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Permit
� , i CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 14 4 , COMMUNITY DEVELOPMENT Permit #: FPS2011 -00135 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2011 Parcel: 2S 112 DA01400 Jurisdiction: Tigard Site address: 15350 SW SEQUOIA PKWY 350 Project: Cornett PC Subdivision: 1996 -048 PARTITION PLAT Lot: 2 Project Description: Adding (3) sprinkler heads to existing system. Contractor: FIRESTOP CO Owner: PACIFIC REALTY ASSOCIATES 3203 NE 65TH ST. #2 ATTN: N PIVEN VANCOUVER, WA 98663 15350 SW 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 11/16/2011 $51.09 12% State Surcharge - Building 11/16/2011 $6.13 Type of Use: COM Info Process /Archiving - Lg Sheet (over 11/16/2011 $2.00 Class of Work: ALT Type of Const: 11x17) Occupancy Grp: Height: ft Info Process /Archiving - Sm Sheet (up to 11/16/2011 $3.00 Stories: 11x17) Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Hazard: LT Density: .10 Design Area: 1500 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 $62.22 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $500.00 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 n ed within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow tb rules opted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may ob ain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / _ __ IssuedBy:AP •ermitteeSignature: Call s e _. by 7:00 a.m. for the next available inspect . n 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 USE ONLY City 4F' Received permit No.: of Tigard tY g �� r Date/B : / t� ebb — �• v 13125 SW Hall Blvd., Tigard, 7223 1 . 1 9 g a ° & ' �'� Plan Rview O Permit: /,�1 I —l.� , ) 1Iw Phone: 503.718.2439 Fax: 503f59,13:49‘611' Q Date/By: � !�)lVA 00 1 T l G n R D Inspection Line: 503.639.4175 � .I , p Date Ready/By: J ' See Page 2 for Internet: www.tigard- or.gov \v VT N Notified/Method: "l -- , Supplemental Information TYPE OF WORK�e REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction © Demolition Permit fees* are based on the value of the work performed. Indicate the value (rotnded to the nearest dollar) of all Addition/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 ommercial /industrial Valuation: $ ❑ 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 z. 5 t / �� 0 J �? iz ) 51 New dwelling area: square feet City /State /ZIP: fl rti a ,, t , Garage /carport area: square feet Suite/bldg. /apt. no.: ti ) Project name: op ' ei -ri 7 Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: 1 Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rourded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. L� 414 -,s /9 r_ Valuation: $ 5 Da DC..:) gv 1 � ' gJ � 0 J u r � - - r Existing building area square feet /" rj a Vz Pv New building area: square feet ❑ PROPERTY OWNER J ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: APPLICANTONTACT PERSON NOTICE Business name: 1 1 7 TD ,A AI, All contractors and subcontractors are required to be Contact name: 1 `n e licensed with the Oregon Construction Contractors Board 1 under ORS 701 and may be required to be licensed in the Address: 3 73 e-- L �i- (. • ( .. jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City /State /ZIP: U A t3 n J 0 Z) i),1 A t / ,\ (� apply: Phone: ( 3 ( g b ) " %t90 F a x : : ( ) X116 — Caste`s E -mail: CONTRACTOR BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: l State surcharge (12 [ / 9„,... 1 / 9„,... 1 P p, Permit fee: ' Address: —t r ! & 1 6, 1 , (12% of permit ' ? ww � �/ /o f it fee): City /State /ZIP: V R ( 1) dSZ- IJ`r Pr FLS plan review (4 ° permit fee): tn.) c4nzl,. Phone: (N90 ) ---4. �[ (_ 0 1 f Far: ("%, 'T.( — bb 3 . e upon application.) CCB lic.: lJ l Total permit fees: 1 �6"p / ,.2 Authorized signature: Amount received: $ tll This permit application expires if a permit is not obtained Print name: - 4`c SO D ate: �' r 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(I I /02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work-to be done: 1.) ■ New 2.) Mo fication to sprinkler heads only: ddition 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 L ) 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 (Stand Alone 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. L \ Building \ Permits \FPS- PemutApp.doc 02/01/2011 2