Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
i r `�
I COMMUNITY DEVELOPMENT Permit #: FPS2010 00113
D 13125 SW Hall Blvd. Tigard OR 97223 503.639.4171 Date issued: 10/14/2010
"�' Parcel: 2S101DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE# 100
Subdivision: FARMERS INSURANCE Lot: 0
Project: Triangle Pointe
Project Description: Clean agent fire suppression system.
Owner: FEES
TRIANGLE POINTE LLC Description Date Amount
901 NE GLISAN ST #100
PORTLAND, OR 97232 Permit Fee - COM 09/30/2010 $188.28
12% State Surcharge - Building 09/30/2010 $22.59
PHONE: 503 - 297 - 8791 Plan Review - Fire Life Safety - COM 09/30/2010 $75.31
Contractor:
PATRIOT FIRE PROTECTION INC
4708 NE MINNEHAHA ST
VANCOUVER, WA 70822
PHONE: 360- 699 -4403
FAX: 360- 699 -4485
Type of Use: COM
Class of Work: ALT Type of Const: IB
Occupancy Grp: B Height: ft
Stories: 5
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Dry
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: Cut Sheets Required: Yes
Total $286.18
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 11000
Residential Square Footage: 0
Fire Alarm Valuation:
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. You may obtain a copy of the rules
or direct questions to OUNC •y calling 503.246.6699 or 1.800.332.2344. ..
MINIPArn
Issued By: — Permittee Signature: • r A
Call 503.: y + 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
Fire Protection System ��
�� FOR OFFICE USE ONLY
City of Tigard Received
Date/By: b 10 , T - Permit No.: '�St0 to — 00 ( 3
114
° 13125 S W Hall Blvd., Tigard, OR ! 3 O Plan Review p. in f rn Other Permit 1
Phone: 503.639.4171 Fax: 500` 1'• •0 ® 'l %� Date/B : /:i 10 I '111 1v .1 _. a_ ,I j
a 7 GA R D Inspection Line: 503.639.4175 b p� ,, Date Ready e • : • 1wis: El See Page 2 for
Internet: www.tigard-or.gov (C t G Q+ �o` Notified/Method: `; O ) 1/ JO I3— ' 7. T Supplemental Information
0F� q 1J` I LYvi r - h '' . .- 14 - . ,' 0 0, - TYPE - OF NO �,. • REQUIRED DATA: I- , 12- FAMILY DWELLING
❑ New construction 44atiolition 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.
❑ 1- 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: ( 3333 StO 6G- 14r p J cv i y New dwelling area: square feet
City/ State/ZIP: • -'l G ✓ in!) og.- 9 - a3 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: r 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: I 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.: 2
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
oei-t-) �Wl ZOo (�(,„ A- 6 Y`7 t/ Valuation: $ 1 / a
l3 pea e r 5[ c, Js - c..L7 T-, Existing building area: ! square feet
'Pa e- di-c —T i j i)rC -t kc C S i S - 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: 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:( ) I Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: 'ern a r� e� (Please refer to fee schedule)
Address: `- r l t ` ► `' Permit fee:
'1
"{ ®� 11�N 5� State surcharge (12% of permit fee):
City/State/ZIP: ti A 0 (i) L)v az i w l4 1 g� /
l FLS plan review (40% of permit fee):
Phone: (3 ( b qq ., c 1 ( . 1 o 3 Fax: (3 (,a) b 909 _ ti 6 s. (Due upon application.)
CCB lic.: Total permit fees: , ( B
Amount received: ^ (8
Authorized signature:
This permit application expires if a permit s not obtained
Print name: e ,(2, ( (A} 314.1 Date: _ 30 - I v 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 l /02/COM/WEB)