Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 -00138
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/11 /2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Triangle Point Subdivision: VARNS ACRES Lot: 9
Project Description: Fire Alarm for ground floor lobby
Contractor: PARKIN ELECTRIC INC Owner: TRIANGLE POINTE LLC
14001 FIR STREET 901 NE GLISAN ST, #100
OREGON CITY, OR 97045 PORTLAND, OR 97232
PHONE: 503 - 657 -4958 PHONE:
FAX: 503 - 557 -1059
FEES
Description Date Amount
Specifics: Permit Fee - COM 09/11/2012 $102.20
12% State Surcharge - Building 09/11/2012 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 08/15/2012 $40.88
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 09/11/2012 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 5 Misc Administration Fee 09/11/2012 $5.00
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 $162.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,300.00
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 1.800.332.2344. /
Issued By:
Alt n )(,�( Permittee Signature: , 1 1 f f� -Ptic j Dia
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 ZSOEV Zip FOR OFFICE USE ONLY
City of Tigard a9 2 01 Received G 1 , 12- b
¢� Date/B : _ - A Permit No. 47�(J g
111
13125 SW Hall Blvd., Tigard, OR 97223 AU P l a n Rev Mier
Phone: 503.718.2439 Fax: 503.598.1960 R, I R' (.75 Da : ��� In Other Permit Pa p fa .001 a,
TI G A R D Inspection Line: 503.639 � ° iy } p� yN ^�l`� Date Ready /By: 9 --. ® See Page 2 for
Int www.tigard or.gov ��� �� Notified/Method: /Y Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ 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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial/industrial Valuation: $ WO
❑ 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: 13333 SW 68 Parkway New dwelling area: square feet
City /State/ZIP: Tigard Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Triangle Pointe; Ground 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.
Fire Alarm
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Triangle Pointe LLC Type of construction:
Address: 901 NE Glisan Street #100 Occupancy groups:
City /State/ZIP: Portland, OR 97232 Existing:
Phone: ( ) Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON - NOTICE
Business name: Parkin Electric All contractors and subcontractors are required to be
Contact name: Dave Parkin licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 14001 Fir Street jurisdiction in which work is being performed. If the
City / State/ZIP: Oregon City, OR 97045 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 657 -4958 Fax: : (503) 557 -1059
E -mail: dave @parkinelectric.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: Parkin Electric (Please refer to fee schedule)
Permit fee:
Address: 14001 Fir Street
State surcharge (12% of permit fee):
City / State/ZIP: Oregon City, OR 97045
FLS plan review (40% of permit fee):
Phone: (503) 657 -4958 I Fax: (503) 557 -1059 (Due upon application.)
1/CB lic.: 35151 Total permit fees:
Authorized signature: 09 /6 Amount received:
This permit application expires if a permit is not obtained
Print name: David B Parkin Date: 08/08 /2012 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits )FPS- PermitApp.doc Rev 01/05/2012 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:
12 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 0
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Su I pression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 2 0
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
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