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CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• ' COMMUNITY DEVELOPMENT Permit#: FPS2022-00081
Date Issued: 5/31/2022
T t G A ft I" 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S126CA01100
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 100
Project: Target Subdivision: None Lot: None
Project Description: Fire Alarm Permit-Add in(1)Fire Alarm Annunciator and(1)Addressable pull station into existing Fire Alarm
System.AFFIDAVIT SUBMITTED
Contractor: COCHRAN INC Owner: DAYTON HUDSON CORPORATION
7550 SW TECH CENTER DR#220 BY TARGET CORP T-0345
TIGARD, OR 97223 PROPERTY TAX DEPT/TPN-0950
PO BOX 9456
MINNEAPOLIS, MN 55440
PHONE: 503-234-6564 PHONE:
FAX: 503-238-2098
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/25/2022 $145.24
12%State Surcharge-Building 05/25/2022 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 05/25/2022 $58.10
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 05/25/2022 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $221.27
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $7,000.00
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
Issued By:
�t, �4� AP‘..111/
Permittee Signature: ��
ill _mac ______________
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.
D
Building Permit ApplicatioEENE al
Fire Protection System MAY 13 Z022 FOR OFFICE 1-SE()NI.)
City of Tigard Received G
14 13125SW Hall lvd.,Tigard,OR 9722JI[Y OF TIGAHU D te/Bn :Review✓II , r tPl jt�Y 411 I����
Phone: 503.718.2439 Fax: 503s98. LDING DIVISION" Date/B : N1p ItPemitt No.:Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Redit/By: s 'ZZ ® See Page 2 for
Internet: www.tigard-or.gov Notifiethod: Supplemental Information
IAtt ,D Eta t N
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.
Valuation: $
❑ 1-and 2-family dwelling Commercial/industrial
ElAccessory building 0 Multi-family Number of bedrooms:
0 Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9009 SW Hall Blvd New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Target Washington Square Covered porch area: square feet
Cross street/directions to job site: 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.
Add in (1) Fire Alarm Annunciator and Valuation: $ 7, 000
(1) Addressable Pull Station into existing Existing building area: square feet
Fire Alarm system. New building area: square feet
❑ PROPERTY OWNER III TENANT Number of stories:
Name: Target Type of construction: Tenant Improvement
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) fax:( ) New:
0 APPLICANT U CONTACT PERSON NOTICE
Business name: Cochran Inc. All contractors and subcontractors are required to be
Contact name: Erin Holmes licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7550 SW Tech Center Drive Suite 220 jurisdiction in which work is being performed.If the
City/State/ZIP: Tigard, OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:( 971)-205-4262 Fax: :( )
E-mail: eholmes@cochraninc . com
CONTRACTOR BUILDING PERMIT FEES*
Business name: Cochran InC. (Pleaserejertnjeeschedule)
Address: 7550 SW Tech Center Drive Suite 220 Permit fee: l
City/State/ZIP: Tigard, OR 97223 State surcharge(12�o of permit fee):
FLS plan review(40%of permit fee):
Phone:( 9 7 7)-2 0 5-4 2 4 6 Fax:( ) (Due upon application submittal.)
CCB lie.: 1Z''Li Z Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: Scott Buche . -;=.;„,=-'"°-`°"°-"'" Date: 5/10/2 0 2 2 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
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: 2
▪ Addition or ❑ 1-10 heads: Affidavit required and 1111 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:
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 ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
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): $
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_PemutApp_031016.doc 2
OFFICE COPY RECEIVED
• City13125 oW TiHall Blvd.,Tigard,OR 97223 MAY 13 2022 Permit No.: F 20 Z 000 al
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: Mai 1 3 2022
Inspection Line: 503.639.4175 ,l l Y OF TIGARD —
�(''N I,I) Internet: www.tigard-or.gov CAN( Of \1:6
3UILDING DIVISlOJ
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Tigard Washington Square Occupancy: Tenant
Job Address: 9009 SW Hall Blvd Suite:
Contractor: Cochran Inc. Phone: 503-523-7376
Valuation of work: $7,000
Type of System: (check one) ❑Required ❑Non-required
(check one) ['Automatic ['Manual ['Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) 1 /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) 1 /To be Relocated (max 5)
I Scott Buche Oregon Construction Contractors Board No. 72942
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
f) Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
In addition, I understand the following is required:
• Submit(3)copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• Electrical permit.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: Scott Buche Date: 5/10/2022
Print Name: Scott Buche
I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1