Permit (194) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
: I COMMUNITY DEVELOPMENT Permit#: FPS2018-00072
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/19/2018
T f( A ill fj g Parcel: 2S1010001600
Jurisdiction: Tigard
Site address: 7670 SW HUNZIKER RD
Project: The Fields Apartments-Building 1 Subdivision: FIELDS APARTMENTS Lot: None
Project Description: Fire supply line for buildings 1-6.
Contractor: DBG PROPERTIES LLC Owner: FIELDS, FRED W REVOCABLE LIVING
2164 SW PARK PLACE 111 SW 5TH AVE#3675
PORTLAND, OR 97205 PORTLAND, OR 97204
PHONE: 503-956-4355 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/19/2018 $1,406.59
12%State Surcharge-Building 07/19/2018 $168.79
Type of Use: COM Plan Review-Fire Life Safety-COM 07/19/2018 $562.64
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 07/19/2018 $20.00
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 Gales Provided: Cut Sheets Required:
Total $2,158.02
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $232,500.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
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 •_ calling 503.232.1987 or 1.800.332.2344.
/ / Permittee Signature: ...__,
Issued By: / / g `�...
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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.
Building Permit Application
Fire Protection System W { " ,vE FOR OFFICE USE ONLY"
Cl of Tigard ,„.Received _ _
}y // Permit No.: ,�f� /�
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Date/By:to/gkl � / 6r 5 Al/ o L) 7
41 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review! /► _
6 ) Other Permit5�y�! yr c7C/�Q cif
Phone: 503.718.2439 Fax: 503.598.1960 i i {j (. ,, Date/By: / -
TIGARD Inspection Line: 503.639.4175 DateReady/By: auris: Id See Page 2 for
Internet: www.tigard-or.gov +r 1 oti ed/Method: �� `�� Supplemental Information
CITY
OF
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®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
work indicated on this application.
❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: $
❑Accessory building ®Multi-family Number of bedrooms: NA
❑Master builder 0 Other: Number of bathrooms: NA
ATION; LOCATIONTotal number of floors: NA
Job site address:SW Hunziker north of Wall Street 7(x70 5L, yZl..�t/ New dwelling area: NA square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: NA square feet
Suite/bldg./apt.no.: Project name:The Fields Apartments Covered porch area: NA square feet
Cross street/directions to job site:the site is located on SW Hunziker,just Deck area: NA square feet
north of Wall Street Other structure area: NA square feet
DATA: ()M itERC .o. �+ .Iifilijs
Subdivision: Lot no.:1600 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S101000160 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
1{1; {1 E Dl ' O "QV a liniiiiifiiiiiriniiiiiiRMARIPLYMPRFEMOMQ work indicated on this application.
Underground fire water line to supply fire water to the Fields Apartment Valuation: $$232,500.00
buildings. Permit is for underground line in site only. Existing building area: square feet
New building area: square feet
i IY.t I{F �. ,� fN �t 6
#,f K i N` ,e . +�1 - �f Number of stories:
Name:Fred W.Fields Revocable Living Trus Type of construction:
Address:111 SW 5th Ave,#3400 Occupancy groups:
City/State/ZIP:Portland,OR 97204 Existing:
Phone:(503)205-2332 Fax:( ) New:
Y .t C0� CTPE1 t31 , ... CER
K
Business name:Otak,Inc All contractors and subcontractors are required to be
Contact name:Kyle Childers licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:808 SW 3rd Avenue,Suite 300 jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97204 applicant is exempt from licensing,the following reasons
apply:
Phone:(619)838-7448 Fax::( )
E-mail:kyle.childers@otak.com
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Business name:DBG Properties LLC
Permit fee: 1404
Address:2164 SW Park Plac
State surcharge(12%of permit fee): 169
City/State/ZIP:Portland,OR 9720
FLS plan review(40%of permit fee): 562
Phone:(503)816-4084 Fax:( ) (Due upon application submittal.)
CCB lie.:201911 / Total permit fees: 2135
yY .............c7-2.--\) -- Amount received: 562
Authorized signature: .."2.:..........................:-...
,
This permit application expires if a permit is not obtained
Print name: V Vim.' (rnd,.,L\ Date: 6/A DA U within 180 days after it has been accepted as complete.
I:ABuildingVPermits\FPS-PermitApp_031016.doc V 4404613T(11/02/COM/WEB)
Otak
Letter of Transmittal
Transmitted By: Date: 4/3/2018 Project No.: 17052.001.002.200
❑ Mail Project: The Fields Apartments
❑ Courier: 2 hours
r Hand Deliver: To: City of Tigard -Building Department
❑ Will Call Address: 13125 SW Hall Blvd.
Tigard, OR 97223
Ph: 503-718-2421
We Are Sending You: Transmitted:
0 Plans/Drawings ® For Approval
❑ Specifications ❑ As Requested
❑ Samples ❑ For Your Use
® Other ❑ For Comment
Copies: Description:
3 Full Size 22x34 Fields Apartments Private Site Utilities Plan Set-including fire water line
1 Underground Fire Protection Permit Application form (original w/signature)
1 Submittal Check for$562
Remarks:
SveMiTXAL. roe. 0.3t,4 GRoo4D TM- ' "Ro...1 SYS'TM 'f32.
From: Kyle Childers, PE 503.415.2408 kyle.childersotak.com
cc: Project files
DBG Properties, LLC
l:1projectl170001170521adminlcorresp117052 tigard fps submittal 06-21-2018.docx
808 SW Third Avenue, Suite 300, Portland, OR 97204 - Phone (503) 287-6825 Fax (503) 415-2304 otak.com
CITY OF TIGARD RECEIPT
i 13125 SW Hall Blvd.,Tigard OR 97223
- 503.639.4171 ►
TIi;AI'.I)
Project Name: The Fields Apartments-Building 1
Site Address: 7670 SW HUNZIKER RD
Receipt Number: 418027 - 06/26/2018
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
FPS2018-00072 Plan Review-Fire Life Safety-COM 230-0000-43108 $562.00
Total: $562.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 000116 BTAGGART 06/26/2018 $562.00
Payor: DBG Properties LLC
Total Payments: $562.00
Balance Due: $0.64
Page 1 of 1
DBG Properties LLC Check Number: 000116
To: City of Tigard 3125 Date: 06/18/2018
Invoice Number Date Description .. Amount Discount Paid Amount
061518 06/15/2018 Permit Fee-The Fields $562.00 $0.00 $562.00
•
TOTALS: $562.00 $0.00 $562.00