Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I 'I COMMUNITY DEVELOPMENT Permit #: FPS2013 00080
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/03/2013
Parcel: 2S 101 AA09100
Jurisdiction: Tigard
Site address: 12447 SW 69TH AVE
Project: Capitol One Subdivision: WEST PORTLAND HEIGHTS Lot: A
Project Description: Installation of (4) fire alarm strobes in new conference room.
Contractor: CAPITOL ELECTRIC CO INC Owner: TIGARD CORPORATE CENTER LP
11401 NE MARX STREET 15325 SW BEAVERTON CREEK CT
PORTLAND, OR 97220 BEAVERTON, OR 97006
PHONE: 503 - 255 -9488 PHONE:
FAX: 503 - 257 -7121
FEES
Description Date Amount
Specifics: Permit Fee - COM 07/03/2013 $61.85
12% State Surcharge - Building 07/03/2013 $7.42
Type of Use: COM Plan Review - Fire Life Safety - COM 07/03/2013 $24.74
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 07/03/2013 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 07/03/2013 $5.50
11x17)
Misc Administration Fee 07/03/2013 $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 $106.51
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $900.00
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 Notif ion Ce -r. 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 estions to OU by • g 503.232.1987 or 1.800.332.2344.
Issued B , Permittee Signat � / , ' 1 ,/ ' /
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.
t Building Permit Application
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. ' , # Received IIAB
114 V C of Tigard Date/By: ( / 9 /3 U- ' Permit No.: /5 ° S . 020/-5 0ooPO
1 3125 SW Hall Blvd., Tigard, OR 97223 JUN P lan Review A O
-, '! 't ie Phone: 503.718.2439 Fax: 503.598.1960 1 2 013 DateBy: -, Z 1 Other Permit:
iTIGARD Inspection Line: 503.639.4175 Ready/By: 0
Date Read : Juris: See Page 2 for
._r
..r;r, Internet: www.tigard or.gov CITY OFTIGARD Notifie Method: 7/6 3 ' Supplemental Information
BUILDING DIVISION 1/01 44?
TYPE OF WORK LREQUIRED 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 ® m
Comerciallindustrial Valuation: $
111 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: 12447 SW 69 Ave. (Tigard Corporate Ctr, Bldg -C) New dwelling area: square feet
City/State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt- no..: Floor - Project name: TCC - FA Strobe Additions 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.
Install (4) fire alarm strobes in new conference rooms per plans Valuation. $900
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name: Capital One Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: Capitol Electric Company, Inc. (Please refer to fee schedule)
Permit fee: 61.85
Address: 11401 NE Marx Street
City/State/ZIP: Portland, OR 97220 State surcharge (12% of permit fee): 7.42
FLS plan review (40% of permit fee): 21.51
Phone: (530) 255 - 9488 Fax: (503) 255 - 1966 (Due upon application.)
CCB lic.: 48748 Total permit fees: 24.74
Authorized signature: a[j\—--- ,
Amount received: 106.01
T his permit application expires if a permit is not obtained
Print name: Dan Wilson Date: 6/13/2013 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- 46i3T(II /02/COM/WEB)
PERMIT FEE DOUBLES IF WORK HAS STARTED WITHOUT BENEFIT OF PERMIT
TO CALCULATE TOTAL FEE
PERMIT FEE CALCULATION (REFER TO TABLE)
$ 900.00 ROUNDED VALUATION
$ 51.09 (BASE FEE FOR FIRST $ 500.00 OF VALUATION)
+ $10.76 ($ 2.69 PER $ 100.00
$61.85 BASE PERMIT FEE
+ $7.42 STATE SURCHARGE = 12% OF BASE PERMIT FEE
+ $24.74 PLAN REVIEW CHARGE = 40% OF BASE PERMIT FEE
$94.01 TOTAL PERMIT FEES
+ $7.00 RECORDS RETENTION FEES
+ $5.00 MISC ADMIN FEE (MAILING)
_ $106.01 TOTAL DUE FOR THIS PERMIT
EXAMPLE
CITY OF TIGARD
RECORDS RETENTION FEES WORKSHEET
BUILDING PERMITS
Fees for scanning building department submittals.
Size # of Pages Cost per Page Total
8 1/2" x 11" 10 X $0.50 $5.00
8 1/2" x 14" X $0.50 $0.00
11" x 17" X $0.50 $0.00
18" x 24" X $2.00 $0.00
24" x 36" X $2.00 $0.00
30" x 42" 1 X $2.00 $2.00
Other formats X $2.00 $0.00
TOTAL RECORDS RETENTION FEE ( $7.00 I