Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
. COMMUNITY DEVELOPMENT Permit #: FPS2010 -00096
T 1 GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/07/2010
Parcel: 25101 DA00100
Jurisdiction: Tigard
Site address: 13010 SW 68TH PKWY 100
Subdivision: TRIANGLE CORPORATE PARK Lot: 7
Project: US Bank Equipment Finance
Project Description: Upgrade fire alarm system.
Owner: FEES
PACIFIC NW PROPERTIES LIMITED PA Description Date Amount
6600 SW 105TH AVE #175 Permit Fee - COM 09/02/2010 $83.37
BEAVERTON, OR 97008 12% State Surcharge - Building 09/02/2010 $10.00
PHONE: Plan Review - Fire Life Safety - COM 09/02/2010 $33.35
Contractor:
PERFORMANCE SYSTEMS INTEGRATION
COR
7324 SW DURHAM RD
PHONE: 503 -641 -2222
FAX: 503 - 641 -1464
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: Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $126.72
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 1650
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 • 1 work is s pended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Center. Those - • r- set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You ma obtain a copy of the rules
or • irect que ions to OUNC by -Iling .03, 246.6699 or 1.800.332.2344.
Issued By: / ' Permittee S• nature:
Call 503.639.4175 by 7:00 a.m. for an inspection that buss. = s 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.
po:9%3%ZZ
Building Permit Application Et -- ol6 op .
Fire Protection System _ FOR OIIICI Use C)NLY
City of Tigard Date/Bv: Received /O Permit No.: Q ,, , /p-000M
0 13125 SW Hall Blvd., Tigard, OR '? • Plan Review`
I II Phone: 503.639.4171 Fax: 503.5' ".' ',.1 G Date/Bv: Ainf f neialla other permit:
. 1 I C; A R l3 Inspection Line: 503.639.4175 Date Rcadv /Bv: Juris: Il See Page 2 for
Internet: www.tigard or.gov SEP 0 2 2010 Notified /Method: Supplemental Information
TYPE OF OF TIGARD REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction EiniedinSION Permit fees* are based on the value of the work performed.
I F'v' 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.
❑ I- and 2- family dwelling Commercial /industrial
Valuation: $
❑ 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: 130 ■Q S f ‘, A vz . New dwelling area: square feet
City /State /ZIP: "T 61 ,, A 4 / CV, / 07.2_23 Garage /carport area: square feet
Suite /bldg. /apt. no.: ton Project name: US BA,* taviR FiwrAwu -e Covered porch area: square feet
Cross street /directions to job site: -s W t'IAMPtf)N i SW 65 t�+ Avt 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials. labor, overhead, and the profit Rtr the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ 1 650 4s—
ANN. p l OT1 cilA ith b '.l rs t 1 P xk r -.` 1r:i?g Jrtl - IJr fart 5y S.
Existing building area: square feet
New building area: square feet
❑ 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: - per, oRr„nw,GE S STflrt; All contractors and subcontractors are required to be
Contact name:- �o- 372.40 � r licensed with the Oregon Construction Contractors Board
►i Af'u��1t� under ORS 701 and may he required to be licensed in the
Address: R fo T326t SW � VRt1t►r7 jurisdiction in which work is being perrnted. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP:
po c e 4L,rN,, / OR, 'Al 2 7 — apply:
Phone: ( vi 1 -2222 Fax: : ( soi ) G'i i - l'{b `{'
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
(Pkase refer to fee scheduIe
Business name:
�ep_focrl iA,3ce S yStP_r15 Pennit fee:
Address: 132`( Sim 'Dvx.►.to,r4 (Lek . State surcharge (12% of pennit fee):
City /State /ZIP: pCcac►.Aw9 / O e..../ ¶ 122_'( FLS plan review (40 %ofpenult fee):
Phone: (503 ) 6'{l -222'2, Fax: ( 5J'�) &i- 1464 (Due upon application.) ,/
CCB tic.: l S 0 1_47 � } t Lire Total pennit fees: N 6. 72.--
�
Authorized signature: r Amount received:
___ 7 This permit application expires if a permit is not obtained
Date: ` within 180 days after it has been accepted as complete.
Print name:
WR(Zp G►1ir�(o �J{ Z/-2,0 r,0 * Fee methodology set by Tri- County Building Industry
Service l3oard.
1:\ nuitding 'Pennits\EI'S- 1'cnnitApp.doc 03!23/06 440- 461 1,02,COM'W En)
I
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
W Addition ❑ 1 -10 heads: No plan review required.
Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
•
Additional description of work:
Atop uEw •oTi P■O'rc" orl G.acv: _• e)0ST syS h
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Densitu-
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: 1 $
C.) Fire Alarm
Submittal shall Batten Calculations g, Yes
include: Individual Component [ Yes
Cut Sheets
Fire Alarm Project Valuation: $ � ( 5 0 °'''
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Perrnit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
•
7,201 and greater $381.50
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): $
I7hS 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.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
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