Permit 111. a CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2014-00003
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/09/2014
Parcel: 2S103DD01201
Jurisdiction: Tigard
Site address: 13920 SW PACIFIC HWY
Project: Goodwill Subdivision: MELROSE Lot: 7-8
Project Description: Replace existing fire alarm control panel.
Contractor: PHILLIPS ELECTRONICS Owner: GOODWILL INDUSTRIES OF THE
3247 NW 29TH AVE COLUMBIA WILLAMETTE
PORTLAND, OR 97210 1943 SE 6TH AVE
PORTLAND, OR 97214
PHONE: 503-222-5083 PHONE: 503-238-6165
FAX: 503-227-4992
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/09/2014 $102.20
12%State Surcharge-Building 01/09/2014 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 01/09/2014 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 01/09/2014 $4.50
Occupancy Grp: Height: ft 11x17)
Stories: 1
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:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $159.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,273.00
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.
Issued By: ittee Signature:
x 9.4175 by 7:00 a.m.for the next available inspe on 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.
Piilding Permit Application RECEIVE 1 •
Fire Protection System FOR OFFICE USE ONLY .
III City of Tigard JAN 0 2 2014 Date/Bee Z /1/. PermitNo.�j
°. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revte ( '° °� 7 OD003
Phone: 503.718.2439 Fax: 503.598.19 DateBy: I v I /l Other Perr,�j,[�o�/3 �t7 30 y
TICARD Inspection Line: 503.639.4175 CITY®�' �IGARD Date Rea y: ,, ris: ® See Page 2 for
• Internet: www.tigard-or.gov BUILDING DIVISION N�fie / et��/V �r1 T/ - Supplemental Information
. �J
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.
•
❑ 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: 13920 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP:Tigard,Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Goodwill Tigard Covered porch area: square feet
Cross street/directions to job site:SW McDonald 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.
of
Replace existing Fire Alarm Control Panel Valuation: $ t,2'73
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER . 0 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 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* . "-
Busincss name:Phillips Electronics (Pleaserejerrojeescbedule)
Permit fee:
Address:3247 NW 29th Ave
City/State/ZIP:Portland,Oregon 97210 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)222-5083 Fax:(503)227-4992 (Due upon application.)
CCB lic.: 125364 Total permit fees:
Q� � Amount received:
Authorized signature: i
This permit application expires if a permit is not obtained
Print name:' 1J C S,o 7r Date: 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 doe Rev 01/05/2012 440-4613T(11/02/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: $ 2,273.00
D.) Residential Sprinlder (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.
http://www.tigard-or.gov/city_hall/departments/cd/docs/FPS-PermitApp.doc Rev 01/25/2012
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13920 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Fire Protection System
998 Alarm Final
2014-02-18 00:00:00
FPS2014-00003
PASS - No C of O
Violation Summary:
Inspector Contractor