Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
S COMMUNITY DEVELOPMENT Permit#: FPS2013-00016
T[G AR D 13125 SW Hall Blvd,Tigard OR 97223 503 718.2439 Date Issued: 01/23/2013
Parcel: 25101 DB00103
Jurisdiction: Tigard
Site address: 7360 SW HUNZIKER RD 103
Project: Platinum Lending Subdivision:CONDO SUPPLEMENTAL PLAT NO.4 Lot: 22830-2
Project Description: Add(2)smoke detectors and(3)horn/strobe
Contractor: AMERICAN SECURITY ALARMS, INC. Owner: ROBINSON FAMILY TRUST
5411 SE MCLOUGHLIN BLVD 21360 NW AMBERWOOD DR
PORTLAND, OR 97202 HILLSBORO, OR 97124
PHONE 503-231-0303 PHONE 503-645-8531
FAX. 503-230-1044
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/23/2013 $64 54
12%State Surcharge-Building 01/23/2013 $7 74
Type of Use: COM Plan Review-Fire Life Safety-COM 01/23/2013 $25 82
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 01/23/2013 $2 00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 01/23/2013 $4 50
11x17)
Commercial Sprinkler System:
Sprinkler Required No Sprinkler Type
Standpipe Required: Hazard:
Density 0 Design Area 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type.
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided Cut Sheets Required.
Total $104 60 ■
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $925.00
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 `' n Q/ f /� ,7 ` `
Issued By: Permittee Signature: O)J. ,1-°L 6 --[ ok(_
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 RECEIVE
y
Fire
Protection System FOR OFFICE USE ONLY
City of Tigard JAN 2 3 2013 Date t:e� ( • .�) Permit No. ),o/3-vQ o 1,6
■ 13125 SW Hall Blvd.,Tigard,OR 97223 /��� Plan Revi , :I
t V �aQn �.`� Other Permit:
Phone:SW 503.718.2439 Blvd. Fax: 503.598 97223 p�' {��/� nt 14J DateB : • /
11 G A R D Inspection Line: 503.639.4175 BUILDING DIVISIO Date Ready: : hula 65® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: `"1 (0 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 CONSTR CTION work indicated on this application.
❑ 1-and 2-family dwelling ommercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
Ill Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 73 W- 511/ /4'.J Z/tS-c „ Nev dwelling area: square feet
City/State/ZIP: ' 7/6, zo 0( Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: /4/ 1,..2.I p 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.
Indicate the value(rounded to the nearest dollar)of all `
Tax map/pancel no.: equipment,materials,labor,overhead,and the profit for the
,,
IIMIIIIIIMEESCRIPTION TION OF work indicated on this application.
ADD ea ♦ ..Ii lk. 7_ .i-
_ J- of . Valuation: . $ � .
jExisting building area: square feet
,'r ^y e:44,41-1 New building area: square feet
❑ PROPERTY. ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: _
Phone:( ) Fax:( ,,) New:
APPLICANT I!1 CONTACT PERSON NOTICE
Business name: /b1-7/d/44-y� Lt C-1. All contractors and subcontractors are required to be
Contact name: /A-4 /4'/./4€, licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: j'// S C Cp'1.1,..,It/, , Sidi jurisdiction in which work is being performed.If the
City/State/ZIP: Po If lew+.-/
9 774 1- applicant is exempt from licensing,the following reasons
apply:
Phone:($1)) 7 o& A f Fax::( ) 230 I to W
E-mail: S-evrft ( AS 1:4,te",'/k'!, t e0r1'1
• CONTRACTOR BUILDING PERMIT FEES*
Business name: My�;,.I/41-1..,, ,,)C_/ c f p:-,,ti (Please refer to fee schedule
Address: 52,//! Q fl C f
4-01-Y l rt ,$Ad. - Permit fee:
City/State/ZIP: ,q,),yeif-i / 04- 9724 2, State surcharge(12%of permit fee):
Phone:(e,�) 7o4 • ,/(�,Or Fax:(,SU 2-30. /p FLS plan review(Due u%of permit ion.)
(Due upon application.)
CCB lic.: O (,'.it 0 Total permit fees:
Authorized si attmre: fe Amount received:
This permit application expires if a permit is not obtained
Print name: , (, //IttL /I Date: J` 24 , /3 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(I1/02/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: $
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): $ 925, 0
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.
http://www.ngard-or.gov/aty_hall/departments/cd/docs/FPS-Perms Wpp doc Rev 01/25/2012
1114 " Building Division
Over-The-Counter (OTC) Building Permit
TIGARD
DCheck List
Project Description: f/ - 1 3 -
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: kt-T- Occupancy Group: 173 Type of Construction:
*Type of Use: C-05ILk Occupancy Load: Oregon Specialty Code: 2c (Z"j
SPECIFICS
Number of Stories: `L Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: _ Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback-Left Sideyard Setback-Front
Sideyard Setback-Right Sideyard Setback-Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access.Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 6i 2--""D , Co FEES DUE
$ DC Prov Rvw,COM TI-Ping
$ DC Prov Rvw,COM TI-LRP
DC Provision Review Fee for COM TI $ Permit Fee-Add,Alt,Demo
Project Valuation Planning LRP $ 7,- 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ Plan Review,Structural
$5,000-$74,999 $67.00 $10.00 $ Plan Review,Fire Life Safety
$75,000-$149,999 $167.00 $25.00 $ 2;C '3 Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $268.00 $39.00 $ 4 : Info Proc/Arch,Sm(up to 11x17$0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc.Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date/Time: $ 1(4.;C TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM=commercial;CMS=commercial manufactured structure.
CLASS OF WORK ACS=accessory;ADD=addition;ALT=alteration;FND=foundation;DEM=demo;
FND=foundation;FPS=fire protection system;NEW=new;OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies);
REP=repair.
I:\Building\Forms\OTC-BUP.docx 07/01/2012