Permit (106) ,, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
i pq 'g .''` COMMUNITY DEVELOPMENT Permit #: FPS2011 -00126
Date Issued: 10/18/2011
'TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel: 1 S1356D00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 500
Project: Plaza West Subdivision: ASHBROOK FARM Lot: PTS 5 &
Project Description: Add (2) strobes and (1) horn /strobe to existing circuit
Contractor: FIRE SYSTEMS WEST INC Owner: SUN LIFE ASSURANCE CO OF CANADA
600 SE MARITIME AVE #300 BY NORRIS BEGGS & SIMPSON
VANCOUVER, WA 98661 121 SW MORRISON ST #200
PORTLAND, OR 97204
PHONE. 360- 693 -9906 PHONE.
FAX: 503 - 289 -2208
FEES
Description Date Amount
Specifics: Permit Fee - COM 10/18/2011 $72 61
12% State Surcharge - Building 10/18/2011 $8 71
Type of Use: COM Plan Review - Fire Life Safety - COM 10/18/2011 $29.04
Class of Work: ALT Type of Const: Info Process /Archiving - Lg Sheet (over 10/18/2011 $2.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process /Archiving - Sm Sheet (up to 10/18/2011 $3.00
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 Alarm Type:
Pull Station Required: Smoke Detectors Req
Battery Calcs Provided. Cut Sheets Required
Total $115.36
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,265 00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable la . . . will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuanc or if work is sus. -nded for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit Notification Center. Tho e - - are set forth in OAR 952 - 001 -0010 through OAR 9 :11-0090. You may obtain a copy of the rules
or d ect questions to OUNC by , g 503 2 . '87 or 1 800 332.2344
-11110 j� � �
Iss ed By: i // Permittee • ignature: ��AJ /
Call 503.639.4175 by 7:00 a.m. for the next available • on 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
Fire Protection System : " . • FOR OFFICE FUSE oNLY : •
ill City of Tigard �� ��� B d %�� ��/' Permit No ' /.790 42 (D
N 13 125 SW Hall Blvd., Tigard, OR "iv. Plan Revie ' 1 1•, '1i
V Phone: 503 718.2439 Fax 503.598.1960 y� � Date /B : i � �` ��i Other Permit
Inspection Line: 503.639 4175 0� t'' Date Ready t y Juns ® See Page 2 for TIGARD Internet. www.tigard -or gov `�`� lSl Notified Method Supplemental Information
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E] 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
_:: 1'-'' i "' ;':, lit i'; .OF < " ; O ` >> r ;, ' ft ;;;;;,,,_ _ work indicated on this application.
. , • x GATECORY ' ", , I OV; , > '' `',
Valuation $
❑ 1- and 2- family dwelling ® Commercial/industrial
❑ Accessory building ❑ Multi- family Number of bedrooms
❑ Master builder ❑ Other: Number of bathrooms:
",` �•' =r..g Total number of floors:
;. JUB °'SITE INBORMATI(JN 'AND GOGATIOPI '? ,
x` -��" �, <. ° _�., .. r., "�,;' :tea syx,,:, . - �;�'. >,,.:��� ;�... _, sf >; =`a%° ..�`'' o
Job site address: 9600 SW Oak St New dwelling area: square feet
City /State /ZiP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 500 Project name. Plaza West Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
- REQUIRED DATYA COMMERC1AL4 JSE °CHECKLI T ?
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
; .- ,''a -- ,...rte°,,, a,<a - overhead, nd th profit for the
10,'' y ' OSCRIPTIO 16WORIC.- y ,r�; �, work equipment,
this application
Add 2 strobes and 1 horn /strobe to existing circuit Valuation: $$1,265.00
Existing building area- square feet
New building area: square feet
® UWI�TER;��`'' a, h -; Number of stories.
u
." A
,;, lYT"
Name: Type of construction: f
Address: Occupancy groups: fJ
City /State /ZIP: Existing:
Phone: ( ) Fax ( ) New:
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t -
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Business name: 5 5 U s All contractors and subcontractors are required to be V " `
Contact name. E �
under ORS 701 and may be required to be licensed in the
licensed with the Oregon Construction Contractors Board
t`�L � ,�� AA `` /�
Address: 600 S� Y"\�c 2 - 14 AO a_ .A jurisdiction in which work is being performed. If the
City /State /ZIP: J�OU �A g �(ct!Df applicant is exempt from licensing, the following reasons
apply:
Phone: (5(1C) ) Is 3 — 0 (o Fax:: ( )
E -mail `r.iciL.p Q•P gaE5y5{-e.u,L5 Uf e-4• Co' +
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Business name: Fire Systems West •• .. { Plea -reje''r.ro�eescu i.,• = ..::::• < -`' ` :.a " ' '
Permit fee:
Address: 600 SE Maritime Ave #300
City /State /ZIP: Vancouver, WA 98661 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee)
Phone: (360) 693 -9906 Fax. (360) 289 -2208 (Due upon application.)
CCB lie.: OR 49732._ Total permit fees: 2
Authorized signature Amount received. f / i • 7 0
This permit application expires if a permit is not obtained
/ ��� l within 180 days after it has been accepted as complete.
Print name: Rick Pa g el / � ,,- Date: 10/18/2011
1 �i * Fee methodology set by Tri- County Building Industry
Service Board.
I \ Budding \Permis \FPS- PermrtApp doc 02/01/11 440-461 3T( I 1 /02 /COM /WEB)
rl
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Descnbe�w rk to b, ,don ���_,�, .,� ��� � W �
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
,.� °,�; � �"'i =; ; t�.'. ,^
e of $- .steirr ` ACozx lete A F BC'ar'I? as a ' licable<
(1Y .
r '
at "' ial rikle te ='�"
y
°F
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B uT e = ::Hood ° Fire Su ' ' res " sal on S ste " zi
Hood Project Valuation: $
�; F, � � � g _ Yom; �� %�,,k�.' „' �•, ��:`; �r ; .,.,n : -.
C aj!u
.;
Fire: p „ „w
y
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1265.00
. � ;yrsfr
-.,.a. 1;
In i✓nkl�'' a �$ , ri YAl ii t rn �,•
°D.. '- „Reside r
.,$ ta o e °�S.'.s a ' �',�,:,;,' '�•� :,<�;. �y.y
Square Footage: Permit Fee:
to 2,000 $198.75 „ ', : 4 �; %r;?
2,001 to 3,600 $246.45 " '_"
3,601 to 7,200 $310.05
7,201 and greater $404.39 1 , ` s
:hoc ^�
Sprinkler Project Square Footage: sq. ft.
°•��.� �� ... -, Fire;rPrateet><on >PermitFees,„
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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
http / /www tigard -or gov /cty_ hall /department, /cd /dots /PPS- PcrrrntApp doe 02/01/121