Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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2 _- COMMUNITY DEVELOPMENT Permit #: FPS2009 -00037
Date Issued: 06/17/2009
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 2S101 CB00500
Jurisdiction: TIGARD
Site address: 12670 SW Hall _BLVD
Subdivision: Lot: 0
Project: Apex Industries
Project Description: Add to existing fire alarm system duct smoke detector.
Owner: FEES
TCTPI LLC Description Date Amount
25977 SW CANYON CREEK RD #J
WILSONVILLE, OR 97070 Permit Fee - COM 06/01/2009 $62.50
12% State Surcharge - Building 06/01/2009 $7.50
PHONE. Plan Review - Fire Life Safety - COM 06/01/2009 $25.00
Contractor:
ACTION TECHNOLOGY SYSTEMS
835 SE 17TH AVE
PORTLAND, OR 97214
PHONE: 503 - 231 -1992
FAX: 503 - 231 -1402
•
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: F -1 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: No Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total .$95.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 1200
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 to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ` t c__,,,,k,0■ O / l Permittee Signature: ° /
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.
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Building Permit Application
Fire Protection System City of Tigard FOR OFFICE USE ONLY
r� ECG - - � t" '� Received Pit N
. v 13125 SW Hall Blvd., Ti aid, OR 97223 Date/By: : . / Permit o. F �00q. X37
g 20 09 Plan Review i
Phone: 503.639.4171 Fax: 503.598.1960 JUN o Date/By: C ( h 6 Other Permit:
Inspection Line: 503.639.4175 Date ReadyBy: 1 ® See Page 2 for
T18ARD Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: 6" /7 o'' — 1 Supplemental Information 47 DI dl f11t\If: IUIC,o1N
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❑ 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
...., ,.:,,. >;° ;,:r <F = .;. ,- JCT II indicated this application.
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Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
111 Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
al ` ,JOB,,.SI7?E*ORMATiUN.,,r io- U.GA C ON''` .; . ', Total number of floors:
Job site address: 12670 SW HALL New dwelling area: square feet
City /State /ZIP: TIGARD OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: APEX INDUSTRIES Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
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:'.REQULKED;DA-T`A: ;C.OMMERCL L-1 E CHECKLIST;
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Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.:
equipment, materials, labor, overhead, a nd the profit for the
i •'•4: :, ° _:, t,c - •; ;_' t ?` work indicated on this application.
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DESCRIPT O °OF; WORIC�� >t ���,«�� PP
ADD TO EXISTING SPRINKLER MONITORING SYSTEM -DUCT SMOKE Valuation: $$1,200.00
DETECTOR
Existing building area: square feet
New building area: square feet •
v ' ;., ., >, ,_ ^: :��':. t, : ��,,,,,�,. Number of stories:
, P R O P,ERTY-; . Q^W. ,NERE; :: . ear ;;.. TENA z �' -
Name:
Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
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Business name:
All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: apply:
Phone: ( ) Fax::( )
E -mail:
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. i.> ;> B TFEES
,'.3 LIIIDING'PERMI ”
CONTRACTORS ed u '
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Business name: ACTION TECHNOLOGY SYSTEMS LLC Permit fee:
Address: 835 SE 17 AVENUE State surcharge (12% of permit fee):
City /State /ZIP: PORTLAND OR 97214 FLS plan review (40% of permit fee):
Phone: (503) 231 -1992 Fax: (503) 231 -1402 (Due upon application.)
CCB lic.: 157630 Total permit fees:
Amount received: %. c 'y
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: STEVEN A. BARRY Date: 6 -1 -2009 * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits \FPS - PermitApp.doc 03/23/06 440- 4613T(1 l /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
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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:
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❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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Hood Project Valuation: $
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Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1200.00
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Square Footage: Permit Fee: _ ` %�_<�' ' �;� � `�.
0 to 2,000 $187.50 ; : % >- e., �
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.
`a '`3?riiecuori I'ermtt Fees. _t
Project valuation subtotal (see A, B & C above): $ 1,200.00
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