Permit 111 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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": COMMUNITY DEVELOPMENT Permit #: FPS2011 00127
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439
Date Issued: 10/18/2011
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 350
Project: Plaza West Subdivision: ASHBROOK FARM Lot: PTS 5 &
Project Description: Add (2) strobes and (1) horn /strobe to existing circuit.
Contractor: FIRE SYSTEMS WEST INC Owner: SUN LIFE ASSURANCE CO OF CANADA
600 SE MARITIME AVE #300 BY NORRIS BEGGS & SIMPSON
VANCOUVER, WA 98661 121 SW MORRISON ST #200
PORTLAND, OR 97204
PHONE: 360- 693 -9906 PHONE: 503 - 352 -8113
FAX: 503 - 289 -2208
FEES
Description Date Amount I
Specifics: Permit Fee - COM 10/18/2011 $77 99
12% State Surcharge - Building 10/18/2011 $9 36
Type of Use: COM Plan Review - Fire Life Safety - COM 10/18/2011 $31 20
Class of Work: ALT Type of Const: Info Process /Archiving - Lg Sheet (over 10/18/2011 $2.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process /Archiving - Sm Sheet (up to 10/18/2011 $3 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 Alarm Type:
Pull Station Required Smoke Detectors Req
Battery Calcs Provided. Cut Sheets Required:
Total $123.55
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation $0 00
Residential Square Footage 0
Fire Alarm Valuation. $1,500.00
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 adopted by the Oregon
Utility Notification Center. 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 que . s to • i • C • -, (line 503 232.1987 or 1 800 332.2344.
Issued B : 4.s, Permittee Signat 411111111W40
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 ' :',, .:..,', .•,::. ; ' .',.: FOR oFFIaE USE. ONLY
City of Tigard
q 13125 SW Hall Blvd., Tigard, OR 97223 e,
Prill c■,\4,)4C)1
",.: ' Phone: 503 718.2439 Fax 503.598 Cr) %*\ Received , , ,,,, re, Permit No :
. . ,
Date/B . IV / 6 A fiZ ' ) Aw..019 a
Plan Review -,,,,, i ,
Date/B AMOK& Other Permit
639.4175 Date Ready/ : ,
'TIGARD
Inspection Line 503 639. - him gi See Page 2 for
%
Internet. www.tigard-or.gov \„435 Non tied/Method. 7-0• i , Supplemental Information
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4.3= 1tr4,,ei.45v,,:i, e.. -,,, Itki.9- ',.
0 New construction 0 Di6 .1, Permit fees* are based on the value of the work performed
■\‘t. ' Indicate the value (rounded to the nearest dollar) of all
El Addition/alteration/replacement D Oft equipment, materials, labor, overhead, and the profit for the
,,,6 v igr. : ivoj work indicated on this application.
,••• .•WW ' % . , :,.W1=4.4%',,f,- 7 ..., ; ; ,- M''
0 I- and 2-family dwelling El Commercial/industrial Valuation: $
Number of bedrooms
D Accessory building iii Multi-family
0 Master builder 0 Other. Number of bathrooms.
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JOB T NFpRMATIQND LOCATION Total number of floors:
k?/gg `SI :, , ,, , - -, ---,
Job site address: 9600 SW Oak St New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg/apt. no.: 350 Project name: Plaza West Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
0 §);-: ,"
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
. :":"''.1 work indicated on this application.
Add 2 strobes and 1 horn/strobe to existing circuit Valuation: $$1,500.00
Existing building area: square feet
New building area: square feet
,' iif,rifirdnir,w gt:::wkwv;;:iiiicio,erig,****:; Number of stories: .5-9
Name: Type of construction o iA
Address: Occupancy groups:
' Th
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New
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Business name 1_ La S5..Ve vi All contractors and subcontractors are required to be
Contact name: PA og
licensed with the Oregon Construction Contractors Board
-- R , (AL. Cr
under ORS 701 and may be required to be licensed in the
Address tea) SE tiV■Avi 1 * jurisdiction in which work is being performed. If the
City/State/ZIP: Ucouq applicant is exempt from licensing, the following reasons
p em. OA . 481042 I apply:
Phone: ( 3(0) to i 3 ql o to Fax• : ( )
E-mail: Ill 1 04 e .f lag sti 4e Wes+, eini4 •
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'-vmg'kg:F•,w'-rrW.:'kile fee schedu/4kfgft
Business name: Fire Systems West
Permit fee:
Address: 600 SE Maritime Ave #300
State surcharge (12% of permit fee):
City/State/ZIP: Vancouver, WA 98661
FLS plan review (40% of permit fee):
Phone: (360) 693-9906 Fax: (360) 289-2208 (Due upon application.)
CCB lic : OR 49739 ) _, Total permit fees:
Amount received f/g 5 .5
Authorized signature:' 4/1,
/ i I i Date 10/18/2011 This permit application expires if a permit is not obtained
Print name: Rick Pagel
/ within 180 days after it has been accepted as complete.
* Fee methodology set by Tn-County Building Industry
Service Board.
i )13611dIng \ Permits \ FPS-PermitApp doe 02/01/1 I 440.461 3T(1 I /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Descxi6'e`:work.,ta :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:
T e'. °o`f S, stem' Com "lete "B %C :or D a a` "li'cable
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❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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Hood Project Valuation: $
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Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1500.00
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Square Footage: Permit Fee: ` ? -,%
0 to 2,000 $198.75
2,001 to 3,600 $246.45 ° °_ °;;•.,
3,601 to 7,200 $310.05 N; , ,• ee , <, ,
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
' �a:�= > .� ;.F><re:Protect><an> e z >: � : . -> ,- :
Y. ,. �, .. . . ... .. . .,,.,, ,,�,,, .,....� Perm , <, , •
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.
http / /www tigard- or.gov /city_ hall /departments /cd /does /PPS- PcrmitApp doc 02/01/21