Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
r$ COMMUNITY DEVELOPMENT Permit #: FPS2012 -00064
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/24/2012
Parcel: 2S 101 DA00102
Jurisdiction:
Site address: 13221 SW 68th PKWY 450
Project: Spec Space Subdivision: VARNS ACRES Lot: 9
Project Description: Fire sprinkler, modification of (7) heads.
Contractor: T & L COMMUNICATIONS INC Owner: GK TRIANGLE CORPORATE PARK III
PO BOX 87387 P.O. BOX 130174
VANCOUVER, WA 98687 -7387 CARLSBAD, CA 92013
PHONE: 360 - 737 -9725 PHONE: 503 - 221 -1900
FAX: 360- 737 -9648
•
FEES
Description Date Amount
Specifics: Permit Fee - COM 04/24/2012 $56.47
12% State Surcharge - Building 04 /24/2012 $6.78
Type of Use: COM Plan Review - Fire Life Safety - COM 04/24/2012 $22.59
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
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 $85.84
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $700.00
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 yo. to follow the rules adopted by the Oregon
Utility N. - • - enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -01 -0190. You may obtain a copy of the rules
or dir= questions to O b k C b - mg 503 32.1987 or 1.800.332.2344.
Issu =d By: , ' / / Permittee Signature: Al ,Y i
Call 503.639.4175 by 7:00 a.m. for the next available inspect- 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.
I
Building Permit Application
Fire Protection System ED � FOR OFFICE USE ONLY
City of Tigard RECEIV R Deatae 7
II e � ' / Permit No.:` l , d ,,i .. 0 ,, ,
° 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review �j�� /
11 Phone: 503.718.2439 Fax: 503.598.1960 APR 2 4 2012 Date/By: Other OIo /65
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: kris' El See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BOILING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rotded 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 ® Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13221 SW 68 Parkway New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 450 Project name: TCP3 -STE 450 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: Lot no.: Permit fees' are 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
• DESCRIPTION OF WORK work indicated on this application.
Fire sprinkler tenant improvement , Valuation $$700.00
. Existing building area . s quare feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
0 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: T &L Communications, Inc All contractors and subcontractors are required to be
Contact name: Larry Bushaw licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be li ensed in the
Address: PO Box 87387 jurisdiction in which work is being performed. If the
City/State /ZIP: Vancouver, WA 98687 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 737 -9725 Fax: : (360 -) 737 -9648
E -mail: office @tl- communications.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: T &L Communications, Inc (Please refer to fee schedule
Permit fee: /j .V17
Address: PO Box 87387
State surcharge (12% of permit fee): t . ? Q
City/State /ZIP: Vancouver, WA 98687 FLS plan review (40% of permit fee): �
Phone: (360) 737 -9725 Fax: (360) 737 -9648 (Due upon application.) °� �• , f
CCB lie.: 67787 Total permit fees: gS ; gY
Amount received: 'C5
Authorized signature: 4 .47 „.6 .4 4 1e44....... ..... ,
This permit application expires if a permit is not obtained
Print name: Larry Bushaw [ Date: 4 -24 -12 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 Rev 01 /05/2012 440 -4613T(I1 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to b a 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: 7
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: $ 700.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
- . C.) Fire Alarm
Submittal shall Battery Calculations ' ❑ Yes
i nclude: 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.
http : / /www.tigard- or.gov /city_hall/ departments /cd /docs /FPS - PermitApp.doc Rev 01/25/2012