Permit (137) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00112
Date Issued: 09/18/2019
TI ERf 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 140
Project: Home Street Bank Subdivision: 2004-015 PARTITION PLAT Lot: 2
Project Description: Fire sprinkler. Adding/replacing(23)sprinkler heads for TI.
Contractor: DELTA FIRE INC Owner: SN PROPERTIES PARTNERSHIP
14795 SW 72ND AVE 1121 SW SALMON ST
PORTLAND, OR 97224 PORTLAND, OR 97205
PHONE: 503-620-4020 PHONE:
FAX: 503-620-1058
FEES
Description Date Amount
Specifics:, Permit Fee-COM 09/18/2019 $166.76
12%State Surcharge-Building 09/18/2019 $20.01
Type of Use: COM Plan Review-Fire Life Safety-COM 09/18/2019 $66.70
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/18/2019 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 09/18/2019 $24.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No 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 $279.97
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $8,604.00
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 ar set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy the rules
or direct questions to OUN, ca.! 503. 987 or 1.8 .332.2344.
Issued By: ` Permittee Signature:
, 4 �f cc
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 ISE()NEI'
City of Tigard Received
11111 q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 7 �� �� ��
' i Phone: 503.718.2439 Fax: 503.598.1960 DateB : _ - Other Permit:
TI G A R D Inspection Line: 503.639.4175 ti° e, Date Ready/By. Juris: H See Page 2 for
Notified/Method: Supplemental Information
Internet: www.tigard-or.gov
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Permit fees*are based on the value of the work performed.
❑New construction 0 Demolition
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
.^ " ti work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
1 1' r ` t..• ! i R ''''''' '''''''''''"9'- ''''''
A x . !SCA tt .-raymor i Total number of floors:
Job site address:16230 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: /(10 I Project name:Home Street Bank TI Covered porch area: square feet
Cross street/directions to job site:Durham Rd Deck area: square feet
Other structure area: square feet
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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
,. -_ i= r r� work indicated on this application.
Furnish and install sprinkler modifications to assusre 100%sprinkler coverage. Valuation: $$8,604.00
Existing building area: 1996 square feet
New building area: 1996 square feet
iii Number of stories: 1
a.. .. , wry. r _�. . . �Name: Type of construction: V-B Sprinklered
Address: Occupancy groups:
City/State/ZIP: Existing: Light Hazard
Phone:( ) Fax:( )
New: Light Hazard
Business name:Delta Fire,Inc All contractors and subcontractors are required to be
Contact name:Patty Cartales licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:14795 SW 72"d Avenue jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97224 applicant is exempt from licensing,the following reasons
Phone:(503)620-4020x113 -- ax:: •( 503)620-1058
apply:
E-mail:patty@deltafire.com
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Business name:Delta Fire,Inc
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Permit fee:
Address:14795 SW 72"d Avenue
State surcharge(12%of permit fee):
City/State/ZIP:Portland,OR 97224
FLS plan review(40%of permit fee):
Phone:(503)620-4020 Fax:(503)620-1058 (Due upon application submittal.)
CCB lic.:64174 Total permit fees:
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name:Patty Cartales Date:8/29/19 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
440-4613T(11/02/COM/WEB)
I:\Building\Permits\FPS-PermitApp_031016.doc
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 23 Number of alarm devices:
® Addition or El 1-10 heads: Affidavit required and El 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 El 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
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00,,11116010,10
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Sprinkler Type ® Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line El Yes ® No
Hazard Group Light Hazard
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: I $
type- ood11I ; .,.. �. a end ��_ . `..._ 0151$1011340000por 1°,;!,
. . ._.
Hood Project Valuation: $
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Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
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Footage:S uare Permit Fee:
Square �:�.�. �llllll��(,� �.-
0 to 2,000 $198.75 ',5 Rau, 104 RAW
--_ r
3,601 to 7,200 $310.05
7,201 and greater $404.39 -
Sprinkler Project Square Footage: I sq. ft.
P # 4�69 � 4& � � »�` �t iliu
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: $
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