Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s COMMUNITY DEVELOPMENT Permit#: FPS2014-00107
T 1G 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2014
Parcel: 15 1358 D00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 325
Project: Carter Counseling Subdivision: ASHBROOK FARM Lot: PTS 5&
Project Description: Fire alarm-adding(2)devices.
Contractor: POINT MONITOR CORP Owner: SUN LIFE ASSURANCE CO OF CANADA
5863 LAKEVIEW BLVD STE 100 BY NORRIS BEGGS&SIMPSON
LAKE OSWEGO,OR 97035 121 SW MORRISON ST#200
PORTLAND,OR 97204
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/17/2014 $64.54
12%State Surcharge-Building 06/17/2014 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 06/17/2014 $25.82
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
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 Caics Provided: Cut Sheets Required:
Total $98.10
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,000.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable I- . •1 will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuan -, or if work is sus.: ded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili. Notification Center. Thos. • -s are set forth in OAR 952-001-0010 through OAR 952-011-0090. You may obtain a copy of the rules
or.irect questi. s to OUNC b • 50' '.1987 or 1.800.332.2344.
ssued By: Z / Permittee Signature: J� ,
Call 503.639.4175 by 7:00 a.m.for the next available ins ion 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 CE(VED FOR OFFICE USE ONLY
City of Tigard �� Received
`J g Date/B : .• Permit No.:KS gel I' C7
lig • 13125 SW Hall Blvd.,Tigard,OR 9jI2�7.3� y 7 2014 A Plan Review /1 i
e Phone: 503.718.2439 Fax: 503.59..1 7 't pate/g : Other Permit: Au p. 4,
i 1(, N r.I Inspection Line: 503.639.4175 CITY f J�_a�� Date Ready/By: t B See Page 2 for
Internet: www.tigard-or.gov GA Notified/Method: Supplemental Information
'II Iff!iHiirs -‘ ,f,,0-,
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 [1 Comercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
1:1 Master builder ❑Other: Number of bathrooms:
JOB SITumemTION AND LOCATION Total number of floors:
Job site address: ;'i" � do New dwelling area: square feet
City/State/ZIP: (G�4 1—�ji 1 Da_ C7"7 al 3 Garage/carport area: square feet
Suite/bldg./apt.no.: �(/2 G3 Project name:(,,,i✓i4 if Coil/1(p /, ii e 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 work indicated on this application.
Valuation: $ / U 00 0 0
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups: rj
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
q APPLICANTn� ❑ CONTACT PERSON NOTICE
Business name: / V] f- 1'1'1((,Z ( Fo✓ („:(2),-- { , All contractors and subcontractors are required to be
•Contact name: ,Cie .^�C�j Li l� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: C50 R CQ o► ceto ,t f( jurisdiction in which work is being performed.If the
``�� applicant is exempt from licensing,the following reasons
City/State/ZIP: (J Y� 7Q� apply:
Phone:(6) ,) Vd.7—0/ 0 0 Fax::( )
E-mail: —1'-t-v-ci ecI p-0€ poi V] 144(i f"i 1 roc- (C'/1 i --
ONTRACTOR BUILDING PERMIT FEES*
Business name: fi �/ I��o(� ( +tjt/ cV� `7 (Pkasereferto feescheIuk
I / /� 1 Permit fee:
Address: �i 3 La Le V 1 -eAv lg. I v cr
City/State/ZIP: C�k Q (� 04 f 7036
State surcharge(12%of permit fee): y. 'if
r !�l FLS plan review(40%of permit fee): I 0� „ i
Phone:(90 6,,9,---7—V/(j Fax:( ) (Due upon application.) ' '6'Sri
CCB lic.: i 3e„, / Total permit fees: j
Amount received: 10 dig. /0
Authorized signature /'.
i / This permit application expires if a permit is not obtained
Print name: 1`ci lam, / �T e /j/ Date:
within 180 days after it has been accepted as complete.
(( ` ( * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Build img\Permits\FPS-PamitApp.doc Rev 01/05/2012 440-46131(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be clone:
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 T - 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: $ /,aQ
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 (sec A,B & C above): $ l G
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\ttraeden\Downloads\FPS-PennitApp.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
9600 SW OAK ST 325, TIGARD, OR, 97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
July 9, 2014 at 8:09:22 AM
FPS2014-00107
Jeff Grove
Violation Summary:
Inspector Contractor