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Permit • • CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2012 -00162 - TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/25/2012 Parcel: 25101 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 310 Project: Cascade Management Subdivision: VARNS ACRES Lot: 9 Project Description: Fire sprinkler modification for TI Contractor: T & L COMMUNICATIONS INC Owner: GK TRIANGLE CORPORATE PARK III L PO BOX 87387 BY THOMSON REUTERS INC VANCOUVER, WA 98687 -7387 ATTN: MEGAN DOWLING • PO BOX 130174 CARLSBAD, CA 92013 PHONE: 360 - 737 -9725 PHONE: FAX: 360 - 737 -9648 FEES Description Date Amount Specifics: Permit Fee - COM 10/25/2012 $102.20 12% State Surcharge - Building 10/25/2012 $12.26 Type of Use: COM Plan Review - Fire Life Safety - COM 10/18/2012 $40.88 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Sm $0.50 (up to 10/25/2012 $5.50 Occupancy Grp: B Height: ft 11x17) Stories: 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 $160.84 Valuations: Required Items and Reports (Conditions) • Sprinkler Valuation: $3,000.00 • 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 Notific ' enter. 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 estions to O C by ca • g 503.232.1987 or 1.800.332.2344. Issued y: 0 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. Fire Protection System . Building Permit Applicati IV FOR OFFICE USE ONLY � /� City of Tigard Permit No.: S f 2 -•d0/ / IN • 131 SW Hall Blvd., Tigard, OR 9722 18 20 1' DReceived a an R v i ew Q � � / ,.,/. 2 O Review / Other Permit: f (PNf �►^LS Phone: 503.639.4171 Fax: 503.598.1990+ Date/B Inspection Line: 503.639.4175 Date Ready /By: tuns: El See Page 2 for TIGARD Internet: www.tigard- or.gov (1YOFTIGARD Not ied/Method: f #/ 0s i� S Information QuILDING D1v S ON O 0 G I w/ ✓� ' "-' TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING El 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. ❑ 1- and 2- family dwelling ® Commercial/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: 13221 SW 68th Parkway New dwelling area: square feet City /State/ZIP: Tigard, OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: No Project name: Cascade Management 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: $ 3,000.00 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: 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 licensed 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: y: Phone: ( 360 ) 737 - 9725 Fax: : ( 360) 737 - 9648 E - mail: office @tl communications.com CONTRACTOR BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: T &L Communications, Inc. Permit fee: Address: PO Box 87387 City /State/ZIP: Vancouver, WA 98687 State surcharge (8% of permit fee): FLS plan review (40% of permit fee): Phone: ( 360) 737 - 9725 Fax: ( 360) 737 - 9648 (Due upon application.) CCB lic.: 67787 9 //y /ey Total permit fees: erg Authorized signature: A Amount received: • t b cv2-4---, t, Th is permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Larry Bushaw D ate: r U Q ' * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits\FPS- PermitApp.doc 03 /23/06 440-4613T( I 1/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be 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: 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: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: I $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ 2,175.00 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: 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 (8% 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 protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. http: / /www.tigard- or.gov/ city_ hall/ departments /cd /docs /FPSPermitApp.doc 2