Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2021-00015
Date Issued: 2/16/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S112DA01300
Jurisdiction: Tigard
Site address: 6640 SW REDWOOD LN 100
Project: Portland Clinic South Subdivision: 1996-048 PARTITION PLAT Lot: 1
Project Description: Fire alarm permit: replacing control panel and SLC devices
Contractor: STONER ELECTRIC Owner: PACIFIC REALTY ASSOCIATES
1904 SE OCHOCO ATTN: N PIVEN
MILWAUKIE, OR 97222 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-462-6500 PHONE:
FAX: 503-659-2765
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/11/2021 $285.12
12%State Surcharge-Building 02/11/2021 $34.21
Type of Use: COM Plan Review-Fire Life Safety-COM 02/11/2021 $114.05
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00 (over 02/11/2021 $12.00
Occupancy Grp: B Height: ft 11x17)
Stories: 4 Info Process/Archiving-Sm$0.50(up to 02/11/2021 $12.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type: Automatic
Pull Station Required: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $457.88
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $20,000.00
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: l /1 Permlttee Signature: , J foivi c, r7 n 1-/
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.
. .Building Permit ADM!!
Fire Protection System �j''�{ FOR OFFICE USE ONLY
RECEIVED Received
- City of Tigard Datc tsy Z\ �F'S?AZ1-Oc 15
1101
g �. � Penult Nu..
' 13125 SW Hall Blvd., Tigard.OR 97223 Plan Review
Phone: 503 718.2439 Fax 503.598.1960 JAH 20�� Date Bc: �* g Other Permit:
Tl CARD Inspection Line: 503.639 4175 Date Readh Rv- tuns. El See Page 2 for
IntemeC www Tigard-orgov CR OF WARD Not d/Niethnd / / Supplemental Information
BUY D4NG DMSION
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Ej Addition/alteration/replacement D Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling Commercial/industrial
Valuation: S
0 Accessory building 0 Multi-family Number of bedrooms.
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:6640 SW REDWOOD New dwelling area: square feet
City/State/ZIP:TIGARD, OREGON 97224 Garage/carport area: square feet
Suite/bldg./apt no.: Project name:PORTLAND CLINIC SOUTH Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet '
Other structur square Feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 Lot no.: Permit fees*are based on the value of the work perdu med.
Indicate the value(rounded to the nearest dollar)of all •
'fax map/parcel no.:
equipment.materials,labor overhead,and the profit for the
•
DESCRIPTION OF WO work indicated on this application.
REPLACE EXISTING SIEMENS FACP& POW PPLIES WITH POTTER Valuation: $20,000
EQUIPMENT, REPLACE EXISTING S C DEVICES Existing building area: square feet
t r'' Rciol• i,W'r Sf 'Ly k Su rwi, New building area:ZERO square feet
.0 PROPERTY OWNER Q TENANT Number of stories:3
Name:THE PORTLAND CLINIC Type of construction:
Address:6640 SW REDWOOD LANE Occupanc} groups:B
City/State/ZIP:TIGARD, OREGON 97224 Existing:
Phone:( 1 Fax:( ) New:NO CHANGES
0 APPLICANT [j CONTACT PERSON NOTICE '"
Business name:STONER ELECTRIC, INC. All contractors and subcontractors are required to be
Contact name:DENNIS WHITCOMB licensed with the Oregon Construction Contractors Board
under ORS 701 and may he required to be licensed in the
Address:1904 SE OCHOCO jurisdiction in which work is being performed. If the
City/State/"LIP:MILWAUKIE, OR 97222 applicant is exempt from licensing,the following reasons
apply:
Phone:( 1503-462-5214 Fax: :( )503-659-4968
F.-mail:PERMITS@STONERGROUP.COM
CONTRACTOR BUILDING PERMfl'FEES*
(Please refer to fee schedule)
Business name:STONER ELECTRIC, INC.
Permit tee:
Address:1904 SE OCHOCO
State surcharge{I2%of permit feel:
City/State/LIP:MILWAUKIE, OR 97222 Ft„S plan review(40%of"permit fee):
Phone:( )503-462-6500 Fax:1. )503-659-4968 (Due upon application submittal.)
CCB lic.:44823 Total permit lees:
Authorized signature: 6Ce A 2. 7 Amount received:
This permit application expires if a permit is not obtained
Print name:DENNIS WHITCOMB Date:01/07/2021 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-Count'Building Industr.
Service Board.
I U l s hoc 44U-46 I31'(I I'(n_q'pp7W F,N)
L
w + p
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information •
Describe work to be done:
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: Q
❑■ 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 Q 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ Dr
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
L Lizard Group
Density
Design r ea
h. Pac
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations Q Yes
include: Individual Component ❑■ Yes
Cut Sheets
Fire Alarm Project Valuation: $20,000
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Pee:
0 to 2,000 S198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater S404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above : $20,000
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (sec D above): $
State Surcharge (12% of permit fee): $
CIS Plan Review (40°% of permit fee): $
TOTAL: $
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