Permit ,, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2011 -00139
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2011
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 350
Project: Williston Financial Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9 -25, PT
Project Description: Adding (2) horn strobes and (4) strobes, and rewiring third floor horn strobes. 11/17/11, reprinted permit for
address correcti n.
Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACIFIC REALTY ASSOCIATES
15495 SW SEQUOIA PKWY STE 100 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 968 -3353 PHONE:
FAX: 503 - 968 -3398
FEES
Description Date Amount
Specifics: Permit Fee - COM 11/16/2011 $102.20
12% State Surcharge - Building 11/16/2011 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 11/16/2011 $40.88
Class of Work: ALT Type of Const: Info Process /Archiving - Sm Sheet (up to 11/16/2011 $4.00
Occupancy Grp: Height: ft 11x17)
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: Yes
Total $159.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,200.00
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.3 •
Issued By: / - - rmittee Signature: \� U
Call 5.4175 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.
,� CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' COMMUNITY DEVELOPMENT Permit #: FPS2011 -00139
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2TIGARD
Parcel: 2S101AD03200
3 Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY
Project: Williston Financial Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9 -25, PT
Project Description: Adding (2) horn strobes and (4) strobes, and rewiring third floor horn strobes.
Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACIFIC REALTY ASSOCIATES
15495 SW SEQUOIA PKWY STE 100 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 968 -3353 PHONE:
FAX: 503 - 968 -3398
FEES
Description Date Amount
Specifics: Permit Fee - COM 11/16/2011 $102.20
12% State Surcharge - Building 11/16/2011 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 11/16/2011 $40.88
Class of Work: ALT Type of Const: Info Process /Archiving - Sm Sheet (up to 11/16/2011 $4.00
Occupancy Grp: Height: ft 11x17)
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: Yes
Total $159.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,200.00
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 -0091 You may obtain a copy of the rules
or direct questions to OUNC b calling 503.232.1987 or 1.800.332.2344.
Issued By: . ms -- ' =nature:
Call 503.639. • / 0 a.m. for the next available inspi n 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 OFFICE USE ONLY
-e
City of Tigar Date/B f ' Mgr Permit No.. f , i/6 __.
q III ' 13125 SW Hall Blvd., Ti ard, OR 9 2 ' \
'—"�+ -
g Pl an Review f , n Other Permit. /�
Phone: 503.639.4171 Fax: 503 " 9 4 �. '� DateB : . � � •
� I 1 � o �� 0
TI GARD Inspection Line: 503.639.4175 A\ . �Il?ate Ready/B Juris: E3 See Page 2 for
Internet: www.tigard- or.gov 0 c a - 1 P Notified/Method: 7::r4 supplemental Information
a g „ a °a r � P max. s �. : ' : , m� ' ` iV O f i ' ,. t
:t ,, ' m � . . .. ,,,.v TYaPE OF WO r i; `', + ,' ' � ,' ,L ` ' t R QU RED i D > A• , ; 1 » D Z M LY D L LI PI G
�� ti Permit fees* are based on the value of the work performed.
111 New construction ❑ P
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration /replacement it Other: equipment, materials, labor, overhead, and the profit for the
,t �CATEGO O CON TS RUC rION work indicated on this application.
111 1- and 2- family dwelling ® Commercial /industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
['Master builder ❑ Other: Number of bathrooms:
JOB SITE� INFORMAIT O N ,AND LOCATION '' r";,...4-11 Total number of floors:
Job site address: 12909 SW 68 PARKWAY CENTER #350 New dwelling area: square feet
City /State /ZIP: PORTLAND, GON 97223 Garage /carport area: square feet
Suite bldg. /apt. no Project name: WILLINSTON FINANCIAL GROUP Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIREDmD J A•AOMMERGIAL -� SI CHECKLIST `
Subdivision: I 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
Y equipment, materials, labor, overhead, and the profit for the
, q :� DFSCRIP'I�ION OF WORK , " work indicated on this application.
