Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 11 COMMUNITY DEVELOPMENT Permit #: FPS2011 -00122
Date Issued: 10/21/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 1S1356D00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 350
Project: Plaza West Subdivision: ASHBROOK FARM Lot: PTS 5 &
Project Description: Add (23) fire sprinkler heads to existing system.
Contractor: FIRE SYSTEMS WEST INC Owner: SUN LIFE ASSURANCE CO OF CANADA
600 SE MARITIME AVE #300 BY NORRIS BEGGS & SIMPSON
VANCOUVER, WA 98661 121 SW MORRISON ST #200
PORTLAND, OR 97204
PHONE: 360- 693 -9906 PHONE 503 - 352 -8113
FAX 503 - 289 -2208
FEES
Description Date Amount
Specifics: Permit Fee - COM 10/21/2011 $112 96
12% State Surcharge - Building 10/21/2011 $13 56
Type of Use: COM Plan Review - Fire Life Safety - COM 10/07/2011 $45 18
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Sm Sheet (up to 10/21/2011 $8 00
Occupancy Grp: B Height: ft 11x17)
Stories: 5
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type' Wet
Standpipe Required. Yes 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 $179 70
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $4,000 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 Notif . on - ; Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules
or direc .uestions to OUNC • in 5 . 232 1987 or 1.800.332 2344.
Issue° By: / � Permittee Signat
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 FORrOFFICEUSEONLY > P i s � �
City of Tigard Received �
Permit No /
y DRatet6 , /o� l ' p"I�S .mil —A�1�2
13125 SW Hall Blvd , Tigard, OR 9 -, i' ` plan Review
Ph one 503 71 S 2439 Fax 503 59 $r � 1 D . / ^ t ' Othe3 Petnut
� il o Date /B I� ®�
TIG Ins Line 503 639 4175 C 1 %1 1.• date 'ear ir 1 mu is El See Page 2 for
Internet www tigard - or gov P OC �� ��� O Notified/Method tie'thod r / / fr �� Supplement:) Information
,, T,I,PEnO �yOR .> '� •., ° '» <i1.: �.- t UI DATA: 1 F,���M DWEL " ='
a
'� >,.,�.:`.•� W �� �. �° ';;�n ,• 1 s_ = , Q - ;: ,- ss�r�; : >2�;..�,. ••::.,�- :. �•
❑ New construction ❑ p n 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
_�'`,' :1':- °,° S ,333 �?,;
'''' ^�'• ''t;CATECORY O� ,CO � �tii =��`;;,,,��::�•°
z;. •II °". „�. -: ?.'• .v y'✓ ". ,-, � r� ' ` . .. nom �� , ' �aw E3 ` `.., work indicated on this application
dwelling Valuation $
❑ I - and 2-family g ® Commercial /urdustrlal
CI Accessory building ❑ Multi -family Number of bedrooms:
❑ Master builder ['Other: Number of bathrooms:
z ' ,,1 '-,31> ; u, , - - :- ,..�......, : < ::. s , p " q , -,7,0,m Total number of floors
1 x l ,;, 1.JOB.,:.:S1 , IN FOAION" A
RMT L A TI O N
,f 3.�• +3 ,:I� r -i��`, ' -I� € *„ .... ;, .... , ._ :r te.= .:::x.,.<OC
:i�� ... ,. �:,. N ,. .... ..,, .'�ii?jl'�
Job site address' 9600 SW OAK STREET New dwelling area square feet
City /State /ZIP TIGARD, OR 97223 Garage /carport area square feet
Suite /bldg, /apt. no . STE Project name PLAZA WEST Covered porch area square feet
Cross street /directions to job site 5 ((I Nc' Deck area square feet
1 6 T Other structure area square feet
moo ' ' • :3 "17:a� "' . - � r3. d , �
REQUIRED; DATA:l3COMi&JERCIAL -USE; CHECKLIST, 4
�A' :•3 > ��. ;
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
�� _ q overhead, and the profit equipment, materials, labor, a e ofit for the
r
. €t. , 3 °;D'ESCRIP'TION QF WORK % ' ` � work indicated on this application.
3 FLOOR, SUITE .Deer NANT IMPROVEMENT. ADDITION OF 23 AUTOMATIC Valuation: $$4,000.00
•
FIRE SPRINKLERS TO EXISTING SYSTEM. Existing building area 17300 square feet
New building area 2175 square feet
„a'- ❑ keiC6 T'Y�,t,OWNER' TENANT r ' '`' Number of stories: 5
' � ,3, tt: . -,., o._-. , �;a- v.,:,,. ,: -.. , `;;�.
