Permit 1 o p CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11 1 s COMMUNITY DEVELOPMENT Permit #: FPS2011 -00027
Ti G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/17/2011
Parcel: 2S112DC00100
Jurisdiction: Tigard
Site address: 15705 SW 72ND AVE
Project: Bridgeport Distributing Subdivision: OREGON BUSINESS PARK III Lot: 2
Project Description: Remove sprinkler drops to return space to warehouse.
Contractor: FIRESTOP CO Owner: PACIFIC REALTY ASSOCIATES
3203 NE 65TH ST. #2 15350 SW SEQUOIA PKWY #300
VANCOUVER, WA 98663 PORTLAND, OR 97224
PHONE: 360- 718 -8604 PHONE: 503 - 624 -6300
FAX: 360- 718 -8603
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/17/2011 $88.75
12% State Surcharge - Building 03/17/2011 $10.65
Type of Use: COM Plan Review - Fire Life Safety - MF 03/09/2011 $35.50
Class of Work: ALT Type of Const: Info Process /Archiving - Sm Sheet (up to 03/17/2011 $0.50
Occupancy Grp: Height: ft 11x17)
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 $135.40
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,850.00
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 to OUNC
a by calling 503.232.1987 or 1.800.332.2344.
Issued B y . / ` / �� i �, / / Permittee Signature:
`// Call 503.639.4175 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 FOR OFFICE 1 S1: ON 1.)
IN City of Tigard RECEIVED DateBea ,. (7 If / Permit No.: ,, , 'Gaa /
13125 SW Hall Blvd., Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503. a Date/By: Other Permit:
�. l A R D Inspection Line: 503.639.4175 P<'. r -, � - 7 Date Ready/By: J�� Iii See Page 2 for
Internet: www.tigard - or.gov Notified/Method: /lc: Supplemental Information
CITY OF TIGARD
TYPE DIVISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (romded to the nearest dollar) of all
' KA '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 Oercial/industrial Valuation: $
mm
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 5 7O �
5- h , New dwelling area: square feet
City /State /ZIP: Pe ,mo _ „U 0 � g " 7 2... 2- K Garage /carport are. • square feet
Suite/bldg. /apt. no.: - ` Project name:
J Covered port : ea square feet
Cross street/directions to job site: Deck are. square feet
Othe tructure area: square feet
R' I ULRED 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.
� Pdv∎0 JZ 5p . - ►_K) k1 �- Qcf 5 -�p✓ Valuation: $ / R SQ,—
i e4nn, - TT) �1(,CIL0 -D 1� -t-40 Existing building area square feet
New building area: square feet
i sl_PROPERTY OWNER I 0 TENANT Number of stories:
Name: - Pa_ c, L ✓ %A.. „L.- Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
g
Phone: ( ) Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON NOTICE
-
Business name: s Yc.S ¢-b T C.D. All contractors and subcontractors are required to be
Contact name: `e...c. (�, ���✓ licensed with the Oregon Construction Contractors Board
t r ' under ORS 701 and may be required to be licensed in the
Address: 3 2-0 3 /�) / _ S =1. - jurisdiction in which work is being performed. If the
" 1I/ / applicant is exempt from licensing, the following reasons
City/State /Z1P: i C IAJ � ( ✓ ( ,J l Ljc ( ' o co 3 apply:
Phone: - Fax:: ( 3 (8 ` 867o5
E -mail: `P - S +o G17 . C'
CONTRACTOR BUILDING PERMIT FEES*
Business name: ✓ ., (Please refer to fee schedule)
Permit fee:
Address:
State surcharge (12% of permit fee):
City /State /ZIP: FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application.)
CCB lit.: ` 8 % 2 - 1 Total permit fees: spit ' STS -
Authorized signature: received:
_ This permit application expires if a permit is not obtained
Print name: A L b ok., / Date: - 4 -- 1 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1: \Building\Permits\FPS- PermitApp.doc 02/ 01/2011 440- 4613T(11 /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 ❑ 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
Vfl- Wet ❑ Dry
Additional Standpipes C)
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 1 8 SO T
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Ye
Cut Sheets
Fire Alarm Project Valuation:
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permi ' ee:
0 to 2,000 8.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Spr' er Project Square Footage: sq. ft.
Fire Protection Permit Fees
Projec - aluation subtotal (see A, B & C above): $
Permit fee • ; ed on project valuation (see fee schedule): $
Pe • 't 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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
I:\ Building \Pemrits \FPS- PermitApp.doc 02/01/2011 2
RECEIVED
MAR - 9 2011
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Ov Q.. G)(' i(-,�` jJ) 3203 NE 65th Street, Space 2 Q e
�p � ALEC BAKER Vancouver, WA 98663
�Q�-• c '-- w 1 CeN# (360) 909 -8273 Office: (360) 718 -8604
pe�s alec�firestopco.com Fax: (360) 718 -8603
AUTOMATIC FIRE PROTECTION