Permit CITY OF .TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2009 -00063
.TL G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/27/2009
• Parcel: 2S113AB01201
Jurisdiction: TIGARD
Site address: 16505 SW 72ND AVE
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Liberty Mutual
Project Description: Add /relocate (10) heads.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY
Permit Fee COM 07/27/2009 $62.50
#300 12% State Surcharge - Building 07/27/2009 $7.50
PHONE:
Contractor:
CROSSFIRE SPRINKLER CO
17400 SE 82ND DR
CLACKAMAS, OR 97015
PHONE: 503 - 210 -5506
FAX: 503 - 210 -5538
Type of Use: COM
Class of Work: FPS Type of Const:
Occupancy Grp: B Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $70.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 1372
Residential Square Footage:
Fire Alarm Valuation:
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 dir questions to NC calling 503.246.6699 or 1.800.332.2344.
•
Is ued By: Permittee Signs )01. I ,
CaII 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.
•
07 -21 -2009 08:39 CROSSFIRE SPKR 5032105538 PAGE1
Budding Permit Application
Fire Protection System RECEIVED
For: ():fl( 1.: 1; ti r ONLY
City of Tigard Received
4 be Permit No. :. J
13125 SW Hall Blvd., Ti OR 97223 J 21 2009 Daro/B : 7 t7 j ___ 5 . i� 400 / 3
Plan Review
Phone: 503.639.4171 Fax: 503.591...1961 Dataili : (riper Penult:
11(; A . k 1) InspoctiOn Line: 503.639.4175 CITY OF TIGARD , Datc Ready /By: Jluu ® Sce Page 2 for
Internet: www.tigard- or.gov BUILDIN• G DIVIS10 Notifcd/Mcthod: g o / , Supplemental Information
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El New construction ❑ Demolition Permit fee* are based on the value of the work performed.
indicate the value (rounded to the nearest dollar) of all
.Addition/alteration/replacement ❑ Other: s �r�q q{ equipment, materials, labor, overhead, and the profit for the
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1: I - and 2- family dwelling b. Commercial /industrial . _. _ '
❑ Accessory building ❑ Multi - family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms::
l l
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r N �r,r'rpill; ;`,Tl017 hrnP)4 1∎ l l ' .dsPU_Olg Y 1' c'L9 Total number of floors: ■ i 'ff �tW 7. „ 41 , ,�rmmim„ 1 ,I,Ht,.-E r „'4tH, hu ii l „ttik a� .ayu Wii
Job site address: t L5 g„a — 11, 4 c., A d ., 1. s ; cam . Ncw dwelling arca: square fcct
City/State/Z1P: V ,..4...31-. en — Garage/carport area square feet
Suite/bldg. /apt. no Project name: L,t I %an.. M ,Yeze• t_ 1 2 _ Covered porch arca: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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Subdivision: 1 Ot no.: ju7";:"',,,,""71'- '49;:.7:-„ (;-;4 - 4 , 4 ritR'N:ox iir...akXrlr.,aa,. m4 wrroi
Permit fees* are based on the value of the work perfortned.
fax map /parcel no.: indicate the value (rounded to the nearest dollar) of all
it(i rilti , , , , t ; i vl',r ! y v , r ,r tt r + t "ll sir 4 q {4g4P tK > ,, ry+ lrn,t h t ti r p equipment, materials, labor, overhead. and thc profit for thc
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Valuation: $ l xIel '”
Leda 1 R E... 1 o t•'kAt -S
Existing building area: square feet
New building area: square feet
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Name: Type of construction:
Address: Occupancy groups:
Ciry /State/ZiP:
_ Existing:
Phone: ( ) Fax: ( ) Ncw:
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Business name: All contractors and subcontractors arc required to bc
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may bc required to be licensed in thc
Address: junsdic1ion in which work is being performed. if the
City/State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E-mail:
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Business name: �2.. .,�",Re. ..Jrl2_�N�.LzA. `O. itiY�1F ,IRIN,NIMIAKXIX•1X. /,1n�:V n. = r ._i. 0 :: :.;
h Permit fee: (0 X i
Address: 114 0o SC. %2., 1Nx� lt,
State surcharge (12% of pemtit fee): 7, ”
City /State/Z1I':
LALALA w. A.S t r 4 9 . 1 cA.CD _ FLS plan review (40% of permit fcc): /
Phone: (3 ) '7 o 5501. 0Se
I Fax: x5) 2 %a ...to53�... _ (Due upon application.) "le �
OU
CCB lie.: 1�1A AL twF.:-2.a` ' �JAlo■ Total permit fees: * 70 •
Authorized signature: �i'r+ Atuouut received:
This permit application expires if a permit is not ohtalned
I �j-1.7,.,,,..) within 180 days after it has been accepted as complete.
