Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
.74 a COMMUNITY DEVELOPMENT Permit #: FPS2010 -00130
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/03/2010
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 215
Subdivision: PACIFIC CORPORATE CENTER Lot: 0
Project: Umpqua Bank
Project Description: Modification of (11) fire sprinkler heads for TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 Permit Fee - COM 10/29/2010 $77.99
12% State Surcharge - Building 10/29/2010 $9.36
PHONE: 503 - 624 -6300 Plan Review - Fire Life Safety - COM 10/29/2010 $31.20
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: IIB
Occupancy Grp: B Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0 Design Area: 0
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 $118.55
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 1500
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 to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: / Permittee Signature: ��/ I '
—0 Iff
Call 50 . • 9.4175 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
• .a
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received �
f 2 Date/By: Q /Q Permit No.: �/jaD(o -00/0
13125 SW Hall Blvd., Tigard, OR 97223 � . Plan Review ' • /�
Phone: 503.639.4171 Fax: 503.598.1960 sfut�" Date/13‘ : � 1 1 ,® Other Permit: albeit,- 41:042,21 �
T 1 G A R D Inspection Line: 503.639.4175 C► ` " 0 DV Date Ready/By: 1,,, runs: ® See Page 2 for
Internet: www.tigard- or.gov v1' ^ � ( �y � ►` Notified/Method: y„ / V �/'� Supplemental Information
TYPE OF WORK Y' REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (roarded to the nearest dollar) of all
XAddition/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 Valuation: $
❑ y g �Commerciallindustrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE LNFORMATION AND LOCATION Total number of floors:
Job site address: C9C9 5O go lRec) ( io ) . 4CQ' G J (4 New dwelling area: square feet
City /State /ZIP: pt 7 t �, y� O Q `- r rA n C3 ' ALAI t L •1 l Gar /arport area: square feet
. ' . ` / f � l "
Suit CD. i t. no.: I G2 Project name: OfTe Ij ' es V\ Covered porch area square feet
Cross street/direaions 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.
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.
el0C 1 f l heC4 ,/� Co( 1 ! T= Valuation
� S I i -100. Q0
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:
)9kAPPL1CA.NT ❑ CONTACT PERSON
NOTICE
Business name:�p �� ,.. r ��'
� `. All contractors and subcontractors are required to be
Contact name:H�P`- •,� o �,, licensed with the Oregon Construction Contractors Board
^ ^ yr v► under ORS 701 and may be required to be !tensed in the
Address: Iy 795 `A) 7)nci JP_ jurisdiction in which work is being performed. If the
^ ^ ` applicant is exempt from licensing, the following reasons
City /State /ZIP: ') f ( ' ' t d � (:)1; c a I a ppl y:
Phone: (c,�'
/fin O ` '' , l r � Or �o Fax: : ZJ � G D O � - IO5S'
C _ fI a d� (1
E -mail: h�lt[A 4S C�le_14u� l i Cam
CONTRACTOR BUILDING PERMIT FEES*
Business name: 1 \p 1. ( /(. (Phase refer to fee schedule
Address:
lug 5 sw -79,1d vid •rn Ale. Permit fee:
PI -land O � �� State surcharge (12% of permit fee):
City /State /Z1P: a J-I FLS plan review (40 %ofpermit fee):
Phone:503 (090 - 1-169.0 Fax: 5 (l'�
31 - 10 5 5 ' /Due upon application.)
CCB Iic.: Coil I ,,4 Total permit fees:
Authorized signature:
Amount received:
11 A . / , 2114 • , This permit application expires if a permit is not obtained
Print name: L - ` ' � ` u �, — P / Date: I r it I O within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1 Bulding\PermitsTPS- PermitApp.doc 03,23/06 440- 4613Ti II 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 r-1 i -1v heads: _No pl an review required.
O A Alteration H , 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: It
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinlder
21, Wet ❑ Dry
Additional Standpipes m A
Information: Hazard Group L:jerk-
Density .10
Design Area 1500
K. Factor 5, to
Sprinkler Project Valuation: $ I1 500 , 00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinlder (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): I $
FLS Plan Review (40% of permit fee): I $
TOTAL: $ I I $, FJF3
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.
[: \ Building Permits \FPS -Per itApp.doc 2