Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II
2 COMMUNITY DEVELOPMENT Permit#: FPS2012 -00048
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/30/2012
Parcel: 2S113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 200
Project: Perlo Construction Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Relocating existing strobes and installing (3) strobes.
Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACIFIC REALTY ASSOCIATES LP
15495 SW SEQUOIA PKWY STE 100 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 968 -3353 PHONE: 503 - 624 -6300
FAX: 503 - 968 -3398
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/30/2012 $91.44
12% State Surcharge - Building 03/30/2012 $10.97
Type of Use: COM Plan Review - Fire Life Safety - COM 03/30/2012 $36.58
Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Sm $0.50 (up to 03/30/2012 $3.50
Occupancy Grp: B Height: ft 11x17)
Stories:
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: Cut Sheets Required: Yes
Total $142.49
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,000.00
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. o • okl is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adoptee by the Oregon
Utility ification Ceh -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You ay obt •a cop of the rules
or dire questions to OU .y li 13.232.1987 or 1.800.332.2344.
Issue B y : 1 / � � 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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System -)4C) FOR OFFICE USE ONLY
City of Tigard DateB : y �, Permit No.: PPS, • . __kg ;
° Phone: 503.63 Fax: 503.598.
13125 SW Hall Blvd., Tigard, OR 972 r tQ�
19 Received
lig Plan Review —
C s er Permit:
A
1.
�0 Date/B : a elQ �J „A: /,
TI G A It D Inspection Line: 503.639.4175 ` �P� '� P �� a ate ReadyBy: runs % See 'age 2 for
Internet: www.tigard- or.gov \ G\ `` "..0 Notified/Method.: "may Supplemental Information
TYPE OF WORK
,%t ` o� REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Dem�ion 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 Valuation: $
® Commercial/industrial
❑ Accessory building ❑ Multi - family • Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: .
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16101 SW 72 AVE New dwelling area: square feet
City /State /ZIP: PORTLAND, OREGON 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: 200 Project name: PERLO CONSTRUCTION Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
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
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
INSTALL THREE STROBES / RELOCATE EXISTING AS INDICATED ON Valuation: $52,000.00
DRAWING
Existing building area: square feet
New building area: square feet
•
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PACIFIC REALITY ASSOCIATES Type of construction:
Address: 15350 SW SEQUIOA PARKWAY . Occupancy groups:
City /State /ZIP: PORTLAND, OREGON 97224 Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: STANLEY SECURITY SOLUTIONS All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: GARY TAUSCHER under ORS 701 and may be required to be licensed in the
Address: 15495 SW SEQUOIA PARKWAY jurisdiction in which work is being performed. If the
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
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
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):
Phone: (503) 968 -3355 Fax: (503) 968 -3398 (Due upon application.)
CCB lic.: 161567 Total permit fees: 9
I n Amount received: lib* 1
Authorized signature: ell p L ► C�� YY"`--^^^ „/ This permit application expires if a permit is not obtained
lJ within 180 days after it has been accepted as complete.
Print name: GARY TAUSCHER Date: 03/30/2012 * Fee methodology set by Tri -County Building Industry
Service Board.
I: \ Building \Permits\FPS- PermitApp.doc 03/23/06 440.4613T(II /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: $ 600
D.) Residential Sprinkler (Stand Alone System)
• Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
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.
"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 \FPS- PemvtAAp PACTRUST 16101 SW 72 PERLO.doc