Permit (222) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00196
f [G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2016
Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15333 SW SEQUOIA PKWY 190
Project: Pahlisch Homes Subdivision: PACIFIC CORPORATE CENTER Lot: 3
Project Description: Adding(12)sprinkler heads and relocating(19)sprinkler heads.
Contractor: PAHLISCH HOMES INC Owner: PACIFIC REALTY ASSOCIATES LP
15333 SW SEQUOIA PKWY#190 ATTN: N PIVEN
TIGARD, OR 97224 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-596-2208 PHONE: 503-624-6300
FAX: 503-213-6012
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/21/2016 $112.96
12%State Surcharge-Building 11/21/2016 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 11/21/2016 $45.18
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 11/21/2016 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 11/21/2016 $13.50
11x17)
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 $187.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,676.50
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 o e• 32.2344.
Issued By: "tee Permittee Signature:
Ca 503.639.4175 by 7:00 a.m.for the next available insp•ction 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.
1
Building Permit Application
Fire Protection System
1,oROFFut. tsr0Li
City of Tigard E E Received
13125 SW Hall Blvd I igard,OR 97223 Date/Hy // ��(p Permit No.: � /i _own;
Phone Spa 715.2439 Fax: 503,5981960 ? 1 Plan Review t(,
Date k3 : ���� r ��f Other PetYnit:��t J' • ��� .
N .1 t .r�r l� Inspection tine: 503.639.4175 —, -
tntemet: www.tigard•orgnv CITY
� Date Ready/By t 4 Ju❑s. 91 See ale 2 for
-I�1 � Notified/Method/CV..��/ _ • -, Supplemental information
31r 1 N E/''/�}�t_ �Lc tl
.--..2-0,4,-,x--.-�4 .w j '' %""} ,4- ^Y - n- P,✓
' is rs" :.,.. '''''r''''''
..-1� P4 u!' i-" "`F` �'d ska �.
:. ,. zz> °. � ' '"¢ r. ''r �k' zp `ri "z.'. J1 e � s # y� 4` 'r 3�d a d, A-A`a.^,,
-4 ''''''�„ ^�.t e e` in :v,�ae ' .�,r, Spy s. 'a-`i ,
❑;::::1:0',;;;'
ew construction ❑Demolition Permit fees*are based on the value of the work performed.
►�� Addition/alteration/replacement []Other Indicate the value(rounded to the nearest dollar)of all
���i° �:_ 0.�, equipment,rnatarials,labor,overhead,and theprofit for the
1 ..;'`" �, ,_, 4 :,w,r�, ;44- ,- - vvork indicated on this application. p
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: S
❑Accessory building ❑Multi-faintly Number of bedrooms:
0 Other: Number of bathrooms:
❑Master builder
r;,,,.� .'' t►v ' ' 9 ; Total numbearea:of s:
Job site address:15333 SW Sequoia Pkwy New dwellingurea:
square feet
City/State/ZIP:'Tigard,OR 97224
Garage/carport
arca: square feet
Covered porch area: square feet
Suite/bldg./apt.no.: --'rqt), I Project name:Pahliseh Homes Office TI
Cross street/directions to job site:SW Sequoia Pkwy&SW Upper Boones Ferry
Deck area: square feet
Other structure area: square feet
t �y4#t gr. l4s.,�'y� w -.,j ,a .
Subdivision: � � t x ,0
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
i � �� rz
equipment,materials,labor,overhead,and the profit for the
` �' ' � '? ' - " . work indicated on this application.
head relocation for office TI e Valuation: S3676.5Q
t & L�� ��)t„=c is j ,lL L�,h fit . (14� rt
Existing building area: 5000 square feet
' New building area: square feet
,,,:b,64,33, 34.--46,6^,a6;;;43,34,,,,,,,>,, . ,� " ^ .i .� , '� Number of stories {
Name:PacTrust-Pacific Realty Associates LP
Type of construction:
Address: 15350 SW Sequoia Parkway Suite 300
Occupancy groups:
I City/State/ZIP:Portland OR 97224
Existing:
Phone:(503)624-6300 Fax:( )
7a44. New:
'tr' ' `Business name:S3 Design Build LL( C(B#199988
All contractors and subcontractors are required to be
Contact name:Kelly Broderick licensed with the Oregon Construction Contractors l3oard
Address: 1927 NE Rodney Ave under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed.lithe
City/State/ZIP:Portland OR 97212 applicant is exempt from licensing,the following reasons
Phone:(503)856-6333 apply:
Fax::( )
E-mail:kellyb(¢s3fp.com
� �w ��,a„ �y�a�f,fir,'?�s x�� ;;� -�
� �' &mo } ,^
;.�a �� ..�2.- ..... .' w��, . .est'4;4'—'
N �{ r -'44''"'
iw. e 'V'.° a t m Y n` ,fir x4' "' ns 'r
}Business name:Pahlisch Homes Inc � %
I
Address: 12725 SW 66th Ave Suite 101 Permit fee:
City/State/Z1P:Tigard OR 97223 State surcharge(12%of permit fee):
Phone:(503)S9(i 2208 FES plan review(40%of permit fee):
I Fax:(5503)213-6012 (Due upon application submittal)
CCB lie.:42067 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: Kelly Broderick J Date: 11/20/2016 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
App1'.BuildingtPermits\}PS_ytrmit 031916dtu Service Board.
440.4613111 1,021C ONU'W t13)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
iii;;
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
i
❑ New system Number of sprinkler heads: 31 Number of alarm devices:
® Addition or 1=11-10 heads: Affidavit required and
Alteration ❑ 1-5 devices: Affidavit required and
(3) copies of sketch showing area (3) copies of sketch showing area
toe rating of work within building structure of work within building structure
Yl
® 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: add 12 heads and relocate 19 heads
��
Sprinkler Type
Additional ® Wet ❑ Dry
Standpipes 6r/t9e )
Information: Sprinkler Supply Line Yes
® No
Hazard Group Light
Density e /0
Design Area (re`, /
�(il kc n)�(, - tic, i?ems/ S yS 7t'Z°ti,
K. Factor (e 1<
Sprinkler Project Valuation: I $ 3676.50
a
Hood Project Valuation: $
fje ***** ��
Submittal shall Battery Calculations
include: ❑ Yes
Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
m ' i . ` � ; IA * � *** ' :'vel Tm�` ��
_ 172; wz
S.uare Foota!e: Permit Fee:
Oto 2,000 � �
$198.75 * ,
To A
2,001 to 3,600 $246.45 ,, r•Wr
_ 3,601 to 7,200 r,
$310.05
7,201 and greater
$404.39 •
.< .` ,. `;-,y.z ..
Sprinkler Project Square Footage: sq.ft.
Project valuation subtotal (see A,B &C above)..b $ �$
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: $
C:\Users\ke11y\Desktop\FPS_PemutApp.doc
2
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15333 SW SEQUOIA PKWY 190, TIGARD, OR,
97224
Record Type:
Commercial - Fire Protection System
Inspection Type:
999 Sprinkler final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
FPS2016-00196
Inspector:
Chip Barnett
Contractor