Permit p CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
° COMMUNITY DEVELOPMENT Permit #: FPS2013 -00014
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/23/2013
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 300
Project: Eagle Home Mortgage Subdivision: VARNS ACRES Lot: 3
Project Description: Relocate (1) smoke detector and (1) horn strobe
Contractor: AMERICAN SECURITY ALARMS, INC. Owner: HILLTOP BUSINESS CENTER LLC
5411 SE MCLOUGHLIN BLVD HUNZIKER LLC
PORTLAND, OR 97202 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 231 -0303 PHONE:
FAX: 503 - 230 -1044
FEES
Description Date Amount
Specifics: Permit Fee - COM 01/23/2013 $51.09
12% State Surcharge - Building 01/23/2013 $6.13
Type of Use: COM Plan Review - Fire Life Safety - COM 01/23/2013 $20.44
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 01/23/2013 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 3 Info Process /Archiving - Sm $0.50 (up to 01/23/2013 $3.50
11x17)
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: Yes Alarm Type:
• Pull Station Required: Smoke Detectors Req:
... Battery Calcs Provided: Cut Sheets Required:
•
Total $83.16
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation:
Residential Square Footage: 0
Fire Alarm Valuation: $452.50
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: Permittee Signature: APPLi (AU
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 RECEIV .i ' FOR OFFICE USE ONLY
. City of Tigard Date/Bea _ ��� Permit No.: 3 fps ) 3 -000 t `-
V 13125 SW Hall Blvd., Tigard, OR 97223 JAN 2 3 2013 Plan Review �y C
Phone: 503.718.2439 Fax: 503.598.1960
Date/13 : / -
T l GARD Inspection Line: 503.639
Su
CITY OF TI GAR ® Date ReadyBy ethod:
r 8 See Page 2 for
Internet: www.tigard-or.gov
GAR Notifie Supplemental Information
BUILDING DIVISIO 1
TYPE OF WORK REQUIRED DATA: I- 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 COJVSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling [Uo mercialIindustrial Valuation: $
❑ 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: 7,z, gyp 14W Z/6-c6a, Nev dwelling area: square feet
City /State /ZIP: 7 16,,6f '. 0 Pc
Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: "I/ 1uL 4P 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.
,.f' (i eet.t / Ikf'rrPkC. 5 a° . I trvC, Valuation: ' S 5 ■ SD
( A f "- r" F / h tr ,te° (.47 i, ke Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address:
Occupancy groups:
City /State /ZIP:
Existing:
Phone:( ) Fax: ( )
�� New:
APPLICANT, L7 CONTACT PERSON
NOTICE
Business name: r-)yj f? 1/42-3-, . .i - All contractors and subcontractors are required to be
Contact name: �/; C f /41, e . e licensed with the Oregon Construction Contractors Board
,. : under ORS 701 and may be required to be licensed in the
Address:
1/ t t I J A 1,.'t 3I'll jurisdiction in which work is being performed. If the
City /State /ZIP: A :l i 6.,..1 or... 9 11-d 2 - applicant is exempt from licensing, the following reasons
apply:
Phone: (
S75) 7 0 Ea it (DS Fa x:: ()) 2.3 0 10 W t4
E -mail: 5evYrt. & C;S Cs,Ee<.,f e0.1j
CONTRACTOR
BUILDING PERMIT FEES*
Business name: 5 (Please refer to fee schedule)
Address: r + Permit fee:
City /State /ZIP: i 'f) , t 1� t �) ., 9 224 State surcharge (12% of permit fee):
Phone: (V,,, 7 0 /6 or Fax: (1.) 2-30 , / D l P 4 FLS plan rev (40% of permit fee):
,^,d (Due upon application.)
CCB lie.:
.9 4 r 0
. Total permit fees:
-.
Authorized signature: r. '�? y'' , -
� Amount received:
This permit application expires if a permit is not obtained
Print name: 4efri f CG4'/ ,. Date: J - 12 '► /3 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 -46 t 3T( t t /02 /COMV 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 Er Yes
include: Individual Component LiV 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): $ y$' .$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.tigard- or.gov/ city_ hall /departments /cd /docs /FPS- PermitApp.doc Rev 01/25 /2012
° Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Project Description: /7 �\k rI S c' `dW / `f'
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION _
*Class of Work: IT Occupancy Group: -0 Type of Construction: �-
*Type of Use: _ Occupancy Load: Oregon Specialty Code: 71�([)
SPECIFICS
Number of Stories: 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: $ � .00 FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ "j1 , Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ 'ZQ, M Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ 2-.CC) Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ 7 j,ISO 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: $ 90, ( 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;
I = 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