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Permit (111) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 11 '- COMMUNITY DEVELOPMENT Permit#: FPS2018-00091 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2018 TIGARD 9 Parcel: 2S101 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 500 Project: Health Net Subdivision: None Lot: None Project Description: Fire sprinkler permit:Relocating(83)sprinkler heads. Contractor: CROSSFIRE SPRINKLER CO Owner: GK TRIANGLE CORPORATE PARK III L 17400 SE 82ND DR ATTN KBS REALTY ADVISORS CLACKAMAS,OR 97015 P 0 BOX 28270 SANTA ANA, CA 92709 PHONE: 503-210-5506 PHONE: FAX: 503-210-5538 FEES Description Date Amount Specifics: Permit Fee-COM 08/14/2018 $242.08 12%State Surcharge-Building 08/14/2018 $29.05 Type of Use: COM Plan Review-Fire Life Safety-COM 08/14/2018 $96.83 Class of Work: ALT Type of Const: VA Info Process/Archiving-Lg$2.00(over 08/14/2018 $2.00 Occupancy Grp: B Height: ft 11x17) Stories: 5 Info Process/Archiving-Sm$0.50(up to 08/14/2018 $4.50 11x17) Misc Administration Fee 08/14/2018 $5.00 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Yes Hazard: LT Density: .10 Design Area: 1500 K Factor: 11.2 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $379.46 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $15,375.00 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: Permittee Signature: 2,,...t///51-7:9/1"4/C' e 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. Builcin2 Permit Application Fire Protection System FOR OFFICE USE ONLY Received Cityof Tigard Permit No.: �- 7 , 11111 Ill g r l�' Date/B : � � ✓1l t Z.D 1 13125 SW Hall Blvd.,Tigard,OR 97223JUL 1 0000. plan Review C/ Phone: 503.718.2439 Fax: 503.598.1960 Date/B : " 7— ; b Other Permit: '�� y TIGARD Inspection Line: 503.639.4175 D. -R-.. /B•: 0 ® See Page 2for Internet: www.tigard-or.gov ,.E .7, Notified/Metho•it / /cf. h' ` Supplemental Information AN111. b-7^-7�i t '7'7/''Io// ?4 6RK REQu Wait.;1 F Y DWE ,t tgt :_ ❑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 0 Other: equipment,materials,labor,overhead,and the profit for the \ \ CATEGOR /i O , U 'ON work indicated on this application. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: ?; / " Total number of floors: JOB Ea® 11011 AND I CATIQ:,.%,44 cr am.,. � \...�� :. ,,.� .:. Job site address:13221 SW 68th Parkway New dwelling area: square feet City/State/ZIP:Tigard,OR Garage/carport area: square feet Suite/bldg./apt.no.:5th Fir jI Project nam /) ,my- Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet a ,. k '! c&o 1 IAL-USE corkKOsiAll 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 'V , l\ N op worn( ` ; gf work indicated on this application. Relocate Sprinkler Heads at new ceilings to maintain coverage Valuation: $$15,375.00 Existing building area: square feet New building area: square feet ©P V. OWNER f ` 14' CANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: g Phone:( ) Fax:( ) New: NOTICE ..s.,..„ Business name:Crossfire Sprinkler All contractors and subcontractors are required to be Contact name:Timothy A Bishop licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 17400 SE 82nd Drive jurisdiction in which work is being performed.If the City/State/ZIP:Clackamas,OR 97015 applicant is exempt from licensing,the following reasons apply: Phone:(503)210 5506 Fax: :(503)210 5538 E-mail:timothy@crossfiresprinkler.com �� e RACTOR !%,i% ✓-BU1 DtNfx PERMIT FEES* Business name:Crossfire Sprinkler {fuse refc" ) l Permit fee: Address: State surcharge(12%of permit fee): City/State/ZIP: FLS plan review(40%of permit fee): Phone:( ) Fax:( ) (Due upon application submittal.) CCB lic.:174746 Total permit fees: 1111"1° Amount received: Authorized signature: This permit application expires if a permit is not obtained Print name:Timothy A Bishop Date:7/19/18 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I:ABuildingV Permits AFPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB) • City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information y � c r rk" be e: 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: ❑ New system Number of sprinkler heads: 83 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 0,rOns "b le • ".. , A.) Coma erctal Sprinkler ' Sprinkler Type ® Wet El Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group Light Density .10 Design Area 1500 K. Factor 11.2 Sprinkler Project Valuation: $ 15375.00 Hood Project Valuation: $ C.) Fire Alum \ Submittal shall Battery Calculations El Yes include: Individual Component El Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler(Stand Alone S s ) Square Footage: Permit Fee: `" y 0 to 2,000 $198.75 2,001 to 3,600 $246.45 j' o y 3,601 to 7,200 $310.05 7,201 and greater $404.39 3 ...,.,00zy-.. .t Sprinkler Project Square Footage: sq. ft. \\\\\ b* %/ /Fire. to eti n" ern tt Fees w 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 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13221 SW 68TH PKWY 500, TIGARD, OR, 97223 November 13, 2018 at 9:21 :53 AM Record Type: Record ID: Commercial - Fire Protection System FPS2018-00091 Inspection Type: Inspector: 999 Sprinkler final Chip Barnett Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor