Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2021-00024
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/24/2021
T f[;A R fi g Parcel: 2S 101 AC01300
Jurisdiction: Tigard
Site address: 7105 SW HAMPTON ST
Project: Kaiser Dental Subdivision: BEVELAND NO.2 Lot: 18-19, P
Project Description: Fire alarm permit-install radio for monitoring fire alarm
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: KAISER FOUNDATION HEALTH
7324 SW DURHAM ROAD PLAN OF THE NORTHWEST#838
PORTLAND, OR 97224 ATTN PROPERTY ACCOUNTING
500 NE MULTNOMAH ST
PORTLAND, OR 97232
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/18/2021 $86.06
12%State Surcharge-Building 03/18/2021 $10.33
Type of Use: COM Plan Review-Fire Life Safety-COM 03/18/2021 $34.42
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 03/18/2021 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1
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: No
Battery Calcs Provided: No Cut Sheets Required: Yes
Total $136.81
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,789.50
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: •'`, r t Permittee Signature: , 1.-\ C PP,
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 Application
Z ay z/ /s7
Fire Protection System RECEIVED FOR OFFICE USE ONLY
Cityof Tigard Received . 9
t _ g fEB Date/By:
?S�V�J Permit No.: t ��Z��VVOZ
1� • 13125 SW Hall Blvd.,Tigard OR 97223 2 202�
g Plan Review 1.5 i i
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: V .p2I Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date ReadyBy i1�� %G&� Ivrs. H See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION N Scd/Method: Supplemental Information
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
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ElCommercial/industrial Valuation: S
0 Accessory building El Multi-familyNumber of bedrooms:
ElMaster builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:7105 SW Hampton St New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg.lapt.no.: Project name:KP--Tigard Dental Office Covered porch area: square feet
Cross street/directions to job site: 141 5Ce Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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
DESCRIPTION OF WORK work indicated on this application.
Install Radio for Monitoring ty A t_A-2M Valuation: 1789.50
i
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address:
Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:
( ) New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name:Performance Systems Integrated All contractors and subcontractors are required to be
Contact name:Katie Harbaugh licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:7324 SW Durham Rd jurisdiction in which work is being performed.If the
City/State/ZIP:Portland, OR 97224 applicant is exempt from licensing,the following reasons
apply:
Phone:( )5036412222 Fax::( )5036411464
E-mail:katieh@psintegrated.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:Performance Systems Integrated
Permit fee:
Address:7324 SW Durham Rd
State surcharge(12%of permit fee):
City/State/ZIP:Portland, OR 97224 FLS plan review(40%of permit fee):
Phone:( )5036412222 Fax:( )5036411464 (Due upon application submittal)
CCB lic.:227526 Total permit fees:
Authorized signature: �I z • „yei _ [ Amount expire received:
/l j/r(,Uj,(T This permit application expires if a permit is not obtained
Print name:Katie Harbaugh ' Date:2/22/2021 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:Building\PermitsiFPS-PernitApp_031016.doe 440-4613T(I I/02/COMNJEB)
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