Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 a COMMUNITY DEVELOPMENT Permit #: FPS2009 -00069
I G AR E) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/06/2009
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Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 400
Subdivision: TIGARD TRIANGLE CENTER Lot: 0
Project: Silkin
Project Description: Install (3) additional horn strobes on existing fire alarm.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 Permit Fee - COM 08/06/2009 $62.50
12% State Surcharge - Building 08/06/2009 $7.50
PHONE: 503 - 624 -6300 Plan Review - Fire Life Safety - COM 08/06/2009 $25.00
Contractor:
STANLEY SECURITY
15495 SW SEQUOIA PKWY #100
PORTLAND, OR 97224
PHONE: 503 - 968 -3353
FAX: 503 - 968 -3398
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: B Height: ft
Stories: 4
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $95.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 1500
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 -0100. You may obtain a copy of the rules
or direct questions t OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: athA. ` Permittee Signature: —
Pr Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
r Building Permit Application
'Fire Protection System FOR OFFICE USE ONLY
RECEIVED
City of Tigard Received
DateB 0 4 Permit No.: 9 Z 009
1,1 • O O O
a 13125 S50 Hall .417 Tigard, OR 98 Plan Revie jell s p •+ Y P7 . o . /' 6
� Phone: 503.639.4171 Fax: 503.598.1960 AUG 0 6 2009 Dat e/Bv: 10 Other Permit: C tG
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: til See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: T) Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
dwelling Valuation: $
❑ 1- and 2-family g ®C ommerciaUindustrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12909 SW 68Th PARKWAY, #400 New dwelling area: square feet
City/State /ZIP: PORTLAND, OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: 400 Project name: SILKIN Covered porch area: square feet
Cross street/directions to job site: 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
INSTALL THREE ADDITIONAL HORN STROBES ON EXISTING FIRE Valuation: $
SYSTEM Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PACIFIC REALITY ASSOCIATES Type of construction:
Address: 15350 SW SEQUOIA PARKWAY Occupancy groups:
City/State /ZIP: PORTLAND, OR 97224 _ Existing:
Phone: (503)624 -6300 Fax: (503)624-7755 New:
0 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: STANLEY SECURIITY SOLUTIONS All contractors and subcontractors are required to be
Contact name: GARY TAUSCHER licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15495 SW SEQUOIA PARKWAY, SUITE 100 jurisdiction in which work is being performed. If the
City/State /ZIP: PORTLAND, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 968 -3355 Fax: : (503) 969 -3398
E -mail:
CONTRACTOR BUILDING PERMIT FEES* schedu
Business name: STANLEY SECURITY SOLUTIONS °mjeeul
Permit fee:
Address: 15495 SW SEQUOIA PARKWAY, SUITE 100
City/State /ZIP: PORTLAND, OR 97224 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 968 -3355 Fax: (503) 968 -3398 (Due upon application.)
CCB Iic.: 161567 Total permit fees:
Authorized signature: Amount received: Q5. 00
This permit application expires if a permit is not obtained
Print name: STEVE MOREHOUSE Date: 8/6/2009 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri -County Building Industry
Service Board.
1:\ Building \Permits\FPS- PermitApp.doc 03 /23/06 440- 46I3T(11 /02/COM/WEB)
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City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
® Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: 1 $
C.) Fire Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
http: / /www.tigard- or.gov/ city_ hall /departments /cd /dots /FPS - PermitApp.doc 2