Permit (38) 1111 43 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'> COMMUNITY DEVELOPMENT Permit#: FPS2016 00125
T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016
Parcel: 2S 113AB00600
Jurisdiction: Tigard
Site address: 16150 SW UPPER BOONES FERRY RD
Project: Perlo Construction Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: Fire sprinklers-Relocate(46)heads for TI
Contractor: CROSSFIRE SPRINKLER CO Owner:
PACIFIC REALTY ASSOCIATES LP
17400 SE 82ND DR ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-210-5506 PHONE:
FAX: 503-210-5538
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/16/2016
$156.00
12%State Surcharge-Building 08/16/2016 $18.72
Type of Use: COM Plan Review-Fire Life Safety-COM 08/16/2016
Class of Work: ALT T $62.40
ype of Const: Info Process/Archiving-Sm$0.50(up to 08/16/2016 $0.50
Occupancy Grp: B Height: ft 11x17)
Stories: 3
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 1500
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 $237.62
Valuations:
Required Items and Reports(Conditions)
Sprinkler Valuation: $7,361.00
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: _ _/ 4111111P Permittee Signature:
•'=sl 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.
Building Permit Application
Fire Protection System R fta
k„„y , -, '1I�• . FOR OFFICE USE ONLY
._^ Received �
City of Tigard `���,,� 7/a t i , CT- e0 Permit No.: t'ibo9v/& t O/a5-
54
• 13125 SW Hall Blvd.,Tigard,OR'9232 iDate/B
_, 2016Paan Review j1�• i.
Phone: 503.639.4171 Fax:,3(�3*598 1960 Date/13 :Alatal � Other Permit: /“Pc9;,/6--Qo l q
T I G A R D Inspection Line: 503.639.4475'4rt '. ; 1 _ } t Date Rea ms kris: ® See Page 2 for
Internet: www.tigard or.ge44,,.t� i : „1i':r•j Notified/Method:
B
s , a AIWAr Supplemental Information
!1
i i
., .'� :. t✓ .v�� se ,. 3 2 g7. ) /. �;. ... ilif1,. '*f4; Atir,ki1 1� 1t P` i
❑New construction 0 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 0 Other: materials,equipment,
' i?` ,` t i s work indicated on this lapplication.abor, ea ,and theprofit for the
`a��.
�
r
❑ 1-and 2-famil Y dwellin Valuation: $
g ®Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
1y A.® ►, 8 s s a f `,t' a 'o " Total number of floors:
Job site address:16150 SW Upper Boones Ferry Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR Garage/carport area: square feet
Suite/bldg./apt.no.: 1 Project name:Perlo Office Remodel-C Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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,
erials,labor,
abor,overhead,and the profit for the
1 414,1
, _‘ i, - t s work indicated thisapplication.
Relocate Existing Sprinkler Heads into new ceilings to maintain proper coverage Valuation: $$7,361.00
Existing building area: square feet
New building square q re feet
' s
i)hi
I�,, Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax ( )
New:
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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:( ) I Fax::( )
E-mail: l w.oz►-t'a 6) G2i:SSc ESPPu-ALc.e2. CcDN—
'\`�\. 4 l aw' s \ s \ i; `a,,,. moottv-k$, ,,,,,,r7, ,,,..,' :7
Business name:Crossfire Sprinkler Company `�" ' oY
Address: 17400 SE 82°d Drive Permit fee:
City/State/ZIP:Clackamas,OR 97015 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)210-5506 Fax:(503)210-5538 (Due upon application.)
CCB lic.:174746 ' Total permit fees:
Authorized signature: / Amount received:Air
This permit application expires if a permit is not obtained
Print name:Timothy A Bishop Date:7/21/16 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp.doc 10/01/09 440-4613T(11/02/COM/WEB)
'City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1.) ❑ New
❑ Addition
2.) Modification to sprinkler heads only
❑ 1-10 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 46
Additional description of work:
'?_.',i10,0.24
:. € �3 ' ate €a €� ,; a `€iyc \ \ r
4
'fr
.,, '
oil:" €€ 4:4 \ „.' . . .. .. „ ' f,„� - \.'.ate\ /.:-, \ w-m>
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group Light Hazard
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 7361.00
€ �•:. tee,.. . ' !
Hood Project Valuation: $
%,k.',,-: ''ti--.4' '$'---- ,';t\;:#\'%.,--i4,,',4 ,i-,"',1-,g-,, :- ''s- ,, ' '''' '
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
r,,I,,.e.,---,!, ,vm, --.1".:;,.„,,, ,, -,,!,i,,.. . -,',,,,': ''''''''i '''''''''• -,41,,, ,,?: !, 4-- ,,.',4. ..,,,,,,i,:,,,;;, g,,,,, ,,,I,,;.
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.\ \ ; aha.:
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
a&i.„ . , fir.; ,r.
Sprinkler Project Square Footage: sq. ft.s \\ :� ,reg 0... ... ra€ \ x \\ T
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 2 sets of plans at submittal. Plan review fees are required at submittal.
C:\Documents and Settings\CAD\My Documents\Permits\tigard permit.doc 10/01/0
14 CITY OF TIGARD FEE AND PAYMENT HISTORY
m
'., 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
FPS2016-00125 - 16150 SW UPPER BOONES FERRY RD, TIGARD, OR 97224
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
Permit Fee-COM 230-0000-43104 $156.00 $156.00
$156.00
12%State Surcharge-Building 100-0000-24001 $18.72 $18.72 $18.72
Plan Review-Fire Life Safety-COM 230-0000-43108 $62.40 $62.40 $62.40
Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $0.50 $0.50 $0.50
11x17)
Totals for Fees $237.62 $237.62 $0.00 $237.62
Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount
Total Payments: $0.00
Balance Due: $237.62
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16150 SW UPPER BOONES FERRY RD,
TIGARD, OR, 97224
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
October 28, 2016 at 9:21:13
AM
FPS2016-00125
Chip Barnett
Violation Summary:
Inspector Contractor