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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT • COMMUNITY DEVELOPMENT Permit#: FPS2015-00191 TiGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/07/2015 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 310 Project: Bunce Palmer Subdivision: 1996-048 PARTITION PLAT Lot: 2 Project Description: Relocating(3)sprinkler heads. Contractor: DELTA FIRE INC Owner: PACIFIC REALTY ASSOCIATES 14795 SW 72ND AVE ATTN: N PIVEN PORTLAND, OR 97224 15350 SW SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-620-4020 PHONE: FAX: 503-620-1058 FEES Description Date Amount Specifics: Permit Fee-COM 12/07/2015 $64.54 12%State Surcharge-Building 12/07/2015 $7.74 Type of Use: COM Plan Review-Fire Life Safety-COM 12/07/2015 $25.82 Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 12/07/2015 $2.00 Occupancy Grp: Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $100.10 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $908.00 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 que UNC by c 503.232.1987 or 1.800.332.2344. Issued B : Permittee Signature: 7gietilzigt_ie2euarilL • 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 ApplicationVEP �� I Fire Protection System FORKOFpF�ICE USE ONLY City of Tigard F r 7 2 n<5, Date/BReceive:./ - 1 r) `/ Permit No.: 10,aj�/'s'�/7, 36 I u 13125 SW Hall Blvd.,Tigard,OR 97223 U Plan Review /� Phone: 503.718.2439 Fax: 503.598.1960 Date/B ©TC OtherPenniC u ��5��3 T 1 GARD Inspection Line: 503.639.4175 CITY 014 1IGAKD Date Ready/By: tuns: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information BUILDING DIVISI01‘ 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 ❑■ 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 M Commercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑ Master builder LIOther: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:6650 Redwood Lane New dwelling area: square feet City/State/ZIP:Portland, Oregon Garage/carport area: square feet Suite/bldg./apt.no.:310 Project name:PCC-Bunce Palmer TI 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(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Relocate 3 sprinkler heads Valuation: $908.00 Existing building area: square feet New building area: square feet X] PROPERTY OWNER 0 TENANT Number of stories: Name:PacTrust Properties Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: csi APPLICANT ® CONTACT PERSON NOTICE Business name: Delta Fire, Inc. All contractors and subcontractors are required to be Contact name: 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: CONTRACTOR BUILDING PERMIT FEES* Business name: Delta Fire, Inc. (Please refer to fee schedule) Address: 14795 SW 72nd Ave. Permit fee: i 00 I° 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: �'15 'UV at �n Amount received: Authorized signature: I L This permit application expires if a permit is not obtained Print name:Melissa Boughton Date:12-7-15 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\FPS-PenmtApp_07 I514.doc 440-4613T(11/02/COM/WEB) 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: 3 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 ❑ 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 ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $908.00 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 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: $ C:AUsers\heidis\AppData\].ocal\Temp\t+PS_PermitApp.doc 2