Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 -00067
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/17/2012
Parcel: 2S113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 200
Project: Perlo Construction Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Modification of approximately (30) fire sprinkler heads for TI.
Contractor: DELTA FIRE INC Owner: PACIFIC REALTY ASSOCIATES LP
14795 SW 72ND AVE ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503- 620 -4020 PHONE: 503 - 624 -6300
FAX: 503 - 620 -1058
FEES
Description Date Amount
Specifics: Permit Fee - COM 05/17/2012 $123.72
Plan Review - Fire Life Safety - COM 04/27/2012 $49.49
Type of Use: COM 12% State Surcharge - Building 05/17/2012 $14.85
Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg $2.00 (over 05/17/2012 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process /Archiving - Sm $0.50 (up to 05/17/2012 $26.00
11x17)
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $216.06
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $4,762.00
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 No '•• Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may Vain a , opy •J the rules
or dire• questions to c NC by . ' g 503.232.1987 or 1.800.332.2344. / /
lssu =. By: I 'IC ( / Permittee Signature: /
i
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 FOR OFFICE USE ONL1
City of Tigard �CEIVED Received P Nor:
DateiR ► J/ , � /IV i
• 13125 SW Hall Blvd., Tigard,OR plan Review / I . L
Phone: 503.639.4171 Fax: 503.5 D ' ; l Other Permit:
TIC n R D Inspection Line: 503.639 APR 2 7 ' n 12 Date Ready/By: �A& ,„ Jurir. ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method:-"' 1° �' Supplemental Information
• . TYPE o �±r i i
n d:�l. t . R DATA: 1 A1V1� Z- 1FAMILY DWELLING
❑ ...." • Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
is 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: $
a.
❑ 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: • 0 lvIVIIMMINIIIMINI New dwelling area: square feet
City/State/ZIP: t ` , c , • 0 ` • / „111'■-- Garage /carport area: square feet
r _e • t: g. /apt. no.: 01 Project name: ` • ' '. L Jo C� Covered porch area square feet
Cross street/directions to job site: i � -• g ` r Deck area: square feet
Other structure area: square feet
REQU1RF GQ.',.1 CIAL US CHE KL�
IST :
Subdivision: Lot no.: Permit fee' are based on the value of the work performed.
Tax map /parcel no Indicate the value (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
���� DESCRIPTION :OF WORK - • . • • - • .. • work indicated on this application. CO �TI,f/.� ' .11 _ . � el. Valuation: S L I B ' WOOL W
Existing building area square 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:
2 ❑ C ONTACT PERSON .. .
NOTICE • .... .1 •
L All contractors and subcontractors are required to be
Contact name: • . c ' J• •� , ..1.n..., licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be lcensed in the
Address: iiMINNIRIMEN0 e. jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
�,� P: 14 . apply
Phone: • i 4 ' 0 • r Fax:: .rL • 90 — IC •
- , CONTRACTOR • BUILDING- PERMIT FEES*
I • (Please refer to fee schedule, - ' • •
Permit fee:
Address: (,I • ... to l • ► - a
Cit /State/LIP: c ` • /�� State surcharge (12% of permit fee):
y •' /' FLS plan review (40% of permit fee):
Phone: 0 3) • 0 , 6 — 8 6 112 (tg „ Vr (Du ( Due upon application.)
Total permit fees: • Authorized signature: / � / / ' WI" Amount received: 019‘ _ This permit application expires if a permit is not obtained
�
Print name: g i �� � � • '� .- \ within 180 days after it has been accepted as complete.
/I Date: 112111
• Fee methodology set by Tri -County Building Industry
Service Board.
I: \BuildinglPermin \FPS- PermitApp.doc 03/23 /06 440- 4613T(lI /02/COM/WEB)
City, : of, `Tigard.; Fire Protection Permit- Checklist
Page 2 - Supplemental Information
Describe work to be' done: ";
L) ❑New - 2.) - - Modification to sprinkler heads only:
a Addition 1 -10 heads: No plan review required.
Alteration 11+ heads: Plan review required.
❑ Repair 2 �
Number of sprinkler heads:..SJ
tton
- des crigtion o wor : -- —
Type of System(Comylete..A, B,.; C or: D as .applicable):
A.) Commercial Sprinkler
• Wet ❑ Dry
Additional Standpipes
Information: Hazard Group - In - Wt?c,d
Density
Design Area
K. Factor 6- COO -
Sprinkler Project Valuation: $
B.) . Type! - Hood Fire 'Suppress Sy -
Hood Project Valuation: $
C.) Fire.Alarm-
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ NA <
D.) Residential Sprinkler (Stand Alone System)
•
Square Footage: Permit Fee:
0 to 2,000 $187.50 . .
.
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50 • •
•
7,201 and greater $381.50
Sprinkler Project Square Footage: A ) k 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 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fire prote systems require that plans bear the original seal of an Oregon licensed are suppression
engineer, or NICET level "3" technicians.
I: \ Building \ Permits \FPS -PennitApp.doc 2
DELTL� 14795 .W. d °
PORTLANDS 72n O 9 ' y 4 CE/VEa OF TRANSMITTAL
, . CAB 64 4 APR 2 72012
B � tDlNla p �AR O DATE 4/25/2012 JOB NO. 12 -4940
'V
ATTENTION: BUILDING DEPARTMENT
RE: Pacific Business Center #200
TO: City of Tigard Perlo Construction Office
13125 SW Hall Blvd.
Tigard, OR 97223
VIA: Mail
COPIES 1 NUMBER 1 DESCRIPTION
3 Sheet 1 -1 of 1 Architect Approved Drawings
3 Pg 1 -45 of 45 Architect Approved Data Submittals
1 Pg I -1 of 1 Permit Application
1 Each Check Totaling $49.49 for Plan Review Fees
THESE ARE TRANSMITTED as checked below:
X For Approval _ For Review and Comment n
_ For Your Use Approved
X As Requested ` Submit copies for distribution
REMARKS:
REPLY REQUIRED: DYES ONO BY DATE:
BY: Craig Spicer /Heidi Scarbrough