Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11111 ' COMMUNITY DEVELOPMENT Permit#: FPS2014-00095
T t G AR L7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/29/2014
Parcel: 2S110DCO2200
Jurisdiction: Tigard
Site address: 15660 SW PACIFIC HWY A-3
Project: World Champion Taekwondo Subdivision: 1997-016 PARTITION PLAT Lot: 2
Project Description: Modify(1)sprinkler head for TI for new tenant.
Contractor: PACIFIC FIRE SYSTEMS LLC Owner: TRC MM LLC
6704 RIVERIA CT 5973 AVENIDA ENCINAS STE 300
WEST LINN, OR 97068 CARLSBAD,CA 92008
PHONE: 503-710-6646 PHONE
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/29/2014 $51.09
12%State Surcharge-Building 05/29/2014 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 05/29/2014 $20.44
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
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 $77 66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $240.00
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: � - 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 RECEIVED
Fire Protection System I OIZ (11 1.I( I I • I. O.I 1
Received r �� Permit No.: i
City Sof W Tigard MAY 2 9 2014 Date B : ��`�„r S ,� �009�
1N . • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.l 0 Date/B : Other Pe '� P „,/ --A i er.
I WARD
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: funs: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 776-- Supplemental Information
BUILDING DIVISION
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 grommercial/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: /5a0 SGti �"t (.t/ New dwelling area: square feet
OYf i c
City/State/ZIP: 774 tc t D et /7 Garage/carport area: square feet
/ �P Suite/bldg./apt.no.: 4-3 Project name: KtitJOufcr'f/t1P/I7A1 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.
LOW WL / h +-0.G' �0�2 �J (le 1 // Valuation: S .21/0-°�j
/ /f�• Existing building area square feet
�f ej `/i r. 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: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: r�?� 5-7,--� (Please refer to fee schedule)
(�Ct�l G r, Permit fee: 5/i 6?
Address: 70 L1 g,.1,/',C,rlZst ,T
City/State/ZIP: �,r�7-' ,C �>n N g I 9 70� � State surcharge(12%of permit fee): / �!3
/ Q FLS plan review(40/o ofpermit fee): V s `J
Phone:(So5) 7/() —G 6.y4 Fax:( ) (Due upon application.) ovSia . 7
CCB lic.: / c-0/t7/0 A, Total permit fees:
Authorized signature:
de./ This permit application expires if a permit is not obtained
Print name:/� / / Date: T—a 9/ tit within 180 days after it has been accepted as complete.
`- y � * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp.doe Rev 01/05/2012 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.) M. fication to sprinkler heads only:
❑ Addition -10 heads: No plan review required.
❑ Alteration ❑ 11+heads: Plan review required.
❑ Repair
Number of sprinkler heads: 7
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 L%
Density
Design Area
K. Factor fj- ,
Sprinkler Project Valuation: $
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 $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.
I:\Building\Permits\FPS_Per itApp.doc Rev 01/05/2012 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15660 SW PACIFIC HWY A-3, TIGARD, OR,
97224
Commercial - Fire Protection System
999 Sprinkler Final
PASS - No C of O
June 3, 2014 at 11:39:57 AM
FPS2014-00095
Jeff Grove
Violation Summary:
Inspector Contractor