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CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
III 44
COMMUNITY DEVELOPMENT Permit#: FPS2022-00056
Date Issued: 4/26/2022
T(G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 126CC00200
Jurisdiction: Tigard
Site address: 10065 SW CASCADE AVE
Project: Tesla Subdivision: None Lot: None
Project Description: Fire alarm for TI.
Contractor: ERTELL ELECTRIC LLC Owner: 10065 SWC LLC
PO BOX 279 BY ALSTON& BIRD LLP
FOREST GROVE, OR 97116 BANK OF AMERICA PLAZA
101 SOUTH TRYON ST STE 4000
CHARLOTTE, NC 28280
PHONE: 503-841-4511 PHONE:
FAX: 503-359-5652
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/21/2022 $317.40
12%State Surcharge-Building 04/21/2022 $38.09
Type of Use: COM Plan Review-Fire Life Safety-COM 04/21/2022 $126.96
Class of Work: ALT Type of Const: Misc Administration Fee 04/21/2022 $12.50
Occupancy Grp: Height: ft Info Process/Archiving-Sm$0.50(up to 04/21/2022 $10.00
Stories: 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: Yes Cut Sheets Required: Yes
Total $504.95
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $22,500.00
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
r
Issued By: Permittee Signature: �� b
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.
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
RECEIVED
E C E I V E Received
illiCity of Tigard DateBy: S-> Permit No.: es .o�L•- �
N 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / / �(3�IT
2 Phone: 503.718.2439 Fax: 503.598.1960 APR
Date/By: 4' 2,..-22 1 Other Permit: � � �2�-0vv --
T I G A K D Inspection Line: 503.639.4175 APR 4 2022 Date Ready/By: 7uris: H See age 2ifforr IJ
Internet: www.tigard-or.gov Notified/Meth : 212 7.7__, Supplemental Information
CITY OF TIGARL ,e "�}►
TYPE OF Wo,.I))f t\f, fl tioli.)fs, 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
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10065 SW Cascade Blvd New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Tesla 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.
Install fire alarm system for new tenant improvement Valuation: $ 22,500
Existing building area: 43,125 square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Benderson Development Type of construction: II B
Address: 7978 Cooper Creek Blvd Occupancy groups: B & S1
City/State/ZIP: University Park, FL, 34201 Existing:
Phone:( ) 941-359-8303 Fax:( )
New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: All contractors and subcontractors arc required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply: _
Phone:( ) / / k I Fax: :( )
E-mail: /yla4 �- e-rfc s cc6,it:•ec -ri•
CONTRACTOR BUILDING PERMIT FEES*
Business name: Ertell Electric, LLC (Please refer to fee schedule
Permit fee:
Address: PO Box 219
State surcharge(12%of permit fee):
City/State/ZIP: Hillsboro, OR 97123
FLS plan review(40%of permit fee):
Phone:( ) 503-841-4511 (Due upon application suhnzittal.)
CCB lie.: 180540 Total permit fees:
Amount received:
Authorized signature: t
..4,1 This permit application expires if a permit is not obtained
Print name: Dylan Werort Date: March 29th 2022 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:Building Permits FPS-PermitApp_031016.dor 440-4613T(1 I/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:
❑ Addition or ❑ 1-10 heads: Affidavit required and ❑ 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 111.fs 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� d F t�3{3.i did r
t d4 ba°dx�itit� , r k ass e*S d'n���'df g A'$6a #'' bS4iS � a: sJ aea�(�(4»5t "��`�q � $iI �''°%�d dJ �' X ` aka>e tii+p�`IN rHi.
3
O:t +`!i - ._ a l�e= � - � -k ����ae. d his fla"�p IP
frr, fti "c�'1
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: $ 22,500
l ivy 'r`� ?.. i i xr ..-1 4' a o�.- ±mac«
,t.�' r�. �b a.t .,�p�,�is � ��'aa.€�br�a ej+, € �. - 'aYSr r9 '
....� — " ^ 4r�Fu�Y �
D.) Residential Sprinkler(Stand Alone System)
Square Footage: Permit Fee: � �� C:�.
l.
0 to 2,000 $198.75 arcs '
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05 tf � �
7,201 and $404.39 greatermmm.s :. � �Hw� ,..., >z
Sprinkler Project Square Footage: sq.ft.
Fire Protection Permit tees " z ' ray -ttvierul i ?
Project valuation subtotal (see A, B & C above): $ 22,500
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