Permit (104) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
F 11
COMMUNITY DEVELOPMENT Permit#: FPS2017-00152
TiriA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2017
Parcel: 2S 101 AD03500
Jurisdiction: Tigard
Site address: 6600 SW HAMPTON ST
Project: Farmers Insurance Subdivision: WEST PORTLAND HEIGHTS Lot: None
Project Description: Fire sprinkler permit:Adding sprinklers for TI.
Contractor: CROSSFIRE SPRINKLER CO Owner: PACIFIC REALTY ASSOCIATES
17400 SE 82ND DR ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-210-5506 PHONE:
FAX: 503-210-5538
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/10/2017
$295.88
12%State Surcharge-Building 10/10/2017 $35.51
Type of Use: COM Plan Review-Fire Life Safety-COM 10/10/2017
$118.35
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 10/10/2017 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 10/10/2017 $1.00
11x17)
Misc Administration Fee 10/10/2017 $5.00
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 $457.74
Valuations:
Required Items and Reports(Conditions)
Sprinkler Valuation: $20,110.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: j
/ / ermittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
• Fire Protection System
FOR OFFICE USE ONLY
City of Tigard Received /
]3125 SW Hall Blvd.,Tigard OR 97223 '� t., I,i""`^ " Date/By: / �(1 PermitNo.: P50,4//7'4/74 c�
_` Phone: 503.718.2439 Fax: 503.598.1960 "`"" ' G Plan Reviewi.1N
�"'�
Inspection Line: 503.639.4175 Date/Rea in( el L`� Otherermitga�]/,/> /�/1/q
TIGARD p Q►l/ /
Internet: www.tigard or gov 1; 9 ) Date Rea y: f Juris: F� See Page 2 for
.b N e hod ��
ohfied/M t
�) / I Supplemental Information
�- f/ V Su le
4 A 4 A;;; '',*—* * 1" ;ifiiii0i MiLlitelAirdr k. ;,"' ' *; —;::064i... l• :o'
❑New construction �;w � * ,V
0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other:
equipment,materials,labor,overhead,and the profit for the
\6 A A A X A 'A A A A A)A %A''‘ �� `$ RTP -*': work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
�� 0 Accessory building IDMulti-familyNumber of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
� � , k K Total number of floors:
Job site address:6600 SW Hampton St
New dwelling area: square feet
City/State/ZIP:Tigard,OR
Garage/carport area: square feet
t Suite/bldg./apt.no.: I Project name:Farmers Insurance TI
Covered porch area: square feet
rocs street/directions to job site:SW 68°'Parkway
Deck area: square feet
Other structure area: square feet
N1 Subdivision: .® $' .....—D,)1)4 ) r ! 64414v*
41 644> 1 Aii
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
X x ** work indicated on this application.
Add Pendent Sprinkler Heads into new ceilings Valuation:
$$20,110.00
td
Existing building area: square feet
New building area: square feet
iii tVt
u Number of stories:
t� Name:
Address:
Type of construction:
City/State/ZIP: Occupancy groups:
Phone:( ) Existing:
Fax ( )
4 *m,1* -,i4I" 4. � 1 i .
New:
v.
Business name:Crossfire Sprinkler . . �, ,, - • N x ;
All contractors and subcontractors are required to be
ontact name:Timothy A Bishop licensed with the Oregon Construction Contractors Board
Address:17400 SE 82"d Drive under ORS 701 and may be required to be licensed in the
City/State/ZIP:Clackamas,OR 97015 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
gPhone:(503)210 5506 I Fax::(503)210 5538 apply:
E-mail:timothy@crossfiresprinkler.com
Business name:Crossfire Sprinkler *A * -� � E
6; •44540.„,1 _
`� .
Address: Permit fee:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) r I Fax:( )
CCB lic.:174746 — _ (Due upon application submittal.)
i��/� Total permit fees:
Authorized signature: /� Amount received:
--,L_)
This permit application expires if a permit is not obtained
Print name:Timothy A Bishop Date:9/29/17 I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
I:\Building\Permits\FPS-PermitApp_031016.doc Service Board-
440-4613T(1 I/02/COM/WEB)
• City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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 . -etch showing area
to existing of work within building structure of work % in building structure
system
0, 11+ heads: Plan review required and ❑ 6 devices: Plan review required and
(3) sets of plans. 3) sets of plans.
Additional description of work:
foo P„ 9 & \-\._,44. -->
Osis abr4btt A oWD*spDli k * * * * 7 _ *.
Sprinkler Type Wet ❑ Dry
AdditionalStandpipes
Information: Stan
Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Lt 6,14lAQZ.,Ar2- — oF,Sr-
Density _to I tsoe'
Design Area /
510
K. Factor S- to
Sprinkler Project Valuation: I $ 2 c.e t t o
` i inpai'ijSSwp fan!g \A � �
Hood Project Valuation: $
Submittal shall Battery Calculations __ -----
include: Indiyidual striponent ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
4d11 p ( + bee i e * * �' `
9 g
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 `` """ �. "�'
$246.45 *
3,601 to 7,200 $310.05 * i M ,
7,201 and eater
$404.39 ` - v � 3 ;*' ..,
Sprinkler Project Square Footage: sq. ft.
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:\Documents and Settings\CAD\My Documents\Permits\tigard permit.doc 2