Print name: 1 oe\t-f b(511.t- / Date: I • Fix methodology set by Tri-County Building Industry
Service Board.
1; \13;01010 l Papliu\fPS•PamilApp.4uv 0323106 640-4611'1V 1 1 N12!(1 1M/WF:K)
07 -21 -2009 08:39 CROSSFIRE SPKR 5032105538 PAGE2
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
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1.) ❑ New 2.) ! Modification to sprinkler heads only:
Addition 1 - 10 heads: No plan review required.
Alteration 114 heads: Plan review required.
Repair
Nunil>er of sprinkler heads: 10
Additional description of work: A 11 1
L4 CC 1'lxti to NZ>�� 11Ao.,,0-0 1.1E\...) Ant 0..v,._4—J
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1' Wet ❑ I)ry
Additional Stand i cs
Information: IIaeard Group (...k
Density
Des' • Arca
K Factor
Sprinkler Pro•ect Valuation: $ 13'1-I. "
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� � � 7 r✓r an @••P+ +�n rn 71'1 . f � t 1 . �Pi � t ,
1 focal Project Valuation: $ r
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�) � t �? f if i
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,L..•1 . .. .......... ... •Y..I6.�J > 71:11.. - �----'---"
Submittal shall Battery Calculations ❑ Yes IP
include: Individual Component ❑ Yes t-
(:ut Sheets _ U
Fire Alarm Project Valuation: $ 1 t1
i
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„1., . o u�d ri :,.:4u.1., r t a .r �u+1..,,8.{II{rieY d tt�Nis zi iirk s M, 1, I t ,I . H kA I 16+r M V 11x1 n n+:
_ - I'en it Fee:
Vitt � I i , , ti ff iu , tti; J Q
U to 2,000 .80 Z OR a {iaiI 171 " ''';'•t �'�it1�It_ 1 10 �1 � V �'
mil
2,001 to 3,600 $232.50
f y r N 4 J i _ '
3,601 to 7,200 $292.50 ' �� "�+fi4 t1) {(��1 O'11t � 1
! u'4unn.in,ms rlibu i 'l ;i p„ -
7,201 and _rcatcr $381.50 _ _ ___ .._,_ :_..:: ,____: 3
_ ,_1111..
Sprinkler Project Square Footage: sq. ft. p 1...1
V ';L` 1 f I 1 1 a , t y ° ' {i'`; 44;4 , *, � 11___._ , .. , _ ., 111
}• Il(19 �l C '� � ��' h 1 -t t r r w ti a : =*1
-- � r, � }{ ,,f,; h�t 1i�,$, � ' : � •.�J � ::7 4 r . •, M � r .�. I { , I s i � i . =__-
Pro'ect valuation subtotal see A, B & C above): $
Permit fee based on rci ect valuation see fee schedule ; $
Permit fcc based on square footage (sec D above): $
State Surcharge (12% of permit fcc): $
FLS Plan Review (40% of pertnit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fete protection systems require that plans bear the original seal of an ()regon licensed fire suppression
engineer, or N10ET level "3" technicians.
httpl/www.tiRard-otgov/city hall / departments /cd /dots /FPS- PermitApp,doc 2