Permit „ CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a • COMMUNITY DEVELOPMENT Permit#: FPS2015-00147
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/06/2015
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY, STE#210
Project: NW Capital Management Subdivision: VARNS ACRES Lot: 9
Project Description: Relocating(10)fire alarm horn strobes and removing(4)smoke detectors for tenant improvement.
Contractor: METRO SAFETY& FIRE INC Owner: TRIANGLE POINTE TWO LLC
PO BOX 33650 901 NE GLISAN ST, STE 100
PORTLAND, OR 97292 PORTLAND, OR 97232
PHONE: 503-231-2999 PHONE:
FAX: 503-256-4691
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/23/2015 $77.99
12%State Surcharge-Building 09/23/2015 $9.36
Type of Use: COM Plan Review-Fire Life Safety-COM 09/23/2015 $31.20
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 09/23/2015 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 09/23/2015 $6.00
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 $126.55
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,500.00
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 C by calling 503.232.1987 or 1.800.332.2344.
Issued By: 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.
.4Bui ding Permit Application
Fire Protection System FOR OFFICE USE ONLY
Received ]��y�
City of Tigard Received Dateive / p Is- � — Permit No.: 1–�'�o/08 ..ao 1 y]
;� - ° 13125 SW Hall Blvd.,Tigard,OR 9 Plan Revie
Phone: 503.718.2439 Fax: 503.598.1960 DateiB : a rh �a Other Permit: • _ `
TIGARD Inspection Line: 503.639.4175 SEp 2 3 2015 Date Ready!.. n See Page 2 for
Internet: www.tigard-or.gov Notified/Method: a ININMEINTIA Supplemental Information
CITY OF TIGARD (� 1.vr�- v rlI,IV ,Q�. - -
TYPE olg ®ING DIVISION 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
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 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: —N‘ New dwelling area: square feet T)W114-41-111
City/State/ZIP-:—i— Garage/carport area: square feet
Suite/bldg./apt.no.: _,t= Project name: ►17W i r`r't Covered porch area: square feet
Cross street/directions to job site: 5 U (,62S-14 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.
mac-i_s�c1ir� �2 _ ��..2_n a o,''...L� 'r TAt;4 k c z.— Valuation: $ ��JVO o0
_k D.�1r- I!T'r-rtit�E�h t Existing building area: square feet
New building area: 44 S� square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fay:( 1 Nev,:
❑ 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::( )
F-mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: ‘.., tit, fib �`1 ;��
(Please refer to fee schedule,
`11 Permit fee:
Address: k �- , 4 . � <,t~ s .
City/State/ZIP: -i c- State surcharge(12%of permit fee):
FLS plan review(40/o of permit fee):
Phone:(�..s ) Z� , Z9R°i '1 Fax:(.�a ) (Due upon application submittal.)
CCB lie.: 63 9 Total permit fees: / ) -
Authorized signature: Amount received: 1 pt. �
'l(� ,ate, • A ,1 This permit application expires if a permit is not obtained
Print name: n.,Q �_\ ���� I Date:� within 180 days after it has been accepted as complete.
\ Z� '? �J * Fee methodology set by Tri-County Building Industry
Service Board.
L'Building,Permits'FPS-PennitApp_07 014.doc 440-46I3T(I I'02/COM/WEB)
• «
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe w ork to b a done:
1.) Type of Work 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinlder heads: Number of alarm devices: i
❑ Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+heads: Plan review required and j2r6+devices: Plan review required and
(3) sets of plans. (3) sets of plans.
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: I $ 1
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): $
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: $
Y:\Tun\Admin\City of Tigard FPS_PermitApp.doc 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
13333 SW 68TH PKWY STE 210, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00147
Chip Barnett
Violation Summary:
Inspector Contractor