Permit (45) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00136
TIGARD13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/08/2016
Parcel: 2S113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 140
Project: Perlo Construction Subdivision: None Lot: None
Project Description: Fire alarm-modification for TI
Contractor: CAPITOL ELECTRIC CO INC Owner: PACIFIC REALTY ASSOCIATES LP
11401 NE MARX STREET ATTN: N PIVEN
PORTLAND, OR 97220 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/08/2016 $75.30
12%State Surcharge-Building 09/08/2016 $9.04
Type of Use: COM Plan Review-Fire Life Safety-COM 09/08/2016 $30.12
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/08/2016 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 09/08/2016 $4.00
11x17)
Misc Administration Fee 09/08/2016 $5.00
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 $125.46
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,400.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: �� a
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
PEuildin2 Permit Alica . >-
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Fire Protection System - -IA-' i � FOR OFFICE USE ONLY
C1 0f Tigard Received AAAA, 4--,::::6/3 3
`� g ® 4 z0 DateBy:� K 41 /� PermitNo.: / �l (p
114 - 'l 13125 SW Hall Blvd.,Tigard,OR 9 �3 Plan Review (I if...,
Phone: 503.718.2439 Fax: 503.598.1960 ,� a Date/By: 5 l( Other Permit: -On/y6
TIGARD Inspection Line: 503.639.4175 cifr� ..v1` id" .\ Date Read r Juris Fa See Page 2 for
Internet: www.tigard-or.gov 1 Notified Method: "L j /t, `, l Supplemental Information
.'1 0'_.. ":.� -e. t 0 ....•'. "'� <$ L-<3 ! ' W. 'IN IF,_ AND.": r 1,'-', "V''''.:':
iii 4.05
'''''''''''''147:
❑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
: !',!d :Fir. -- Hip ��i ,t--7.,,,,,
. � CA-• ,e r RY Cl 1 h t N �� ! � � work indicated on this application.
1:11-and 2-family dwelling ®Commercial/industrial Valuation: $
E Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 1:::1 Other:
Number of bathrooms:
TO SFO ""y'-+ iON ' t L Total number of floors:
Job site address:16101 SW 72'd Avenue New dwelling area: square feet
City/State/ZIP:97224 Garage/carport area: square feet
Suite/bldg./apt.no.:Ste 140 1 Project name:Perlo Construction TI Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
laurs=
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
1."SCR¢'i,.,,4,,1"4'1 0,
6 ® a + work indicated on this application.
Install fire alarm devices per plans Valuation: $1,400.00
Existing building area: square feet
New building area: square feet
y . , " _ m "`
N .:Imq PER R ANT Number of stories:u
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
PLI N P.E'� A 1. � l� ��a! u !
*:, � Pii ,a . 1'1.1711 I ... _. - `a 7 u_ NOTA I ` " �,�.t�'"
-.� �ua, i, °
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:( ) I Fax::( )
E-mail:
ON -4,1. OR ,
.: ,-.!„,,..-=.-;-=4,,, is, - ,----1,-fl :.NY`fli6. ;'„,:, Ail n i ,'!,, :i P 4.:£ .-y; N S6 II.rI 1 {iT 5r�, e,44`p •.
Business name:Capitol Electric Company,Inc.
4..' -- 1 (Pl, ere- 'feeschedule '"4 al:*44 ',„ h- 4
Permit fee: 75.3
Address:11401 NE Marx Street
City/State/ZIP:Portland,OR 97220 State surcharge(12%of permit fee): 9.04
FLS plan review(40%of permit fee): 114.46
Phone:(530)255-9488 Fax:(503)255-1966 (Due upon application.)
CCB lic.:48748 Total permit fees: 131.46
AAuthorized signature: €Amount received:
This permit application expires if a permit is not obtained
Print name:Shane Tercek Date:08/01/16 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.doc Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1.) ❑ New 2.) Modification to sprinkler yheads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
11-"1-4-1;`,°- ` r a _ w si' ` y'
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
{11,:g
r 3:- o^.; p®re�um , 9t: a a
�r,
Hood Project Valuation:
b- p
Submittal shall Battery Calculations Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: 1400
VSII® U!R4i
'.W
Square Footate: Permit Fee: 10 110 giok.
0 to 2,000 $198.75 7,
2,001 to 3,600 $246.45
_ 141C 4;-
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
lik ,41r-
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.
\\CE-VSBS11\RedirectedFolders\Dan\FA Jobs\zz161464-45 Perlo Office\1 PPS-Pere tApp.doc Rev 01/05/2012