Permit (137) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
N ' • COMMUNITY DEVELOPMENT Permit#: FPS2019-00110
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2019
T I t;;�R[7 g Parcel: 25101 DC03900
Jurisdiction: Tigard
Site address: 7150 SW SANDBURG ST
Project: Immunology Consultants Laboratory(ICL) Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Fire alarm permit:New fire alarm system with manual pull stations at each exit,smoke detectors on all fire doors
with existing magnetic door holders,monitoring of duct detectors HVAC shutdown,and notification devices
throughout.
Contractor: PACIFIC NETWORKS INC Owner: LESLIE SANDBURG LLC
16869 SW 65TH AVE,STE 373 ATTN:JOHN G LESLIE
LAKE OSWEGO, OR 97035 14056 GOODALL RD
LAKE OSWEGO, OR 97034
PHONE: 503-645-4000 PHONE:
FAX: 503-352-0202
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/17/2019 $338.92
12%State Surcharge-Building 09/17/2019 $40.67
Type of Use: COM Plan Review-Fire Life Safety-COM 09/17/2019 $135.57
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/17/2019 $20.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 09/17/2019 $27.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type: Automatic
Pull Station Required: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $562.66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $25,000.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are -t forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OU calling 50 32.r:7 or 1.80 344.
407 :
Issued By: -VAC i4 Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
.FireP'rotection System FOR OFFICE FSE OvLy
111 City of Tigard R E C E! V !B �t`ili'�'/ f'" i /.$.$<c>IY`C) r
`J g Permit No.: �r-
N 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �!�
t Phone: 503.718.2439 Fax: 503.598.1960 201' Date(By: f 7 Other Permit- �z� t
AUG `� ) �,) i y-c1,:i7'
T It,\li D Inspection Line: 503.639.4175 Date Ready/By: '1 huts: See Page 2 for
htternet: www.tigard-or.gov CITY OF TIGARiNotifi •ethod:7 7� Cf ( Supplemental Information
axe. �L! //
m � . =I�.s r s°al 1 • -�� _.� t, ..`+Y�li 17.7 R(
0 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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑1-and 2-family dwelling g Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:7150 SW Sandburg Street New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Immunology Consultants La Covered porch area: square feet
Cross street/directions to job site:SW 72nd Ave&SW Sandburg St Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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
DESCRIPTION OF WORK work indicated on this application.
New fire alarm system with manual pull stations at each exit,smoke detectors on Valuation: $25,000
all fire doors with existing magnetic door holders,monitoring of duct detectors Existing building area: square feet
HVAC shutdown,notification devices throughout. New building area: square feet
............ .... . .
''-' PROPERTY OWNER 0 TENANT Number of stories: 2
Name:Immunology Consultants Laboratory Type of construction:
Address:7150 SW Sandburg Street Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing: B
Phone:( ) Fax:( )
New:
tl'iAPPLICANT 0 CONTACT PERSON
NOTICE
Business name:Pacific Networks,Inc. All contractors and subcontractors are required to be
Contact name:Jared Kimber licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:16869 SW 65th Ave.#373 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:Lake Oswego,OR 97035
a'ply:
E-mail:jared@pacnetworks.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Pacific Networks,Inc (P1eAaertr�erto.fee schedule
�
Permit fee:
Address:16869 SW 65th Ave.#373
State surcharge(12%of permit fee):
City/State/ZIP:Lake Oswego,OR 97035
FLS plan review(40%of permit fee):
Phone:(971)708-7136 Fax:( ) (Due upon application submittal.)
CCB lie.:184982 Total permit fees:
Authorized signature
Amount received:
-- This permit application expires if a permit is not obtained
Print name:Jared Kimber Date:8/27/2019 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\FPS-PermitApp_03I016.doc 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: Number of alarm devices: 13.2
❑ Addition or ❑ 1-10 heads: Affidavit required and 0 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
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:
Type of System(Complete A,B,C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type 0 Wet
❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
ego `+ ® i e 1i g`,ress.ton yStem
Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Calculations 1 Yes
include: Individual Component ® Yes
Cut Sheets
Fire Mann Project Valuation: I $ 25,000
D.) Rcsidezxt.ial Spt;u tiler(St;wd Alone`Systetr)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600
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): $ 25,000
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: $
/Users/jaredkirnber/Downloads/FPS_PermitApp.doc 2