Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2013-00133
Date Issued: 09/17/2013
T i c ARD 13125 SW Hall Blvd,Tigard OR 97223 503 718 2439 Parcel: 2S112DA01000
Jurisdiction: Tigard
Site address: 6610 SW CARDINAL LN
Project: Umpqua Bank Subdivision: 1995-098 PARTITION PLAT Lot: 1
Project Description: Fire alarm-FACP upgrade for elevator recall
Contractor: STONER ELECTRIC Owner: PACIFIC REALTY ASSOCIATES
1904 SE OCHOCO ATTN• N PIVEN
MILWAUKIE, OR 97222 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE. 503-462-6500 PHONE: 503-624-6300
FAX: 503-659-2765
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/17/2013 $145.24
12%State Surcharge-Building 09/17/2013 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 09/17/2013 $58 10
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 09/17/2013 $1 50
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 Yes
Total $222 27
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation. $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $7,000.00
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, • - is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility 'otification Cent- Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules
or• ect questions to OUNI : - ling 503.232 1987 or 1 800 332.2344
I sued 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
Fire Protection System RECEWED FOR OFFICE USE ONLY
RECEWED City of Tigard Received Date/13y. 9 /le , , I Permit No•,12562%,/3-eel 33
13125 SW Hall Blvd.,Tigard,OR 97223( - 1 6 2013 Plan Revtew
1 11. Phone: 503.718 2439 Fax: 503.598 1966 - Date/By
/� 7 �� Other Permit
T I G A R D Inspection Line: 503.639.4175 Date Ready Juns Ea See Page 2 for
Internet. www.tigard-or.gov CITY OF TIGARD Notified/Method. q//7/�3 tgrr—I Supplemental Information
BUILDINGDIVISION *Fpake will. Acct.(
TYPE OF WORK REQUIRED DATA:I-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.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: S
❑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:6610 SW Cardinal Lane New dwelling area: square feet
City/State/ZIP:Tigard,OR.97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Umpqua Bank-0021 PCC 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 this application.
FACP upgrade for elevator recall Valuation: $7,000.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 3
Name:Umpqua Bank Type of construction:
Address:20085 NW Tanasbourne Drive Occupancy groups:
City/State/ZIP:Hillsboro,OR.97124 Existing:
Phone:(877)240-4868 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 licensed 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*
Business name:Stoner Electric Group (Please refer to fee schedule)
Permit fee:
Address: 1904 SE Ochoco St.
City/State/ZIP:Milwaukie,OR.97222 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)462-6500 Fax:( ) (Due upon application)
CCB lie.:44823 Total permit fees:
Ale Authorized signature: ,(_71 ■ . '� Amount received: 0—
This permit application expires if a permit is not obtained
Print name:Nick Gianopoulos Date:9-16-2013 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
i.\Budding\Per mts\FPS-PermaApp doc Rev 01/05/2012 4404613T(I I/02/COM/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:
El 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: $ 7,000.00
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.
O•\STS\_Accounts\Umpqua Bank\_Oregon\0021 Pacific Corporate Center\FLS\00212ACP Upgrade 18211V\0021 City of Tigard FPS Permit App.doc Rev 01/05/2012