Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 ' COMMUNITY DEVELOPMENT Permit #: FPS2011 00022
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/17/2011
Parcel: 1S Si 35 B B00500
Jurisdiction: Tigard
Site address: 10355 SW CASCADE AVE
Project: Fisherman's Marine & Outdoor Subdivision: Lot: 0
Project Description: Fire alarm.
Contractor: ALL COUNTY ELECTRIC LLC Owner: RAM /CASCADE CENTER LLC
15515 NW 2ND AVE. BY ELLIOTT ASSOCIATES INC
VANCOUVER, WA 98685 901 NE GLISAN ST
PORTLAND, OR 97232
PHONE: 360- 904 -7923 PHONE:
FAX: 360- 314 -2244
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/17/2011 $231.32
12% State Surcharge - Building 03/17/2011 $27.76
Type of Use: COM Plan Review - Fire Life Safety - COM 02/18/2011 $92.53
Class of Work: FPS Type of Const: VB Info Process /Archiving - Lg Sheet (over 03/17/2011 $6.00
Occupancy Grp: M Height: ft 11x17)
Stories: Info Process /Archiving - Sm Sheet (up to 03/17/2011 $4.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type: Automatic
Pull Station Required: No Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $361.61
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $15,000.00
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 ad); ed by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. ou -y ob �a co., of the rules
or direct questions to OUN C by calling 503.232.1987 or 1.800.332.2344.
Issued By: /) / , r% Permittee Signature:
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 completio 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
Cl of Tigard Received Permit No.: ►
Phone: 503.639.4171 Fax: 503.5 0 ' 131 SW Hall lvd., Tigard, OR 9722 13125 Y p Date aan B R v: � ie —' "- 1, - �■ v �� '�
■ cf( i� Other Permit: : /
T I G A R D Inspection Line: 503.639 $ 1 Date Ready/By: .A. -. See Page 2 for
Internet: www.tigard or.gov r oi Notified/Method: I / Supplemental Information
j pi p VIIG S�Q 1' 014- ', ;:± -' "-
TYPE OF WOIIiCL i.ct ' REQUIRED DATA: 1- AND 2- FAMILY DWELLING
New construction El 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.
❑ 1- and 2- family dwelling commercial /industrial Valuation: $
❑ Accessory building 111 Multi-family Number of bedrooms:
❑ Master builder ['Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ID 3 s5 &.j l .f& d..,(..L , a, J New dwelling area: square feet
City /State /ZIP: — T"' j ( r A / 02 C 7 0-...), 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: r l,4,„Yltb✓'S i Y,, l ,-" y ( .f4.,,,, Covered porch area: square feet
Cross street/directions to job site: 1 , 6 , in Deck area: square feet
CCC/// 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 for the
DESCRIPTION OF WORK work indicated on this application.
17r1 S - , f I n I Valuation: $ 1 JA
p,u / 74) , / �[ , / /s1-1/1,7 / t , rl _ Existing building area: square feet
d+t -/ 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: Ail b U f l -/-L �-� i C� I I_ � All contractors and subcontractors are required to be
Contact name: `sS� � licensed with the Oregon Construction Contractors Board
Via under ORS 701 and may be required to be licensed in the
Address: V ')C u�l
O ft'� bt 9 d V FS jurisdiction in which work is being performed. If the
i c applicant is exempt from licensing, the following reasons
City /State /ZIP: apply:
Phone: ( ) Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: A I I c u 4 - 1 4 - L' e i l,(� -f (Please refer to fee schedule
G Permit fee:
Address: / y ''S f S Aj si- (�/
City /State /ZIP: V � U U. ✓.e V ` /3/4 . 9 d 6 FL" State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (`` pv , *it _ 7%7.0 Fax: ( ) (Due upon application.)
CCB lic.: / 7 ? 3 �7 Total permit fees: /91 ,5--
Amount received: q �7
Authorized signature: . • 5
This permit application expires if a permi is not obtained
Print name: M ) ..1.6. ,p h n s v,-i Date: .11 g J ' 1 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.doc 10/01/09 440- 4613T(1 l /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: $
!M
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.
\ \Safeserver \d$ \ SAFE \ Forms \Use these forms \Permit Apps \Tigard \FPS- PermitApp4c 10/01 /09