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Permit (116) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT • 11. COMMUNITY DEVELOPMENT Permit#: FPS2018-00008 Date Issued: 03/21/2018 Tt G R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101AB03100 Jurisdiction: Tigard Site address: 12115 SW 70TH AVE 200 Project: Dr.Steven Gabel MD PC Subdivision: 2012-009 PARTITION PLAT Lot: 3 Project Description: Add(59)sprinklers for TI. Contractor: SPRINKIT FIRE PROTECTION INC Owner: TIGARD TRIANGLE PARTNERS LLC PO BOX 2227 18187 SIERA DR OREGON CITY, OR 97045 LAKE OSWEGO, OR 97034 PHONE: 503-272-6650 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-COM 03/21/2018 $209.80 12%State Surcharge-Building 03/21/2018 $25.18 Type of Use: COM Plan Review-Fire Life Safety-COM 03/21/2018 $83.92 Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 03/21/2018 $2.00 Occupancy Grp: B Height: ft 11x17) Stories: 1 Info Process/Archiving-Sm$0.50(up to 03/21/2018 $5.50 11x17) Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: LT Density: .01 Design Area: 1500 K Factor: 5.5 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $326.40 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 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. 344. Issued By: ,11.." rmi4feeSf9nature: � •��/\ — ./ 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. w Building Permit Application Fire Protection System FiE(3EIVEr) FOR OFFICE USE ONLY City of Tigard Received Permit No.: t �� DateB : � � # 11111 a 13125 SW Hall Blvd.,Tigard,OR 9722f-EB 2 0 ?018 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/B : — I Other Permit: A_/ iv 1. Inspection Line: 503.639.4175 CITY O fi Date Ready/By: : ,�� H See Page 2 for Internet: www.tigard-or.gov U! T I G.4 R D ,giNL'D Notified/Method:- -! ( Supplemental Information ef t�� ,� �+t LL '771 77 lis TYPE OF WORK REQUIRED DATA:1-AND 2FAMILY DWELLING ❑New construction 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 ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. GATEGORY;OFCONSTRUCTION - Valuation: $ 0 1-and 2-family dwelling ®Commercial/industrial Number of bedrooms: ❑Accessory building 0 Multi-family Number of bathrooms: 0 Master builder 0 Other: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 12115 SW 70th Ave#200 New dwelling area: square feet City/State/ZIP: Tigard, OR 97233 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Dr. Steven Gabel Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRE=D 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. Valuation: $ $12,167 Add sprinklers for tenant improvement Existing building area: square feet New building area: square feet 0 PROPERTY OWNER ,0 TENANT 4 Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: £ ® APPLICANT:" 0 CONTACT P'R NOTICE , _ � v t= w. Business name: Same as below All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP: apply: Phone:( ) Fax::( ) E-mail: CONTRACTOR BUILDING PERMIT FEES* 'Please refer t©fee schedule Business name: Sprinklt Fire Protecton Inc. Permit fee: Address: p0 Box 2227 State surcharge(12%of permit fee): City/State/ZIP: Oregon City,OR 97045 FLS plan review(40%of permit fee): Phone:(503 ) 272-6650 Fax:( ) (Due upon application submittal.) Total permit fees: CCB lie.:211320 Amount received: Authorized signature:� y� ,50.,,ti Q/1, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Travis Schweitzer Date: 2/14/18 * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\FPS-PermitAPP_031016.doc 440-4613T(11/02/COM/WEB) 4 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: ❑ ew system0/ 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 m 1`J 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work: n f,1 s,f� (,if j., 11„,�Y .' - i yer ,�a Type of System(Complete A,B,C or D as applicabie ,, ,,f A.) Commercial Sprinkler Sprinkler Type Wet ❑ Dry Additional Standpipes Ji.fti(.... Information: Sprinkler Supply Line 0 Yes j7J No Hazard Group tui Lit” Density Design Area K. Factor Sprinkler Project Valuation: $ B.).,Type I - Hood Fire.Suppression Systei JiHood Project Valuation: $ C.) Fire Alarm , Submittal shall Battery Calculations 0 Yes include: . 1 A. Individual Component 0 Yes Cut Sheets Fire Alarm Project Valuation: $ r D.) Residential Sprinnkl (Stand Alone System) :. n Permit Fee: Square Footage: �, �t�� , 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:\Users\Sprinklt Fire\Downloads\FPS_PermitApp.doc 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12115 SW 70TH AVE 200, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Fire Protection System FPS2018-00008 Inspection Type: Inspector: 999 Sprinkler final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor