Permit 1 , 1 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2010 -00149
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010
TIGARD Parcel: 1S134CC01700
Jurisdiction: Tigard
Site address: 12325 SW KATHERINE ST
Project: Woodward Elementary Subdivision: Lot: 0
Project Description: Fire Alarm.
Contractor: PERFORMANCE SYSTEMS INTEGRATION CORP Owner: TIGARD - TUALATIN SCHOOL
7324 SW DURHAM RD DISTRICT #23J
PORTLAND, OR 97224 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503 - 641 -2222 PHONE:
FAX: 503 - 641 -1464
FEES
Description Date Amount
Specifics: Permit Fee - COM 12/22/2010 $242.08
12% State Surcharge - Building 12/22/2010 $29.05
Type of Use: COM Plan Review - Fire Life Safety - COM 12/22/2010 $96.83
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: El Height: ft
Stories: 1
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: Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $367.96
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $15,650.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No cation C er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or direc questions to OU by . ling 50. !32.1987 or 1.800.332.2344. 110 I ,. /
Issued y: ,/ \ / ' / Permittee Signature: \ . Iv •
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System FOR E.
OFFICE USONLY
•• . Received
City of Tigard %`�. Q 10 �� l�
1 1,11 Dlncthv:
13125 SN' flail Blvd., fi OR 97223 (�� �^� Plan Review �i� /
' R
Phone: 503.639.4171 Fax: 503.598.19NY 1 •® Date /ts+-: / �/�I
TI( btspcctionLme: 5(13.(39.4175 �f • xi l \Ors DateRd,.' y. - Anti ®
Iniemi +l: + +'ww•tigard- mg" 0. �, `� ✓ � 1 �t 7 +• 7 Notified/Method: / / ti e Iemrntal Information
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❑ New construction ❑ Demolition P - ' ces" are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
IN Addition /alteration /replacement ❑ Other: equipment, materials, labor. overhead. and the profit for the
: r' " n" ` .t work indicated on this application.
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1=1 I- and 2-family dwelling ISAConunercial /industial Valuation: S
❑ Accessory building ❑ Multi- family Number of bedrooms:
ID builder El Other:
Number of bathrooms: • '! "$ u .; I ifiAITI' 1 \i ORAI (I Ni Vi OCA I A , , k s 5 o Total number of floors:
Job site address: %23yS so K4Aa4r►t ia_ New dwelling area: square feet
City /State'ZlP:.rt aR 9'7 i, 21 Garage /carport area: square feet
Suite/bldg./apt. nt.: Project name :N�, � lrre A V fI. 446"4. Covered porch area: square fret
Cross street/directions tts un job site: S W (��ity .I r 121 S'e 43 r6.PL Deck area: square feet
Other structure area: square feet
RbQt11RED DA l A COIVIMI Rd IAI USE;CHI CKlclt l t'
n"x!
Subdivision: I Lot no.: Permit lees;: are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
fax map/parcel no" equipment. materials, labor. overhead, and the profit for the
•
-<- )` 't , DI: SCR IPT iii?. )F R \ ()RK ' " 1, K - .. ra` work indicated on this application.
lication.
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Valuation: 56 0 $
Po( 41 molt_ Existing building area: square feet
Ness' building area: square feet
f - ❑ PROPI in 1 U V1 N '
R z . M „ r - s : g q ti 4 I ry ,,,. `
u v ®� krine lr¢ a� . a ntberofstories:
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Name: Type of construction:
Address: ' Occupancy groups:
City /State %Zl P: Existing:
Phone: ( ) Fax:( ) New:
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Business name: " F , RfGRe,h► tt -E �y's)�• S All contractors and subcontractor are required to he
r / 3 ( J1 , licensed with the Oregon Construction Contractors Board •
Contact moue:
-�OHn3 �att -ril 6 - 1) C CI / 16 lit under ORS 701 and may he required to be licensed in the
Address: 1-3-)- st- Si ti wirHwrtl A_ J urisdiction In which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: pOtizS►.r, / ors / 0(122)t apply:
Phone: ( SUS (01 1-2,217 I Fax: : ( Cc-ft - 046 c{.
E -mail: ..
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Business name: -- ?ER-a. -a Sys. / ErAS
/ Permit fee:
Address: ? 32y Sk; b oxsiA,4 R4�
j State surcharge (1 2% of permit ice):
City /State /ZIP: poTw �
+A / oil- / 6 11_22.4
/// FLS plan review (40% of permit fee):
Phone: (503 ) ( ( -2222_ I Fax: ( &o.V) (A i k,L+ (Due upon application.)
•
CCB tic.: Total permit fees: 6, 7, e
Amount received:
Authorized signature:` Y
. 7 "
This permit application expires if a permit is mH obtained
Print name: `�1RRD G�'i; Fa Date C - b) -2 t
within 180 days after it has been accepted as complete.
Fee methodology set by Tli- County Building Industry
Service Board
Ial3uilding 'S- I'ermitA'TAN 03'23;06 440- 161:MI1:01- COM-wF.I3)
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