Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
3 COMMUNITY DEVELOPMENT Permit #: FPS2012 -00133
T [ A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/08/2012
G
Parcel: 2S112AD01000
Jurisdiction: . Tigard
Site address: 7007 SW CARDINAL LN 145
Project: Cundiff Engineering Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: Relocate (4) existing pendent sprinklers and add (1) pendent sprinkler for TI
Contractor: WESTERN STATES FIRE PROTECTION Owner: PACIFIC REALTY ASSOCIATES LP
13896 FIR ST STE B ATTN: N PIVEN
OREGON CITY, OR 97045 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 657 -5155 PHONE: 503 - 624 -6300
FAX: 503 - 657 -5182
FEES
Description Date Amount
Specifics: Permit Fee - COM 08/08/2012 $72.61
12% State Surcharge - Building 08/08/2012 $8.71
Type of Use: COM Plan Review - Fire Life Safety - COM 08/08/2012 $29.04
Class of Work: DEM Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes 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 $110.36
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
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: • Perrnittee Signature:
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 oiiici USE ONLY
Received ! �r}C ' ^f
City of Tigard Date /B , 1a „ sr Permit N -POI .
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
11 1
II . Phone: 503.718.2439 Fax: 503.598.1960 AUG 2 0 G 0 g 2012 Date /B : Other Permit d� � P � 'x �/ 7 (/
TI G A I: D Inspection Line: 503.639.4175 Date Ready /By: Ir j See Page 2 for
Internet: www.tigard-or.gov
CITY OF TlfG RD Notified/Method: t t, Supplemental Information
TYPE OF W IILDINC; DIVISION
REQUIRED DATA: 1- AND 2- FAMILY' DWELLING
❑ New construction ❑ Demolition 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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- 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: 7007 SW Cardinal Lane New dwelling area: square feet
City/State /ZIP: Tigard, Oregon Garage /carport area: square feet
Suite/bldg. /apt. no.: 145 Project name: Cundiff Engineering 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.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
relocate four (4) existing pendent sprinklers and add one (1) pendent sprinkler Valuation: $$1,292.00
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:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name: Western States Fire Protection Co. All contractors and subcontractors are required to be
Contact name: Darrell Fluit licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13896 Fir Street, Suite B jurisdiction in which work is being performed. If the
City/State /ZIP: Oregon City, OR 97045 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 657 -5155 Fax: : (503) 657-5182
E -mail: darrell.fluit @wsfp.us
CONTRACTOR BUILDING PERMIT FEES*
Business name: Western States Fire Protection Co. (Please refer fa fee schedule)
Permit fee:
Address: 13896 Fir Street, Suite B
City/State /ZIP: Oregon City, OR 97045 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 657 -5155 I Fax: (503) 657 -5182 (Due upon application.)
CCB lic.: 104570 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: Darrell Fluit I Date: 08 -01 -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 440-461 3T( I I /02 /COM/WEB)