Permit (65) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
2 COMMUNITY DEVELOPMENT Permit#: FPS2017-00088
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2017
Parcel: 2S101BCO2201
Jurisdiction: Tigard
Site address: 8300 SW HUNZIKER RD
Project: Solutions Yes Subdivision: None Lot: None
Project Description: Fire alarm:Adding cellular communicator. Affidavit submitted.
Contractor: PHILLIPS ELECTRONICS Owner: HUNZIKER ONE LLC
3247 NW 29TH AVE 956 WEST POINT RD
PORTLAND, OR 97210 LAKE OSWEGO, OR 97034
PHONE: 503-222-5083 PHONE:
FAX: 503-227-4992
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/13/2017 $53.78
12%State Surcharge-Building 06/13/2017 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 06/13/2017 $21.51
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 06/13/2017
anc Grp: $0.50
Occupancy Y Height: ft 11x17)
Stories:
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:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $82.24
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $595.00
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 o ;I• 44.
Issued By: Permittee Signature:
91,(--
Call 50 .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 Application
Fire Protection System
FOR OFFICE USE ON IIII
Clty Of T1gard Received
q 13125 Sw Hall Blvd.,Tigard,OR 97223 RECEN : Date/B : r 7 Permit No.: i
= Phone: 503.718.2439 Fax: 503.598.196 Plan Revie
Inspection Line: 503.639.4175 Date/B : Other Permit:
TIC A R D p 13 2017 Date Read/B See 7'� . �
Internet: www.tigard-or.gov JUNReady/By: Page 2Inr
�r� Notified/Method: � Supplemental Information
TYPE OF WO...,DEITY O T1GABD
I�+�IMG DIV%S90N REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction .,emo itton Permit fees*are based on the value of the work performed.
Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all
0 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: $ �r3,.—�. _
❑Accessory building ❑Multi-family Number of bedrooms: �"�[7
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: - c5 )
j-taNz.. key- 5+ New dwelling area: square feet
City/State/ZIP: '1' 1 d'_ r- )).
•� y 7
' `'-i Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: 5c.,10";-;A,A .5 VQ.5 Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
Subdivision: REQUIRED DATA OMMERCIAL-USE CHECKLIST�v
I 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
x equipment,materials,labor,overhead,and the profit for the
' ''r:_ * * ''
DESCRIPTION O O * ;
// <N � �„� �,�, '� �=.� work indicated on this application.
Acki.N'It C'ei�t��C r CE�'1M17ti�JC0.T��'1 Valuation: $ OJ
Existing building area: square feet
New buildingarea:
,. square feet
.4 PRO E * ' ** *I ''. ''wq
4 44 4, 4, - 4 * , , 0 *; ,, , 0` * .-•, Number of stories:
Name:
Type of construction:
Address:
City/State/ZIP:
Occupancy groups:
Phone:( ) Existing:
Fax:( )
New:aA � , - � ' �* � � � fir *irk
* * * T ,m 4l ; * tO1� ,Business name:
� 6440
All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
Address: under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
Phone:( ) I apply:
Fax::( )
E-mail:
R INGPERMITES*le.. � y Plaserefertofee shedBusiness name: tiIt. S ti.ec tr� .CS
Address: J7 ate 7 rl� Permit fee:
City/State/ZIP: P c� �C State surcharge(12%of permit fee):
of �?i Esc: ` 72/0
Phone:(5"0"));U2 , 03 ` Fax:( ) FLS plan review(40%of permit fee):
(Due upon application submittal.)
CCB lic.: I ZS 36 ct
Total permit fees: ' n.,, ,L,
Authorized signature: , Amount received:
ram_ This permit application expires if a permit is not obtained
Print name' , within 180 days after it has been accepted as complete.
e��� I Date: I * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Buildiug\Permits\FPS-PermitApp_031016.doc
440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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:
1-5 devices: Affidavit required and
❑ Addition or 1-10 heads: A
❑ ffidavit required and El
Alteration (3) copies of sketch showing area (3) copies of sketch showing areaof work within building structure
to existing of work within building structure
system6+ devices: Plan review required and
[L1 11+ heads: Plan review required and ❑
(3) sets of plans. (3) sets of plans.
Additional description of work:
A,B,C or Das •
Type of System (Completeapplicable):
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: I $
Bf•)-T 'Pe Y. Ho d'Fit �l res + System_ y ,_. . . w v
Hood Project Valuation: I $
....a..
m
‘4*
* A1 N : $ x o e;. r *
'1/4") .1/4
lamo * 4 .a
Submittal shall Battery Calculations 11] Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
fix�
D
' 40,�)� es�c�entzal St�. #r�'�tx !. S.� .= � 44.� rt
Permit Fee: 4. a
Square Footage:
0 to 2 000 $198.75 4 AA,* w=
2001to3600 246.45x 'z4 m * . a
3,601 to 7,200 $310.05 444.4444 . * *4444
7,201 and greater
$404.39 :j' =A A A 4 s
Sprinkler Project Square Footage: I sq. ft.
* . . , er it l ee
� fir rot. coon P � �
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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2
RECEI
City of Tigard VE`hermit No.: j�5 t 7' c
13125 SW Hall Blvd.,Tigard,OR 97223 JUN 1 3 2017Phone: 503.718.2439 Fax: 503.598.1960 Date Received:
`� 643// 7
1_[C,A V 1) Inspection Line: 503.639.4175 CITY O , FIGAR BY:
Internet: www.tigard-or.gov s A' 49 ~ ki r�
LDING DIVISION
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: S,U \-3015 \lE 5 Occupancy:
Job Address: SSD() SO I40✓1Z;Kev S$— Suite:
Contractor: CkV t\'f S EIec 4110n J c 5' Phone:
"0
Valuation of work: $ SRS
Type of System: (check one) gRequired ONon-required
(check one) RjAutomatic ❑Manual ❑Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) I /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) /To be Relocated(max 5)
I, 4)h)1X)p a t l ec.6Ot.&- j Oregon Construction Contractors Board No. I 9,3-36 4(
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
f) Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
In addition,I understand the following is required:
• Submit(3)copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• Electrical permit.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: 614117
Date: cS l�'-- 7
Print Name: l�e S'eoi
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