Permit (72) 114CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
2 `-` COMMUNITY DEVELOPMENT Permit#: FPS2016 00139
T/GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2016
Parcel: 25101 BD00200
Jurisdiction: Tigard
Site address: 8005 SW HUNZIKER RD
Project: Medline Subdivision: None Lot: None
Project Description: Fire alarm-Add fire alarm devices for added safety.
Contractor: WESTERN STATES FIRE PROTECTION Owner: TIGARD DISTRIBUTION CENTER LLC
13896 FIR ST STE B 4800 SW MACADAM, STE 120
OREGON CITY, OR 97045 PORTLAND, OR 97239
PHONE: 503-657-5155 PHONE:
FAX: 503-657-5182
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/12/2016 $156.00
12%State Surcharge-Building 09/12/2016 $18.72
Type of Use: COM Plan Review-Fire Life Safety-COM 09/12/2016 $62.40
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/12/2016 $2.00
Occupancy Grp: S-1 Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 09/12/2016 $2.50
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: No Alarm Type: Automatic
Pull Station Required: No Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $241.62
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $7,200.00
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 to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
Permittee Signature:
all 3.639.4175 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 RECEIVED FOR OFFICE USE ONLY
g d don
Cityof Tigard Date/BReceive: ,,gy/4 r Permit No.: j/ �de eir:e/3
13125 SW Hall Blvd.,Tigard,OR 97'AJ 1 1� 2016 Plan R�1
■ Phone: 503.718.2439 Fax: 503.59 M•tjjr ' Other Permit:
Date/B
T 1 G A R p Inspection Line: 503.639.4175 CITY OF TIGARD Date lll+ X Juris: ® See Page 2 for
Internet: www.tigard-ot'.gov iillLLll Notified/Method: 1'� Supplemental Information
.
BUILDING DIVISION e� .� r/riGtM.
TYPE OF WORK :` 4RE4 - 2-FAINTLY DWELLING
' UIR�D DATA:1-AND 2
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
S.Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El1-and 2-family dwelling [(Commercial/industrial Valuation: $
111Accessory building ElMulti-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE'"INFORMATION AND LOCATION Total number of floors:
Job site address: O5 c1:11 �t fI 2-i Xkr- s-jj- New dwelling area: square feet
`�]
City/State/ZIP: 774,el 0 7 ?z-2- Garage/carport area: square feet
Suite/bldg./apt.no.: / ' Project name: fil ///11.- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
/��1� t�C 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.
/`"tCIC T Id'`� exIc.i- d C lit.e5 f L'u' (.Cit e( Valuation: $ 7Ze . UO
57, �� t/ Existing building area: square feet
New building area: square feet
®.:PROPERTY"OWNER' '❑ TENA14T '' Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
0 APPLICANT 0 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:
v� tip"
CONTRACTOR ', '
', BUILDING PERMIT FEES*_ °_� "
x:.
Business name: ) j / j�"� � .9' ,. (Please refer tofee sclie4ule)
1,(r' ki S A:e.e J. a ca.-
3 6 9 j Ft,- c Permit fee:
Address: (IC T
City/State/ZIP: O ,.. c t ly ag q let y-YState surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(511; ) ?7/()7 uu2,7/ Fax:( ) (Due upon application submittal.)
CCB lic.: loci 510 ;iE/( Total permit fees:
Amount received: /�
Authorized signature: I V
This permit application expires if a permit is not obtained
Print name: 1/t)r(/1 17 S IC,-,4--4 Date: Fse-(2_.—( (z, within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(1 1/02,COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describcwork to be done:1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ 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 El 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete.A,B, C or D as applicable)
A.) Commercial Sprinkler
Sprinkler Type El Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type System ;;.
a�- Hood.Fire Suppression res�io� ....., ;� "
Hood Project Valuation: $
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.)[ tection eri�i t 17iSiSr
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 (400/0 of permit fee): $
TOTAL: $
l:ABuilding\Permits\FPS_PermitAPP_(131016.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
8005 SW HUNZIKER RD, TIGARD, OR, 97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2016-00139
Jeff Grove
Violation Summary:
Inspector Contractor