Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a. • COMMUNITY DEVELOPMENT Permit#: FPS2021-00034
Tigard OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 4/15/2021
TfC;ARi) 9
Parcel: 1 S 136CD02000
Jurisdiction: Tigard
Site address: 7805 SW DARTMOUTH ST
Project: Auto Zone Subdivision: None Lot: None
Project Description: Fire alarm permit-fire alarm installation
Contractor: APPLIED TECHNICAL SYSTEMS INC Owner: 7805 SWD LLC
7015 SW MCEWAN RD BY ALSTON&BIRD LLP
LAKE OSWEGO,OR 97035 BANK OF AMERICA PLAZA
101 SOUTH TRYON ST STE 4000
CHARLOTTE, NC 28280
PHONE: 503-684-9611 PHONE:
FAX: 503-598-0498
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/14/2021 $500.12
12%State Surcharge-Building 04/14/2021 $60.01
Type of Use: COM Plan Review-Fire Life Safety-COM 04/14/2021 $200.05
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 04/14/2021 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/14/2021 $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 $774.68
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $44,970.00
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: HolyVawD&Wege PermitteeSignature: Owlpp liCarWtVt
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 . 1r-ali')121
Fire Protection System FOR OFFICE USE ONLY
City of Tigard MAR 3 0 2021 Received �y
„ - Dan
�/4 Ol ZOZ( '� Permit Na ',�S.ZoZI'GY�d3
J
m 13125 SW Hall Blvd.,Tigard,OR 97223 aa Revie ^
Phone: 503.718.2439 Fax: 503.598.196(;ITY OF TIGARDDale By: g_ad
Other Permit.
TIGARD Inspection Line: 503.639.4175 Date Ready/By: / 3uris: H See Page 2 for
Internet: www.tigard-or.govl1ILDING DIVISION tified/Method:� l� / iiii '1-16 Supplemental Information
TYPE OF WORK REQUREW& ND 2-FAMILY DWELLING
❑ New construction 0 Demolition
El Other:
Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
{�-Addition/alteration/replacement equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and2-family dwelling 54 Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
ElMaster builder ❑ Other: Number of bathrooms:
.IOB SITE. INFORM4TION AND LOCATION Total number of floors:
Job site address: ?-$0 s VilgrgAarrii s7 New dwelling area: square feet
City/State/ZIP: I 9
e* . � 3 n Garage/carport area: square feet
Suite/bldg./apt.no.: j Project name: 4t4 ' qje -15 / Ty Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL LSE 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. �
tive ,4-�aa2G . s1 �C 1 .� �i .//a17 T Valuation: $ 7/ r z
/ Tr 6 --
Existing building area:37// f square feet
New building area: I square feet
0 PROPERTY OWNER 1 r 7 LNANT Number of stories: /y5/
'!
Name: 0�0 ��i:e Type of construction: `(' /( II
Address: ‘?Z /—' P4 ►ov Sf Occupancy groups: eg
City/State/ZIP: � �
77,Q, �ej ?���j pc 3 Existing:
Phone:( ) Fax:( )
New:
APPLICANT CONTACT PERSON NOTICE
Business name: ,473-/'� D All contractors and subcontractors are required to be
+Contact name: 7 ' , ,¢� � licensed with the Oregon Construction Contractors Board
E under ORS 701 and may be required to be licensed in the
Address: a5 /q Air 6.c>t_tirg e r jurisdiction in which work is being performed.If the
City/State/ZIP: 4,v .V_'�� 6� qT��8 applicant is exempt from licensing,the following reasons
a 1
\��J�/W,��(/�/� ��(a M��fJ U / Pp Y
Phone: JFax:
E-mail: �t�gG(��d/� Q`�Q awl 1
... CONTRACTOR( 1 .- `r r.-_-7 .i i(!
- , � fi -1tiI �-fr + s +, aLDIivGPERMITFEES"
Business name: �r Ie f�/ 5i75' �j =, l J. —�':i(Ptease refer aa fee schedule
Permit fee:
Address: lc- SO 'G' K ?et
City/State/ZIP: �^ke en„,..,,,, fo, 9 e'�S+_ State surcharge(10%of permit fee):
Phone:To�L l$ ,?_ci 7 FLS planD review(40%tionsubmt fee):
aC Fax:( ) (Due upon application submittal.)
CCB lie.: 8! ! l/. .,..\.. Total permit fees:
Authorized signature: r
Amount received:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 6�f t- Ayer Date: l
Y f * Fee methodology set by Tri-County Building Industry
Service Board.
I.\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(I I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
T) I1�iy a *-`r- it ill' +t0, ,`3.31��.� 11 I.' Yyi
> fleor BYra �l _3° " y„ `ui EGEi Fl .+ >;
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 yi 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 ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations Yes
include: Individual Component IJ Yes
Cut Sheets
Fire Alarm Project Valuation: $ `f5�,? 77-43 —
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.
11 - =I:7zFire Protection Permit Fees
Project valuation subtotal (see A,B &C above): $ [t/c%1`7
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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2