Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2021-00041
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/28/2021
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD, STE#301
Project: Driveway Finance Subdivision: None Lot: None
Project Description: Fire alarm permit-extend existing fire alarm notification circuit(31 devices)
Contractor: PRIME ELECTRICAL SERVICES LLC Owner: LITHIA REAL ESTATE INC
3312 SE BELLA VISTA PL ATTN DEBOER, MARK
VANCOUVER,WA 98683 150 N BARTLETT ST
MEDFORD,OR 97501
PHONE: 503-318-5170 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/28/2021 $177.52
12%State Surcharge-Building 04/28/2021 $21.30
Type of Use: COM Plan Review-Fire Life Safety-COM 04/28/2021 $71.01
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 04/28/2021 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/28/2021 $6.00
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 $277.83
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $10,000.00
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: Permittee Signature: owl L!GGfIX)Vt
Ho Lb ,,De, Vege 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 13- - _
Fire Protection System RECEIVE; FOR OFFICE USE ONLY g�
Received /y//2 J 2/ Penuil No..f- ZQL� V
City of Tigard Date/By:��l 7/L '^9n �ry
• I3125 SW Hall Blvd.,Tigard,OR 97223 r 'V,' plan Rev�v 1. 1 �1 �' guPG(/�/•W 2
Phone: 503.7L8.2439 Fax: 503.598.1960 APR '` �l° Date/By:3y: `7 0< Other Permit
Ins Inspection Line: 503.639.4175 Date Ready/By: j + la See Page 2 for
I c A R l s p CITY OF TIGARD No. 'Method: 0 . // er supplemental Information
Internet: www.tigard-or.gov
TYPE OF ti I !NIP lI Ita.' .�
,; WORK REQUIRE t I ATA:1-AND 2-FA6ili,Y DWELLING
❑Demolition Permit fees*are based on the value of the work performed.
D New construction Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
Valuation: $
❑ I-and 2-family dwelling ®Commercial/industrial -
Number of bedrooms:
❑Accessory building ❑Multi-family
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATIONif Total number of floors:
Job site address: 9020 SW Washington Square Rd. New dwelling area: square feet
city/state/z1P: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:STE 301 Project name: Driveway Finance TI Covered porch area: square feet
Cross street/directions to job site: 3rd Floor Deck area: square feet
Other structure area: square feet
REQUIRED DA. KLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Extend existing fire alarm notification circuit for new Valuation: $ 10,000.00
Existing building area: square feet
tenant improvement
New building area: square feet
0 PROPERTY OWNER 0 TENANT' ;. _ Number of stories:
Name Type of construction: office space
Address: Occupancy groups:
City/State/ZiP: Existing:
Phone:( ) Fax: ( ) New:
® APPLICANT ❑ CONT'ACT PERSON NOTICE
Business name: Prime Electrical Services, LLC All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board
Contact name: Oleg Primachenko under ORS 701 and may be required to be licensed in the
Address: PO Box 872395 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: Vancouver, WA 98687 apply:
Phone:( 503)318-5170 Fax: :( )
E-mail oleg.p@,primeelectricalco.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name: Prime Electrical Services, LLC Permit fee:
Address: PO Box 872395 State surcharge(12%of permit fee):
City/State/ZIP: Vancouver, WA 98687 FLS plan review(40%of permit fee):
Phone: ( 360)335-3565 Fax:( ) (Due upon application submittal.)
/CCB lie.:
217825Total permit fees:
Amount received:
Authorized signature:
This permit application-expires ifs permit is not obtained
Date: within 180 days after it has been accepted as complete.
Print name: Oleg Primachenko4/12/2021 * Fee methodology set by Tri-County Building industry
Service Board.
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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: 31
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 ❑X 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'I'ype ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B. T le I - Hood Fire Su, sression S stem- `
Hood Project Valuation: $
C.) Fire Alarm ;..
Submittal shall Battery Calculations ❑X Yes
include: Individual Component ❑X Yes
Cut Sheets
Fire Alarm Project Valuation: $ 10,000.00
D.) Residential Sprinkler (Stand Alone System)
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 Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 10,000.00
Permit fee based on project valuation (see fee schedule): $ 177.52
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 21.30
FLS Plan Review (40% of permit fee): $ 71.01
TOTAL: $ 269.83
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