Permit :' CITY OF TIGARD
PROTECTION SYSTEM PERMIT
71 COMMUNITY DEVELOPMENT Permit #: FPS2010 00007
T E C AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 01/29/2010
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY
Subdivision: TIGARD TRIANGLE CENTER Lot: 0
Project: Pacific Parkway Center
Project Description: Relocate (4) heads and add (1) head for TI.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 Permit Fee - COM 01/29/2010 $64.54
12% State Surcharge - Building 01/29/2010 $7.74
PHONE: 503 - 624 -6300
Contractor:
DELTA FIRE INC
14795 SW 72ND AVE
PORTLAND, OR 97224
PHONE: 503 - 620 -4020
FAX: 503 - 620 -1058
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $72.28
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 1000
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 rules
or direct questions o OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: / ✓ 1 Ar
Cali 503.639.4175 by 7:00 a.m. for an inspection that business 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 Application
Fire Protection System
}' ! � FOR USE U \I Y
City of Tigard REC REew IVED DPermit No20 tO SvTigard OR 972 'v V
,, Phone: 503.639.4171 Fax: 503.598.196yq N Date/By: Other Permit:
IN
T I G A'R D Inspection Line: 503.639.4175 2 9 2010 Date Ready /By. ti,trtis i See Page 2 for
.. r u•
Internet: uw.tigard- or.gov Notified/Method: I 0) Supplemental Information
l)[ OF T RO
TYPE OF - W,+@1 t G DIVISION . . REQUIRED DATA 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition P e r mit fee are based on the value of the work performed.
Indicate the value ( to the nearest dollar) of all
ddition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Wommercial/industrial
Valuation: $
Accessory building Number of bedrooms:
❑ ❑ Multi - family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I 909 �I/ �'1 �� New dwelling area: square feet
City /State /ZIP: I l J ( tan � / (1 y (,I . , Gar age /carport area: square feet
o as _
Suite - Idg. /apt. no.: I 1, koject name: Lk `. .-ht' Covered porch area square feet
Cross street/directions to job site: v �p ry I • • f Deck area: square feet
�"" r 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.
Indicate the value rotnded to the nearest dollar of all
Tax map /parcel no.: •
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ I
SA i It as . t ' .. 4. C�0.0�
f net A) Ce : t'i Yl( oV� Existing building area square feet
G New building area: square feet
0 PROPERTY OWNER I 0 TENANT . . Number of stories:
Name: Type of construction:
Address:
Occupancy groups:
City /State /ZIP:
Existing:
Phone: ( ) Fax: ( )
New:
APPLICANT ❑ CONTACT PERSON NOTICE.
Business name: D - F, -, " EnC • All contractors and subcontractors are required to be
Contact na e: f 1eic1.1 3 a licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be lcensed in the
Address: ' A h (# jurisdiction in which work is being performed. If the
City /State /ZIP: 0 tT� rA.A• f O (L q a L1 applicant is exempt from licensing, the following reasons
�♦ V`^^' apply:
Phone: e P.. - ILO Fax:: 0 ) e 0 - 0 • .
DEM ' n •. O. 1C
CONTRACTOR - 'BUILDING PER,tiIIT,FEES*
Business name:'- 'rife- 1 f C' (pledr
Address: r V► + Permit fee: 51.1 I
State surcharge ( permit fee):
City- /State /ZIP: • ,�. 1 • ` • - I. ��
r � FLS plan review (40 %ofpermit fee): n
Phone: F3 ( _ L4 )&O I Fax: (503) 6 `� g (Due upon application.) i f t
CCB lic.: , I L Total permit fees: `7a. a t
Authorized signature: J Amount received:
i r M '� This permit application expires if a permit is not obtained
Print name: k L 3C f 01 / Date: a• 0 010 within 180 days after it has been accepted as complete.
j , * Fee methodolow set by Tri- County Building Industry
v Service Board.
1: Building'PermitsyFPS -Perry tApp. doc 03/23%06 440- 4613T(11/02 CONI WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 -. Supplemental Information ,
Describe work to be done:
1 1.) ❑ New 2.) Modification to sprinkler heads only:
Addition 1 10 heads: No plan review required.
Alteration ❑ 11+ heads: Plan review required.
Repair
Number of sprinkler heads: •
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
N , Wet ❑ Dry
Additional Standpipes NI/4'
Information: Hazard Group L ��-
•
Density �' I
Design Area 600 -.
K. Factor 5.14 9—
Sprinkler Project Valuation: $ 00.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ A`P1/4-
•
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ )J A
•
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50 .
2,001 to 3,600 $232.50 .
I 3,601 to 7,200 j $292.50
•
1 7,201 and greater 1 5381.50 .
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): $ '< , bq
Permit fee based on square footage (see D above): $ AIN -
State Surcharge (12°ro of permit fee): $ --7l._ .
FLS Plan Review (40% of permit fee): $
TOTAL: 1 $ - ,a. &g
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.
L Bun±.•g \Pea,dcs \ FRS- PerniAapp.coc 2