Permit 111111 �� CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II COMMUNITY DEVELOPMENT Permit#: FPS2015 00003
Date Issued: 01/26/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101 DC00200
Jurisdiction: Tigard
Site address: 13535 SW 72ND AVE 200
Project: Umpqua Bank Subdivision: 72ND BUSINESS CENTER Lot: 13
Project Description: Fire alarm alterations
Contractor: ERTELL ELECTRIC LLC Owner: PNWP LLC#2
PO BOX 279 BY PACIFIC NW PROP LTD PTNSP
FOREST GROVE, OR 97116 PO BOX 2206
BEAVERTON, OR 97075
PHONE: 503-841-4511 PHONE:
FAX: 503-359-5652
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/26/2015 $166.76
12%State Surcharge-Building 01/26/2015 $20.01
Type of Use: COM Plan Review-Fire Life Safety-COM 01/26/2015 $66.70
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 01/26/2015 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 01/26/2015 $2.50
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: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $257.97
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $9,000.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable 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: Permiee Si g na � �► r i„ d/ '-
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Call 503.639.4175 by 7:00 a.m.for the next available inspectio 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 1 Oil (i l I It I I ,I O\I
City of Tigard RECEIVE ;eC`i`ed � ��� Permit No.: . al A;� ° 13125 SW Hall Blvd.,Tigard,OR 97223 Plam Revi
Phone: 503.639.4171 Fax: 503.598.1960 D81e�By.,- rt , IZ /..j Other Permit: pgy y ddby
\r.1 Inspection Line: 503.639.4175 ( Date R-. :y: �` • Juns: 0 See Page 2 for
Internet: www.tigard-or.gov JAN 1.x/2015 Notified/Method: / .24Jr i/ ' Supplemental Information
1/13._ b
TYPE OF W r 3 *6 • REWIRED DATA:1-AND24AM LY DWELLING
❑New construction li 1 ii. I ` I ■ Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
XAddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF work indicated on this application.
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation:r •
❑Accessory building 0 Multi-family
Number of bedrooms:
❑Master builder ❑Other:
Number of bathrooms:
JOS-S1fI'E INFORMATION AND LOCATION Total number of floors:
Job site address: 1 35'35" 6 W 7Z"a Ave New dwelling area: square feet
City/State/ZIP: • , • I • Garage/carport area: square feet
Suite/bldg./apt.no.:S, 260 Project name: 1"7 u0. k Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:.
Subdivision: I 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
DI RU�TII1ON OF WORK work indicated on this application.'Fire, A IOuf' AI fex-al I o v15 Valuation: $ y/+,Z) (;°.4
-y)
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: c/�c v 4> 6r.-/;01..J 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
applicant is exempt from licensing,the following reasons
City/State/ZIP: apply:
Phone:( ) Fax::( )
lI' E-mail: O yiet.vx ckv1Je /
lbehtc . Cr),./.‘
CONTRACTOR BUILDING PERMIT FEES*
(Please triir Wks -
Business name: E,r_z L A c t LLB Permit fee:
Address: -0. K Z el —
State surcharge(12%of permit fee):
City/State/ZIP: 4 r 1«o �e (( g -7 ( 2 3 FLS plan review(40%of permit fee):
Phone:(s5'0) 5-414„, _L(55 W Fax: _ 0 S'�-)°_ sG• 2 (Due upon application.)
CCB lic.: / ;iv j 11 O Total permit fees:
Authorized signature: Amount received: ��
7,, This permit application expires if a permit is not obtained
i within 180 days after it has been accepted as complete.
Print name: t 2. VP ,— 1t: � Date: Ai
Fee methodology set by Tri-County Building Industry
Service Board.
t:\Building\PermitsWPS-PermitApp.doc 03/23/06 440W613T(i1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
'Describe work to be dons
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: r$
C.) Fire Alarm
Submittal shall Battery Calculations Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $ ODD
D.) Residential Sprinkler(Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
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 2 sets of plans at submittal. Plan review fees are required at submittal.
"New"fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer,or NICET level"3"technicians.
\\I RTEIJ,ELIiC\Documents\Low_Voltage\communications\FIRE ALARM\Darren!ermit Apps\Tigard\Tigard Fire l'ermit.doc
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
13535 SW 72ND AVE 200, TIGARD, OR, 97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00003
Jeff Grove
Violation Summary:
Inspector Contractor