Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111/ 2 ° COMMUNITY DEVELOPMENT Permit#: FPS2016-00025
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/08/2016
Parcel: 1 S135BB00501
Jurisdiction: Tigard
Site address: 10575 SW CASCADE AVE
Project: Biamp Subdivision: OAKBURG Lot: 27
Project Description: Fire alarm modifications for new tenant
Contractor: WESTERN STATES FIRE PROTECTION Owner: ICON OWNER POOL 3 WEST LLC
13896 FIR ST STE B BY INDCOR PROPERTIES
OREGON CITY, OR 97045 2 NORTH RIVERSIDE PLAZA, STE 235
CHICAGO, IL 60606
PHONE: 503-657-5155 PHONE:
FAX: 503-657-5182
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/08/2016 $220.56
12%State Surcharge-Building 03/08/2016 $26.47
Type of Use: COM Plan Review-Fire Life Safety-COM 03/08/2016 $88.22
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 03/08/2016 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 03/08/2016 $10.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes 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 $349.25
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $14,000.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of O'- Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work s not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow e rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo may obtain a copy of the rules
or direct q ions . •UNC by calling 503.232.1987 or 1.800.332.2344.
Issued y: 0 I - Permittee Signature:
4' i/AL - �I\\��_►�
Call 503.639.4175 by 7:00 a.m.for the next available inspe"• 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 SystemilECEIVE1) • FOR OFFICE USE ONLY
Cityof Tigard Received
g DateB - r / , / Permit No.: eCO.-
'I 13125 SW Hall Blvd.,Tigard, 2 Plan Revte , ,Phone: 503.718.2439 Fax: 5 3�.IS1bp 2 DateBy: 4„ 3 .7 .,.., Other Permit: ,,c/15 )3/7
TIGARD
Inspection Line: 503.639.4175 Date Read/B luris: 0 See Page 2 for "'
Internet: www.ti and-or. o rr rr i �I Notified/Method: 3 `� '' Supplemental Information
g g �.11��J� 11t,�KU �_O-1 �/ PP -
1 , • ' ° 1 - .I;xa)C1I4ai 1 1 4t":‘.0-..,x'.16 'jr'"I'Ift`31''i ,141"',
..mm ., .. , ,..xu.,
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
JIddition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
‘IPt a wI �• t )� .{.. .- t, PP
_ _ a ..-- ' ' .. ., ... Valuation: $
❑ 1-and 2-family dwelling F ommercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
,iaj .N. :- 'i z41:iSi. Kala: .ail :N;11,.....q1,(5);',. Total number of floors:
Job site address: 05-75 5�qW cA.O 6" � New dwelling area: square feet
City/State/ZIP:' t(,p.,(/,0 Vt -q1l ..?i Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: 161 .. Kra/ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
'' b.1,c3/% / ,1.) ).Vx ,t tt:9 ' ?,V}P E.0 i 6 :':itsd.'e„,:
Subdivision: I 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
cj�at444i ‘ti TA 'a1^ VAit,i� work indicated on this application.
s - ri{C.A<1 Q Au tied. Valuation:lit boDe $
Existing building area: square feet
New building area: square feet
L..-, s;n{®)l;a;`�ts 's,Y.f.i!GO t• '11.40=4,4" Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
"' .: 4�pir1 ,,M - l',.._ ir.ik nit tit DiakX0 e x •:;1' z:l-„,ik,siN. ',.a. R ”'
Business name: W a.01- 47.4.1, S e s -ve tx..31 All contractors and subcontractors are required to be
Contact name: Sc.p� i. `�wT (J�� licensed with the Oregon Construction Contractors Board
- under ORS 701 and may be required to be licensed in the
Address: t3wit`e f\v,... ST1IYatrt,( �v,,,tiZ 3 jurisdiction in which work is being performed.If the
City/State/ZIP" Cor1104,L,0 OV. Cc-10'Ar applicant is exempt from licensing,the following reasons
apply:
Phone:cel )65').-S--k - I Fax::( )
E-mail: S C,e'(r- #Atli '4.• . k p-- '5 \ . lKS
..,,... .....s _ `t0)4k A5 0 ....,.. ..}:.a .
'• a L.. -.,.-$ ' . ,)rl 1 4 F' ° ti i t ii":: ',-...1",;,..::';';'''
Business name:
S A yJ\ kr., ArGO 4 `?
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.:kp IJ Q Total permit fees:
Amount received:
Authorized signature.
This permit application expires if a permit is not obtained
Print name: Date: r within 180 days after it has been accepted as complete.
o f ou, a d t
�� Fee methodolo set byTri-Count Building
gY Y Industry
Service Board.
I:\Building\Permits\FPS-Permit App_0715 t4.doc 440-4613T(11/02/COM/WEB)
e •
• City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
„vol. a it. .to)i 's
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
0 New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
❑ Wet ❑ D
Additional Standi.es
Information: Hazard Grou.
Densi
Desi: Area
K. Factor
S.rinkler Pro Sect Valuation: $
Hood Pro'ect Valuation: $
_ ;,eX; %41406.:
Submittal shall Batte Calculations • Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Pro'ect Valuation:
r , 414 41;4*ip+lkZtot� + i
S•uare Foota:e: 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 : eater $404.39
Sprinkler Project Square Footage: sq. ft.
Pro.ect valuation subtotal see A,B &C above : $
Permit fee based on .ro.ect valuation see fee schedule : $
Permit fee based on ssuare foota•e see D above : $
State Surchar•e 12%of .ermit fee : $
FLS Plan Review 40% of•ermit fee : $
TOTAL: $
http://www.tigard-or.gov/document_center/Building/FPS_PermitApp.doc 2