Permit (62) RECEIVED
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ;`'`{ 16 2013
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s . Request for Permit Action CITY OFTIGARD
k T i t i Alt l) 13125 SW Hall Blvd. •Tigard,Oregon 97223 • 503-718-2439 • www.ti*ar
� d.-o . iILDING DIVISION
I TO CITY OF TIGARDv 0 1 0
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223 -51?;,"-51?;," -,
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuil.dingPermits@tigard-or.gov
FROM: ❑ Owner ID Applicant ❑ Contractor ❑ City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) Performance System Integration LLC
Mailing Address: 7324 SW Durham Rd
City/State/Zip: Portland, Or 97224
Phone No.: 503-641-2222
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
Ej CANCEL/VOID PERMIT APPLICATION.
0 REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
}
0 REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit).
Permit#: FPS2017-00103
Site Address or Parcel#: 9378 SW Mandamus Ct
Project Name: Ashbrook Apartments
Subdivision Name: Ashbrook Farm Lot#: 25
EXPLANATION: This permit was requested to change out the FACP dialer with an AES
E Radio. The signal strengh was not adequit, and monitoring was not changed to the Radio Technology.
Signature: el.,/ Date: 05/16/18
Print Name: Bill Driver
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorise the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests. / /r � Lf f�- r y?r / , 37
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Route to Sys Admin: Date ByRoute to Records: Dater/2,2 /n B}rr
Refund Processed: Date.5,7/, 2 Invoice Processed: Date By
Permit Canceled: Date a /.t B { Parcel Tag Added: Date By
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TIGARD
City of Tigard
6/1/2018
Performance System Integration LLC
7324 SW Durham Rd
Portland, OR 97224
Re: Permit No. FPS2017-00103
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 9378 SW Mandamus Ct
Project Name: Ashbrook Apartments
Job No.: N/A
Refund Method: ® Check#228669 in the amount of$55.42.
❑ Credit card"return"receipt in the amount of$ .
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account "deposit"receipt in the amount of$ .
Comment(s): Per applicant's request as signal strength was not adequate so monitoring
was not changed on radio technology. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
! 4. i
,: i /
Dianna Howse
Building Division Services Supervisor
Enc.
1
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13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
„ .. COMMUNITY DEVELOPMENT Permit#: FPS2017-00103
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2017
f '� g Parcel: 1 S 135ACO2500
Jurisdiction: Tigard
Site address: 9378 SW MANDAMUS CT
Project: Longstaff Apartments Sales Office Addition Subdivision: ASHBROOK FARM Lot: 25
Project Description: Installation of AES radio for fire alarm system monitoring.
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: MACH 1 GE-ASHBROOK LLC
7324 SW DURHAM RD 851 SW 6TH AVE#1500
PORTLAND, OR 97224 PORTLAND, OR 97204
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/27/2017 $61.85
12%State Surcharge-Building 07/27/2017 $7.42
Type of Use: COM Plan Review-Fire Life Safety-COM 07/27/2017 $24.74
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 07/27/2017 $12.50
Occupancy Grp: 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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $106.51
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $850.00
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 questio. to OUNC by calling 503.232.1987 or 1.800.332.2344.
i
Issued = Permittee Signature:
i
Call 503.639.4175 by 7:00 a.m.for the next available in •ection 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
� �;+� �re,�c.�.� �J ��S1r�n. FOH OFFICE IsE o�L�� �.
Received 7 7 j,. Permit No.: — 0
City of Tigard DateB
- " 13125 SW Hail Blvd.,Tigard,OR 97223 Plan Review ^�' �� Ocher Permit ..
Phone: 503.718.2439 Fax: 503.598.1' ' tvtDateBy: i � �7 ''�' ^
�' Date Read/B / Jur,s: ® See Page 2 for
Inspection Line: 503.639.4175 a y y' `
T I G A R D Notified/Method: Supplemental Information
Internet: www.tigazd-or.gov =''
1
TYPE QE WORK REQUIRED DATA:!-�2-FAMILY DWELLING
�T�GXPermit fees*are based on the value of the work performed.
❑New construction ❑D °'' ' l �} Cy Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑O ' ' t`0' y��®t`�k� equipment,materials,labor,overhead,and the profit for the
1J work indicated on this application.
CATEGORY OF Co 'd IQN Valuation: $
0 1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
❑Accessory building ❑Multi-family
Number of bathrooms:
❑Master builder 0 Other:
JOB SITE INFORMATION AND LOCATION
Total number of floors:
New dwelling area: square feet
Job site address:9378 SW Mandamus CT
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: !-.G' �` - `' rJ. e I3 Covered porch area: square feet
t \ Deck area: square feet
Cross street/directions to job site: (e� c���� �-t9s'► �ej.
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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
p it ION t F q ORK work indicated on this application.
Valuation: $ ?50 0 0
Installation Of AES Radio for Fire Alrm System Monitoring
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ❑''TENAN Number of stories:
Type of construction:
Name:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
refer tofu
Business name:Performance Systems Integration LLC Structural plan review fee(or deposit):
Contact name:Dan Schelhaas FLS plan review fee(if applicable):
Address:7324 SW Durham RD Total fees due upon application:
City/State/ZIP:Portland,OR 97224 Amount received:
Fax: :(503)641-1464
Phone:(503)641-2222 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:dan@psintegrated.com Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name:Performance Systems Integration LLC and fire department access,along with the 2010 Oregon
Address:7324 SW Durham RD Solar Installation Specialty Code checklist.
Permit fee(includes plan review $180.00
City/State/ZIP:Portland,OR 97224 and administrative fees):
Phone:(503)641-2222 I Fax:(503)641-1464 State surcharge(12%of permit fee): $21.60
CCB lic.:205924 Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
Authorized sign. within 180 days after it has been accepted as complete.
Date:6/28/17 * Fee methodology set by Tri-County Building Industry
Print name:Dan Schelhaas Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only toalarm 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 El 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
's. 11:4/11404;;;14.. ' 1 a t ? f X = -`i^x ?�,
/� ❑ Wet ❑ D
Additional Stand i i.es
Information: .. 0 Yes ❑ No
Hazard Grou.
Densi
Des': Area
K. Factor
tig 1 • ' . ' , ' ' $
Hood Pro'ect Valuation: $
Submittal shall Batte Calculations �.�M Yes
include: Individual Component y "es
Cut Sheets
Fire Alarm Pro'ect Valuation:
t!!".",`a 1r � ��`�. sa. '� ,�,s,w ,, .:.•'„f � ar � `,�„ a °'� s, baa �
.
P6 6 a'�K,.,,5, r: i " 4 ti c7 � '�4 ,
•
S•uare Footage: Permit Fee:
0 to 2 000 4,1 4 .-
$198.75 r
2,001 to 3,600 $246.45 }
3,601 to 7,200 $310.05
7,201 and • eater
$404.39 .:. �1. �*'
Sprinkler Project Square Footage: sq. ft.
Pro'ect valuation subtotal see A,
Permit fee based on .ro'ect valuation see fee schedule : $
Permit fee based on s.uare foota•e see D above : $
State Surchar:e 12%of .ermit fee : $
FLS Plan Review 40% of.ermit fee : $
TOTAL: $
2
I:\Building\Permits\FPS_PernutApp_031016.doc