Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II • COMMUNITY DEVELOPMENT Permit #: FPS2010 -00089
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/31/2010
Parcel: 2S101 BC00900
Jurisdiction: Tigard
Site address: 12291 SW KNOLL DR
Subdivision: Lot: 0
Project: The Knoll at Tigard
Project Description: Fire alarm for 48 unit apartment complex.
Owner: FEES
THE KNOLL AT TIGARD Description Date Amount
PO BOX 23206
TIGARD, OR 97281-3206 Permit Fee - MF 08/25/2010 $188.28
Additional Plan Review 08/25/2010 $1.00
PHONE: 503 - 293 -4038 12% State Surcharge - Building 08/25/2010 $22.59
Additional Plan Review 08/31/2010 $65.31
Contractor:
AZIMUTH COMMUNICATIONS INC
P.O. BOX 508
WILSONVILLE, OR 97070
PHONE: 503 - 639 -0110
FAX: 503- 639 -0115
Type of Use: MF
Class of Work: ALT Type of Const: VB
Occupancy Grp: R -2 Height: ft
Stories: 4
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: No
Total $277.18
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 11000
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all of er
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 1: i • ays of
issuance, or if wo kis-sus • ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted • the Oregon
Utility Not ion Center. • e rules a - set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain - •py of the rules
or dire questions to OUNC by Ili r • 50 24. - • 99 or 1.800.332.2344.
Issu d By: � Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that busin: -s d. .
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 11511 OiN 1_1
City of Tigard Received /�e,
`J b R N r�W DateB i � (D MN Permit No.: l / R
q 13125 SW Hall Blvd., Tigard, OR 97223 •'�� 0
' C g Plan Review � � On Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 DateB : (J
i- (;M:1 Inspection Line: 503.639.4175 i\ ' ' , ' 1 2 3ia Date Ready : : Jig ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
CIT. - lGARD
TYPE OF Wt1' t; i• a l; DIVISION 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.
dwelling Valuation: $
❑ 1- and 2-family g ❑ Commercial/industrial
CI Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / Z Z, f ( 5 CJ ./C 4e,) 4 New dwelling area: square feet
City /State /ZIP: � `` * � ,,,,,,,w c / Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 7`, v ' (. / i Covered porch area: square feet
Cross street/directions to job site: "C `7 ` Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
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
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
_ r- Valuation: $ /1/ w
:� _�',�ii� _ , -3 , : - �+a�� .,. _ . /
Existing building area: square feet
- 7 v¢ q.►-et, ivt2. k Otto, T
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are 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:( ) 1 Fax::( )
E -mail:
CONTRACTOR M 56c BUILDING PERMIT FEES*
Business name: -// ( Please refer to tee schedule)
d ,,,,,,L)/4 ei tAts _ tZ<u Permit fee:
Address: 9- SKI ✓.1 4 l w , a 4
City /State /ZIP: � � ,, r ,� �'�,. � -7 State surcharge (12° fee):
U o I ( FLS plan review (40 /o of permit fee):
Phone: ( S 034. l7l((/ _ (s- Z Fax: ( , Vs c 34_ pllt— (Due upon application.)
CCB lic.: / .,a/ Total permit fees:
Authorized signatu Amount received: `69
This permit application expires if a permit is not obtained
Print name: a t Date: /Q -- within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1:\Building\Permits \FPS- PennitApp.doc 10 /01/09 440.4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
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:
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.
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