r ,,, , .x < . _ ., ,. s , —,AN �, ,, . aka
ADD TWO HORN /STROBES FOUR STROBES AN SUITE 350 TO NEW Valuation: $$2,200.00
EXPANDER
MOVE THIRD FLOOR EXISTING STROBE CIRCUIT TO NEW BOOSTER THIRD Existing building area: square feet
FLOOR New building area: square feet
.: r . a r Number of stories:
i :, ® '' OW1VER •• ks ' 3I s > ®,�PENANT ;
_e'er°'. r'..0oo A.- r€a. xx .� :.:.,:, 4 �nar ._' 'e'. �s' ° .e.
Type of construction:
Name: PACIFIC REALTY ASSOCIATES
Occupancy groups:
Address: 15350 SW SEQUIOA PARKWAY
City /State /ZIP: PORTLAND, OREGON 97224 Existing:
Phone: ( ) Fax ( ) New:
* ®AP � � .. CO NTAC T PERSON t , ' # N . - � � t f a... : '- '. -
,k ,� F " �� �:a q
All contractors and subcontractors are required to be
Business name: STANLEY SECURITY SOLUTIONS licensed with the Oregon Constntction Contractors Board
Contact name: GARY TAUSCHER under ORS 701 and may be required to be licensed in the
��r h d 1- jurisdiction in which work is being performed. If the
Address: 15495 SW SEQUOIA PARKWAY applicant is exempt from licensing, the following reasons
City /State /ZIP: PORTLAND, OREGON 97224 apply:
Phone: (503.)965335 - d��e4 Fax: : (503) —
•
0 3) 968 -3398
E-mail. . • - - - . :' evenn/S p 4c.- 471r.4- C% •
et � ' r x ,.. B I I IIsDG RitiI F* tT
s " , � � ,w K E CONT1tAGTOR e a '� ' '' . - ' ., (Pleas r c Ju . __ ' •F:,,
Business name: STANLEY SECURITY SOLUTIONS Permit fee:
Address: 15495 SW SEQUOIA PARKWAY State surcharge (12% of permit fee):
City /State /ZIP: PORTLAND, OREGON 97224 FLS plan review (40% of permit fee):
(Due upon application.)
Phone: (503) 968 -3355 Fax: (503) 968 -3398
Total permit fees: iS71 ,3
CCB lie.: 161567 III gir
Amount received: `53 :
Authorized signature: ' ( 1 T vi' This permit application expires if a permit is not obtained
x within 180 days after it has been accepted as complete.
Print name: GARY TAUSCHER Date: 11/07/2011 * Fee methodology set by Tri- County Building Industry
Service Board.
C\Building\Permits \FPS- PermitApp.doe 03/23/06 440- 46t3T(I1/02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
v %;a ",v=s,"�3.�?' 1. �z"' ,� o 's ,,
Describe work to 13M a M I '� :
,a � � •��xs a �� � � < ���Rs ��� . m� _�. , . �. .tee a _... � �r� „R� ,x.
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 Systern�(Complefe A B} f or i as ap livable)
Ate) Cornmercial Spr nkler. j .< t . ; _, ,.. .i v.
❑ Wet El Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
rtifi I * Hooc�Firc Supp ress on�Sy ems � , t `< ` - _ , ..{ � .n
Hood Project Valuation: $
•
C Flre�'Alarin # } k ' 8 g
Submittal shall Battery Calculations • El Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 600
RI AR=" "b 'V�,� y `''.ia'4�w #�. a� sf, 3 ,&' .t .. �
S,� 4:1
R ;S rinklerl(Stapd Alone Systein)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50 lr
7,201 and greater $381.50 �x
Sprinkler Project Square Footage: sq. ft.
a Fire &Protec�tion„Permt
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.
C: \Documents and Settings \gmtl026 \My Documents \Fire Tests \ Permits \FPS- PemutA2p PACTRUST WILLINSl'ON 12909 PARKWAY.doc