Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
_ .�- . COMMUNITY DEVELOPMENT Permit /I: FPS2013 -00072
Date Issued: 06/04/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S 135DA03500
Jurisdiction: Tigard
Site address: 11481 SW HALL BLVD 200
Project: Serenity Subdivision: METZGER ACRE TRACTS Lot: 19
Project Description: Relocate (3) sprinkler heads, add (3) and demo (2) for TI for new tenant.
Contractor: DELTA FIRE INC Owner. BECKAL LLC
14795 SW 72ND AVE 7100 SW GABLE PKWY
PORTLAND, OR 97224 PORTLAND, OR 97225
PHONE: 503 - 620 -4020 PHONE:
FAX: 503 -620 -1058
FEES
Description Date Amount
Specifics: Permit Fee - COM 06/04/2013 $91.44
12% State Surcharge - Building 06/04/2013 $10.97
Type of Use: COM Plan Review - Fire Life Safety - COM 06/04/2013 $36.58
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Height: ft
Stories: 2
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 $138.99
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 o the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. r • Issued By: Permutes Signature: 1 l JJ / "' 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 Application R ECEIV ,f FOR OFFICE USE ONLY
�
City of Tigard ,: ceived Date /B : 6 y ' - � Permit No 5.20i3 —pt 72
• 13125 SW Hall Blvd., Tigard, OR 97223 JUN - 4 2013 Plan Review Other Pertr�,(���3—DO�aS
Phone: 503.639.4171 Fax: 503.598.1960 Date /B
Ti G A R D Inspection Line: 503.639 CITY OF TIGARD Date Ready /By Jurss El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
BUILDING DIVISIO'
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
® 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: 11481 SW Hall Blvd. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Unit 200 Project name: Hall Park Office Center .c .e - 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 3 sprinkler heads, add 3 sprinkler heads and demo 2 heads for new TI Valuation: $2,000.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER l 0 TENANT Number of stories:
Name: Type of construction: v 1 2,
Address: Occupancy groups: [J
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Delta Fire, Inc. All contractors and subcontractors are required to be
Contact name: Heidi Scarbrough licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 14795 SW 72 Ave. jurisdiction in which work is being performed. If the
City/State/ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 620 -4020 Fax: : (503) 620 -1058
E -mail: heidis @deltafire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: Delta Fire, Inc. (Please refer to fee schedule)
Permit fee:
Address: 14795 SW 72 Ave.
City/State/ZIP: Portland, OR 97224 State surcharge (8% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 620 -4020 Fax: (503) 620 -1058 (Due upon application.)
CCB lic.: 64174 a l II II Total permit fees:
Authorized signature: I
Amount received:
. This permit application expires if a permit is not obtained
Print name: Heidi Scarbrough late: 6/4/2013 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri -County Building Industry
Service Board.
I: \Budding\Permns \FPS- PermuApp.doc 03 /23/06 440- 4613T(II /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be do ne:
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: 8
Additional description of work
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Z Wet ❑ Dry
Additional Standpipes N/A
Information: Hazard Group Light
Density 0.10
Design Area 1500
K. Factor 5.62
Sprinkler Project Valuation: $ 2,000.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
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.
1 \ Budding \ Permits \FPS- PamitApp doc 03/23/06 440-4613T( 1 1 /02 /COM/WEB)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11481 SW HALL BLVD 200, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler Final
06/19/2013
FPS2013-00072
FAIL
Head with in 6' of each other at rear offices next to conference room
Violation Summary:
Inspector Contractor