Permit (191) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
. .N COMMUNITY DEVELOPMENT
Permit#: FPS2018-00093
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2018
I[' l`n9 Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Clean Water Services Subdivision: None Lot: None
Project Description: O&M-Phase 2: Fire alarm for administration building remodel and new conference room.
Contractor: CHRISTENSON ELECTRIC INC Owner: CLEAN WATER SERVICES
17201 SACRAMENTO ST 2550 SW HILLSBORO HWY
PORTLAND, OR 97230 HILLSBORO, OR 97123
PHONE: 503-419-3344 PHONE:
FAX: 503-419-3695
FEES
Description Date Amount
Specifics: Building Misc Fund(copies/prints) 09/06/2018 $9.25
Permit Fee-COM 09/06/2018 $379.22
Type of Use: COM 12%State Surcharge-Building 09/06/2018 $45.51
Class of Work: ALT Type of Const: VB Plan Review-Fire Life Safety-COM 09/06/2018 $151.69
Occupancy Grp: B Height: ft Info Process/Archiving-Lg$2.00(over 09/06/2018 $22.00
Stories: 11x17)
Info Process/Archiving-Sm$0.50(up to 09/06/2018 $22.50
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: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $630.17
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $30,000.00
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.
I
Issued By: � / _ -ee Signature: (�� y
Call 503.639.4175 by 7:00 a.m.for the next available inspection da e. L..," Y.2
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 ONLY'
.. t Received , •
City of Tigard Date/By: <�� �� 40. Permit N ...5_,,,,,,/„-P.-- 0/t1if 0 93
13125 SW Hall Blvd„Tigard,OR 97223 sy Plan Review //
m. Phone: 503.718.2439 Fax: 503.598,1960 J LU t_ 2 4: 20th Date/liy: 1"j 3 .j O ' other Permit:
T I G A It D Inspection Line: 503.639.4175 Date Ready/E3y: ,....../ lois: ® See Page 2 for
Internet: tti�vW.tigard-Or.govCITY ` to Notlthod � Supplemental information
r I 1 j°fi0gij,: tbr ;,. r
$t $ $ $ t$ l �� t
❑New construction 0 Demolition Permit fees*are based on the valueof 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
Wi 4 s work indicated on this application.
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ElOther: Number of bathrooms:
`�� � i : Zi:',4#4c9-0.4,41'.1":400,441.,4,,,,,,,V70, Total numberof floors:
Jobsiteaddress:1b869'$ V85TrI New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name:CLEAN WATER SERVICES Covered porch area: square feet
Cross street/directions to job site: 0 9 Al P/9/9-SC , ,, Deck area: square feet
Other structure area: square feet
0 $' 3S$ 1 @ t i R$ .'$
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
$ ® ' work indicated on this application.
JOB#70581 FIRE ALARM SYSTEM .176,11/Ad �j/.---J e Valuation: $$30,000.00
72C11 --� �/ALJ .�n/ �y — � Existing building area: square feet
New building area: square feet
Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 s ,
ti
All
Business name:CHRISTENSON ELECTRIC contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
Niunder ORS 701 and may be required to be licensed in the
Address: r(�'f jurisdiction in which work is being performed.If the
City/State/ZIP: �^ applicant is exempt from licensing,the following reasons
Phone: apply:
(r�hC� Fax::( )
E-mail: („
tri r%G el.cs.-• S Iv" vZ s H S"6 1-,
t C irL�t
i y v s
t $ $ifl' ,. $,...r., ,
Business name:CHRISTENSON ELECTRIC
Permit fee:
Address: 17201 NE SACRAMENTO ST
State surcharge(12%of permit fee):
City/State/ZIP:PORTLAND,OR 97230
FLS plan review(40%of permit fee):
Phone;(503)419-3344 Fax:(503)419-3695 (Due upon application submittal-)
CCB lie::458 Total permit fees:
Authorized signature:
Amount received:
jhettr F This permit application expires if a permit is not obtained
Print name:ROBERT BRUEN Date:7/24/18 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board-
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I:giuilding'Permits\FPS-PermitApp 031016.doe
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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.11u ° .11 7*!UU,,, I. .5A.Ri.DP140F4A'itit'ItatitOl-gat,6,41iiiiSt.'::$1. AA1-2;!;*1 Wi* :120;, 4airitt'Vvref
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:
El Addition or El 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
El 11+ heads: Plan review required and D 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Sprinkler Type El Wet El Dry
Additional Standpipes
Information: Sprinkler Supply Tine U Yes U No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
*OW- • Hood Project Project Valuation: $
:".
4 A 4,,,,ocky!,..z.47.21,,,;}:',..W. ,';,4t,??,,e-p,4.;.•,--t,,,Ntiv{:).1.6'320.<:.•.-::, .41,.'..‘,A.,- . ;
Submittal shall Battery Calculations U Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
A): -
- . .'; • •
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45 4;'74,414.41:.CZfa. ,
3,601 to 7,200 $310.05 44fregtarzier4
7,201 and greater S404.39 • ;
Sprinkler Project Square Footage: sq.ft.
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: $
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