d D i 0. P mot. “4 New dwelling area: square feet
City/State/ZIP: -r- j p �, v Garage/carport area: square feet
Suite/bldg./apt.no...-2,„.1.3,4i60 Project name: 5 k ,, co tcel,L 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(romded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
,,((�� DESCRIPTION OF WORK
rrII work indicated on this application.
F £GL l 1 5e tnvt e,ir �c— 1 CLL4C to Valuation: $ y,30Q C CO
Existing building area square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Se. 4 e.NnS 4-1✓l.0• All contractors and subcontractors are required to be
Contact name: 5 L.:f, - ','. et-la-4-3 with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: Ic't,-L 5 S 1.17. l 2°l Cl" jurisdiction in which work is being performed.If the
City/State/ZIP: � ,v,, 0 a_ �-0(e Z applicant is exempt from licensing,the following reasons
��,�,pp apply:
Phone:( D3) Leal Z•ct 2$'-f Fax: :(�3) (o 12. 118(0
E-mail:-Sttsc .tti6)i a.Cp s..(S .L.t.vv,
CONTRACTOR BUILDING PERMIT FEES*
Business name: �p`,4, as, 4�eve_
(Please refer rode Permit schedule)
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%ofpermit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.: Le-15 3■-t Total permit fees:
) Amount received:
Authorized signature•�( l fie,.�►aJ
This permit application expires if a permit is not obtained
Date: t within 180 days after it has been accepted as complete.
Print name:
tea` V� �t�id`(� • Fee methodology set by Tri-County Building Industry
Service Board.
I uilding'Permits\FPS-PermitApp.doc Rev 01/05/2012 440-46131(11ro2/coa/WES)
--s
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done:
1.) Type of-Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: ( Number of alarm devices:
[Addition or ❑ 1-10 heads: Affidavit required and El 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
® Wet El Dry
Additional Standpipes Na
Information: Hazard Group /f
Density , (13
Design Area
K. Factor- Cj,IR
S•rinkler 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 $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: $
I:\Building\Permits\FPS_PermitApp_071514.doc 2
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
15115 SW SEQUOIA PKWY 200, TIGARD, OR,
97224
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2014-00180
Chip Barnett
Violation Summary:
Inspector Contractor