Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a COMMUNITY DEVELOPMENT Permit#: FPS2016-00088
T[G.A,17e.J} 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/15/2016
Parcel: 2S112DA01000
Jurisdiction: Tigard
Site address: 6610 SW CARDINAL LN
Project: UMPQUA BANK PCC Subdivision: 1995-098 PARTITION PLAT Lot: 1
Project Description: Fire alarm upgrade.
Contractor: STONER ELECTRIC Owner: PACIFIC REALTY ASSOCIATES
1904 SE OCHOCO ATTN: N PIVEN
MILWAUKIE, OR 97222 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-462-6500 PHONE:
FAX: 503-659-2765
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/04/2016 $220.56
12%State Surcharge-Building 05/04/2016 $26.47
Type of Use: COM Plan Review-Fire Life Safety-COM 05/04/2016 $88.22
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 05/17/2016 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 05/17/2016 $10.00
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: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $351.25
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $14,000.00
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 952-001-06.0. You may obtain a copy of the rules
or direct ion , OUNC b calling 503.232.1987 or 1.800.332.2344.
Issu By: / Permittee Si! ature:
Call 503.639.4175 by 7:00 a.m.for the next available ins r ction 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 ; Ft)lt OIII( III is O\l.l
,. City of Tigard ReceivDate/By: 7� Permit No.:r� �)!_ �`�`_, Q�Q
13125 SW Hall Blvd.,Tigard,OR 97223p� 0 Plan Re '� / !�r a{,(J n n
Phone: 503.718.2439 Fax: 503.598.1964L`Y 4 ?016 Date/By: � �i 'L OtherPermit:M qw^ou1`O
I i Ic Inspection Line: 503.639.4175 Date Ready .•. /' L, q Juris: I ® See Page 2 for
Internet: www.tigard-or.gov 1.1.11/ < IN GA RI.4 Notified/Method: it O Al m I Supplemental Information
aE �NG DIVISION
UM ENn/`S
TYPE OF WO litEQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
I
❑ 1-and 2-family dwelling Valuation: $
®Commercial/industrial
1:1Accessory building 0 Multi-family Number of bedrooms:
El Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:6610 SW CARDINAL LANE New dwelling area: square feet
City/State/ZIP:TIGARD,OR Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:UMPQUA BANK 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.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
FIRE ALARM SYSTEM UPGRADE-DEVICE REPLACEMENT Valuation: $$14,000.00
Existing building area: 21000 square feet
New building area: 21000 square feet
❑ PROPERTY OWNER 0 TENANT Number of stories: 3
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: B
Phone:( ) Fax:( ) New: B
0 APPLICANT 0 CONTACT PERSON NOTICE
Business name:STONER ELECTRIC,INC. All contractors and subcontractors are required to be
Contact name:DENNIS WHITCOMB licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1904 SE OCHOCH jurisdiction in which work is being performed.If the
City/State/ZIP:MILWUAKIE,OR 97222 applicant is exempt from licensing,the following reasons
apply: _
Phone:(503)462-5214 Fax: :(503)659-4968
E-mail:PERMITS@STONERGROUP.COM
CONTRACTOR BUILDING PERMIT FEES*
Business name:STONER ELECTRIC,INC. Mem relatofee schadulel
Permit fee: 220.56
Address: 1904 SE OCHOCO
State surcharge(12%of permit fee): 26.47
City/State/ZIP:MILWUAKIE,OR 97222 FLS plan review(40%of permit fee):
Phone:(503)462-6500 Fax:(503)659-4968 88.22
(Due upon application submittal)
f CCB lic.:44823 Total permit fees: 335.25
Authorized signature ..r;�l \51U& Amount received:
This permit application expires if a permit is not obtained
Print name: KN,-4 d . }I me.v.it. I Date:5:-y —t(c within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doe 440-4613T(I 1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Pike 2- Supplemental Information
i
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices:
® 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 ® 6+ 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
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
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: $ 14000
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): $ 14000
Permit fee based on project valuation (see fee schedule): $ 220.56
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 26.47
FLS Plan Review(40% of permit fee): $ 88.22
TOTAL: $ 335.25
N:\Document Services(CAD)\02-Projects\Umpqua Bank PCC-Pacific Corp Center-12re Alarm\03-Permits\24086v Umpqua Bank PCC Fire Alarm Application.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
6610 SW CARDINAL LN, TIGARD, OR, 97224
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2016-00088
Chip Barnett
Violation Summary:
Inspector Contractor
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
6610 SW CARDINAL LN, TIGARD, OR, 97224
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
July 6, 2016 at 8:46:17 AM
FPS2016-00088
Chip Barnett
Violation Summary:
Inspector Contractor