Permit (174) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2018-00014
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/14/2018
T [GAF.t� 9 Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 130
Project: Yecuris Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: Fire sprinkler permit:Adding and relocating(17)sprinklers for TI.
Contractor: WESTERN STATES FIRE PROTECTION Owner: PACIFIC REALTY ASSOCIATES LP
17500 SW 65TH AVE ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND,OR 97224
PHONE: 503-657-5155 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/14/2018 $134.48
12%State Surcharge-Building 03/14/2018 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 03/14/2018 $53.79
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 03/14/2018 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 03/14/2018 $15.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
Density: .15 Design Area: 945
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 $221.41
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $5,440.00
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: / ; /jl Permittee Signature: `� AIX/
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 W TigardHECEIVED Received a _- 6
13125 SW Hall Blvd.,Tigard,OR 9722 Date/By: / tlt Permit No.:��JrC rz )�
s Phone: 503.718.2439 Fax: 503.598.1960 Plan Review J
Inspection4Fax:503.639.4175 Date/By: 3-- )3- j'e �� Other Permit: 7O _
T I G A K IJ pDate Ready/By: // ruris: See P " o �/7J
Internet: www.tigard-or.gov Notified/Method:S /f 7(iSee nt Supplemental2 Informationnf I
� - � �
CITY OF TIGARD .6_,,, - ,i.l r.
TYPE OF BUILDING DIVISION REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all
0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTIONwork indicated on this application.
Er1-and 2-family dwelling Commercial/industrial Valuation: $
ElAccessory building ❑Multi-family Number of bedrooms:
ElMaster builder
❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: '�b Sett c.i N i Ove-k t.•,Li New dwelling area: square feet
City/State/ZIP: \
t`�tti421 1 o .., 122'\ Garage/carport area: square feet
Suite/bldg./apt.no.: V30Project name: '1/46.,.6k),F.t:Jri s """\--\ Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
Subdivision: REQUIRED DATA:COMMERCIAL-USE CHECKLIST
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.
F ►C "1^ t,G 1-,� � + (f`ti Valuation: $ 5j 4 46
li thuto l.G; 4 - Existing building area: square feet
1Y New building area: square feet
0 PROPERTY OWNER I 0 TENANT Number of stories:
Name:
Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( )
New:
0 APPLICANT ' 0 CONTACT PERSON
Business name: ),.. ' NOTICE
r �'✓ All contractors and subcontractors are required to be
Contact name: �0 ill,'1(,1,• licensed with the Oregon Construction Contractors Board
Address: L under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
Phone:( - ) I Fax::( ) apply:
E-mail: ;c.!`6,, by,,. vv,;\\„,, p, 4,./4 i'-‘).CA C
CONTRACTOR
BUILDING PERMIT FEES*
Business name:
'GS'1'2 4' \ '� }� p, �>r�t{.e)"\tlu1 (Please refer toermitschedule)e:
Address: 7'�7/u 5t,,) 65Permit fee:
veiv,J e
City/State/ZIP: State surcharge(12%of permit fee):
date. v5;�.e" v q 70 q _
Phone:( �) -�- t I Fax:( ) FLS plan review(40%of permit fee):
(Due upon application submittal.)
CCB lie.: I 01+7 70 Total permit fees:
Authorized signature: Amount received:
/� This permit application expires if a permit is not obtained
Print name: C7 � ' 1�1\I � I Date: �/7 3,/ within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
I:\BuildingWermits\FPS-PermitApp_031016.doc Service Board.
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: '7 Number of alarm devices:
1-5 devices: Affidavit required and
Addition or [1 1-10 heads: Affidavit required and E] (3) copies of sketch showing area
Alteration (3) copies of sketch showing area of work within building structure
to existing of work within building structure
system6+ devices: Plan review required and
IX 11+ heads: 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
Sprinkler Type & Wet ❑ Dry
Additional Standpipes N/ /n
Information: Sprinkler Supply Line ❑ Yes ❑ No . ! 1
Hazard Group C>`tt i 4
Density ().8c-,- &P(V,;,. 1.
Design Area Ci`'i.``S i:1-2
K. Factor 5,t t 1<
Sprinkler Project Valuation: I $ 'j f Li L1
B.) Type I- Hood Fire Suppression System Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Calculations 0 Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
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: I 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\Joshua.Miller\Downloads\FPS_PermitApp(2).doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15055 SW SEQUOIA PKWY 130, TIGARD,
OR, 97224
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00014
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor