Permit 7 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
; ''` =" COMMUNITY DEVELOPMENT Permit #: FPS2011 -00107
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/09/2011
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15115 SW SEQUOIA PKWY 170 •
Project: Napier Subdivision: Lot:
Project Description: (1) new sprinkler head
Contractor: CROSSFIRE SPRINKLER CO Owner: PACIFIC REALTY ASSOCIATES
17400 SE 82ND DR ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 210 -5506 PHONE:
FAX: 503 - 210 -5538
FEES
Description Date Amount
Specifics: Permit Fee - COM 09/09/2011 $51.09
12% State Surcharge - Building 09/09/2011 $6.13
Type of Use: COM Plan Review - Fire Life Safety - COM 09/09/2011 $20.44
Class of Work: FPS Type of Const: IIIB
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: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $77.66
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $250.00
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 503.232.1987 or 1.800.332.2344.
Issued By: /f f /,/ Permittee Signature:
lam' 1
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.
09/09/2011 14:41 5032105539 • CROSSFIRE PAGE 01/02
Building Permit Application
Fire Protection System. FOR oilier i s : oNi,v
l �i�.t� peltnitNo.:s Q/0
City a Tigard ECF ffVR Date/ ` p �.�
13125 SW Ii:a11131vd., Tigard, OR 97223 Plan Review 'Other Pettttitete Ot d // Bt, /5
, ,
I I Phone: 503.639,4171 Fax: 503.598.1960 D ate/B
Inspection Line: 503.639 - 4175 S E r 9 2 0' 1 Date R / By: Julia: to see gage 2 for
T I Ci K I) Notified/Method: 6 --- Supplemental Information
Internet www tigard or goy
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n New constructions El Demolition
Permit fees are based on the value of tho work performed.
Indicate the value (rounded to the nearest dollar) of all
® A ddition/alteration/replacement . [] Other: equipment, materials, labor, overhead, and the profit for the
t i t - i , r Sn r+v-r 1 s^? ,.k, -• o r,'"m.. ,,.5,� ” . -.—.-` ili t ' F ftl' I{I � i 6 work indicated on this application -
f:9,,,,, r i t s t t h i t I t t, ` , t 4 ,f1 I t1 ;' r a ,,.: 1 3!}t t f7 '�
I ," 1 fw, ik ;.,_,�I.rit r i1C.S ,'i5,r: ; :;ii :. :;;;; ;ridw 1 .,.,. :,: ;5 I {r,, ,..,.!.r --
v .r.{ r., , i ., , , r t:e, }"t, #_ .,. d ., r , valuation:
❑ 1- and 2- family dwelling 0 Conunercial /industrial
❑ Accessory building El Multi-family
Number of bedrooms:
❑ Master builder ❑ Other:
Number of bathrooms:
,:. rt 1 , ri r :.k ; C,., s t ["77:ti .:n i r ;; ,, t : , ;f t r I } [ r i' l r r� ' i 'i L I G I ' F : w t ti Total number of floors:
1 t "t ,: i , e t� 1 '., ` i " `, $ t ' .1... , .,r : r } i , e71 [ t., ( y rrr ,., , ^
. . na ;;Lii . S,1} a .t ":...._,r aw , .,,: Y.... ,. ,. T ...,,, ,. r ,+mow,..,_ I t t , .
Job site address: 15115 SW SEQUOIA FK1 New dwcliing area: square fact
W
City /State /ZIP: Portland, OR 97224 Garagc/carport area: square feet
Suite/bldg. /apt_ no.; f 7 0 I Project name: NAPIER Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: • square feet
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It'1 }S r �.t 51 F r Y v d JI ! ff u 1�
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Subdivision: Lot no.: Permit fees* arc based on the value of the work performed.
indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no equipment, materials, labor, overhead, and the profit for the
0 1 : ; 1 , !}:t[' r > $ . Y i i t ; l f +1N s r ; t { M: u lttt it t $ s t !t work indicated on this application.
