Permit (106) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00102
Date Issued: 09/04/2019
T E[ AEt D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S126DC04700
Jurisdiction: Tigard
Site address: 9575 SW LOCUST ST
Project: Double Tree Hotel Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Replacing fire alarm panel. Adding(14)smoke detectors to floor. All first floor devices to be wireless or
addressable. Adding zone cards for all other floors.
Contractor: FIRE SYSTEMS WEST INC Owner: NHT TIGARD LLC
600 SE MARITIME AVE#300 BY HIGHLAND CAPITAL MANAGEMENT
VANCOUVER,WA 98661 300 CRESCENT CT#700
DALLAS, TX 75201
PHONE: 360-693-9906 PHONE: 971-628-4100
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/03/2019 $363.10
12%State Surcharge-Building 09/03/2019 $43.57
Type of Use: COM Plan Review-Fire Life Safety-COM 09/03/2019 $145.24
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/03/2019 $12.00
Occupancy Grp: R-2 Height: ft 11x17)
Stories: 4 Info Process/Archiving-Sm$0.50(up to 09/03/2019 $17.50
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 $581.41
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
H
Fre Alarm VatuaTioii
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.: '. 75 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 FOR OFFICE USE ONLY
City of Tigard Received
(67 //4 , Pi6S01-0/9-00/02,
13125 SW Hall Blvd.,Tigard,OR 97223 ,.• • Plan Review 0114 �j /
C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: O" C)^ JI v , t C) )i )1
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: G. w�. ® See Page 2 for
Internet: www.tigard-or.gov 1 Noti . ethod Supplemental Information
TYPE OF*0 ,FM, t REQ .IIR 1),DATA It;A AND 2-FAMILY DWELL ?1G
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
11 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
,'' work indicated on this application.
CATEGORY OF CONSTRUCTION ;'
Valuation: $
❑ 1-and 2-family dwelling Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
� Total number of floors:
��:; JOB SITE�IN�URMATION � LOCATION . 4
Job site address: ?,5-7S--- ,_.) ( s�..,,ce , _ New dwelling area: square feet
City/State/ZIP: 77(61� rofCn,, 2L C7 7 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 9,9c<6Lci, f lid" (_ Covered porch area: square feet
Cross street/directions to job site: /-:,...;44_ ,„)---,a),,, /4ra if «��^ Deck area: square feet
( �V (1o '/ L O��:n J S 6/ -:=726-'-T Other structure area: square feet
V V� te' � '4'6'.----' a-' 93
1 ® 4 ,ATA:C011 1.., ' ` `USE IIECKL.t •,
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
{_ ;f .c . 1 work indicated on this application.
. .:DESCRiPTIbN OE WO .4. V.
Valuation: $ , GQC)
19-G-IC}r6 pfiX - t .,'.g p"?.., '-i___. „1Dll /e4 S,,,,,O.EC 1j - j333 ,a .,
f L AJC--��,-v GQ. Ater- ff �lc,,,e..Di v.t.i5 ie,6C u>i.CCCG S S air___
building area: square feet
3
New building area: square feet
"PROPERTY”4 R '. TENANT Number of stories:
Name: !s t `S 07-7_ S Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
-f ) .ICANT� '1< e'0 CONTACT , ;RSON
s:
§Y
Business name: SQL �3 fit✓ ./ All contractors and subcontractors are required to be
Contact name: JI licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIl':
Phone:( ) Fax::( )
E-mail:
�k .__ s 6 R ,� -..�
--741,7------4-4,<;1,.` �r..-;: z �, - .k`<�'. t .3... �x"=. ' Is�N ESS"'"�-`�` '�
�. s v UI GPE FE
Business name: • : (Pl refer 1:04 eeschedu/e)
(1.-_-_7,eC ,Si rdd5 ��� � Permit fee:
Address: 3,7o S i,�f .SG'
City/State/ZIP: £j 6� r State surcharge(12%of permit fee):
-/`�C.OL(-✓G 4 I iti / FLS plan review(40%of permit fee):
Phone:(3(,jzg-- 55'96,6 Fax:( ) (Due upon application submittal.)
CCB lic.: L1 9/ 7 3 a Total permit fees:
Amount received:
Authorized signature:
/ �ZE �f This permit application expires if a permit is not obtained
Print name: V v 4 za—c--,)v r-�S G Date: 9/(.3/,`i within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
-Describe work to b (? a
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:
❑ 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 S c Com 1 B Cor Ilas applicable):
Commercial'Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
y . E � a,
B.) Type Fire pressio
Hood Project Valuation: $
)FAFire Alarm
Submittal shall Battery Calculations a Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $ Q,, 0d, e2) ' ac,
•e1ib . 4b et � � Aloe t mj ',x �
Square Footage: Permit Fee. } 1
ASI
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.
11# ees
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: $
L•\Building\Pernuts\FPS_PemiitApp_031016.doc 2