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Permit (2) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 111 2 COMMUNITY DEVELOPMENT Permit#: FPS2017-00132 T t[a . ;!1. D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2017 Parcel: 2S101 BA00300 Jurisdiction: Tigard Site address: 7350 SW DARTMOUTH ST Project: Triangle Medical Office Subdivision: None Lot: None Project Description: Fire supply line Contractor: LEASE CRUTCHER LEWIS Owner: BASE CAMP I LLC 550 SW 12TH AVENUE 1399 FRANKLIN BLVD PORTLAND, OR 97205 EUGENE, OR 97403 PHONE: 503-223-0500 PHONE: 503-880-5623 FAX: 503-223-2874 FEES Description Date Amount Specifics: Permit Fee-COM 09/18/2017 $561.94 12%State Surcharge-Building 09/18/2017 $67.43 Type of Use: COM Plan Review-Fire Life Safety-COM 09/18/2017 $224.78 Class of Work: NEW Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/18/2017 $2.00 Occupancy Grp: B Height: ft 11x17) Stories: 1 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Standpipe Required: Hazard: Density: 0 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 $856.15 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $54,000.00 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 50 232.1987 or 1.800.332 2344. Issued By: Permittee Signature: ‘,,,,,/ _, „..-(7' ,'(//‘ 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. 0 Ifuilding Permit Application Fire Protection System RECEIVED FOR OFFICE USE ONLY , City of Tigard ReceivDatc/Bey �A /7 / Permit No.: ‘..1),...5A0/2.106/3.3.- 2 22 0 9 7 13125 SW Hall Blvd.,Tigard,OR 9741G Plan Revie Phone: 503.718.2439 Fax: 50 .SQli-4 6J. p t ' Other Permit. )/� /7,vi Q3 Inspection Line: 503.639.417 „ t L,F f lGA D�y Date/Re ,' i� T[C;A k D p �y r i Lam+ Date Readyorris: � See Page 2 for Internet: www.tigard-or.gov 00UILDING 01ViSION Notified/Method: 7/...577/7/90" I Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2 FAMILY DWELLING ®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 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CCONSTRUCTION+ work indicated on this application. ❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $ ElAccessory building 0 Multi-family Number of bedrooms: ID Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCA'T'ION Total number of floors: Job site address:Undeveloped-lot- 75 -0 G --70fi-ii0 ca-1-1 /!.,� , New dwelling area: square feet City/State/ZIP:Tigard/Oregon/97223 "-`J Garage/carport area: square feet Suite/bldg./apt.no.:- Project name:72nd MOB Covered porch area: square feet Cross street/directions to job site:SW of the intersection of SW 72nd Avenue Deck area: square feet and SW Dartmouth Street Other structure area: square feet REQUIRED DATA;COMMERCIAL-USE CHECKLIST Subdivision:- I Lot no.:- Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S101BA/300 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK K work indicated on this application. Construction of 36,000 sf medical office buildin.a 1._• , .• :: : ynch style Valuation: $54,000 L,.Q catch basins,stormwate on,water quality treatment,sanitary A��d.t L Existing building area: 0 square feet connecti i, mestic water connection,and fire water connection. L( 0 New building area: 36000 square feet ® PROPERTY OWNER 0 TENANT Number of stories: 1 Name:Base Camp 1,LLC Type of construction: Address:4550 Kruse Way,Ste.125 Occupancy groups: City/State/ZIP:Lake Oswego/Oregon/97035 Existing:_ Phone:(503)880-5623 Fax:( ) New. ® APPLICANT ❑ CONTACT PERSON NOTICE Business name:Base Camp 1,LLC All contractors and subcontractors are required to be Contact name:Brian Bennett licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address:4550 Kruse Way,Ste.125 jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP:Lake Oswego/Oregon/97035 Phone:(503)880-5623 I Fax:: apply: E-mail:Bennettdevelopment@gmail.com CONTRACTOR - BUILDING PERMIT FEES* Business name:Lease Crutcher Lewis - (Please refer mice schedule) Address:550 SW 12th Avenue Permit fee: City/State/ZIP:Portland,Oregon 97205 State surcharge(12%of permit fee): FLS plan review(40%of permit fee): Phone:(503)233-0500 I Fax:(503)223-2874 (Due upon application submittal.) CCB lic.:92919 Total permit fees: Authorized signature: Amount received: ir( / p This permit application expires if a permit is not obtained Print name: itr�d I( an Z Date: i' /e within 180 days after it has been accepted as complete. f ' * Fee methodology set by Tri-County Building Industry Service Board. I:1BuildinglPennils�FPS•PertnitApp_031016.d°c 440-4613T(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2-Supplemental Information Descnbe.wotk to be;doxxe;: 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: ® New system Number of sprinkler heads: Number of alarm devices: 0 Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and Alteration (3) copies of sketch showing area (3) copies of sketch showing area to existing of work within building structure of work within building structure system 0 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and (3)sets of plans. (3) sets of plans. Additional description of work: Construction of fire water service and double-check detector vault to supply proposed office building fire suppression system T e of S stem(Co mplete A,B,`C of D as applicable). A) Cormfinercial Sprinkler Sprinkler Type ❑ Wet ❑ Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: I $ B) Type I , ,;Hood Fire;Suppression System Hood Project Valuation: I $ C) Ft.re Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ F D Residential S kler Stand Alone S ystem) p ( 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 $404.39 Sprinkler Project Square Footage: sq. ft. Fire. 'rotection Permit Fee$ 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: $ T:\jobs\4700-4799\4762 72nd Avenue MOB\Engineering\FPS_PennitApp.doc 2 Submittal Transmittal .4,KS EnghEenn,c-: 1296 SW -df" _ Suis IsaiatirL - 970E2 ERC-M: Chris Knight AKS Engineering & Forestry j Debbie Adamski, C.P.T. 12965 SW Herman Rd. City of Tigard Suite 100 13125 SW Hall Blvd. Tualatin, OR 97062 Tigard, OR 97223 • KnightC©aks-eng.com debbie@tigard-or.gov 503-563-6151 503-639-4171 pri.cuEom 72nd Avenue MOB DATE SEN-[S 8/22/2017 4762 City of Tigard Fire Protection E 00050 Building Permit Submittal 1 For Review and Comment Courier "'EMARKS. Hello Debbie, Please find the attached water plan and signed application Thanks, Chris Christopher Knight, EI AASC AKS ENGINEERING & FORESTRY, LLC 12965 SW Herman Road, Suite 100 I Tualatin, OR 97062 P: 503.563.6151 Ext. 252 I F: 503.563.6152 I www.aks-eng.com I hnightC4aks-enn.com Offices in: Tualatin, OR I Salem-Keizer, OR I Vancouver, WA CONTENTS QTY DATED DESCRIPTION: ACTION: 3 8/21/2017 C300 Water & Sanitary CITY: DATED DESCRIPTION: ACTION: 3 8/22/2017 Fire Protectection Building Permit - Signed Page 1 of 1