Permit (34) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111111 .
*. ' COMMUNITY DEVELOPMENT Permit#: FPS2016-00093
Tit-3A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/06/2016
Parcel: 2S 101 AA02900
Jurisdiction: Tigard
Site address: 12259 SW 69TH AVE
Project: Consumer Cellular-Building B Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Adding, removing,and relocating sprinkler heads for TI.
Contractor: VIKING AUTOMATIC SPRINKLER CO Owner: SDC TIGARD CORPORATE CENTER INC
3245 NW FRONT AVE ATTN:ANDREW HARPER
PORTLAND, OR 97210 101 CALIFORNIA ST, 26TH FLOOR
SAN FRANCISCO, CA 94111
PHONE: 503-227-1171 PHONE:
FAX: 503-227-1552
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/06/2016 $177.52
12%State Surcharge-Building 06/06/2016 $21.30
Type of Use: COM Plan Review-Fire Life Safety-MF 06/06/2016 $71.01
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 06/06/2016 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 06/06/2016 $2.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 1500
K Factor: 8.0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $276.33
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $9,400.00
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 question_s_to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B6(, / Permittee Signature: (t .
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 RECEIVE])
9E Folz OFI'I( I: I SI,0 N
�l Received _
City of Tigard Date/By: /� Permit No.: F�(.3,.,i y"*,/,tn3
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revi- 1�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: r r �' Other Permit. /�j �j
Inspection Line: 503.639.4175 MAY 11 2016 Ready/. • e h toy�" /�t3
Date loris:
IIt.Altl) S
Internet: www.tigard-or.gov Notified/Method: 414 /4 6042 Supplemental Information
CITY O��Frr TIGARD " , r cs�
L. TYPE of Iii t N1 ' DAT .I (17, t IY t
❑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 El Other: equipment,materials,labor,overhead,and the profit for the
., : , C'ATEGORiI,OF`CON8'1`RUCTION
work indicated on this application.
El1-and 2-family dwelling 0 Commercial/industrial Valuation: $
Number of bedrooms:
El Number building ❑Multi-family
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I, 'a2-,-5-1 (5,t,...) 40 f New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:B,7 Project name:CONSUMER CELLULAR TI Covered porch area: square feet
Cross street/directions to job site:SW 69TH AVE&SW ELMHURST ST Deck area: square feet
Other structure area: square feet
REQUIRED DATA:aCOMMI RCIAL-USE HECKLIST
Subdivision: I 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.
TENANT IMPROVEMENT TO INCLUDE ADDING,REMOVING,AND Valuation: $$9,400.00
RELOCATING SPRINKLER HEADS TO MEET ADEQUATE COVERAGE SET Existing building area: 79120 square feet
FORTH BY NFPA 13 New building area: N/A square feet
❑ PROPERTY OWNER ❑ ENA T Number of stories: 2
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: LH
Phone:( ) Fax:( )
New: LH
® APPLICANT 0 CONTACT PERSON
NOTICE
Business name:VIKING FIRE PROTECTION All contractors and subcontractors are required to be
Contact name:MEGAN GIBBONS licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:3245 NW FRONT AVE jurisdiction in which work is being performed.If the
City/State/ZIP:PORTLAND,OR 97210 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)227-1171 Fax: :(503)227-1152
E-mail:megan.gibbons@vikingsprinkler.net
CONTRACTOR BUILDING PERMIT FEES*
Business name:VIKING FIRE PROTECTION (Please nrl°rt°Jer+elieafe)
Permit fee:
Address:3245 NW FRONT AVE
City/State/ZIP:PORTLAND,OR 97210 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)227-1171 Fax:(503)227-1152 (Due upon application submittal.)
CCB lic.:64837 Total permit fees:
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name:MEGAN B S Date:5/11/16 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:Building Permits FPS-PermitApp_031016.doc 440-4613T(I I 02 COMA WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
eset be 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 ❑ 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:
to A,B,C oR D as applicable):
e i n .�dee E e t . '
Sprinkler Type ® Wet ❑ Dry
Additional Standpipes N/A
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group LH
Density 0.1
Design Area N/A
K. Factor 8.0
Sprinkler Project Valuation: $ 9400
B,) Type I- Hood Fire.Suppression System
Hood Project Valuation: $
C.) Fire M rm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
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 D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
C:AOmni jobs\Consumer Cellular()PC-6412\Permit\Permit:Application.doc 2