Permit n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2013-00153
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2013
Parcel: 1S 136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE#200
Project: Kronos Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Fire alarm modification
•
Contractor: ERTELL ELECTRIC LLC Owner: PNWP LLC#2
PO BOX 279 PNWP LLC
FOREST GROVE,OR 97116 6600 SW 105TH AVE#175
BEAVERTON,OR 97008
PHONE: 503-841-4511 PHONE:
FAX: 503-359-5652
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/28/2013 $102.20
12%State Surcharge-Building 10/28/2013 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 10/28/2013 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 10/28/2013 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 10/28/2013 $3.50
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: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $160.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,100.00
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 N. ' . 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 dir- t questions to'UNC by calling 503.232.1987 or 1.800.332.2344.
Issu • By: I Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available ction
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
t L,CtJED Received
' City of Tigard �] Q Date/By: I��e. /3 Permit No.:�i��,(j !z (53
13125 SW Hall Blvd.,Tigard,OR 97223 i CT 6 V 2013 Plan Review t vJ/✓
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
�'- /�� ' (301her Permit:
I C.n R D Inspection Line: 503.639.4175 r/? ® Date Ready/By: luris, ® See Page 2 for
Internet: www.tigard-or.gov CITY®F 1 IUl�fl® Notified/Method: r0� ,k C-10 Supplemental Information
RI JU nmi(;Il!\fl tiiONI c ,cli,- e-. w/ a4-.4 o
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑Ne 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
0 equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling I' m
Comercial/industrial Valuation: $
❑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: //F577 f� G7.— , ve New dwelling area: square feet
City/State/ZIP: 5-7- 4,,,_6( ' e2 Garage/carport area: square feet
Suite/bldg./apt.no.:- jp- Project name: /er pnOS Covered porch area square feet
Cross street/directions to job site: AX 71.. ir, ,z--5-- Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE 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
equipment,materials,labor,overhead,and the profit for the
. DESCRIPTION OF WORK work indicated on this application.
�� /v5 /ems Valuation: $ r�aftil
7-' 3 7- Existing building area square feet
New building area: square feet
0-PROPERTY OWNER • TENANT Number of stories:
Name: /C iv,n OS Type of construction:
Address: • Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) • New: '
[J'APPLICANT ❑ CONTACT PERSON NOTICE
Business name:��ie.`( i/eG . LL C All contractors and subcontractors are required to be
Contact name:Jam CS /'_ /.61/ �3 , 0 'V - `- a 6 licensed with the Oregon Construction Contractors Board (t
;� v�r"' 7 under ORS 701 and may be required to be Icensed in the
Address: ry 150x i a?-q jurisdiction in which work is being performed.If the ��,
Q applicant is exempt from licensing,the following reasons
City/State/ZIP:
-�ored-(irz„)e OQ 17/(6 apply:
Phone:( -03) g4((- (.j (f / // Fax: :(473) 35 - g15 6-2
E-mail:Ja,,ie5�tr-/el/Se_/u°Chs.le t 40'14
CONTRACTOR , BUILDING PERMIT FEES*
-(Please refer to fee schedule)
Business name: e a b air k a Permit fee:
Address: •
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%ofpermit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.: /10'^c16) Total permit fees:•
,���, Amount received:
Authorized signature: ` i,�`._�
This permit application expires if a permit is not obtained
`� Date: * within 180 days after it has been accepted as complete.
Print name
' ("" 7 Fee methodology set by Tri-County Building Industry
/ Service Board.
I:\Building\Permits\FPS-PetmitApp.doc Rev 01/05/2012 440-4613T(I1/02/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:
❑ 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: $
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.
I:\Building\Permits\FPS_PemvtApp.doc Rev 01/05/2012 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11850 SW 67TH AVE STE 200, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
2014-03-13 (null)
FPS2013-00153
PASS - No C of O
Violation Summary:
Inspector Contractor