Permit - ' 7 .:;y CITY OF TIGAR
11 FIRE PROTECTION SYSTEM PERMIT
Y � ;< - COMMUNITY DEVELOPMENT Permit #: FPS2011 00098
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/16/2011
. �". Parcel: 1 S136CD00100
Jurisdiction: Tigard
Site address: 11705 SW PACIFIC HWY L
Project: Big 5 Sporting Goods Subdivision: Lot:
Project Description: Replacing existing fire alarm system with new system.
Contractor: FOCUSMICRO INC Owner: PACIFIC CROSSROADS PROPERTIES IN
4640 CAMPUS PL #100 BY WYSE INVESTMENT SERVICES CO
MUKILTEO, WA 98275 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97205
PHONE: 425 - 293 -0436 PHONE:
FAX: 425 - 293 -0393
FEES
•
Description Date Amount
Specifics: Permit Fee - COM 07/26/2011 $145.24
12% State Surcharge - Building 07/26/2011 $17.43
Type of Use: COM Plan Review - Fire Life Safety - COM 07/26/2011 $58.10
Class of Work: ALT Type of Const: VB Info Process /Archiving - Lg Sheet (over 07/26/2011 $4.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm Sheet (up to 07/26/2011 $5.00
11x17)
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: No Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $229.77
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,841.34
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 . ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Not !cation C- - er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct q estions to OU ■ by c.. g 03.232.1987 or 1.800.332.2344. z Issued By. �/ Pe rmittee Signature: / ., , 4 ......- ......
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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System 06 a O
k .„,,, .. r ,,� FOR OFFICE USE ONLY U J N
F s� Rece
City of Tigard n `l Permit No i'," - G
14:: ' ® Date /B t �7r ' ,
" 13125 SW Hall Blvd., Tigard, OR 97223 Plan R eve �'
Phone: 503.718.2439 Fax 503.598.1960 ��� ` i .hne /By � � L r. Iif a Other Permit
Inspection Line: 503 639.4175 " X11 I Date Rea '. B See Page 2 for
T IG A RD e , p Internet: www.tigard -or. g oat C OCS Notified /Method: // At, M Supplemental Information
r5pdcl. 4) SA,./
TYPE OF WORK
III New construction Print name:
❑ Demolition
REQUIRED DATA: 1- AND 2- FAMILY DWELLING
® Addition /alteration /replacement ❑ Other:
Permit fees* are based on the value of the work performed.
CATEGORY OF CONSTRUCTION Indicate the value (rounded to the nearest dollar) of all
❑ 1 - and 2 -famil dwellin equipment, materials, labor, overhead, and the profit for the
y g ® Commercial /industrial
work indicated on this application.
❑ Accessory building ❑ Multi - family
Valuation: $
❑ Master builder ❑ Other:
Number of bedrooms:
JOB SITE INFORMATION AND LOCATION
(1
Number of bathrooms:
Job site address: 93SW Pacific Highway
Total number of floors:
City /State /ZIP: Tigard, WA 97223
New dwelling area: square feet
Suite /bldg. /apt. no.: L Project name: Big 5 Sporting Goods #233
Garage /carport area: square feet
Cross street/directions to job site:
SW Beaverton - Tualatin HWY Covered porch area: square feet
Deck area: square feet
Subdivision: Lot no.: Other structure area: square feet
Tax map /parcel no REQUIRED DATA: COMMERCIAL. - USE CHECKLIST
DESCRIPTION OF WORK Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Replacing Fire System with new Addressable Fire System equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
Valuation: SS6,841.34
Existing building area: 3800 square feet
❑ PROPERTY OWNER ® TENANT
New building area: square feet
Name: Big 5 Corp
Number of stories: 1
• Address: 2525 - E El Segundo Blvd
Type of construction:
City /State /ZIP: El Segundo, CA 90245
Phone: (310)363 Fax: ( ) Occupancy groups:
® APPLICANT ❑ CONTACT PERSON Existing:
Business name: FocusMicro New:
Contact name: Sal Gutierrez NOTICE
Address: 4640 Campus Place Suite # 100 All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
City /State /ZIP: Nlukilteo, WA 98275 under ORS 701 and may be required to be licensed in the
r jurisdiction in which work is being performed. If the
Phone: (425) 293 - 0487 Fax:: (425) 349 - 5202
applicant is exempt from licensing, the following reasons
E - mail: sal.gutierrez @focusmicro_com apply:
CONTRACTOR
Business name: r`v,.4.4 S /11 / vA. i>
Address: c/ (j0 cw�p A � B PERMIT FEES"
z• 5 j /� l�� (Please refer JO fee schedule)
City /State /ZIP: Ai / <1L 7Q Permit fee: 310.05
Phone: ( ) C,5 .. _ S" S Fax: ( ) State surcharge (12% of permit fee): 37.21
CCB lie.: ("7(Q -"7 — � T - 7�2 c CI4fI3r(II /02 /COM /WEB) � ( FLS plan review (40% of permit fee):
124.02
Authorized signature
/1, 1 : I J—t �. ' 2 7 a 4, (Date upon application.)
I BuildingAPermits \FPS- Perin .d 02/01 �. �7
-
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: 0
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes N/A
Information: Hazard Group N/A
Density N/A
Design Area N/A
K. Factor N/A
Sprinkler Project Valuation: $ N/A
B.) Type I - Hood Fire Suppression System
I ood Project Valuation: $ N/A
C.) Fire Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 6841.34
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: N/A sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 6841.34
Permit fee based on project valuation (see fee schedule): $ 310.05
Permit fee based on square footage (see D above): $ 0
State Surcharge (12% of permit fee): $ 37.21
FLS Plan Review (40% of permit fee): $ 124.02
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
Z:A\4ikc \City of Tigard FPS- PcrmitApp - Big 5.doc O2 /0 / 1 1 3