Permit 1114 ,� CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
it COMMUNITY DEVELOPMENT Permit#: FPS2015 00146
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2015
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY, STE#210
Project: NW Capital Management Subdivision: VARNS ACRES Lot: 9
Project Description: Fire sprinklers-Install(30)drops and add approximately(10)uprights.
Contractor: EXPRESS FIRE SYSTEMS INC Owner: TRIANGLE POINTE TWO LLC
1913 41ST STREET 901 NE GLISAN ST, STE 100
WASHOUGAL,WA 98671 PORTLAND, OR 97232
PHONE: 360-953-8432 PHONE
FAX: 360-953-8394
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/13/2015 $112.96
12%State Surcharge-Building 10/13/2015 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 10/13/2015 $45.18
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 10/13/2015 $2.50
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 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 $174.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,251.00
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 starte• within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires ypu to follow the rules a••pted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o+t.'n a copy of the rules
or direct questions to OUNC by calling 503.232. •: • .800.332.2344.
Issued By: Permittee Signature:
�i _� _ _ _ _� i/%
al • .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 oft /•tiect.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application �j r ��jj
Fire Protection System RECEIVED FOR OFFICE USE ONLY
ived t'.r�D/Zi )
City of Tigard Rece Dateiv : !D Permit No.: i
• 13125 SW Hall Blvd.,Tigard,OR 1 O 2015
Plan Review Si�t�j�� A1/s.
Phone: 503.718.2439 Fax: 503.598.1960 Plan Date/B R : r 1 •ther Permit: P�(j/�j=QO''7
1 I c,A R t) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: / luris: Supplemental See Page 2 for
Internet: www.tigard-or.gov it CITY if Notified/Method: Min Supplemental Information
- , "TiPE001 AEQUIRED DATA:I AID 2-FAMI.Y 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.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other. Number of bathrooms:
JOB SfE INFORMATRO AND'LOCATION Total number of floors:
Job site address:13333 NE 68th Parkway New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldgJapt.no.:210 I Project name:NW Capital Management 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: I 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
? Rk far 1 r ON OF WORK work indicated on this application.
Install 30 Sprinkler drops due to new ceiling and walls Valuation: $3,251.00
and add approx.10 sprinkler uprights due to new demising walls Existing building area: square feet
New building area: square feet
; ❑`PROPERTY *I .R
�_ ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: Light Hazard
Phone:( ) Fax:( ) New: Light Hazard
APPLICANT; Y .' CONTACT PERSON
NOTICE
Business name: Ex P^<.S.S pre .� All contractors and subcontractors are required to be
Contact name: 7' �t••� j/ ,ert CJ I
licensed with the Oregon Construction Contractors Board
YWV under ORS 701 and may be required to be licensed in the
Address: /� t ) jurisdiction in which work is being performed.If the
�j
City/State/ZIP: ✓0L � KJ /i/V applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax ( )
E-mail. ,(,
_ xi , be , W
:,a ,: / - , C1 A LTQR BUILDING PERMIT FEES*
Business name:Express Fire Systems,Inc. (Please refer(o fee schedule)
Permit fee:
Address:670 S 28th Street
City/State/ZIP:Washougal,WA 98671 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(360)953-8432 Fax:(360)953-8394 (Due upon application.)
CCB lic.:193272 / Total permit fees:
Amount received:
Authorized signature: ek), This permit application expires if a permit is not obtained
Print name:Pattie Wenholz dillillif Date:09-08-15 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Pennits\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(I1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Descdbe;.work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 30
Additional description of work:
Type of System (Complete A,B,C or D as applicable):
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes N/A
Information: Hazard Group Light Hazard
Density N/A
Design Area N/A
K. Factor 5.6 QR
Sprinkler Project Valuation: $ 3,251.00
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 Alane''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: 4,986 sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A,B & C above): $ 3,251.00
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.
S:\Design\_Express Misc\City of FORMS\Tigard City-NW Capital Management---21 doc Rev 01/05/2012
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
13333 SW 68TH PKWY STE 210, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2015-00146
Jeff Grove
Violation Summary:
Inspector Contractor