Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s COMMUNITY DEVELOPMENT Permit#: FPS2014-00098
Date Issued: 06/09/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113AB00700
Jurisdiction: Tigard
Site address: 16255 SW UPPER BOONES FERRY RD
Project: The Circuit Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: Fire alarm for TI.
Contractor: FIRST RESPONSE SYSTEMS INC Owner: COLEMAN BOULDERING LLC
4970 SW GRIFFITH DR#100 ATTN:ANDY COLEMAN
BEAVERTON,OR 97005 16255 SW UPPER BOONES FERRY RD
TIGARD, OR 97224
PHONE: 503-207-5300 PHONE:
FAX: 503-207-5301
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/09/2014 $112.96
12%State Surcharge-Building 06/09/2014 $13.56
Type of Use: COM Plan Review-Fire Life Safety-MF 06/09/2014 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 06/09/2014 $10.00
Occupancy Grp: B 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: Yes Alarm Type: Automatic
Pull Station Required: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: No Cut Sheets Required: Yes
Total $181.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,750.00
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: Permittee ignature: -
Call 51 75 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.
Builain2 Permit Application
Fire Protection System •ck)1 1,0Il01 I.I( I. 1 si. ()Nil
City of Tigard Received (o Permit No.: p ••
Date/B �1I --I '♦
- 13125 SW HaII Blvd.,Tigard,OR *•T' et Plan Re • •
Phone: 503.718.2439 Fax: 503. t,.1 et Date/B : 'Y�`' ��� Other Permit: ,.. 1
63 See Page 2 for
Inspection Line: 503.639.4175 r Date Ready/:y: g
TIGARD Internet: www.tigard-or.gov �� ��G��O Notified/Meh.r �il Supplemental Information
TYPE OF WORK �� REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Dem 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 ®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:16255 SW Upper Boones Ferry Rd New dwelling area: square feet
City/State/ZIP:Tigard OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:The Circuit gym Covered porch area: square feet
Cross street/directions to job site:On the corner of Durahm ave and boones Deck area: square feet
Ferry Rd 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 work indicated on this application.
Installing Silent knight 5208 fire panel,Aes Fire Radio for monitoring,1 smoke Valuation: $$3,750.00
detector,pull station and a horn strobe 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: ,fsr ASP d" All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: ./h t ke /Pi cite Sy under ORS 701 and may be required to be licensed in the
Address: 47/eT10 cirtj- cxt/r4/ jurisdiction in which work is being performed.If the
City/State/ZIP: //�� applicant is exempt from licensing,the following reasons
/.�eF►V'e,z rA,, Cr' apply:
Phone:(S )..141 3- .5-3 op Fax::( )
E-mail: ifs.S'-t/e0c,)/i-—iiJC . C.C.-.1,-t
CONTRAC'T'OR BUILDING PERMIT FEES*
Business name:First Response Systems (Please refer to fee schedule)
Permit fee:
Address:4970 SW Griffith Dr Ste 100
State surcharge(12%of permit fee):
City/State/ZIP:Beaverton OR 97005 a
FLS plan review(40%of permit fee):
Phone:(503)641-6795 Fax:(503)207-5301 (Due upon application.)
CCB lie.:111713 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: Vold V Date: 5/30/ /t f within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building'Permita\FPS-PermitApp.doc 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 El 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: $ 3750
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): $ 3750
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.
C:\Users\heatherc\Desktop\FPS-PermitApp(1).doc Rev 01/05/2012 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16255 SW UPPER BOONES FERRY RD,
TIGARD, OR, 97224
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2014-00098
Chip Barnett
Violation Summary:
Inspector Contractor