Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
-! COMMUNITY DEVELOPMENT Permit#: FPS2022-00134
Date Issued: 10/26/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1156A00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY M
Project: Trader Joe's Subdivision: None Lot: None
Project Description: Fire alarm permit for TI:24 devices.
Contractor: ADT COMMERCIAL LLC Owner: TECOLOTE RESOURCES INC
PO BOX 310702 KELLY'S LEGACY LLC ET AL
BOCA RATON, FL 33431 BY HESLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE: 503-936-6742 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/25/2022 $112.96
12%State Surcharge-Building 10/25/2022 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 10/25/2022 $45.18
Class of Work: ALT Type of Const: VA Info Process/Archiving-Lg$2.00(over 10/25/2022 $4.00
Occupancy Grp: M Height: 25 ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 10/25/2022 $22.50
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 $198.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,700.00
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 not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follpw 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: Permittee Signature:
Call . .4175 by 7:00 a.m.for the next available' spectiomd a.
This permit card shall be kept in a conspicuous place on the job si until co le' n of the project.
Approved plans are required on the job site at the ti ach' action.
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:
El New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or El 1-10 heads: Affidavit required and El 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 1Z14+ 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 El 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 El, Yes
Cut Sheets
Fire Alarm Project Valuation: $ 3 ?0 c.
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_PermitApp_031016.doc 2