Permit n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
;F 2:- COMMUNITY DEVELOPMENT Permit#: FPS201300163
T t GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2013
Parcel: 25101 BCO2401
Jurisdiction: Tigard
Site address: 12650 SW HALL BLVD
Project: Snyder Roofing Subdivision: TIGARDIA TERRACE Lot: 3
Project Description: Fire alarm
Contractor: PHILLIPS ELECTRONICS Owner: JFK PROPERTIES OREGON LLC
3247 NW 29TH AVE 12650 SW HALL BLVD
PORTLAND, OR 97210 TIGARD, OR 97223
PHONE: 503-222-5083 PHONE:
FAX: 503-227-4992
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/18/2013 $83.37
12%State Surcharge-Building 11/18/2013 $10.00
Type of Use: COM Plan Review-Fire Life Safety-COM 11/18/2013 $33.35
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 11/18/2013 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 11/18/2013 $7.00
11x17)
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: Yes Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $137.72
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,698.00
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 O- '.1-0010 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. k
Issued By: . Perm :=-Signature:
•Call 50 .• a.m.for the next available ins tion 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 RECEIVED ONLY
Received /
City of Tigard Date/By: // £ /3 c3 j Permit No.: ee' 3�(' /63
° 13125 SW Hall Blvd.,Tigard,OR 97223 4 2013 Plan Revie' ► 2
II Phone: 503.718.2439 Fax: 503.598.1960 Date/By: io'' ' ri j, ,,3 Other Permit: /c41P0<oi3-U0/475
T I G A R D Inspection Line: 503.639.4175 /��/(�TIGARD Date Ready/By: 9 Duds. El See Page 2 for
Internet: www.tigard-or.gov VII 1 OF Notified/Metho !/�J�� .� Supplemental Information
BUILDING DIVISION _ ,D
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 CONSTRUCTION • work indicated on this application.
El m
1-and 2-family dwelling 0 Comercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND AND LOCATION Total number of floors:
Job site address: 12 650 So 1.1411 (3lvd New dwelling area: square feet
City/State/ZIP: —['.1,3ar�l Ores or` 9'73 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: - ydec Roo;.^9 Covered porch area square feet
Cross street/directions to job site: so COMMerr.:al S4. 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;e... Alaorw, Valuation: S / 698
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 ❑ 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 Lensed 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*
&.7e. ( (Please refer to fee schedulel
Business name: Pk;II 5 Jr/7 n;r 5
P Permit fee:
Address: 3a 1-I'7 W 2 9 o, 4 . o
State surcharge(12%of permit fee):
City/State/ZIP: pa,4.la4 0(e r 7721 0 FLS plan review(40%ofpermit fee):
Phone:(son ) 9.24._ $D$3 Fax:( ) (Due upon application.)
CCB lie.: i a 5 3G/4 Total permit fees:
Authorized signature: Amount received: ^151'
This permit application expires if a permit is not obtained
Print name: -11,e,,p� SL O 77" Date: iofri f 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(I I/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): $
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.
I:\Building\Permits\FPS_PermitApp.doc Rev 01/05/2012 2