Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
■ COMMUNITY DEVELOPMENT Permit#: FPS2019-00133
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/22/2019
Parcel: 1S135AC04100
Jurisdiction: Tigard
Site address: 9010 SW OAK ST
Project: Oak Street Apartments Subdivision: ASHBROOK FARM Lot: 15
Project Description: Fire alarm. Adding(1)device.
Contractor: THE SPANOS CORPORATION Owner: DBG OAK STREET LLC
10100 TRINITY PARKWAY, 5TH FL 2164 SW PARK PL
STOCKTON, CA 95219 PORTLAND, OR 97205
PHONE: 209-478-7954 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/22/2019 $51.09
12%State Surcharge-Building 10/22/2019 $6.13
Type of Use: MF Plan Review-Fire Life Safety-COM 10/22/2019 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 10/22/2019 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
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 Calcs Provided: Cut Sheets Required:
Total $78.16
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $200.00
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;7. You may obtain a copy of the rules
or direct questions to OUNC by ca ing 503.232.1987 or 1.800.332.2344.
By:
t
r
Issued arR‘
Permittee Signature: !`
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 RECEIVE . FOR OFFICE USE ONLY
City of Tigard OCT 1 7 2019 DateB d Af i Pe 4.. , /`�j OCA/..�
11„,
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / �
■ Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD Date/B : r L is' ' --a,1 7
t.1 G 1z D Inspection Line: 503.639.4175 BUILDING DIVi3ION Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
xiNewconstruction ❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
IDI-and 2-family dwelling 111Commercial/industrial Valuation: $
❑Accessory building Tzir Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: go!0 3W r* 4 New dwelling area: square feet
City/State/ZIP: rum.42) to ci?ZZ 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 0A1 sneer TS Covered porch area: square feet
Cross street/directions to job site:
'�'�fr!`'{{ Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
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
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ "cam
(-_,A)
��iC,t Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: v 4` S-r'p_ .---- ,4.16S ALL Type of construction:
Address: /c Z2 J SW theeer0 (3ve/- go '3Q Occupancy groups:
City/State/ZIP: c n..4 rt,,) 7l- '7 92.2_3 Existing:
Phone:(.SG''))Z ?- --9J3 3 Fax:( ) New:
E APPLICANT 0 CONTACT PERSON NOTICE
Business name: (5/4.4 s;-'oec-T- h3 Zu All contractors and subcontractors are required to be
Contact name: 5� N licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: / j2Ca 5 y4 cif 46 &) 4 p_i) *530 jurisdiction in which work is being performed.If the
City/State/ZIP: pC7 O g- 1?2 Z 3
applicantpis exempt from licensing,the following reasons
apply:
p1
Phone: 551)3) 2:-Z//.�t,3) Fax::( )
E-mail: ) 11 CJa_157)cVb5' COY"
CONTRACTOR BUILDING PERMIT FEES*
Business name: A ITl . .-?,,4,,o. (Please refer to fee schedule)
Address: /02 ZO 5y4 en2e6„,Bt 2h gL) ii53O Permit fee:
City/State/ZIP: pbl Tom. ) per— 9.p-223 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(5D3)i. /2— 3) Fax:( ) (Due upon application submittal.)
CCB lic.: 2,0 6 Total permit fees:
%,...........__/ Amount received:
Authorized signature
This permit application expires if a permit is not obtained
Print name: . r• kiguvn Date: t D/ ,1./ within 180 days after it has been accepted as complete.
/ * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PennitApp_031016.doc 440-4613T(11/02/COM/WEB)
7"° City of Tigard E I Permit No.: flP5? 4!7 0��3
- .. .
� 13125 SW Hall Blvd.,Tigard,OR 97223 1 /
Phone: 503.718.2439 Fax: 503.598.1960 OCT 7 2019 Date Received: C(, // 7 A
T 1 G ARD Inspection Line: 503.639.4175 B ( C �/1,114 e7
9T
Internet: www.tigard-or.gov CM/ . :GARn y. �l{"i�y/
BUILDING OW'JL; .,,.
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: C;94 - 3Q- 7- i472-7-i,16 T5 Occupancy: ,/a-T7 7�1LY
Job Address: %)/0 6N4 OA-L 5T Suite:
Contractor: SpA,c " Phone: 5C Z 7 Z
Valuation of work: $ Zcv 6t)
Type of System: (check one) ,1equired ❑Non-required
(check one) j7lAutomatic ['Manual ['Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max 5) /To be Relocated(max 5) 1
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) /To be Relocated(max 5)
a Pte) ,, 4-I Oregon Construction Contractors Board No. ,9 c 9
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
f) Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
In addition, I understand the following is required:
• Submit(3) copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• Electrical permit.
• A copy of . is docum nt with a copy of the sketch attached shall be available for all inspections.
Signature: Date: lc/ (7-A l
Print Name: �0...0) M
I:\Building\Fonns\FireAlannAffidavit_071514.docx Page 1 of 1
. y
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:
❑ Addition or 1-10 heads: Affidavit required and e.elf 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, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type n Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line Yes ❑ No
-Group
pestTh-Area
actor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations Yes
include: Individual ComponentYes
Cut Sheets 1
Fire Alarm Project Valuation: $ ate, (�
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): $
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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2