Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
.111 • COMMUNITY DEVELOPMENT Permit#: FPS2015-00118
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2015
Parcel: 2S 112 DB00300
Jurisdiction: Tigard
Site address: 7233 SW KABLE LN 500
Project: Nuance Systems Subdivision:HERN PACIFIC TIGARD INDUSTRIAL Lot: 5
Project Description: Adding 11 sprinkler heads to new enclosures.
Contractor: DELTA FIRE INC Owner: PACIFIC REALTY ASSOCIATES
14795 SW 72ND AVE ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-620-4020 PHONE:
FAX: 503-620-1058
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/03/2015 $123.72
12%State Surcharge-Building 08/03/2015 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 08/03/2015 $49.49
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 08/03/2015 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 08/03/2015 $25.00
11x17)
Commercial Sprinkler System:
Sprinkler Required Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
Density: .2 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 $215.06
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $5,000.00
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 . copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. J /
Issued By: Permittee Signature:
Call 04175 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 RECEIVED FOR OFFICE USE ONLY
City of Tigard
Received _
III Date/B : ? L� rJ/ Permit No.: Air A 0 i 57_,_,,6
" 13125 SW Hall Blvd.,Tigard,OR 9722311 2 8 2015 Plan Review i
= Phone: 503.718.2439 Fax: 503.598.1961-'L Date/By: ( t�' Other Permit:
T l G A K D Inspection Line: 503.639.4175 OF TIGARD Date Ready/By: / Jurist ® See Page 2 for CITY
Internet: www.tigard-or.gov BUILDING OF DIVISION
Notified/Method: t5 'X� Supplemental Information
BUILDING /{9 /
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
(S1 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
I=1 1-and 2-family dwelling IE Commercial/industrial Valuation: $
I=1 Accessory building ID Multi-family Number of bedrooms:
❑Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 72.33 SW Kable Lane New dwelling area: square feet
City/State/ZIP: Portland, Or 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: 500 Project name: Nuance System - Cleanrooms 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.
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.
Add 11 heads to new enclosures within existing building Valuation: $5,000.00
Existing building area: square feet
New building area: square feet
El PROPERTY OWNER ❑ TENANT Number of stories:
Name: Nuance Systems, Inc. Type of construction:
Address: 7233 SW Kable Lane#500 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing:
Phone:( 503) 620-9922 Fax:(503) 620-9921 New:
Git APPLICANT ® CONTACT PERSON NOTICE
Business name: Delta Fire, Inc. All contractors and subcontractors are required to be
Contact name: Heidi Scarbrough licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 14795 SW 72nd Ave. jurisdiction in which work is being performed.If the
City/State/ZIP: Portland, OR 97224 applicant is exempt from licensing,the following reasons
apply:
Phone:( 503) 620-4020 Fax::(503 ) 620-1058
E-mail: heidis @deltafire.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule/
Business name: Delta Fire, Inc. Permit fee:
Address: 14795 SW 72nd Ave.
State surcharge(12%of permit fee):
City/State/ZIP: Portland, OR 97224 FLS plan review(40%of permit fee):
Phone:( 503) 620-4020 Fax:(503) 620-1058 (Due upon application submittal.)
CCB lie.: 64174 Total permit fees:
Authorized signature. Amount received:
This permit application expires if a permit is not obtained
Print name: Heidi Scarbrough Date: 7-28-15 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Pennits\FPS-PennitApp_071514.doc 440-4613T(I I/02/COM/W EB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done: 1111111111116_ Eir -11111.11
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 ❑ 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
IN 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
T e of S stem Com lete A, B, C or D as a licable :
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group ORD Grp. 1
Density 0.2
Design Area
K. Factor 5.6
Sprinkler Project Valuation: I $ 5,000.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm I
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
D.) Residential Sprinlder(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 1)above): $
State Surcharge (12% of permit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
C:\Users\heidis\AppData\Local\Temp\FPS_PermitApp.doc 2
D E I.__'i' �S 14795 S.W.72nd AVENUE
PORTLAND,OR 97224 LETTER OF TRANSMITTAL
FIRE, INC. ��B# 746058020
DATE: 7/28/2015 I JOB#: 15-5462
ATTENTION: BUILDING DEPARTMENT
RE: Nuance System-Cleanroom
TO: City of Tigard
13125 SW Hall Blvd.
Tigard,OR 97223
VIA: Delivery By Heidi
COPIES I NUMBER I DESCRIPTION
3 Sheet 1-1 of 1 Drawing
3 Pg 1-58 of 58 Data Submittal
1 Pg 1-1 of 1 Permit Application
THESE ARE TRANSMITTED as checked below:
X For Approval For Review and Comment n
X For Your Use _Approved
X As Requested Submit_copies for distribution
—
REMARKS:
REPLY REQUIRED: DYES ONO BY DATE:
BY: David Aschbacher/Ben Smith/Heidi Scarbrough