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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT INCOMMUNITY DEVELOPMENT Permit#: FPS2014-00024 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/24/2014 T f�''�R O g Parcel: 2S113AD01900 Jurisdiction: Tigard Site address: 16640 SW 72ND AVE B10 Project: Copytronix Subdivision: ROSEWOOD ACRE TRACTS Lot: D Project Description: Modification of fire sprinkler heads for TI,approximately 43 heads. Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES 9095 SW BURNHAM ATTN: N PIVEN TIGARD, OR 97223 15350 SW SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-684-2928 PHONE: 503-624-6300 FAX: 503-684-9657 FEES Description Date Amount Specifics: Permit Fee-COM 02/24/2014 $112.96 12%State Surcharge-Building 02/24/2014 $13.56 Type of Use: COM Info Process/Archiving-Lg$2.00(over 02/24/2014 $2.00 Class of Work: ALT Type of Const: 11x17) Occupancy Grp: Height: ft Info Process/Archiving-Sm$0.50(up to 02/24/2014 $5.00 Stories: 11x17) Plan Review-Fire Life Safety-MF 02/24/2014 $45.18 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: LT Density: .10 Design Area: 1000 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 $178.70 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $3,540.00 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 ob a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By(121 Permittee Signature: Call 503.638.4175 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. r • • 'w Building Permit Application Fire i'rotection System RECEIVED FOR OFFICE USE O1\1.1 City of Tigard Received , Permit No.: • 13125 SW Hall Blvd.,Tigard,OR 97223r Date/B . •_„�/ r —QQ�pl q� Plan Review Phone: 503.718.2439 Fax: 503.598.1 EB 1 1 2014 Date/By:i /y 1 Other Permit: Pc/f-cifee TI , iz I) Inspection Line: 503.639.4175 Date Ready/By: Juris: 65 See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method:,/.// . 3,) Supplemental Information lANNG DIVISION Sf'6 ke G'_ ''T7,[bt GGt^S hkigt TYPE O 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: S ❑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:16640 SW 72ND AVE New dwelling area: square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Copyronix 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. Add and relocated sprinklers for TI Valuation: $$3,540.00 Existing building area: square feet New building area: 0 square feet ❑ PROPERTY OWNER ® TENANT Number of stories: 1 Name: Type of construction: Comb Address: Occupancy groups: City/State/ZIP:T Existing: Light Phone:( ) Fax:( ) New: Light ® APPLICANT 0 CONTACT PERSON NOTICE Business name:Wyatt Fire Protection All contractors and subcontractors are required to be Contact name:Ashley Payne licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address:9095 SW Burnham Rd jurisdiction in which work is being performed.If the City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons apply: Phone:(503)684-2928 Fax: :( E-mail:a.payne @wyattfire.com CONTRACTOR BUILDING PERMIT FEES* Business name:Wyatt Fire Protection (PlasrrejerroJeeselYedrle� Permit fee: Address: State surcharge(12%of permit fee): City/State/ZIP: FLS plan review(40%of permit fee): Phone:( ) f Fax:( ) (Due upon application.) CCB lic.:64077 . t if, Total permit fees: ` 4 1 Authorized signature: Amount received: . This permit application expires if a permit is not obtained Print name:Ashley Payne Date:2/10/2014 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Pmnita\FPS-PennitApp.doc Rev 01/052012 440.46131(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: ❑ Addition ❑ 1-10 heads: No plan review required. ® Alteration ® 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: 41 Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler Z Wet ! ❑ Dry Additional Standpipes Information: Hazard Group Light Density .10 Design Area 1000 K. Factor 5.6 Sprinkler Project Valuation: $ 3540 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. C:\Users\Ashley\Desktop\TigardApp.doc Rev 01/05/2012 2 CITY OF TIGARD FEE AND PAYMENT HISTORY r i • 13125 SW Hall Blvd..Tigard OR 97223 503.639.4171 TIGARD FPS2014-00024 - 16640 SW 72ND AVE B10, TIGARD, OR 97224 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Permit Fee-COM 230-0000-43104 $112.96 $112.96 $112.96 12%State Surcharge-Building 100-0000-24001 $13.56 $13.56 $13.56 Info Process/Archiving-Lg $2.00(over 230-0000-43135 $2.00 $2.00 $2.00 11x17) Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $5.00 $5.00 $5.00 11x17) Plan Review-Fire Life Safety-MF 230-0000-43108 $45.18 $45.18 $45.18 Totals for Fees $178.70 $178.70 $0.00 $178.70 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount Total Payments: $0.00 Balance Due: $178.70