Permit 11 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 COMMUNITY DEVELOPMENT Permit #: FPS2011 -00156
13 125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2011
TI G'AR Parcel: 2S112DC00100
Jurisdiction: Tigard
Site address: 15605 SW 72ND AVE
Project: Consumer Cellular Subdivision: HERN PACIFIC TIGARD INDUSTRIAL Lot: 1 -2
Project Description: Fire alarm
Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACTRUST
15495 SW SEQUOIA PKWY STE 100 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 PORTLAND, OR 97224
PHONE: 503 - 968 -3353 PHONE: 503 - 624 -6300
FAX: 503 - 968 -3398
FEES
Description Date Amount
Specifics: Permit Fee - COM 12/22/2011 $123.72
12% State Surcharge - Building 12/22/2011 $14.85
Type of Use: COM Plan Review - Fire Life Safety - COM 12/22/2011 $49.49
Class of Work: ALT Type of Const: Info Process /Archiving - Lg $2.00 (over 12/22/2011 $2.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process /Archiving - Sm $0.50 (up to 12/22/2011 $3.50
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 $193.56
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
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 Notificatio• -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. Y. may obtain a copy of the rules
or direct .. -stions to OU N , by ca • - 1 503.232.1987 or 1.800.332.2344.
Issue By: ' / / Permittee Signature:
A I /J4. w4 4,4 __
Call 503.639.4175 by 7:00 a.m. for the next available inspection
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 Applic
Fire Protection System FOR OFFICE USE ONLY' -
DEC 22 2011 s �o�� � 5�
City of Tigard Received a /2 .2 2-/// k ,i PennitNo..
V 13125 SW Hall Blvd., Tigard, • i P lan Review P •
Phone: 503.639.4171 Fax: 51. TIGA iD rr i Other Permit: �L( aQ // - OOoS[�'
Date/By: ,
T IGARD Inspection Line:" 503 . 639 . 411 BUILDING DIVISION Date Rea,„ At.: Juris: 0 See Page 2 for
Internet: www. tigard- or.gov Notified/Method: Supplemental Information
' ^�'r° - - x ; ., . - -. • _ N , 3.,:_ .t� r',:e., .. a, <. ;o; lit- ^: i� :: s ,.� - - t ..' e :. ,e a �.. .q
° }, " ,,:4., n l + e, g - T,STE :OF W ORK " ' ': ` A q i = ; .. a . ? ,' : - SQUI D 1 `AND 2 TAMIL DW EL`L1NG
�ovs,s 4 .. fAd Ess K �A• -A _ A X >c:AAA .A sw.T a g .+, -`^ AAAN', A- r �2 S? .,. � _ o ,.a AKA, 4:7i6 . . i :3,1 . ra.f2y 7., , a LS O +Ba , ; -0 :• Yrea .•rY.9K"=: ° .1
❑ New construction ❑ 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
, RGATE%» GOR% f rOF °CONSTRUCr` r o work indicated on this application.
T[ON � ,� "° °
El 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder CI Other: Number of bathrooms:
i °'fix _i si ., , rsl ' ,� n , t .
