Permit IN 41 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2022-00167
Date Issued: 12/19/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 151346C00401
Jurisdiction: Tigard
Site address: 12442 SW SCROLLS FERRY RD 100
Project Providence Scholls Ferry Subdivision: None Lot: None
Project Description: Fire alarm system: install(1)AES radio.
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: PROVIDENCE HEALTH &SERVICES-OREGON
7324 SW DURHAM ROAD ATTN: REAL ESTATE&CONSTRUCTION
PORTLAND, OR 97224 4400 NE HALSEY BLDG 2 STE 190
PORTLAND, OR 97213
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/13/2022 $67.23
12%State Surcharge-Building 12/13/2022 $8.07
Type of Use: COM Plan Review-Fire Life Safety-COM 12/13/2022 $26.89
Class of Work: NEW Type of Const: Info Process/Archiving-Sm$0.50(up to 12/13/2022 $2.00
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 $104.19
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,068.00
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 Ce ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma obtain o of the rules
Issued By: 1 Permittee Signature:
Call 503.639.4175 7:00 a.m.for the next available inspection date.
111 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.