Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II 2 COMMUNITY DEVELOPMENT Permit #: FPS2013 -00056
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/07/2013
Parcel: 151 36DA00100
Jurisdiction: Tigard
Site address: 11308 SW 68TH PKWY
Project: Comcast Tech Ops West Subdivision: PFAFFLE PLAZA CONDO Lot: 2
Project Description: Fire sprinkler modifications
Contractor: COSCO FIRE PROTECTION INC. Owner: BENENSON 68TH PARKWAY KEY LLC, T
2501 SE COLUMBIA WAY SUITE 100 BY PROVIDENCE HEALTH SYSTEM
VANCOUVER, WA 98661 ATTN: PROPERTY MANAGEMENT
1235 NE 47TH STE 160
PORTLAND, OR 97213
PHONE: 360 - 883 -6383 PHONE:
FAX: 360- 883 -6390
FEES
Description Date Amount
Specifics: Permit Fee - COM 05/07/2013 $674.92
12% State Surcharge - Building 05/07/2013 $80.99
Type of Use: COM Plan Review - Fire Life Safety - COM 04/30/2013 $269.97
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 05/07/2013 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 05/07/2013 $17.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 Design Area: 948
K Factor: 11.2
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $1,047.38
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $75,000.00
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
Util 'otificatio - -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
direct questions to O. calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee 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 RECEIVED FOR OFFICE USE ONLY
City of Tigard Received / 3 , f Permit No.: /152o/ 3 - Oeo 5-0
Tigard, OR 9722 ►
13125 SW Hall Blvd., Ti Date /By:
g R 3 0 2 013 Plan Revie "'""J' Phone: 503.718.2439 Fax: 503.598.1' . I Z._
r "'""J' ,� Other Permit:
Date /By:
TIGARD
Inspection Line: 503.639 CITY OF TIGARD Date Rea A // 2 ✓ �,/ lur s: El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: p* 431 Supplemental Information
Bl1ILDING DIVISION .) ytL u+ ?iv✓
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 (rounded to the nearest dollar) of all
0 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: 11308 SW 68 Parkway New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Comcast TOC West 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: I 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.
Relocating pendent and upright fire sprinkler heads off the existing systems, to Valuation: $75,000.00
accommodate new ceilings and walls in T.I. space. Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name: Comcast Cable Communications Type of construction:
Address: One Comcast Center 1701 John F. Kennedy Blvd. Occupancy groups:
City /State /ZIP: Philadelphia, PA 19103 -2838
Existing:
Phone: ( ) Fax: ( )
New:
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: Cosco Fire Protection All contractors and subcontractors are required to be
Contact name: Ken Molinari licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 2501 SE Columbia Way Suite 100 jurisdiction in which work is being performed. If the
City /State /ZIP: Vancouver, WA 98661 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 883.6383 I Fax: : (360) 883.6390
E -mail: kmolinari @coscofire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: Cosco Fire Protection (Please refer to fee schedule)
Permit fee:
Address: 2501 SE Columbia Way Suite 100
State surcharge (12% of permit fee):
City/State /ZIP: 2501 SE Columbia Way Suite 100
FLS plan review (40% of permit fee):
Phone: (360) 883.6383 I Fax: (360) 883.6390 (Due upon application.)
CCB lie.: 67508 Total permit fees:
Authorized signature: E 1� Amount received: t a ‘ 2 7, Y 7
This permit application expires if a permit is not obtai ned
Print name: Ken Molinari Date: 4.30.13 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 4404613T(11/02/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:
El Addition ❑ 1- 10'heads: No plan review required.
El Alteration El 11 + heads: Plan review required.
El Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet El Dry
Additional Standpipes
Information: Hazard Group
Density
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 El 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.
K: \PD 5111 Comcast TOC \Permit Docs \City of Tigard Permit Application.doc Rev 01205/2012