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, ..e,Y t :. : ::i � _ J _. c , '># r. l !11n ! , , , !,`r , w ., .?.,, i t4. J.?1 .I, :i :fon {,I'.t� , , t,) lilt., r- d.6: iiiise:, 2 t,,tt 4--4 ::
Valuation: $$250.00
NEW SPRINKLER READS =1 Existing building area: square feet
New building area: square feet
y -;. t r - . 1 , r 17 - ew w .� , �t E= r t a G ,r r t r i
:;-.75E: , 1i' '?�" 1 � l >' �,,' }� t; ' `� I i t `fit �l fifli')T l l' 4 i 11 1 � h , ,�-' �� f rl 1 :i i1 f ; r Number of stories:
!. ._..._ 1 „_...x..,n4 ,,.m,.._ t . .. :,..... ,,,.i t,d..:,,r t... :... ._.. t,u.., c! ....... .. r,..
Name: PacTruse 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:
n' r r1. - 1 x, hT�_z rt: i�.. .. f 1 , I I } :;`; �,,[, r� ,a, t f'f Ft1 ”( ; " ra,e,; 3 " a [ J °` 7 1 "f,f:r r T �
>. .. r� 1i } r 'r r }- 1� I +31: t ! ii' r .,� ie:i: t r.,e.$ i li.A yli;gi r+tr 1 a M rr r «'ae ) f( i,),i Yr +�v
....,!,..i,.,.i.,,;�,g,:tt1 -_ .„,.... }._. nit f;y ,. ... �:!,,... t� <.,..»! 1 .41 { ,. � ,rT"{r!�, {,bra „ >lt , ,w, il. _ „?.t.r..t, w r t• H Grlt I) , f r v i �r y r a r f [q'�1��
w�ta...� . ., rf e.re. , , t 1 �. ,, �[,., _ :..,. .,Pa ra „rCr ,. . �;,,, ., . I, ,1+ r4,u,..a +1.�...,.,, r.,
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: ( ) Fax: : ( )
k
E -mail:
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Business name: Crossfire Sprinkler Company - ,•J k ��,...1 , -.:; •.,,fin„ I -.,
Permit fee: Si , 0
Address: 17400 SE 82 Drive
— State surcharge (12% of permit fee): 6, , 4y
City/State/ZIP: Clackamas, OR 97015 FLS plan review (40% of permit fee): t �
Phone: (503) 210 -5506 r Fax: (503) 210 -5538 (Due upon application.} • 7 y
CCB 1ic.: 174746 .411 i,.�llllm.- r wry Total permit fees:
4
I �`r -- ' Amount received:
Authorized signature: r �A _ . -
1 % This permit application expires if a permit Is not obtained
Print name: Timothy : Bishop • Date: 9/9/11 within 180 days after it has been accepted as complete.
.. * Fee methodology set by Tri- County Building industry
Service Board.
I:\ building \Pamits\PPS- pernitApp.doc 10/01(09 440- 46131(11/02/COM/WEB)
09/09/2011 14:41 5032105538 CROSSFIRE PAGE 02/02
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 ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 1
Additional description of work:
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a,: =,cJ t n:,.�k4�:!.- �,,�..h (chi , ,.:•. ii" .'Nr:r.n.,_liur,:ax.,.,...}w n t ev„ t 1 .. 1. ]d6 _. .,. ! , ".... I h r ;P!' ,.,1.:1 { 1 j ,'C {rY f-rf , *1' If �*
Wet ❑ D
Additional Stand i es
Information: Hazard Grou FINCEMIENIMMIM
Densi
Desi• Area
K Factor 5.6
5 I rinkler Pro - ect Valuation: $ 250
' ,, ,,, , Ir 1;' . £
Hood Pro'ect Valuation:!I } J $
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Submittal shall Batt- Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Mann Pro 'eel Valuation:
} } , ,} . }. c } � t r �{, r r ",". : r n r. . 7t {, r f M , 4 lttr F pp �.. , `M'1♦Y2'�*y{r•r: r ,wr
_ - •� Permit Peet
0 to 2,000 $198.75 ) , tl` , i�rl � ,r '
2,001 to 3,600 $246.45
3 601 to 3 $310.05 I + � r
S E f t { 1 •c , f �lh �
7 201 and : cater $404 -39w
Sprinkler Project Square Footage: sq. ft.
1 C I �t 1 ,
l 1.. r
.::,,...,.r ... .,..,... � ,....,:. f 1 { I{ l, { t { 1{
Pro valuation subtotal see A, B & C above : $
Permit fee based on •ro valuation see fee schedule : $
Permit fee based on s • uare foota • sec D above : $
State Surchar: - 12% of .emit 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.
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