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Permit
',.- w�l s 'q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT � P',1' Permit #: FPS2010 -00038 Ili a COMMUNITY DEVELOPMENT '' Date Issued: 04/16/2010 ,TiGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S113AB00101 Jurisdiction: TIGARD Site address: 16101 SW 72ND AVE 140 Subdivision: PACTRUST BUSINESS CENTER Lot: 0 Project: Trinity University Project Description: Relocate (4) sprinkler heads in remodeled suite. Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 Permit Fee - COM 04/16/2010 $51.09 12% State Surcharge - Building 04/16/2010 $6.13 PHONE: 503 - 624 -6300 Plan Review - Fire Life Safety - COM 04/16/2010 $20.44 Contractor: WYATT FIRE PROTECTION INC. 9095 SW BURNHAM TIGARD, OR 97223 PHONE: 503 - 684 -2928 FAX: 503 - 684 -9657 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Height: ft Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $77.66 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: 342.00 Residential Square Footage: 0 Fire Alarm Valuation: 0 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 -0100. You may obtain a copy of the , les direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: , i � Permittee Signature: " / Call 503.639.4175 by 7:00 a.m. for an inspection that busin s day. 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 ApplicationRECEIVFD .. Fire Protection System FOR OFFICE USE ONLY City of Tigard APR 16 2010 Date/By: 9 /�f /o �C � /a e 9 0 0 3J - Permit No.: Ill - /f=: ) . 5,20/1) 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1900 OF TIGARD Date/By: Other Permie�� /Q - CV 0 3C TIGARD Inspection Line: 503.639 BUILDING DIVISION Date Ready /By: Juris: E See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental lnformation TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of 5gCAddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ 1- and 2- family dwelling commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /to / 0 / 5"k / -72 , g- New dwelling area: square feet City /State /ZIP: - j 6A-jLQ p0/C__ `4-,72.:2-4" Garage /carport area: square feet / Suite/bldg. /apt. no.: 1 4,0 Project name: • , j/ ' ft( v,J i V . i u 5 , CD. Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST 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 DESCRIPTION OF WORK work indicated on this application C -A t — J'Q'/ / ) 5P /V4I- Valuation: $ 34-Z, 6='`' i ct S l_ iE ,n© L. c7(»----1 C-- / Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: $ Z,e)4/�Cr©t2- All contractors and subcontractors are required to be ' Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR BUILDING PERMIT FEES* WI ( Ai e � / �� l (Please refer to fee Permit fe schedule) Business name: IA p '/ , 7� t (L/I 1 c J Permit fee: �� 0 / Address: �� 9 5 �tM l�/ G cJ / State surcharge (12% of permit fee): / / j City /State /ZIP: // r� ,/� Q ZZ-3 J 2 �-}y 9i / �'/ I / '— q FLS plan review (40% of permit fee): ,., Phone: (S03) (o 4- - 2900 Fax: (993 ) 04 - 9057 (Due upon application.) 4 9 . / / CCB lic.: f 4 07 7 Total permit fees: lJ g /4 Amount received: 9 '7 + ea 4 Authorized signature: This permit application expires if a permit is not obtained Print name: Ca If /� / �IL / T/ T �I Date: — I5 _ j - / i , ) 4 T, within 180 days after it has been accepted as complete. / v V * Fee methodology set by Tri -County Building Industry Service Board. 1:1Building \ Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(t 1 /02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition .g._ -1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: 4 Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component El Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 3,601 to 7,200 $292.50 7,201 and greater $381.50 Sprinkler Project Square Footage: 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: $ Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. http: / /www.ci.ti city_ hall /departments /cd /dots /PPS- PermitApp.doc 2