Permit r Ai
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 COMMUNITY DEVELOPMENT Permit#: FPS2018-00115
T tGAft D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2018
Parcel: 2S1060001400
Jurisdiction: Tigard
Site address: 13239 SW 169TH AVE
Project: River Terrace East Apartments,Building F Subdivision: RIVER TERRACE EAST Lot: None
Project Description: Building F: Fire alarm.
Contractor: FIRE PROTECTION SERVICES Owner: POLYGON WLH, LLC
5573 SW ARCTIC DRIVE 703 BROADWAY ST, SUITE 510
BEAVERTON, OR 97005 VANCOUVER,WA 98660
PHONE: 503-590-3732 PHONE: 360-695-7700
FAX: 503-628-6214
FEES
Description Date Amount
Specifics: Permit Fee-MF 10/02/2018 $242.08
12%State Surcharge-Building 10/02/2018 $29.05
Type of Use: MF Plan Review-Fire Life Safety-MF 10/02/2018 $96.83
Class of Work: NEW Type of Const: VB Info Process/Archiving-Lg$2.00(over 10/02/2018 $4.00
Occupancy Grp: R-2 Height: ft 11x17)
Stories: 4 Info Process/Archiving-Sm$0.50(up to 10/02/2018 $10.00
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 $381.96
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $16,000.00
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. ! l 1
/
Issued By: Permittee Signature: p / ,, Gn /1/
Call 03.639.4175 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 th- .roject.
Approved plans are required on the job site at the time of each inspection.
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Fire Protection System 1
Building Permit Application FotZ oFFlcl; l sl;oyI.v
City of Tigard ReceiveI Date/By: 9 //fes 4/' 5 0/,'00//S
Permit N ,..
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie i
Phone: 503.639.4171 Fax: 503.598.1960 440010 V ` Plan Re
: �,c., ) 4 ! , Other Permit:
Inspection Line: 503.639.4175 SEP 1. lj.� ' _. Date Read/B Juris: 1 H See Pae 2 for
Internet: www.ci.tigard.or.us Notified/Method/ ,L/l/, Supplemental Information 1
g tlL7i: ` 311,017.s IME+D DATA:1-AND 2-FAMILY DWELLING
®New construction ❑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
t '. 4 work indicated on this application.
�ccXTE ^R'�1 411E o'N;�'I' +®N -�
dwelling Valuation:
❑1-and 2-family g ®Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms: v
0 Master builder 0 Other: Number of bathrooms:
i.i
: t '.14,..;,.,....,..., Total number of floors:
4 .„�. o-az 1.. —
Job site address:13239 SW 169th Avenue New dwelling area: square feet 4
City/State/ZIP:Tigard,Oregon Garage/carport area: square feet
Suite/bldg./apt.no.:F Project name:River Terrace East Condos Covered porch area: square feet
Cross street/directions to job site:SW Friendly Lane Deck area: square feet ?
Other structure area: square feet
t / a`.—/---..&, ,REQUIRED It"DATA:COMMERCIAL-USE CHECKLIST j
Subdivision: 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
equipment,materials,labor,overhead,and the profit for the
41 ' DE fi 01*i, ', wo "A t r t work indicated on this application.
Install New Fire Alarm System to Monitor Sprinklers Valuation: $16,000.00
Existing building area: square feet
New building area: square feet
i ., . p,.OP 'OWN R t Number of stories: 3
Name: Type of construction:
I
Address: Occupancy groups:
,i
City/State/ZIP: Existing:
r
Phone:( ) Fax:( ) New:
- . :,';'''''.'r,„ ci , '.. . 0 CONTACT P ON 4: Nu.ICE .i
Business name:Fire Protection Services Inc. All contractors and subcontractors are required to be a
Contact name:David M Phipps
licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the A
Address:9950 SW Arctic Dr. jurisdiction in which work is being performed.If the
City/State/ZIP:Beaverton,Oregon,97005 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)590-3732 Fax::(503)628-6214
E-mail:phipps@fpsnw.com
Business name:Fire Protection Services Inc
...fr.:,......BUILDING PERMIT FEES*
Address:9950 SW Arctic Dr f.:
Please refer to fee schedule. «•
City/State/ZIP:Beaverton,Oregon 97005
Fees due upon application
Phone:(503)590-3732 Fax:(503)628-6214 Amount received
CCB lic.:154333
Date received:
Authorized signature: This permit application expires if a permit is not obtained
� within 180 days after it has been accepted as complete.
i11
Print name:David M.Phipps Date:09-04-2018 * Fee methodology set by Tri-County Building Industry '
Service Board.
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