Permit v CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• s - COMMUNITY DEVELOPMENT Permit #: FPS2012 -00155
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/15/2012
Parcel: 2S102DA00200
Jurisdiction: Tigard
Site address: 8720 SW BURNHAM ST
Project: City of Tigard - Niche Subdivision: BARNUM PARK Lot: 9
Project Description: Installation of new aerosol(AeroK) system in the existing server room.
Contractor: SIMPLEXGRINNELL LP Owner: TIGARD, CITY OF
6305 SW ROSEWOOD ST. 13125 SW HALL BLVD
LAKE OSWEGO, OR 97035 TIGARD, OR 97223
PHONE: 503 - 683 -9000 PHONE:
FAX: 503 - 675 -6521
FEES
Description Date Amount
Specifics: Permit Fee - COM 10/15/2012 $166.76
12% State Surcharge - Building 10/15/2012 $20.01
Type of Use: COM Plan Review - Fire Life Safety - COM 10/04/2012 $66.70
Class of Work: ALT Type of Const: VB Info Process /Archiving - Lg $2.00 (over 10/15/2012 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 10/15/2012 $10.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Dry
Standpipe Required: Hazard: LT
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type: Automatic
Pull Station Required: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $269.47
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $8,993.45
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: JAI))
jL Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available insp tion ate.
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
CI of Tigard OCT O t� DateiByd / .- en a —� /
11 `J g 2012 Date /By: l� y / Permit No.: i�� Or
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Reviews ( _�, /
Phone: 503.718.2439 Fax: 503.5�81JYOF AR Date/By: ; � �0` (2.... Other Permit: � �O�a `t
Inspection Line: 503.639.4175 �1 1W Date Ready /By: Juris: ® See Page 2 for
TIGARD p BUILDINGDIVISION Not' ed/Method: Ail/5 Oil Supplemental Information
Internet: www.tigard- or.gov � �� ��
TYPE OF WORK / E P f R 4 4 A P 2- FAMILY I WELLING
❑ 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: $
1=1 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: 3 SW "-" Q lvd 17 . `at.0 New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Server Rm Aerosol System 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Installation of new aerosol (AeroK) system in the existing Server Room. / 164 Valuation: $$8,993.45 .
�'/ Existing building area: 136 square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: City of Tigard Oregon / (Contact - Louis Sears) Type of construction:
Address: 13125 SW Hall Blvd Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: (503)639 -4171 Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: SimplexGrinnell All contractors and subcontractors are required to be
Contact name: Jeff Wimvard licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6305 SW Rosewood Street, Suite A jurisdiction in which work is being performed. If the
City /State /ZIP: Lake Oswego, OR 97035 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 683 -9000 Fax: : (503) 675 -6521
E -mail: jwinward @simplexgrinnell.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: SimplexGrinnell
Permit fee: 156.0
Address: 6305 SW Rosewood Street, Suite A
State surcharge (12% of permit fee): .72
City /State/ZIP: Lake Oswego, OR 97035 0
• FLS plan review (40% of permit fee): 62.40
Phone: (503) 683 -9000 Fax: (503) 675 -6521 (Due upon application.)
CCB lie.: 149921 • Total permit fees: / 237.12
Authorized signature: Amount received: 41 ?(�
This permit application expires if a permit is not obtained
Print name: // Date: 10 -04 -12 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.doc Rev 01 /05/2012 440- 4613T(I I /02/COM/WEB)