.& JOB SITE °INFORMATION�AN ��,� Total number of floors:
Job site address: 15605 SW 72 AVE New dwelling area: square feet
City /State /ZIP: PORTLAND, OREGON 97224 Garage /carport area: square feet •
Suite/bldg. /apt. no.: Project name: CONSUMER CELLULAR Covered porch area: square feet
Cross street/directions to job site: OREGON BUSINESS PARK III Deck area: square feet
Other structure area: square feet
R .QUIR % ED e ATA4=COMM.0 Cs'- ,U C , IIECKLI TA
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
�� $ °t equipment, materials, labor, overhead, and the profit for the
� , DES OW ,. � g A c work indicated on this application. •
REMOVE AND INSTALL REPLACEMENT AFA PANEL AND EQUIPMENT. Valuation: $4400
INSTALL SMOKE DETECTORS • '
FOR ELEVATOR CONTROL. INSTALL STROBES AND HORN /STROBES PER Existing building area: square feet
DRAWING New building area: square feet
Number of stories:
® PROPERTY * OWNER ;- e ' ®TENAN I• t, f n
x eC, t ,t,...,. 4. , ".ra . . .i0 , „ - . a, 4 « , ..+�e d' h . _,. ., ..-. w, .0, 5 ' , 4 ° Z ,, ,`- _ . Type of construction:
Name: PACIFIC REALITY ASSOCIATES
Occupancy groups:
Address: 15350 SW SEQUIOA PARKWAY
City /State /ZIP: PORTLAND, OREGON 97224 Existing:
Phone: ( ) Fax:( ) New:
•rtea Car °<
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' ®AP PLIC ANT' °:i .,, ':. 4 ®Eke Tf e � 4.' r i � �r n om'+ .. ''1 ”y4^� s" " ' � <,-,
� ` °` wf .4:= ., ma ` ' `` r ` " " :" "° ", A ,-- �`� •" � ` :1 All contractors and subcontractors are required to be
Business name: STANLEY SECURITY SOLUTIONS licensed with the Oregon Construction Contractors Board
Contact name: GARY TAUSCHER under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed. If the
Address: 15495 SW SEQUOIA PARKWAY applicant is exempt from licensing, the following reasons
City /State /ZIP: PORTLAND, OREGON 97224 apply:
Phone: (503) 968 -3355 Fax: : (503) 968 -3398
E-mail: GTAUSCHER @STANLEYWORKS.COM
° �; M "� - 7 °4BU1LI)ING PERMITtFEES :
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- C O NT R A C TOR ' " "° st " J J . ; x • '� .
e s _. -� ' > 4 _ s k ua n b a Ptease:r er to eeseHe r •
Business name: STANLEY SECURITY SOLUTIONS Permit fee:
Address: 15495 SW SEQUOIA PARKWAY State surcharge (12% of permit fee):
City /State /ZIP: PORTLAND, OREGON 97224 FLS plan review (40% of permit fee):
(Due upon application.)
Phone: (503) 968 -3355 Fax: (503) 968 -3398
Total permit fees:
CCB lie.: 161567
Amount received:
Authorized signature: `, , L \� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: GARY TAUSCHER Date: 12/20/2011 * Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building \Permits \FPS- PermitApp doc 03/23/06 440- 46t3T(11/02 /COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe woretox '' q .,,
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
® Alteration El 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: _
Additional description of work:
n '�"�"�5'�'t � 3` kv �"" K� � '"`^ n�"�i � � � x � w r � � " � 4 fir' F:
Type of Syst (Comple40640 C �or aM applicable) µ % Y � .
A ):m Commercial Sprtnkler , .
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area •
K. Factor
Sprinkler Project Valuation: $
1:03074e I Eta4,ire $oppress `o i18T art t R : 41; , S gt
aY +�... .'+. _ i;... -rte-.: � � z M kt + ..r " rz�R ,� �bx��` � �`��
Hood Project Valuation: $
R
iet Fire Alarm :� E V
5 e ' 4
. . � W li p . �. , w,R
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 4200
t la44: � ha �c t ��. ,; f „��
, oo ^,i �, 4
®)> l�esidential�Spr nkle Alone yste � ') ? V ▪ z
e b , -,� . rSa r
Square Footage: Permit Fee: ` : N
0 to 2,000 $187.50
Z001 to 3,600 $232.50 ▪ _ r .
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
� A e • A- - a:44k ire Prot P'eriri E ee o , Nt* °. _ �ss
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.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
C: \Documents and Settings \gmt1026 \My Documents \Fire Tests \Permits \PPS- PermitAA,p PACTRUST CONSUMER CELL 15605 SW 72ND .doc
Building Division
Over- The - Counter (OTC) Building Permit
TtcAtiD Check List
Project Description: k
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: ( T Occupancy Group: Type of Construction:
*Type of Use: Occupancy Load: Oregon Specialty Code:
SPECIFICS
Number of Stories: 7i Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: � Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ -4- FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ 141 ,7•j Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 1797 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $F Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ `Z ;CX . Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ `5, Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ � � iZ TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; END = foundation; DEM = demo;
END = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \Building \Forms \OTC - BUP.docx 01/13/2011