Permit 1 14 ' CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
®.. COMMUNITY DEVELOPMENT Permit #: FPS2012 -00062
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/20/2012
Parcel: 25101 AB00100
Jurisdiction: Tigard
Site address: 12023 SW 70TH AVE
Project: Red Rock Center, Phase II Subdivision: Lot: 0
Project Description: Sprinkler monitoring system.
Contractor: T & L COMMUNICATIONS INC Owner: FRY, DOUGLAS
PO BOX 87387 23077 SW NEWLAND RD
VANCOUVER, WA 98687 -7387 WILSONVILLE, OR 97070
PHONE: 360 - 737 -9725 PHONE:
FAX: 360 - 737 -9648
FEES
Description Date Amount
Specifics: Permit Fee - COM 04/19/2012 $72.61
12% State Surcharge - Building 04 /19/2012 $8.71
Type of Use: COM Plan Review - Fire Life Safety - COM 04/19/2012 $29.04
Class of Work: ALT Type of Const: VB Info Process /Archiving - Sm $0.50 (up to 04/19/2012 $5.50
Occupancy Grp: B Height: ft 11x17)
Stories: 2
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $115.86
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,250.00
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 -00 . may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1......; - .2344. C
Issued By Permittee Signature:
Cal . 75 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.
Fire Protection System � ►, t ; . ,�: y ," ; /,` o�_, .: ,,;;.
Building Permit Application � FOR OFFICE USE ONLY
City of Tigard C � \�
Date/B , q r" Permit No.: 5A) �aZ — (
I
• 13125 SW Hall Blvd., Tigard, OR 972 1 0, �. Plan R - • .. 1 � ' �� �f lJ�
1 • her Permit: I
e Phone: 503.639.4171 Fax: 503.598.1960 p AA� Date/B : A `1 fv /� f J•1, i [i �� ( 7
T I G A R D Inspection Line: 503.639 p. O � �Gr l OY Date R e : y: ® See • age 2 for
Internet: www.tigard- or.gov l5 Notifie 11 ��
TYPE OF WO � � S Information
� � W . ` G � , W t tr REQUIRED DATA: AND 2- FAMILY DELLING
❑ New construction ❑ Do ition 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 El Commercial/industrial
Valuation: $
m
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
B INFORMATION FORMATION AND LOCATION Total number of floors:
Job site address: 70th Avenue New dwelling area: square feet
City / State/ZIP: Tigard, OR Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: Red Rock Center 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: I 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, a_ nd the pro fit for the
DESCRIPTION OF WORK work indicated on this application.
sprinkler monitoring system
Valuation: . $ 5 "
Existing building area: : f square feet
New building area: square feet
... _ ...... _ " .
❑ PROPERTY OWNER
0 TENANT Number of stories: "
Name: Type of construction:
Address: Occupancy groups:
City /State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: T &L Communications, Inc. All contractors and subcontractors are required to be
Contact name: Ross Bushaw licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed 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 I Fax: : ( 360) 737 - 9648
E - mail: office @tl communications.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: T &L Communications, Inc.
Permit fee:
Address: PO Box 87387
State surchargee pr-7,
City / State/ZIP: Vancouver, WA 98687 FLS plan review (40% of permit fee):
Phone: ( 360) 737 - 9725 Fax: ( 360) 737 - 9648 (Due upon application.)
CCB lic.: 67787, Portland Metro 6981 Total permit fees: � ,
R - n ) Amount received: }/15 , -
Authorized signature:
4M✓� I*t�1 . This permit application expires if a permit is not obtained
Print name: Larry Bushaw CU! Date: 4/19/2012 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I:\Buildingwermits \FPS- PermitApp.doc 0323/06 440- 4613T(11/07JCOM/WEB)