Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2011 -00083
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Date Issued: 07/13/2011
Parcel: 2S113AA00400
Jurisdiction: Tigard
Site address: 16290 SW 72ND AVE B2
Project: Spec Space Subdivision: OREGON BUSINESS PARK I Lot: 18
Project Description: Upgrade sprinkler system for new hazard density.
Contractor: FIRESTOP CO Owner: PACIFIC REALTY ASSOCIATES
3203 NE 65TH ST. #2 ATTN: N PIVEN
VANCOUVER, WA 98663 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 360- 718 -8604 PHONE: 503 - 624 -6300
FAX: 360- 718 -8603
FEES
Description Date Amount
Specifics: Permit Fee - COM 06/29/2011 $166.76
12% State Surcharge - Building 07/13/2011 $20.01
Type of Use: COM Plan Review - Fire Life Safety - COM 06/29/2011 $66.70
Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg Sheet (over 07/13/2011 $2.00
Occupancy Grp: S -1 Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm Sheet (up to 07/13/2011 $7.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: ORD2
Density: .6 Design Area: 2000
K Factor: 11.2
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $262.97
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $9,000.00
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. ) on obtain a copy of the rules
or direct questions to OUNC by calling 503.23.1987 or 1.80
Issued By: Permittee Signature:
Call 50 . • 'f 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 RECEIVED FOR OFFICE USE ONLY
City of Tigard Date/Bya Ia / // Pe rmit No.: �j 0//-
1111 "
13125 SW Hall Blvd., Tigard, OR 9722?� II 9 ZU 2 q �1 Plan Review
' Phone: 503.718.2439 Fax: 503.598.14140 Date/By: o r ' f/ 71 1 < < Other Permit
Inspection Line: 503.639.4175 D ate Ready /:y: / Juris: ® See Page 2 for
TIGnRD Internet: www.tigard- or.gov GTTY OFTIGARO N Noti� ethod: 7 �� Supplemental Information
BUILDING G DIVIS _ �`_, ' w _ •
TYPE OF 'WORK i REQUI "l D`DATA: 1- AND 2-FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
tldition/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 Commercial /industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: New dwelling area: square feet
City /State /ZIP: - -a " C), — Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name Covered porch area: square feet
Cross street/directions to job site: l 14 C,& Deck area: square feet
Other structure area: ' square feet
4
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Subdivision: I 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.
Valuation: $ / t4-® ®41
(l 1 zp tZ 1 C 1 -r(q Existing building area square feet
1 ( 7 � ✓✓ New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: 4' , 1,' J IZ U .Sr Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( Fax: ( ) New:
APPLICANT Xj CONTACT PERSON NOTICE
N . Business name: 4-d 1 o p � All contractors and subcontractors are required to be
M licensed with the Oregon Construction Contractors Board
Contact name: j � l 1
� under ORS 701 and may be required to be lensed in the
. Address: M6-5 I < � v ,, e / ---- 5--r, jurisdiction in which work is being performed. If the
appli
` City /State /ZIP: Q R --f j` \', ) )? t . 5 55(11A apply antis exempt from licensing, the following reasons .
t V ' C r � ,rr L'' `'
vp Phone: ( ) �-1 - Q / P c . Fax :: ( ¢U ) J 5s. - <61 n 3
E -m ail: y 6 . 7 4 , ��l-c e �1 i2 t. - ( ;) e!_a.- L-orY\
CONTRACTOR ' BUILDING PERMIT FEES*
l Please re er to ee schedule
M C
Business name: Z t. 7 71 6 ,
Permit fee:
Address: i. "" G 1 a , , 7 State surcharge (12% of permit fee):
City /State /ZI'. FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application.)
CCB lic.: ) % 3 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: ') (t• O Date: Lp_ 1
`c9 * Fee methodology set by Tri -County Building Industry
Service Board.
t:\ 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
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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 Sprinkler (StandAlone System)
Square Footage: 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 greater $404.39
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): $
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.
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