Permit •
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2011 -00003
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011
Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72ND AVE 130
Project: Siemens Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Relocating (9) sprinkler heads.
Contractor: CROSSFIRE SPRINKLER CO Owner: PACIFIC REALTY ASSOCIATES
17400 SE 82ND DR 15350 SW SEQUOIA PKWY #300
CLACKAMAS, OR 97015 PORTLAND, OR 97224
PHONE: 503 - 210 -5506 PHONE: 503 - 624 -6300
FAX: 503 -210 -5538
FEES
Description Date Amount
Specifics: Permit Fee - COM 01/11/2011 $51.09
12% State Surcharge - Building 01/11/2011 $6.13
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
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 $57.22
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
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 are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.2381._or— .332.2344.
Issued By:, Permittee Signature: -
C .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 1 of 01 t , ,i oNt.l
111 City of Tigard i " EC E ' . E iew P No: 13125 S W HaII lvd., Tigard, OR 972 " ® Phoe 503.639.4171 Fax: 503.598.1960 JA N 1
0 pa t e�g : O Pcrmit
H 9 I,
I RD Inspection Line: 503.639.4175 Date Ready /By: ® ® See Page 2 for
Internet: www.tigard Notified/Method: ��T Supplemental Information
CITY OF TIGARD
s-.s: '._`. a ...... -�rY -- s • i 4 3 a £' ' ' . ,,. b B? s9 k ' q f ' ; R t § : ' s I l< r '.�ik.3 r:5 1�' •
El New constructio ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
.�..
0. , , � w „, -; work indicated on this application.
CI I- and 2- family dwelling (g Commercial/industrial Valuation: $
1=I Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder [] Other: Number of bathrooms:
^ --.. = '.v..r "'1 _i .... 4 e -. _ � F r , 3 0, 6 - +'F47.1. M 6i8 esT t `� r - ,-•: Total number of floors: •
Job site address: 16101 SW 72 AVE New dwelling area: square feet
City/State/ZIP: Portland, OR 97224 Garage/carport area: square feet
Suite/bldg. /apt. no.: 130 I Project name: SEIMENS,REAL ESTATEE Ti Covered porch area: square feet
Cross street/directions to job site: / 1' ■ Deck area: square feet
/w V � , � `'1 / / Other structure area: square feet
/ �` 1 17T / o i. 5 e z_“ rat r ° e,li, } r o -.
Subdivision: k" 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
4 �: r° . equipment, materials, labor, overhead, and the profit for the
:: = •.• ,. � > 1.1 e s I
RELOCATE SPRINKLER HEADS = 9 work indicated on this application
Yy Valuation: $$1,470.00
Existing building area: square feet
New building area: square feet
_.= 'K -' —Tr -- mi '
} . ?��.� r <.=- ;- 3 = �— -- Number of stories:
..
Name: PacTrust Type of construction:
Address: 15350 SW Sequoia Pkwy - Suite 300 Occupancy groups:
City /State /ZIP: Portland, OR 97224 Existing:
Phone: (503)624 6300 Fax: ( ) New:
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a, 4 T'-';., . -]-- - .. c ,---.4,-L....1 -- ----
Business name: 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: ( ) I Fax: : ( )
E -mail:
x: -, =r� .... .- -,,, _ - r t a ... - !— - 3r . .- ... .......,. . :. ^ � 7 . r l.r i t� . j .o
Business name: Crossfire Sprinkler Company is
Permit fee: . J U 9
Address: 17400 SE 82 Drive
City / State/ZIP: Clackamas, OR 97015 State surcharge (12% of permit fee): 1 3
FLS plan review (40% of permit fee):
Phone: (503) 210 -5506 Fax: (503) 210 -5538 (Due upon application.)
Total permit fees:
CCB lic.: 174746 .�A1. . -' Pe S 7 -)-9— I� 1) Amount received:
Authorized signature: 7� �s ...
��1I This permit application expires if a permit is not obtained
Print name: Timothy A Bishop Date: 1/6/11 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permhs\FPS- PeamhApp.doc 1 0/01/09 440- 4613T(11i02JCOM/WEa)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
/s ✓ r x
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: 2
Additional description of work:
® Wet ❑ D
Additional Stand. i. es
Information: Hazard Grou. LIGHT
Densi
Desi• Area
K. Factor 5.6
.t, $ 1470
-
r s . ' (a:x S £I.. r. ..._. ....�� .�...M.....,........,..+.......
Hood Project Valuation: $
•
• 4 L_...- �S'..wm...... —_
Submittal shall Batte Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
17-14 ._._s.. -t `fir•• -z -� s �s _,.� -..� �'T?�' - "� -� _rr:
.z
Square Foot.: e: Permit Fee: =��
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
_ �
7,201 and •eater $404.39 �„_
Sprinkler Project Square Footage: _ sq. ft.
Proect valuation subtotal see A, B & C above : $
Permit fee based on .ro ect valuation see fee schedule : $
Permit fee based on se uare foota • e see D above : $
State Surchar e 12% of .ermit fee : $
FLS Plan Review 40% of .ermit fee : $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
C: \Documents and Settings \CAD \My Documents \ Permits \ tigard permit.doc 10/O1/042