Permit (2) lilCITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I COMMUNITY DEVELOPMENT Permit#: FPS2023-00088
Date Issued: 8/2/2023
T I G AA D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S126CA00900
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 200
Project: Macys Subdivision: None Lot: None
Project Description: Fire alarm permit:Replacing fire alarm control panel and annunciator.
Contractor: JOHNSON CONTROLS FIRE PROTECTION LP Owner: NIEMEYER, JOHN
6305 SW ROSEWOOD ST. 15 82ND DR STE 210
LAKE OSWEGO, OR 97035 GLADSTONE, OR 97027
PHONE: 503-683-9000 PHONE:
FAX: 503-675-6521
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/02/2023 $317.40
12%State Surcharge-Building 08/02/2023 $38.09
Type of Use: COM Plan Review-Fire Life Safety-COM 08/02/2023 $126.96
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 08/02/2023 $10.00
Occupancy Grp: M Height: 45 ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 08/02/2023 $10.00
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:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $502.45
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $22,170.18
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 Ceentteer. 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: /11 Permittee Signature: —'
Call 503.639�by 7:00 a.m.for the next available ins ction date. a
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 E C C I V E D
Fire Protection System L 1 t�
City of Tigard i"3 9 2C25 Raetved IV 20Z h C-DS/117/3•mon
patdgy. /J Pervtit No
i ; 13125 SW Hall Blvd.,Tigard,OR 97223. Plea Review a ^ I
Phone: 503.7161439 Fax: 503.598.1960iY OF TIGARD Dane: Q •i 71 OtnerPermrt:
tic,AID Inspection Line: 503.639.4175 f)!t,,I(( ?'),)ns1GN, DateReady/By: (/ �� t„p: 65 See Page 2for
Internet: www.tigard-or.gov Notifed/Method: it Supplemental information
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❑New construction 0 Demolition Permit fees'are based on the value of the work performed.
lit Addition/alteration/replacement El Other: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
914 t. M-y�ryy+p 1 3•S t - it N 1 s
-8-7= �° . `.1;4 }p t,M1) e 6 , ',,,, e' ,..- x y;�v t14,;, work indicated on this application.
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Ell-and 2-family dwelling jiltCommercial/industrial Valuation: $ 1 1"� 44
,
4
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
x ,"y R d W r +, w •, a, k°p � 'to : Total number of floors:y a 4.Xrx <<;. 7;7. ? � � „ . ,
Job site address: 900,1 C 1 L ) L�0 New dwelling area: square feet
City/State/Z[P:` 0\0 0 �J012. T� f�l� rZ rL 3 LJ Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name:'m_t0 r,,;y e�flixeme Covered porch area:- square feet
Cross street/directions to job site: _"V\ Deck area: square feet
Other structure are . square feet
��re,a•z s,'�s..Mr rt aw.• _ tea`„<•; 'ab a5�rz 7r 1T9:
Subdivision: I 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
. air + �t�.,�y 2„�s= y^, a. -�; „ �,. t equipment,materials,labor,overhead,and the profit for the
W �' Ma' FY„S I.�x- i4 IB r''�a,�,, 'Y;;,i �'r jis£4"'"
%''y, nss' Rw2'5 a„g,,,,_ . . -, '''''',L ,,� � `,. 6f?.,r.-:gam work indicated on this application. Q�
104-12..1 CAri �X 1 5T)_ J, Sl M96t?[, t oionccf Valuation: $ 221-10 e ) OWn e,..I 3;!YM f l.P.]L Li CL o S F� r Existing building area: fS')SD square feet
Y RI.Q`�� C a V t New buildingarea: LJ" ' square feet
4 c V/ k �s+ax l' rd hrt"rt'- -'t ,a' .
h�� � z � ,z.;, "rt�... �, ... .,f „�;��.,; Numberofsrories:
Name: I 1 1 4,,..s
,I Type of construction:
Address: 0 e ' "04 I BA le� ill a,�w�
City/State/ZIP: vt f) 3 . vn OccupancyExistigroups:
1 g�� v J� �L3 Existing:
Phone:( ) Fax ( )
Newi iii an. 9e 0vJ4 a7i , ) it r � ro.s,5-11 WiR $ +5#4. - , rY F ir t yy 4j ^�
Business name: 7a Aso' Co/N.1-r0 All contractors and subcontractors are required to be
Contact name: _ licensed with the Oregon Construction Contractors Board
aw a�
l '�" r under ORS 701 and may be required to be licensed in the
Address: (v305 SW .go50_,.. -Do0 Nv _ -l}ld.
'jurisdiction in which work is being performed-If the
City/State/ZIP: ✓ r Il p �e ,0 0'-�O g S applicant is exempt from licensing,the following reasons
Phone:(S 3 J ( ) 7 aPP1Y
'� )Si-2 2f o q Fax
E mail 1
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Business name: 6k"s n +ro,� , ...mod
'Address: Permit fee:
(AO �� eolp ta..t
City/State/ZIP: < ���/'► 2� State surcharge(12%of permit fee).
O `yam 0 "' O`er FLS plan review(40%of permit fee): -
Phone: )
1Si13)SpZ� 2-to� Fax:( ) (Due upon application submittal)
CCB lie.: I 9
-1 2 I Total permit fees:
Authorized signature: F Amount received:
This permit application expires if a permit is not obtained
Print name:.(�,.re, i Date:f nl e4//L� y within 180 days after it has been accepted as complete.
�wV�� 'rl Fee methodology set by Tri-County Building Industry
Service Board.
I:\Budding,Pmoiu'FP$-PermitApp_031016.doc 4404613T(1 I/02/COM/WEs)