Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS201 5-001 1 7
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2015
Parcel: 25101 AD02400
Jurisdiction: TIGARD
Site address: 12753 SW 68TH AVE
Project: George Fox University Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Extending existing fire alarm system to library. Installing smoke detectors and horn strobes.
Contractor: GEORGE FOX UNIVERSITY Owner: GEORGE FOX UNIVERSITY
414 N MERIDIAN ATTN: FINANCIAL AFFAIRS
NEWBERG, OR 97132 414 N MERIDIAN
NEWBERG, OR 97132
PHONE
PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/28/2015 $145.24
12%State Surcharge-Building 07/28/2015 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 07/28/2015 $58.10
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 07/28/2015 $8.00
Occupancy Grp: E Height: ft 11x17)
Stories: Hourly Building Rate 11/18/2015 $180.00
Hourly Building 12%State Surcharge 11/18/2015 $21.60
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $430.37
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,200.00
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
issuan .r I w. suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utif Notification Center. Th. - rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the r
• direct questions to OUN .y calli • 03.232.1987 or 1.800.332.2344.
Issued By:
Y 101 Permittee Signature: t / //
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.
.ding Permit Application
Protection System FOR OFFICE USE ONLY
City of Tigard j CEIVEP Received •••7 — Permit No.. 1j_,(Air i 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie w�
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : �e�� OtherPermitr I�O(S • ii c. .
Inspection Line: 503.639.4175 q Date Ready :y: 4 • runs See Page 2 for
TIGARD Internet: www.tigard-or.gov JUL 2 8 2015 Notified/Method: 7��V_//S :%'9' Supplemental Information
TYPE OF W /EQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction falattnp DIVISION 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: $
El 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:12753 SW 68th Avenue New dwelling area: square feet
City/State/ZIP:Tigard,OR 997223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Library Remodel Covered porch area square feet
Cross street/directions to job site:SW Hampton Deck area: square feet
NW corner of SW Hampton and 68d Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rotded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Extend existing fire system to library area. Valuation: $86,200.00
Install smoke detectors Existing building area 48000 square feet
Install horn/strobes and power panel New building area: 450 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 2
Name:George Fox University Type of construction: std
Address:414 N.Meridian Occupancy groups:
City/State/ZIP:Newberg,OR 97132 Existing: B2
Phone:(503)554-2080 Fax:(503)554-2009 New: B2
® APPLICANT ® CONTACT PERSON NOTICE
Business name:George Fox University All contractors and subcontractors are required to be
Contact name:Paul Corbett-Furgal licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be lensed in the
Address:Plant Services 1101 N Vila Road jurisdiction in which work is being performed.If the
City/State/ZIP:97132 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)554-20801 Fax::(503)554-2009 non profit,all work in-house
E-mail:pcorbettngeorgefox.edu
CONTRACTOR BUILDING PERMIT FEES*
Business name:George Fox University (Please refer to fee schedule)
Permit fee:
Address:414 N Meridian
City/State/ZIP:Newberg,OR 97132 State surcharge(12%of permit fee):
FLS plan review(40%ofpermit fee):
Phone:(503)554-2080 Fax:(503)554-2009 (Due upon application submittal)
CCB lic.:exempt Total permit fees. >-)
i / Amount received:
Authorized signature: illf /� //i
This permit application expires if a permit is not obtained
Print name:Paul A.Corbett-Furgal I. e:7-21-2015 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board. /_
r\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(II/02/COM/WEB) / , 6°6
. city of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
:Describe=workto�be done: ""7,° ` . _.w . _ t. . �_
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
El New system Number of sprinkler heads: Number of alarm devices:
® Addition or El 1-10 heads: Affidavit required and El 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 ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type cif'S"stem Corti plete'A i3 C=or:D-as.a " livable .= ' '
A.):- Commercial Sprinkler _ i . , �'
El Wet El 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 - ..._ 4,_' . , _...., :
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: I $ 6,200
D.)'.Residential'Sprinkler (Stand Alone Sys tern), ,
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05 .
5 7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire.P.rotection Permit.Fees
Project valuation subtotal (see A,B & C above): $ 6200
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% ofpermit fee): $
TOTAL: $
J.\Plant Services\Electrical\scorbctt\Buildings\Portland Center\Fire\2015addition\FPS2PcrmitApp.doc