Name: NORRIS, BEGGS & SIMPSON Type of construction: STEEL /CONCRETE
Address: 121 SW MORRISON, STE 200 Occupancy groups:
City /State /ZIP. PORTLAND, OR 97204 Existing: OFFICE/ LIGHT
Phone: (503)352 -8113 Fax: ( ) New: OFFICE /LIGHT
:� ; :;,�.: i �a", , � ''333 ;;s5 :`•. ..� " 1 �33?,�3. f,i',3, 3
1i;1
...,, . APPL CA T ;,> ` _' "° ONTACT PE SONS' %' >'' 'E..
. •- . ...- „:_�: NO „
Business name: FIRE SYSTEMS WEST, INC. All contractors and subcontractors are M required to be
Contact name BRENT CULLINANE licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 600 SE MARITIME AVE., STE 300 jurisdiction in which work is being performed If the
City /State /ZIP VANCOUVER, WA 98661 applicant is exempt from licensing, the following reasons
apply:
Phone (360) 693 -9906 Fax. : (503) 289-2208
E -mail: brentc@firesystemswest.com
firesystemswest.com
..'3� -"�„” � 33� „• ..,, . 1 3 f3;;. ",i:;�T�`„ . >�att� - "" X3'1 �'�t`�� , v>;:.; ' , " : ,'
a: • ., a,,,.,.,, ,,,2`:,,';" sf,?;'a. 1.
,....� -, _. _ �,,,.,,< _��; . �,� ; = CONTRACTOR.' ; ,...
``i� `�� ° '�= ��= =`' BU7 _ L DIIVG:PERMIT FEE . A ry
Business name' FIRE SYTEMS WEST, INC. E"�•tt ,,, - iiVieia;feeisc/ierlale)''`` , h4, ; ;SI ''as”
Permit fee:
Address: 600 SE MARITIME AVE., STE 300
City /State /ZIP: VANCOUVER, WA 98661 State surcharge (12% of permit fee)
FLS plan review (40% of permit fee)
Phone” (360) 693 -9906 Fax• (503) 289 -2208 (Due upon application)
CCB lie.: 49732 AI/ 50 Total permit fees
` Amount received:
Authorized signature: ,
This permit application expires if a permit is not obtained
Print name: BRENT CULLINANE Date: 10/03/11 within 180 days after it has been accepted as complete.
* Fee methodology set by Tii- County Building Industry
Service Board
I \Budding \Pen its \ FPS- Pei mttApp doe 02/01/11 440 -4613T( I I/02 /COW WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information ��escrile�w...
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: 23
Additional description of work
�,;t::3= , � � � " ,»tom •,.:" y ;ta� _
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,.. .�,,,.'I)as:applcabl): ...,. ,... ££�t�: =:;;;;�. ., . 3�,,,,
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77 p.
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8
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e a e �ririkler
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P.
® Wet ❑ Dry
Additional Standpipes EXISTING
Information: Hazard Group LIGHT
Density 0.10
Design Area 900 SQ. FT.
K. Factor 5.6
Sprinkler Project Valuation: $ 4,000.00
B: ,:TYPell "'Hood Fire Su res "s " "ioi % SM ''stein
Hood Project Valuation: $ N /A/
;iiir lei: �3i'�. 5i,
3 �`,
_
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c*
Pt":
ire,
Alarm• ° n =- .
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ N/A
-,iF�F •: e� ;:i;1 �. � � • 1t , .,.3. � :i; F=. fa
a £k:
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'-- 7 € €� -`` •" �... " %293 ,
d':Alone' ` stem [[
�D:• _ Res ° ideritial Sil ririkler` r.
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 „ y; ; l
Sprinkler Project Square Footage: sq. ft.
•t��3' �i ' ,3331,'x'",:, ;: ;'t . ^ 6'P' •..,",'�`','.'_. ;'b - �: 9t it, 't.;:i;.331M�9's,,;'1;iA' %„ .�,
,.. . , . , , ��:. °;' ,�f,�,, ,.. Wit;: •:�� „ „££' �_'' ,,,.... ..,,. ,., ...
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 2 sets of plans at submittal. Plan review fees are required at submittal.
C: \Documents and Settings \BrentC \ Desktop \jobs \PLAZA CENTER 270664 \FPS- Per2utApp doc 02/01/11