Permit u CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
illiN 0 COMMUNITY DEVELOPMENT Permit #: FPS2012 00102
T l G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/12/2012
Parcel: 2S113AB01201
Jurisdiction: Tigard
Slte address: 12909 SW 68TH PKWY 120
Project: Phoenix Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30
Project Description: Relocate or add (1) horn strobe for TI.
Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACIFIC REALTY ASSOCIATES LP
15495 SW SEQUOIA PKWY SUITE 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 07/12/2012 $51.09 _
12% State Surcharge - Building 07/12/2012 $6.13
Type of Use: COM Plan Review - Fire Life Safety - COM 07/12/2012 $20.44
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 07/12/2012 $4.00
Occupancy Grp: B 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: Yes Alarm Type: Automatic
Pull Station Required: Smoke Detectors Req: .
Battery Calcs Provided: No Cut Sheets Required: No
Total $81.66
•
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $500.00
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
ou callin• : .232.1987 or 1.800.332.2344. n Issued By: 0 , / Permittee Signature: ( An /^ I ,� 7 i e
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 OFFICE USE ONLY
1111 City of Tigard DateBea �� Permit No.: 'ri 5 a - OD ,/Q
° 13125 SW Hall Blvd., Tigard, OR 972 Plan Review t• � 1� 0l110 Ot .0. _Ai Z9
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : �a1 Permit: lP %#
T I G A 1t D Inspection Line: 503.639.4175 JUL 2 2012 Date Ready 77 • : Juris: See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
CITY OFTIGARD
TYPE °F ORMING DIVISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ 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
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling ® Commercial /industrial Valuation: $
. El Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12909 SW 68 PARKWAY CENTER #120 New dwelling area: square feet
City /State /ZIP: PORTLAND, OREGON 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: PHOENIX SYSTEMS USA 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.
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 is ap lication.
RELOCATE OR ADD ONE HORN TO SUITE 120 ON EXISTING AFA Valuation:
Existing building area:. square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PACIFIC REALITY ASSOCIATES Type of construction:
Address: 15350 SW SEQUIOA PARKWAY Occupancy groups:
City /State /ZIP: PORTLAND, OREGON 97224 Existing:
Phone: ( ) Fax: ( ) New:
0 APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: STANLEY SECURITY SOLUTIONS All contractors and subcontractors are required to be
Contact name: GARY TAUSCHER licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15495 SW SEQUOIA PARKWAY jurisdiction in which work is being performed. If the
City/State /ZIP: PORTLAND, OREGON 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 968 -3355 Fax: : (503) 968 -3398
E -mail: GTAUSCHER @STANLEYWORKS.COM
CONTRACTOR BUILDING PERMIT FEES*
Business name: STANLEY SECURITY SOLUTIONS (Please refer to fee schedule)
Permit fee:
Address: 15495 SW SEQUOIA PARKWAY
City /State /ZIP: PORTLAND, OREGON 97224 State surcharge (12 %ofpermit fee):
FLS plan review (40% of permit fee):
Phone: (503) 968 -3355 Fax: (503) 968 -3398 (Due upon application.)
CCB lic.: 161567 Total permit fees:
Authorized signature: Amount received: la /. 4 f'
� 1. )( 3,0 This permit application expires if a permit is not obtained
Print name: GARY TAUSCHER i Date: 7/11/2012 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
•I: \Building\Permits \FPS- PermitApp.doc 03 /23/06 440- 4613T(11 /02/COM/WEB)
l` 4914,5.
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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 Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ® Yes
Cut Sheets _
Fire Alarm Project Valuation: $ 41
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 - $187.50
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. •
• 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. •
"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 \gnt1026 \My Documents \Fire Tests \Permits \FPS- PermitA2p PACTRUST PHOENIX SYSTEMS 12909 PARKWAY.doc