Permit c, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
71 : - . COMMUNITY DEVELOPMENT Permit #: FPS2012 00003
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/10/2012
TIGARD Parcel: 2S102AA04201
Jurisdiction: Tigard
Site address: 8955 SW COMMERCIAL ST
Project: Essential Planning Group Subdivision: TIGARD HIGHWAY TRACTS Lot: 2
Project Description: Fire alarm for TI.
Contractor: T & L COMMUNICATIONS INC Owner: BUTTERFIELD, CHARLES W JR &
PO BOX 87387 MICHELLE S
VANCOUVER, WA 98687 -7387 825 SW VIEWCREST DR
DUNDEE, OR 97115
PHONE: 360- 737 -9725 PHONE:
FAX: 360- 737 -9648
FEES
Description Date Amount
Specifics: Permit Fee - COM 01/06/2012 $123.72
12% State Surcharge - Building 01/06/2012 $14.85
Type of Use: COM Plan Review - Fire Life Safety - COM 01/06/2012 $49.49
Class of Work: ALT Type of Const: VB Info Process /Archiving - Sm $0.50 (up to 01/06/2012 $9.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2
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: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $197.06
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,000.00
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 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 questions to OUNC by calling 503.232.1987 or 1.800.3 44.
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Issued By: - ' ttee Signature:
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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 OFFICE USE ONLY
City of Tigard
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ue
Dateived 1 Permit No.: r � J a v ' v 3
n
13125 SW Hall Blvd., Tigard, OR tigcre\\A Pl an Rev• 7V if∎ - 1- Phone: 503.718.2439 Fax: 5 DateB : :t�� M in Other Permit: L // i // J li , t'
TIGARD Inspection Line: 503.639.4175 � Q11- Date Ready :y: , 9 A l i ra ions: rA See Page 2 for
Internet. www.tigard- or.gov O 6 Notified/Method: 7" Supplemental Information
V TYPEiOF,eWO RE "UiRED °DATA ";'kl AND "2 A WELLING
❑ New construction n Permit fees* are based on the value of the work performed.
t \\ Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration/replacement 1 Other: equipment, materials, labor, overhead, and the profit for the
'4' '"''''''7'''''''''''4i 1 2 ; :.. Sill fi TO , r � = ,;,./ ; a � ,,. work indicated on this application.
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„ ��'> z ., `x ,.S ,�y/i =4< "" ... - %,;„ ffi.�11'Pre � Viz:. :".; ', „;;�.r�..v:'t'�• ,. .. ..., °at,,, °. ,,,::�A, ,;
dwelling Valuation: $
❑ 1- and 2-family g ® Commercial /industrial
❑ Accessory building CI Multi-family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JQB'SITENIN .M IsOCATI,ON :.-. ' " ? , Total number of floors:
�,.,,,,, , J,,.,,,,,. rat. N,,o.. �t s 4,x'1,
Job site address: 8955 SW Commercial Street New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Essential Planning Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Ott- .. , :.,,,, ,. .
V _
y R Q IRED'DATA" C OMMERcIAL-U S E CHECKLIST
, ..WS 0:/N: ,, AIM.
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
- a;''; r overhead, and the profit materials, labor, overhe d an e ofit for the
r
;° -.� / x, rr, - " % %%'-' Pxi %' \ ', %-" work indicated on this lication.
- 4 y; ,,,. �,, DESCRIPTION OF WORK . ,; «' " app eat" .,, .. .,,3i'; s�i£ "�a's v , ia3b�$R;i'i,.. a�.N.,YE'' � ,,, ��y;• ,i „ :
Fire Alarm Tenant Improvement Valuation: $)
Existing building area �/ square feet
New building area: square feet
O PRPEORTY OWNER'`"�s% . '';',6' ',a y ; . y TENANT Number of stories:
�m i , oT/„Y6'Ti,,,.,,,. _«.. ❑�,. < ,;.,.. f
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
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,!,:;37 : ° APPLICANT :' " - %` °` " PERSO > ° „' °i'
Business name: T &L Communications, Inc All contractors and subcontractors are required to be
Contact name: Larry Bushaw licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be (Lensed in the
Address: PO Box 87387 jurisdiction in which work is being performed. If the
City /State /ZIP: Vancouver, WA 98687 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 737 -9725 Fax: : (360) 737 -9648
E -mail: office @tl- communications.com
:^ :; CONTRACTOR': 1�
?�^I >. �: `' <���t,' �r. >;. ��.BUIL:DING'PERIVIIT�FEES � .
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Business name: T &L Communications, Inc `' ,- ' - :.; (Plea refer tof e ) /. 't'. <Y' ;.
Permit fee:
Address: PO Box 87387
City /State /ZIP: Vancouver, WA 98687 State surcharge (12% of permit fee):
FLS plan review (40% ofpermit fee):
Phone: (360) 737 - 9725 Fax: (360) 737 - 9648 (Due upon application.)
CCB lie.: 67787 Total permit fees: / 7 7 6
Authorized signature: Amount received: -
J�— _ „ This permit application expires if a permit is not obtained
Print name: �. kt -, l (` r i< - `, -
Date: � `a • within 180 days after it has been accepted as complete.
0 `p ` * Fee methodolo' set by Tri- County Building Industry
Service Board.
I :\ Building \Permits\FPS- PermstApp.doc Rev 01 /05/2012 440- 4613T(1 I /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
. ... :A Az. ..
Describe work to b e d one . , —AAA , �� �'` , . � .��a�.
.,r,,,, ............. .: - ' 's,,,E`� -..: 2� �� a ,w, r �.,,, '- 3'.u¢�:i:/�! '�>R' � ,�� �� VA AT,,
i
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition El 1 -1 0 heads: No plan review required.
® Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type; of Systeme:(Complete A B h:C:,or ID „as: apphe'alle):,,
:. .
� � ..� . ,
A...Commercial S rinkler�.., .. ,
P
,. :, " = ,. ”. `;w. .. >s;,, .. .�, ? rte .. ���'
❑ Wet ❑ Dry
Additional _ Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
- Y41
Hood Project Valuation: $
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av 116 v4,
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Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 5000.00
"'lEN1E� %ji,. �� � d; ` ,',� ; %(rg "'�;:\ ;; 51 �:1/ ,;'��- ' %�. ^�E .. `;�c�fv 1y� • 3, ,
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tllo e em`
: D: Res derifa s
Square Footage: Permit Fee: 1,, ';
0 to 2,000 $198.75 =, ;E\;,.
2,001 to 3,600 $246.45'; -- AIT4Ari
3,601 to 7,200 $310.05 "` <` m_
7,201 and greater $404.39 -r< j l
Sprinkler Project Square Footage: sq. ft.
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
http : / /www.tigard- or.gov /city_hall/ departments /cd /dots /PPS- PermitApp.doc Rev 01x5 /2012