Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 00120
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/10/2012
Parcel: 1S135ACO2500
Jurisdiction: Tigard
Site address: 9160 SW MANDAMUS CT
Project: Longstaff Apartments Subdivision: ASHBROOK FARM Lot: 25
Project Description: Building 8 fire alarm
Contractor: WESTERN STATES FIRE PROTECTION Owner: J.T. SMITH CO
13896 FIR ST STE B 5285 MEADOWS RD SUITE 171
OREGON CITY, OR 97045 LAKE OSWEGO, OR 97035
PHONE: 503 - 657 -5155 PHONE: 503 - 975 -7639
FAX: 503 - 657 -5182
FEES
Description Date Amount
Specifics: Permit Fee - MF 09/10/2012 $134.48
12% State Surcharge - Building 09/10/2012 $16.14
Type of Use: MF Plan Review - Fire Life Safety - MF 07/31/2012 $53.79
Class of Work: FPS Type of Const: VB Info Process /Archiving - Lg $2.00 (over 09/10/2012 $6.00
Occupancy Grp: R -2 Height: ft 11x17)
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 09/10/2012 $14.00
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: No Alarm Type: Automatic
Pull Station Required: No Smoke Detectors Req: Yes
Battery Calcs Provided: No Cut Sheets Required: Yes
Total $224.41
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,000.00
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 • ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Ce -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or • irect questions to OU . • ca ing 503.232.1987 or 1.800.332.2344.
I= : ued By: . / • Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspe 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 p � a FOR OFFICE USE ONLY
} Y
Cl of Tigard ri e Received (!'�— Permit No..
City g fl . Plate/BV: 7 31//x-
q /5 -4� /a 0
13125 SW Hall Blvd., Tigard, OR 97 Plan Revie .X
0 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ICJ ( Other Permi��� _ �� 'f
Z I G A R D Inspection Line: 503.639 J U L 3 2 2 Date Ready/By: lad ' ® See Page 2 for
Internet: www.tigard- or.gov o� *d/Method. 9 9 / 1 Supplemental Information
TYPE OF 4 'BK'.:,E, y: / REQUIRED DATA: 1- AND 2- FAMILY DWELLING
construction 12 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
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling �mmercial/industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9./6 Q rv ,... v ,,S T 916 4 7 >7y � 9', 71 - New dwelling area: square feet
City/State /ZIP: 1 1 {) CD Q-... G 1 / ']22_3 l'fo?, // Garage /carport area: square feet
Suite/bldg. /apt. no.: ? Project name: 4 a_ 1€ - kµ ,L Covered porch area square feet
Cross street/directions to job site: C Deck area: square feet
4 M TS 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 (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
c1Q,E ll- 1xn-w\ � ��EN. 1u5-N-4u.4-Tw* Valuation: $ ()OCR
Existing bui ding area square feet
4 0 New building area: square feet
M ❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
1 Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
I CkIriPPLICANT CONTACT PERSON NOTICE
r Business name: s 4 >' I i S cv2ic e(�.��T\0 W . All contractors and subcontractors are required to be
V� licensed with the Oregon Construction Contractors Board
Contact name:
"'c rNo c.�T \ ■ om _ under ORS 701 and may be required to be Ieensed in the
4
Address: `S jam( Li. F v S S w-k.11 3 jurisdiction in which work is being performed. If the
City/State /ZIP: Q t2-s2 (. p applicant is exempt from licensing, the following reasons
apply:
Phone: �'"a`�j) ( ') - S\S�� Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: S AS �� . „I,— (Pfearere %rwleeschedule)
Permit fee:
Address:
State surcharge (12% of permit fee):
City/State /ZIP: FLS plan review (40 %ofpermit fee): 53+ 79
Phone: (5 CCa' - S k•SS Fax: ( ) (Due upon application.)
CCB lic.: \o'kS') c , Total permit fees:
Amount received:
Authorized signature: ■ . .�
` � This permit application expires if a permit is not obtained
Print name t.vr \N vlko ��-T \ ern__ Date:^-I 3 1 2_ C \--1-- within 180 days after it has been accepted as complete.
• Fee methodology set by Tri -County Building Industry
Service Board.
1:\ Building \Permits'FPS•PermitApp.doe Rev 01 /05/2012 440- 4613T(t1 /02/COM/WEB)