Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
ozi COMMUNITY DEVELOPMENT Permit#: FPS2015-00197
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/16/2015
Parcel: 1 S134AA01900
Jurisdiction: Tigard
Site address: 10115 SW NIMBUS AVE 500
Project: Express Employment Professionals Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Adding(3)sprinkler heads for TI.
Contractor: PATRIOT FIRE PROTECTION INC Owner: ROBINSON, CONSTANCE A
4708 NE MINNEHAHA ST BY KILLIAN PACIFIC LLC
VANCOUVER, WA 98661 500 EAST BROADWAY, STE 110
VANCOUVER,WA 98660
PHONE: 360-699-4403 PHONE:
FAX: 360-699-4485
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/16/2015 $59.16
12%State Surcharge-Building 12/16/2015 $7.10
Type of Use: COM Plan Review-Fire Life Safety-COM 12/16/2015 $23.66
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/16/2015 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Hazard: LT
Density: .10 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 $90.42
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $800.00
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: �!
03.639.4175 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.
DEC. 15. 2015 6: 19PM PATRIOT FIRE VAMC N0, 8261 P. 2
BuildinE Permit Application
Fire Protection System
CEIVED
City of Tigard o ived I Permit No.: a01 S W jq
13125 SW Hall Blvd.,Tigard,OR 9722 rise review OlherPermic
Phone: 503.718,2439 Far.; 503.598.19 C 1 � 2015 DPWB
Inspection Line: 503.639.4175 Dote Ready/By H SW]?age 2 for
Tntemer, www,tigard-or.gov CITY OF IGAR® NoriSeNMethod: Soppl-nenudInformadoa
01 111 rslKir-1 nix/IqlaNI AA
110 1� Sao1
i ru r❑New Construction ❑Demolition Dequipmon
e based on the value ofthe work perflue(rounded to rhe nearest dollar)o
®Addition/alteration/replaccmont Other: terials,labor,overhead,and the p fit for the
on this application,❑1-and 2-family dwelling [N Commucial industrialNumer oedroo
❑Accessory building []Multi-family
❑Master builder ❑Other; Number of bathrooms:
Total number of floors:
Job site address: 10115 SW Nimbus Ave New dwelling arevquare feet
City/State/ZIP:
Tigard, OR *Gune/carpo area: squ a f8m
Suite/bldg./apt.no.: 5 0 0 Project name:Express Employment Profess charea: square
Cross street/direcrions to job site: SW SCholis ferry Rd square feet
ure area: square feet
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
g work indicated on this application.
SNRt Valuation, g 800
Add sprinklers to accommodate new tenant
Existing building arca: same square feet
New building area: same square feet
o Number of stories:
1
Name:
Express Employment Professionals Type of construction: 3
Address; 101ZS SW Ni us ve, surto 500 Occupancy groups:
City/State/,ZIP: Tigard, OR 9 23 Existing: B
Phone:(503 )227 4440 pax;( ) New: OREM
B
»+ r
Business name: Patriot Fire Protection, Inc All contractors and subcontractors aro required w be
Ted Saker licensed with the Oregon Construction Contractors Board
Concoct name: under ORS 701 and may be required to be licensed in the
Address: 4708 NE Minnehaha Street jurisdiction in which work is being performed.If the
Vancouver, WA 98661 applicant is exempt from licensing,the following reasons
City/State apply:
Phone:(360) 699 4403 pax::(360 ) 699 4485
I,mail: to . a erOpatzlotfire.cam
P
� IMS •� f
Business name: same as above Permitfec:
Address: State surcharge(12%of permit fee):
City/Statc/ZIP: FLS plan review(40%of permit fa):
Phone:( ) Fax:( ) (Dye upon applicarionsubmittal)-
CCB lic.,
ubmittalCCBlic.: 70822 Total pcnnit fbes: qV-GV
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
Ted Baker Gate; 12-15-15 within 180 days after it has been accepted as complete.
Print name: * Fee methodology set by Tri-County Building Industry
Service Board.
K;au ldiag Penitit3 FrS-PemuNpp 07I514,GOC 440-4613T(1K1ovcotdnvae)
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n OfAY to alarm devices:
. sprinkler ■. .. .• .•
1.) Type of Work; Addition/alteration only
■ New-system Numbex of sprinkler heads; 3 Number
Addition . 'dD� 1 heads: and devices: ..
.• D .
ies of sketch showing area
Alteration .. r
requiredto eDdst, ofwoxk within building structure of work within building stmcrure
systemC] 11+heads: Plan review
. plans.
(3)sets ofplans.
Additional description .
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