Permit (185) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s COMMUNITY DEVELOPMENT
Permit#: FPS2017-00181
Date Issued: 11/22/2017
T[ a.tiR L 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 500
Project: Centene Corporation Subdivision: None Lot: None
Project Description: Relocate(66)sprinkler heads for TI.
Contractor: CROSSFIRE SPRINKLER CO Owner: GK TRIANGLE CORPORATE PARK III L
17400 SE 82ND DR ATTN KBS REALTY ADVISORS
CLACKAMAS, OR 97015 P 0 BOX 28270
SANTA ANA, CA 92709
PHONE: 503-210-5506 PHONE:
FAX: 503-210-5538
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/22/2017 $134.48
12%State Surcharge-Building 11/22/2017 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 11/22/2017 $53.79
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 11/22/2017 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 4 Info Process/Archiving-Sm$0.50(up to 11/22/2017 $0.50
11x17)
Misc Administration Fee 11/22/2017 $5.00
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 $211.91
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $6,000.00
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 503.232 987 or 1.800.332.2344.
Issued By: e �L ...
/ .. Permittee Signature:
i r �
/ 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.
p
Building Permit Application
Fire Protection System RECEIVED
FOR OFFICE USE ONLY
14 - City of Tigard Received l zch
13125 S W Hall Blvd.,Tigard,OR 972230 O V 2 0 2017 Date/By: ( Permit No.: i V X5)017 /Q�
Phone: 503.718.2439 Fax: 503.598.19 Plan Re iew 3 / �, ! !I
Ins ection Line: 503.639.4175 p Date/By: l (7 Other Permit:/ �lD/��`az65-
TIGARD p CITY OF'f IG'°AIID DateReady/By: iurs: O' /i((/
Internet: www.tigard-or.gov otified/Meth d: /� —p—�/ See Page 2 for
BUILDING DIVISION t7" '( , 4 t-i{J— I Supplemental Information
0 New construction ❑Demolition Permit fees*are based on the value of the work performed. ,5
®Addition/alteration/replacement Indicate the value(rounded to the nearest dollar)of all
❑Other
equipment,materials,labor,overhead,and therofit for the
C ! 1 t s work indicated on this application. p
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
IN
� ��X .�` ;.� !,.TION
* Total number of floors:
Job site address:13221 SW 68th Pkwy —
New dwelling area: square feet
City/State/ZIP:Tigard,OR
Garage/carport area: square feet
Suite/bldg./apt.no.:500-520 I Project name:Centene Corp TI
Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
Subdivision: 7 } o-. C✓V.,. R 0-
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,labor,overhead,and the profit for the
V . - &.u ' work indicated on this application.
Relocate Pendent Sprinkler Heads to maintain coverage Valuation:
$6000.00
Existing building area: square feet
. New building area: square feet 5 u.
ER ENANT
., �:�' � �� .� �Y � �; :, Number of stories:
Name:
Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Phone:( ) Existing:
Fax ( )
> iiiNew:
'� ill r
Business name:Crossfire Sprinkler r W ,c
All contractors and subcontractors are required to be
Contact name:Timothy A Bishop licensed with the Oregon Construction Contractors Board
Address: 17400 SE 82"d Drive under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed.If the
City/State/ZIP:Clackamas,OR 97015 applicant is exempt from licensing,the following reasons
Phone:(503)210 5506 I Fax::(503)210 5538 apply:
E-mail:timothy@crossfiresprinkler.com
, •i- X . 1
Business name:Crossfire Sprinkler • � ;
�".r * T:
Address: Permit fee:
City/State/ZIP: State surcharge(12%of permit fee):
/ — FLS plan review(40%ofpermit fee):
Phone:( ) / Fax:( )
(Due upon application submittal.)
CCB lic.:174746 W
f,2' Total
Ip _-� permit fees:
Authorized signature: 1 Ir "'"~ Amount received: —
_-.'
`' -- This permit application expires if a permit is not obtained
Print name:Timothy A Bishop Date:11/17/17 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
I:\Building\Permits\FPS-PermitApp_031016.doc Service Board.
440-4613T(11/02/COM/WEB)
«.
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
11'
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 66 Number of alarm devices:
® 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
® 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
-(.1.,A ifeit 4.it tr1)4s4a' pp-' yr'm itbli)e- ?.., \;:: k t * * ,4 t 4‘ t ** "'!', i( -* :If, i ',X *., '—'
' ' ' ' -44isitinto - - Ai.-,-/ woi „- * X x 4 x * X : * * * x - /
Sprinkler Type ® Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Light
Density .10
Design Area 1500
K. Factor 5.6& 11.2
Sprinkler Project Valuation: I $ 6000
Hood Project Valuation: i $
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: I $
* i.,, ,,,, * * * * , x ,,* * * * * . , :. *' \ : x**4'2 ;", .w !': *.
Square Footage: P•ermit Fee: 3 $ 3 3 3 A 3 4 ¢3
Oto 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.
; � ,
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: $
C:\Documents and Settings\CAD\My Documents\Permits\tigard permit.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13221 SW 68TH PKWY 500, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00181
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor