Permit n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 - COMMUNITY DEVELOPMENT Permit#: FPS2015 00064
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/20/2015
Parcel: 2S 102AD01800
Jurisdiction: Tigard
Site address: 8955 SW BURNHAM ST
Project: City of Tigard Subdivision: TIGARD HIGHWAY TRACTS Lot: 21
Project Description: A single fire alarm system to be installed in(3)buildings,8955,8973&8975 SW Burnham St.
Contractor: E C COMPANY Owner: CARL H JOHNSON FAMILY L P II
PO BOX 10286 BY JOHNSON, CARL H
PORTLAND,OR 97296 8965 SW BURNHAM
TIGARD, OR 97223
PHONE: 503-224-3511 PHONE:
FAX: 503-295-3012
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/07/2015 $209.80
12%State Surcharge-Building 04/07/2015 $25.18
Type of Use: COM Plan Review-Fire Life Safety-COM 04/07/2015 $83.92
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 04/20/2015 $4.00
Occupancy Grp: S-1 Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/20/2015 $8.50
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: No Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $331.40
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $13,000.00
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 Notificati.I 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 q -stions to oUNC b calling 503.232.1987 or 1.800.332,2344.
Issued :y: �/ Permittee Signature:
Call 503.639.4175 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.
Building Permit ApplicatioRE��,,,,I,rt� 1'�E�
Fire Protection System FOR OFFICE USE ONLI
Received r�t�/5 eyt2
City of Tigard APR 7 2015 Received 7 �� Permit No.: J -r/`-'
13125 SW Hall Blvd.,Tigard,OR 972 Plan Revie
i 1 5Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ae 1 ��
TIGARD Inspection Line: 503.639.4175 %ATV OF fI(AR1) Date Ready/By: Juric: 10 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Y is-t y Supplemental Information
BUILDING DIVISI41� 41 arnci, tey
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.
Valuation: $
El 1-and 2-family dwelling 0 Commercial/industrial
1:1 Accessory building El Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:8955,8973,8975 SE Burnham New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name:City of Tigard Covered porch area: square feet
Cross street/directions to job ste: Deck area: square feet
Other structure area: square feet
::;;:::REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees*arc based on the value of the‘tiork performed.
Tax map/parcel no.: C.
aW Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
s DESCRIPTION OF WORK work indicated on this application.
Install fire Alarm system Valuation: $$13,000.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name:City of Tigard Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( 1 New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name:EC Company All contractors and subcontractors are required to be
Contact name:Kathy Kelley licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:PO Box 10286 jurisdiction in which work is being performed.If the
City/State/ZIP:Portland OR 97296 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)224-3511 I Fax::(503)248-6353
E-mail:kathyk @e-c-co.com
4i1 r,41 ol:, To7Co113. a i` ,+ 13 �_j.7
Business name:EC Company
Permit fee: 318.90
Address:PO Box 10286
City/State/ZIP:Portland OR 97296 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)224-3511 I Fax:(503-)248-6353 (Due upon application.)
CCB lic.:49737 Total permit fees:
Authorized signature: L__b
jAdk ji '�� Amount received: 13/ . �v
��"^^ This permit application expires if a permit is not obtained
Print name:Anna Heft Date:4-6-15 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
t:\Building,Permits\FPS-PermitApp.doc Rev 01/052012 440.4613T(11/02/COMIWEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describezork to be done:
1.) [X] New 2.) Modification to sprinkler heads only:
El Addition El 1-10 heads: No plan review required.
El Alteration El 1 1+heads: Plan review required.
Repair
Number of sprinkler heads:
Additional description of work:
- =--- ----
Tpeö --- -eiart mil ete B, COr D as a ea
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:
-111.F.Mar
C.) Fire
Submittal shall Battery Calculations El Yes
include: Individual Component Z Yes
Cut Sheets
Fire Alarm Project Valuation: $ 13,000.00
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.
I ire 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.
G:\!Anna's Folders\Permit Forms-Info\Tigerd Fire Alarm Bldg.Permitdoc Rev 01/04012