Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2013 -00055
T l G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/29/2013
Parcel: 1 S 134AA02100
Jurisdiction: Tigard
Site address: 10300 SW NIMBUS AVE P -A
Project: FMC Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 3
Project Description: Fire alarm system installation
Contractor: ADVANCED ALARM SYSTEMS INC Owner: FRESENIUS MEDICAL CARE, NA
1030 NW CORPORATE DR 5251 DTC PARKWAY
TROUTDALE, OR 97060 GREENWOD VILLAGE, CO 80111
PHONE: 503 - 550 -0999 PHONE: 303 - 712 -1814
FAX: 503 -492 -3413
FEES
Description Date Amount
Specifics: Permit Fee - COM 05/29/2013 $166.76
12% State Surcharge - Building 05/29/2013 $20.01
Type of Use: COM Plan Review - Fire Life Safety - COM 04/30/2013 $66.70
Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg $2.00 (over 05/29/2013 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 05/29/2013 $8.50
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: No Smoke Detectors Req: Yes
Battery Calm Provided: Yes Cut Sheets Required: Yes
Total $263.97
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $8,470.00
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 dire uestion . OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue 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
�f 3 FOR OFFICE USE ONLY
City of Tigard
Date/By : 41 30 II 3 `c� Pet No f r' J�UI 3 SS.'" - " 13125 SW Hall Blvd., Tigard, OR 97223 ie (�,�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Plan Rev ij ((2 Other Permit: rvl.r e ) O,3 . a.)60 9
TIGARD Inspection Line: 503.639.4175 Date ReadyNBy: 5.�1 �j' ... runs / ®See Page 2 for
Internet: www.tigard or.gov 4 Notified/Method. / ' r j Supplemental Information
)IL- l 9414 I C. -- - 5 C— z it / u -e /0 �L &Z�/ —
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 (rounded to the nearest dollar) of all
IN 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 ® Commercial /industrial Valuation: $
❑ 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: 10300 SW Nimbus Ave New dwelling area: square feet
City/State/ZIP: Portland OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: FMC Noble Woods 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 for the
DESCRIPTION OF WORK work indicated on this application.
L /
Fire Alarm system installation Valuation: $ $ ` O -�
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: FMC Type of construction:
Address: Occupancy groups:
City/State /ZIP:
Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
k y (Please refer to fee schedule)
CC
Business name: Advanced Alarm Systems Inc. EIS
Structural plan review fee (or deposit):
Contact name: Scott Sullivan
FLS plan review fee (if applicable):
Address: 1030 NW Corporate Drive
City/State/ZIP: Troutdale OR 97060
Total fees due upon application:
Phone: (503) 550 -0999 Fax: : (503) 492 -3413
Amount received:
E -mail: scottsri advancedalarmsystemsinc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Advanced Alarm Systems Inc. Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 1030 NW Corporate Drive Solar Installation Specially Code checklist.
City /State/ZIP: Troutdale OR 97060 Permit fee (includes plan review $180.00
and administrative fees):
Phone: (503) 550 -0999 Fax: (503) 492 -3413 State surcharge (12% of permit fee): $21.60
CCB lic.: 186615 S/t t.c 1l ( Total fee due upon application: $201.60
Authorized signature: G �. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ` ] fin- S J il IV( 1 ■ ,J Date: 1..,. -l3 * Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building \Permits \BUP -COM PermitApp.doc 02/24/2011 440- 4613T(11/02/COM/WEB) PK Lo t
'?1)
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.) ire Alarm
Submittal shall Battery Calculations 'Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $ Z C_r 7c) , ""
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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