Permit (174) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
2 '- COMMUNITY DEVELOPMENT
Permit#: FPS2018-00173
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2018
T if � Parcel: 2S101AA02900
Jurisdiction: Tigard
Site address: 12123 SW 69TH AVE
Project: Compass Oncology Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Demo existing sprinklers/pipe in levels 1 and 2. Install new fire suppression system consisting of semi-recessed
sprinklers for new wall and ceiling layout of both levels 1 and 2.
Contractor: DELTA FIRE INC Owner: MCKESSON SPECIALITY HEALTH
14795 SW 72ND AVE 10101 WOODLANDS FOREST DR
PORTLAND, OR 97224 THE WOODLANDS,TX 77380
PHONE: 503-620-4020 PHONE: 281-863-4723
FAX: 503-620-1058
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/12/2018 $827.38
12%State Surcharge-Building 12/12/2018 $99.29
Type of Use: COM Plan Review-Fire Life Safety-COM 12/12/2018 $330.95
Class of Work: ALT Type of Const: VA Info Process/Archiving-Lg$2.00(over 12/12/2018 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 12/12/2018 $35.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: 0.1 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 $1,297.12
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $103,813.00
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 -
obtai copy of the rules
or direct questions to OUNC by calling 503.232.1987 or .:.•. .• 4.
Issued By: Permittee Signature:
Id)/AIM
Call 5.3.639.4175 by 7:00 a.m.for the next availabl= ns-•ction ..te!
This permit card shall be kept in a conspicuous place on the jo i . until completion of the project.
Approved plans are required on the job site at th ' e of each inspection.
+ Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
Y ~.4t4 :P ±
City of Tigard " "" Received /0/-;://e �y PermitN f 77,_i7e1/73
Date/By: ,�'�'" v G<
r 13125 SW Hall Blvd.,Tigard,OR 97223 r
(` ? ')O Plan Review
Phone: 503.718.2439 Fax: 503.598.196C 711
-I
�-S-14 Other Pert f /t:O0 C,
Date/By:
i lc,A R t) Inspection Line: 503.639.4175 Date Ready/By: Juris: I ® See Page 2 for
Internet: www.tigard-or.gov L ;i i t : tified/Method.4,/4 // �, Supplemental Information
t .)
Pr REQ 1I ►'D v
//,..717,!",.,.., ,TYPE �.FWORK. �, �, �. , If... x=� DAT AND 2 F � ILY e � LING
El 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
,,t, , v,, ;. "0 4 work indicated on this application.
'CATEGORY OF:CONSTRU ON :
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JB SITE 11,IE0TIMATI°* D LOC ;i ;r Total number of floors:
Job site address:12123 SW 69TH AVE New dwelling area: square feet
City/State/ZIP:Tigard Oregon 97223 A1/49-JS Q ile C t el 6/�/ Garage/carport area: square feet
Suite/bldg./apt.no.:Bldg A Project name: Covered porch area: square feet
Cross street/directions to job site:69t''&Franklin Deck area: square feet
Other structure area: square feet
RED DATA:COMIV ERCIAL- ISE IIEC T t:
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
MSCRIPT OOtl{OF WD ; %i work indicated on this application.
I
Demo existing sprinklers/pipe in levels 1 and 2.Install new fire suppression Valuation: $103,813.00
system consisting of semi-recessed sprinklers for new wall and ceiling layout Existing building area: 41000 square feet
of both levels 1 and 2. New building area: 41000 square feet
i ❑r 1 ERTY OWNER'' CO TEN /' " Number of stories: 2
Name:CO MPASS ONCOLOGY WESTSIDE CANCER CENTER Type of construction: Type II-A
Address: Occupancy groups:
City/State/ZIP: Existing: Light
Phone:( ) Fax:( )
New: n/a
e CAN't ►® CONTACT PRO ''g. 0' 0xt
r , #.<, .., fin, .. ,.,, r NOSE .Ae
Business name:DELTA FIRE INC/CCB 64174 All contractors and subcontractors are required to be
Contact name:ANGELA CARTALES licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:14795 SW 72ND AVE jurisdiction in which work is being performed.If the
City/State/ZIP:PORTLAND OR 97224 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)620-4020 X-109 I Fax::(503)620-1058
E-mail:angic@deltafire.com
t.. C RAGTOR
w
` �r i : "._. . ' � `` ,...,,i,.....,,,,, BUI �ING 1'E1iA4�'~1E'EES �ry
Business name:T NER rnNSTRITCTION COMPANY - V ' (Plguse refer tof esrTiedukiz
Address: Permit fee:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) I Fax:( ) (Due upon application submittal.)
CCB lie.: t91A Total permit fees:
Amount received:
Authorized signature.
�/• This permit application expires if a permit is not obtained
Print name: : :Cart. Date: 11/28/2018 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(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe word ro onesw ; x . . ... =h
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 291 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 oI System (Complete 3 C or:D as applicable):- 3:3 - 35'1",.33
x . v
.331
) ° 4erciai Sprinkler 1,,
Sprinkler Type ® Wet ❑ Dry
Additional Standpipes no
Information: Sprinkler Supply Line ❑ Yes ® No
Hazard Group LIGHT HAZARD
Density .10
Design Area 1500 sq ft
K. Factor 8.0
Sprinkler Project Valuation: $ 103,813.00
;1,1A4 e /- Flood,Fire3Supsessionx S sterir
Hood Project Valuation: $ n/a
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ n/a
-134*-Residential Sprinkler(Srapd Alone Systeth)
3433,3 .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: n/a sq. ft.
,,... _. ... Fire Protecti* raj l . e�.:�'
Project valuation subtotal (see A,B & C above): $ 103813.00
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $ n/a
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $ 1257.62
-I- liOIA
1:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB) 4-
i P, t.co - 3�
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12123 SW 69TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00173
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor