Permit � � CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11 COMMUNITY DEVELOPMENT Permit #: FPS2013 -00025
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TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/19/2013
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD 101
Project: Illo Chiropractic Subdivision: VARNS ACRES Lot: 3
Project Description: Fire alarm modifiaction for expansion of existing tenant suite 101 to encompass both suites 101 and 100. Rewire
existing devices with plenum fire wire. Replace (2) smoke detectors.
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 02/19/2013 $83.37
12% State Surcharge - Building 02/19/2013 $10.00
Type of Use: COM Plan Review - Fire Life Safety - COM 02/19/2013 $33.35
Class of Work: ALT Type of Const: Info Process /Archiving - Sm $0.50 (up to 02/19/2013 $3.00
Occupancy Grp: Height: ft 11x17)
Stories:
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
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Total $129.72
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,675.00
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 Notificaf • • - ,ter. 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 q tions to OU • by c- ' - : 03.232.1987 or 1.800.332.2344. y
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Issued =y: , /� Permittee Signature:
/ _ /e7)/
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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.
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a ='
Building Permit Application
C /� //L / 7 i 1 1 FOR OFFICE USE ONLY
1114
City of Tigard / Date /B : " / / / C--- mi n Permit No.: i v 3 Received
11 ° 13125 SW Hall Blvd., Tigard, OR 97223 FEB 1 9 2013
Phone: 503.718.2439 Fax: 503.598.1960 Date/B IMRE r3
Other Permit:
Inspection Line: 503.639 �w` V M ^, Date Ready /i : Juris: ® See Page 2 for
TIGARD
� u N 0' . u ' i.0 Notified/Method: Supplemental Information
Internet: www.ti ard -or. ov pp
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TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
r,/ Indicate the value (rounded to the nearest dollar) of all
It Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling Commercial /industrial 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: 73 d d o - H U N Zf I4.F $u /1t, / U i New dwelling area: square feet
- City /State /ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: j (4_0 (// /40 P / 7 . 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 /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK l work indicated on this application.
/ .-1,,j/ ri" - k f " ' . ,) ; "r d c/ /4:Lp G,,,ii 7'9Uwa-t4 -frvi- t Valuation: $ d- X "-:-
i e'V IV - "{ e fit" B% / z- o /Fs` S 12w IC-C... Existing building area: square feet
A �
.(C.L.¢71 ; dl/t n i , New building area: square feet
.0 PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State/ZIP: Existing:
Phone: ( ) Fax:( )
�✓ New:
CJ : APPLICANT .- . CONTACT PERSON BUILDING PERMIT FEES*
Business name: /� f f �. / z -7 (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: /Q/ C g f ifc-4.G /
Address: 5 / ,5"F /t e ..F'i.t6..£ /L Iv �. vI) FLS plan review fee (if applicable):
City /State/ZIP: 1 L J3 v I:� q 7 p,-
Total fees due upon application:
Phone: ( 5615) 7 _.- /(,o Fax:: (5 ) Gat ( r.3 f{ Amount received: ` dP y . 7r
E -mail: `j 41 -T +4._. tn. r- / a -�'evi r ,. C - a r PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR
. roof -top mounted Photo Voltaic Solar Panel S, stem.
Business name: /7 . --e- t ; 9 r iC 4 •) . -e%g� ; ''r'1) Submit two (2) sets of roof plan with corn lion details
and fire departm• t access, along with e 2010 Oregon
Address: Solar Installation , ialty Code c . - cklist.
City /State /ZIP: Permit fee (inclu.. .l. • eview
$180.00
and adminis .tt ees):
Phone: ( ) Fax: ( )
_ State surcharge (12°. of permit fee . $21.60
CCB lic.: ,,:a 6 iff )
•- Total fee . .e upon application: $201.60
Authorized signature: ��//:� . r .) I `t" �, '`w This permit application expires if a permit is not obtained
gn K%
within 180 days after it has been accepted as complete.
Print name: A', ci .. E n , Lam .` re , Date: z " j - / 3 * Fee methodology set by Tri- County Building Industry
Service Board.
1:\Building\Permits \BUP -COM PermitApp.doc 02/24/2011 440-461 3T(1 I /02 /COM/WEB)
!PI Building Division •
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description: t
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: ,( Occupancy Group: Type of Construction:
*Type of Use: Csfitil . Occupancy Load: Oregon Specialty Code: #�j1d
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 1`
Fire Sprinklers: !∎-�0 Fire Alarms: `f Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 1� 7 5 c FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ '57 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ JO, CSC) 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 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ 5. G. 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: $ tZ- ,7Z TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; END = foundation; DEM = demo;
END = 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