Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
r y N
X COMMUNITY DEVELOPMENT Permit #: FPS2011 -00034
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/12/2011
Parcel: 2S113AB00600
Jurisdiction: TIGARD
Site address: 16160 SW UPPER BOONES FERRY RD
Project: Dow Agrosciences Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Install fire anncation system.
Contractor: ADVANCED SECURITY & FIRE Owner: PACIFIC REALTY ASSOCIATES
2218 NE SUNRISE LN 15350 SW SEQUOIA PKWY #300
HILLSBORO, OR 97124 PORTLAND, OR 97224
PHONE: 503 - 519 -4550 PHONE: 503 -624 -6300
FAX: 503 - 640 -8311
FEES
Description Date Amount
Specifics: Permit Fee - COM 04/12/2011 $123.72
12% State Surcharge - Building 04/12/2011 $14.85
Type of Use: COM Plan Review - Fire Life Safety - COM 03/18/2011 $49.49
Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg Sheet (over 04/12/2011 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm Sheet (up to 04/12/2011 $10.50
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: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $204.56
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,000.00
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 N. ''cation ter. 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 O C b . n. 03.232.1987 or 1.800.332.2344.
Issued =y: � Permittee Signature: I, 77Z
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 ApplicatioCl
Fire Protection System 1� FOR OFFICE USE ONLY
City of Tigard IA 8 f ` i Dace/B i 4 . , J Permit No.: , "3
il 13125 SW Hall Blvd., Tigard, OR }? Plan, Review -�f.
: ' : Phone: 503.718.2439 Fax: 503. 4 6.�9GOJ F TIGARD Plan R : e1igi�� Other Permit:
p
Ins ection Line: 503.639.4175 BUILDING DIVISION Date Ready '. kris: : ® See Page 2 for
TIGARD
Internet: www.tigard- or.gov Notified/Method:3 7 // 7 J Supplemental Information
cer) L) ■ { l•• D7,t,V I
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 ( romded 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.
❑ 1- and 2- family dwelling aCommercial/industrial Valuation: $
El Accessory building C1 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION f n Total number of floors:
Job site address: A )4,0 SZ( �y) e 0 8o (91165 rry et New dwelling area: square feet
City /State /ZIP: 77 ,,,,,::(/ Q R / -) 0 24 Garage /carport area: square feet
Suite/bldg. /apt. no.: J Project name: /Da to /9/1 0 Se i e' ce. S Covered porch area square feet
Cross street/directions to job site: /6 A S tp 5 ` y 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.
-2 5 9 jr 7Cj 0 e /9 n n c /3 � T- U c) s v s i- e M Valuation: $ s r dQ 0 77
Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: ,O C j p u S4-- Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be liensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone:( ) Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
L (Please refer to fee schedule)
Business name: /9d r/'/4 n C Lv Sec L( i ` 3 F. / T e
'1 Permit fee:
Address:
�"� N .5(4 n r t S e ,� n • State surcharge (12% of permit fee):
City /State /ZIP: A) t ' // ' b r Q �^ R -) / 01-7 FLS plan review (40 %ofpermit fee):
Phone: (50 3) s i 9 LZ 55 5 O Fax: (503) 3s)- C 1 7 (Due upon application.)
CCB lic.: ( g( r 7G Total permit fees:
Authorized signature: 7 Amount received:
� v t a �O r/ V ; � / This permit application expires if a permit is not obtained
Print name: E„ , O / , - 1,,,, t.�c Date: J / / g /!J within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1. Building \Permiu\FPS- PermitApp.dac 02/01/2011 440- 4613T(I l /O2ICOM/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 ❑ 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 Mann
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Mann Project Valuation: $
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
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