Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s COMMUNITY DEVELOPMENT Permit#: FPS2018-00027
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/19/2018
T r r;;�h t� g Parcel: 2S101AB03100
Jurisdiction:
Site address: 12115 SW 70TH AVE 102
Project: TVF&R-Occupational Health Subdivision: 2012-009 PARTITION PLAT Lot: 3
Project Description: Fire alarm permit:Installing(16)alarm devices and appliance power supply next to existing building fire alarm
control panel.
Contractor: DTS SYSTEMS INC Owner: TIGARD TRIANGLE PARTNERS LLC
7905 SW NIMBUS AVE 18187 SIERA DR
BEAVERTON,OR 97008 LAKE OSWEGO, OR 97034
PHONE: 503-643-3127 PHONE:
FAX: 503-643-6194
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/19/2018 $112.96
12%State Surcharge-Building 04/19/2018 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 04/19/2018 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 04/19/2018 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/19/2018 $7.50
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: No Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $183.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,165.00
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:
Call 503.639.4175 by 7:00 a.m.for the next available in•'e. i n da
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.
Iluilding Permit Application
Fire Protection System
11111 City of Tigard . ,. i ,, r,R i°edry Permit No.: au
il t2 SW Hall Blvd.,Tigard,OR 97223 & 'r. t f < >�t y� �� :) G �L 7
Phone: 503.718.2439 Fax: 503.598.1960 .. Date ev`e• _
Date/B : `�I ) ( t r Other Permit:
TIG ARD Inspection Line: 503.639.4175 Date Ready/By::" L rests: [a See page 2 for
Internet: www.tigard-or.gov ei [ 6 t��S
I � �r [,,} ,, No i ted/Method:
o Supplemental Information
TYPE OF WORK C ' if,.?!: 9/ -c- (- k I
s ��a� REQUIRE DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑D 4Iition .; ' ; Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Z Addition/alteration/replacement ❑Other:
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:12115 S.W.7Avenue New dwelling area: square feet
City/State/LIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:102 Project name:TVF&R OCC Health Clinic Covered porch area: square feet
Cross street/directions to job site:S.W.Dartmouth Deck area:
square feet
Other structure area: square feet
Red Rock Center,Building C
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S101AB03100 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.
Install new notification appliance power supply next to existing building fire Valuation: $$3,165.00
alarm control panel.Install notification appliances in Suite 102. Existing building area: square feet
Core&Shell reference permit#BUP2016-00170. New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:
Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing: B
Phone:( ) Fax:( )
New: B
0 APPLICANT
CONTACT PERSON
NOTICE
Business name:DTS Systems,Inc. All contractors and subcontractors are required to be
Contact name:Bud Aitbee licensed with the Oregon Construction Contractors Board
Address:7905 S.W.Nimbus Avenue under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed.If the
City/State/ZIP:Beaverton,OR 97008 applicant is exempt from licensing,the following reasons
apply;
Phone:(503)643-3127 Fax: :(503)643-6194
E-mail:bud@dtssystemsinc.com
CONTRACTOR
BUILDING PERMIT FEES*
Business name:DTS Systems,Inc (Please refer to fee schedule)
Address:7905 S.W.Nimbus Avenue Permit fee:
City/State/ZIP:Beaverton,OR 9700 State surcharge(12%of permit fee):
Phone: 503 643-3127 FLS plan review(40%of penult fee):
( ) Fax:(503)643-6194 (Due upon application submittal.)
CCB lie.:134056 Total permit fees:
Authorized signature: Amount received:
It1t'.F_%C\ This permit application expires if a permit is not obtained
Print nam77,1.4
�.^--- Date giii Ii f within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
I:1Buildh Permits\FPS-pn iiApp_o3tot6.doo Service Board
440-0613T(tife?lCAM1WgB)
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: 16
4 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, Cor 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 I1 Yes
include: Individual Component -1 Yes
Cut Sheets
Fire Alarm Project Valuation: $ 3,165.00
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): $ 3,165.00
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: $
Z:\03 DTS Systems\Permits\City of Tigard\Fire Protection System Permit Application'WF&R Occupational Health Clinic.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12115 SW 70TH AVE 102, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00027
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor