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Permit g /i7 //D --et-eot ..e k_d ./,e.. l-( ITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 0 a IN COMMUNITY DEVELOPMENT Permit #: FPS2010 00043 T [ GP R O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2010 Parcel: 2S 101 AC00400 Jurisdiction: Tigard Site address: 7095 SW GONZAGA ST Subdivision: Lot: 0 Project: WILLAMETTE DENTAL Project Description: Sprinkler monitoring system. 8/17/10, adding elevator recall. Owner: FEES NATIONAL SAFETY COMPANY Description Date Amount 17010 SW WEIR RD Permit Fee - COM 05/14/2010 $123.72 BEAVERTON, OR 97007 12% State Surcharge - Building 05/14/2010 $14.85 PHONE: Plan Review - Fire Life Safety - COM 05/14/2010 $49.49 Additional Plan Review 08/17/2010 $180.00 Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS INC 15495 SW SEQUOIA PKWY STE 100 PHONE: 503 - 968 -3333 FAX: 503- 968 -3398 Type of Use: COM Class of Work: ALT Type of Const: VB Occupancy Grp: B Height: ft Stories: 2 Commercial Sprinkler Svstem: Sprinkler Required: Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: No Alarm Type: Automatic Pull Station Required: No Smoke Detectors Req: No Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $368.06 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: 0 Residential Square Footage: 0 Fire Alarm Valuation: 4375 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 issuanc- • • - • 's suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Util' otification Cent- Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules • direct questions to OU b • • 1 g 503.246.6699 or 1.800.332.2344. t Issued By: / ,, , / Permittee Signature: / AIL. -AL_ k CaII 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. I IJ CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2010 -00043 Date Issued: 05/14/2010 11G 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 251 01 AC00400 Jurisdiction: Tigard Site address: 7095 SW GONZAGA ST Subdivision: Lot: 0 Project: WILLAMETTE DENTAL Project Description: Sprinkler monitoring system. Owner: FEES NATIONAL SAFETY COMPANY Description Date Amount 17010 SW WEIR RD BEAVERTON, OR 97007 Permit Fee - COM 05/14/2010 $123.72 12% State Surcharge - Building 05/14/2010 $14.85 PHONE. Plan Review - Fire Life Safety - COM 05/14/2010 $49.49 Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS INC 15495 SW SEQUOIA PKWY STE 100 PHONE: 503 - 968 -3333 FAX: 503- 968 -3398 Type of Use: COM Class of Work: ALT Type of Const: VB Occupancy Grp: B Height: ft Stories: 2 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: No Alarm Type: Automatic Pull Station Required: No Smoke Detectors Req: No Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $188.06 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: 0 Residential Square Footage: 0 Fire Alarm Valuation: 4375 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 -0100. Yo may obtain a copy of the rules or direct questions to 0 _e by calling 503.246.669• • :61 .2344. i / Issued By: Permittee Signature: CaII 503.639.4175 by 7:00 a.m. for an inspection that business day. 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 as ;. ; Fire Protection System RECEV �. .�a I ORa l � _ , , , Received a ,p ' City Of Tigard ,,w +, DateB : / Z Ti /C./ �� /Ii - Permrt No. f / / _'/ • 'r ° 13125 SW Hall Blvd., Tigard, OR 97223 APR .212010 Plan Review ■ Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 DateB ���� �� .ELTd /p '(k) ( 1 p : ® See Page 2 for �. C iYlt l) Inspection Line: 503.639.4175 Date Ready /By: g g 3 i� Juris // Cj T. 776 Supplemental Internet: www.ti ard -or. Ov CITY OF TIGARD p qq�� DIVISION � Notified/Method � ��./� Su lemental Information RUII fING I lIVISION La Ve 1' / TYPE OF WORK REQUIRED'DATA: l- 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. 111 1- and 2- family dwelling il Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION . Total number of floors: Job site address: 7075-- 5 W 65 il Z1 9 C New dwelling area: square feet City /State /ZIP: I y c r 2 0 2 9 -7 2 33 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Co ; 1( 44 t4-1'C I/244 t ( 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 Pr DESCRIPTION OF WORK : . • work indicated on this application. 5 rr, n 14e- ✓441404.10v.'.t.Gt Valuation: $ 3,5 p J / Existing building area: square feet New building area: square feet O. PROPERTY OWNER • , , .❑ .TENANT ' - Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT .PERSON NOTICE Business name: S F- /e,i All contractors and subcontractors are required to be Contact name: S . � v ekv �- f licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: ' S c r . S w S e#1 1 _, G ,, , ? r-- ( 0 U jurisdiction in which work is being performed. If the City/State/ZIP: op, (. A h ©I` 7 Z Z applicant is exempt from licensing, the following reasons apply: Phone: ( -. 0 5 )) 6 y 3333 (i> / F - ax:: (�jj Gl6 � _ f E -mail: S' t Q*yj(O v'S 9 h ve / fit/ 6, v- -s • CO H . CONTRACTOR ( •BUILDING PERMIT FEES* . _ • Business name: il I Cc /\///6(26-6 -- EC a l ei r SO L “770'/ -S (Please refer to fee schedule Y Permit fee: Address: / cL./ C7 I f ,.! S e- v 0 i e Pic.- kl /C 0 S State surcharge (12% of permit fee): City /State /ZIP: p .(.. la, , ..d Tz- 9 7 Z 7 FLS plan review (40% of permit fee): Phone: ( 5 2) ,i� 7 3 3 3 Fax: (J 5 .7. q - j 3 (Due upon application.) I CCB tic.: / ( p / 5- 6 O 7 � ( 0 Total permit fees: l " DC 1 Authorized signature: Amount received: This permit application expires if a permit is not obtained Print name: S r� V ,� .1 C) n2�.p v i...-e...... Date: q -a _ /0 * within 180 days after it has been accepted as complete. Fee methodology set by Tri- County Building Industry Service Board. 1 \Building`,Permits \FPS- PermitApp.doc 10/01/09 440- 4613T(I I /02 /COMJWEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: ' 1.) El 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: Type of System (Complete A, B, C or D as applicable): • A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: 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: $ • • • 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: $ Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal. L\ Buildin \Permits \PPS- PcrmitApp.doc 10/01/09 2 r,M'