Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s. COMMUNITY DEVELOPMENT Permit #: FPS2011 -00033
T f G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/16!2011
Parcel: 1 S135BC00700
Jurisdiction: Tigard
Site address: 10795 SW CASCADE AVE
Project: Arden Subdivision: Lot: 0
Project Description: Add (2) tamper switches to fire alarm panel.
Contractor: SAFE TECHNOLOGY GROUP INC Owner: CH REALTY III /PORTLAND INDUSTRIA
6400 NE HWY 99 SUITE G375 BY THOMSON PROFESSIONAL &
VANCOUVER, WA 98665 REGULATOR
CONTROLLING OWNER OF
EPROPERTYTA
PO BOX 4900
PHONE: 360 - 699 -2130 SCOTTSDALE, AZ 85261
FAX: 360 - 719 -1527 PHONE:
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/16/2011 $75.30
12% State Surcharge - Building 03/16/2011 $9.04
Type of Use: COM Plan Review - Fire Life Safety - COM 03/16/2011 $30.12
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $114.46
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,373.00
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. Thos rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtai a copy of the rules
or direct questi o OU sy • -Iling 503. 32.1987 or 1.800.332.2344.
Issued By: / 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 RECEIVED FOR OFFICE USE ONLY
1�,
City of Tigard �,�jIVE� Received I Permit No.: /
* 13125 13125 SW Hall Blvd., Tigard, OR 972231 Review
_ Permit ! �b33
i rr, . Pl i ew
-
Phone: 503.639.4171 Fax: 503.598.196 " Date/B : Other Permit:
TI GARD w Inspection Line: 503.639.4175 Date Ready/By: Buis. ® See Page 2 for
Internet: ww.tigard- or.gov CITY OFT Notified/Method: Supplemental Inform .lion
BUILDING YIS' 1i- --
TYPE OF WORK E REQUIRED DATA: 1- AND 2- FAMILY DWELL I NG
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
jAddition /alteration/replacement ❑Other: Indicate the value (rounded to the nearest dollar) of al l
equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1- and 2-family dwelling Valuation: $
❑ y g ®CommerciaUindustrial
❑ 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: 107 q S s j 0415(, d (y/ id New dwelling area: square feet
City/State/ZIP: '54,01 OR Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: JJ'raft 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 1 tr the
DESCRIPTION OF WORK work indicated on this application.
add o2 - FL rn per SO ir.1 e 5 ID Ace..- a (4/4i p‘ev., f Valuation: $ 1373
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups: M /5
City/State/ZIP: Existing:
Phone: ( ) Fax: ( )
New:
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: Safe Technology Group Inc. All contractors and subcontractors are required to be
Contact name: Jason Sweet licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6400 NE Hwy 99 Suite G375 jurisdiction in which work is being performed. If the
City / State/ZIP: Vancouver WA 98665 applicant is exempt from licensing, the following reams
apply:
Phone: (360) 699 -2130 Fax: : (360) 719-1527
E -mail: sales @safetechnology.net
CONTRACTOR BUILDING PERMIT FEES*
Business name: Safe Technology Group Inc. (Please refer to fee schedule)
Address: 6400 NE Hwy 99 Suite G375
Permit fee: 76: .30
City/State/ZIP: Vancouver WA 98665 State surcharge (12% of permit fee): 9.,05/
FLS plan review (40% of permit fee): 22,�,,
Phone: (360) 699 -2130 Fax: (360) 719 -1527 (Due upon application)
Off'
CCB lie.: 173731 VA/// 3 Total permit fees: ''ll
Authorized signature: Amount received: /N. � T
This permit application expires if a permit is not obtained
Print name: , 3;45 avt. ...41Y.41- Date: 3. / Lf , (l within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Indust)
Service Board.
I:\ Building \Permits.FPS- PermitApp.doc 10/01 /09 440- 4613T(11 /02 /COM/WEB)
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 ..�n ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1 3 -) 3
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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
\ \Safeserver \d$ \ SAFE \ Forms \Use these forms \Permit Apps \Tigard \FPS- PermitApp.t ,c 10/01/09
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