Permit (46) .� 8 i
CITY OF TIGARD
r FIRE PROTECTION SYSTEM PERMIT
2 . COMMUNITY DEVELOPMENTIIII Permit#: FPS2017-00037
RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/03/2017
Tf't � g Parcel: 2S103AA00101
Jurisdiction: Tigard
Site address: 10865 SW WALNUT ST
Project: TTSD-Fowler Middle Subdivision: None Lot: None
Project Description: Upgrade fire alarm monitoring.
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
7324 SW DURHAM RD BY MAPLETHORPE, BONITA
PORTLAND, OR 97224 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/03/2017 $102.20
12%State Surcharge-Building 04/03/2017 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 04/03/2017 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 04/03/2017 $4.00
Occupancy Grp: E Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/03/2017 $1.50
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
I Total $160.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,155.50
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.
Aevi,..,„.„
Issued By: �( J� ,'G,/'�i2�C`'"` Permittee Signature: c„ ,,,,,/,. _,,---h`c I.,.
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 a , _ � ,
FOR oI I I( i; US'''.ON IN
City of Tigard y �} 1 4 2ul Received /�" /.0017—al>
.37 l'. „i Date/By: I1 W /i 1 Permit No.: ✓VV
w 13125 SW Hall Blvd.,Tigard,OR 97223 ' Plan Revie'e-.. .,�y ���� `,,,,�—�
` Phone: 503.718.2439 Fax: 503.598.191601-k� e Toa `i t, k 1 DateBy: CL-1 Other Permit: �7 Z�(J7/
T i t O Inspection Line: 503.639.4175 Lk_gr,,,-,1•„,,,,,,,,y, q Date ReJung 0 See Page 2 for
Internet: www.tigard-or.gov i. kon ied7;ethod: 3 ��/!� I Supplemental Information
151&, Z ac/rte v�
g • e s z ,. y DAT. :1 2-PAM y t W r1,J
❑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
,' ,5F;*// :: work indicated on this application.
,moi ,,.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
1=1Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
c
5,> , ]�'E�#Wittil o Loo 1, Total number of floors:
Job site address: 10865 SW WALNUT ST New dwelling area: square feet
City/State/ZIP: TIGARD, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: 1 Project name: TTSD- Fowler Middle Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: 1 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,
abor,overhead,and the profit for the
`�^.... moi, Po v work indicated on thisapplication.
Upgrade Fire Alarm Monitoring Valuation: $ 2I I SS, S�
Existing building area: square feet
New building area: square feet
5or
• - . . - :, � P.. , .... Wini. � *, Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax
New:
ti / ( /! _ , / .. . .
Ino
Business name: Performance Systems Integration, LLC All contractors and subcontractors are required to be
Contact name: Dan SCheIhass licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7324 SW Durham Road jurisdiction in which work is being performed.If the
City/State/ZIP: Portland, OR 97224 applicant is exempt from licensing,the following reasons
apply:
Phone:( 503)641 2222 I Fax::( 503)641 1464
E-mail: Dan@psintegrated.com
•... -. ., - ` .. %, �1 .* ,ice
Business name: Performance Systems Integration, LLC
- Permit fee:
Address: 7324 SW Durham Road
State surcharge(12%of permit fee):
City/State/ZIP: Portland, OR 97224
FLS plan review(40%of permit fee):
Phone:( 503)641 2222 Fax:( 503)641 1464 (Due upon application submittal.)
CCB lic.: 205924 Total permit fees:
Authorized signature: /�� /" Amount received:
-
This permit application expires if a permit is not obtained
Print name: I.r s chelhass Date: within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
a.
City of Tigard: Fire Protection Permit Checklist
,
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imm
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Page 2- Supplemental Information :, �.�epnkler heads: .�„1.)_ T:yp—e of���Wiorkte:a,, 2)'Addition/alter'
onlyi —
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 1:1(3136)+f
6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
-- ---p-Iv,,:fp,„„'
;;;.=::;iiiiiiV,atti,tkaigiif;
yiti9h \
\ ` /%4 \ \ r111,1
\\\✓ ; y�\gy:ra -z ❑A,) C€ 11I Wet ❑ DrySprinkler Type
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
`moi e "anoE• a ia ' �
Hood Project Valuation: $
` i -ttr \ „"//. \ /Jry)
itt'a;
Submshall Battery Calculations Yes
include: Individual Component .4 Yes
Cut Sheets
Fire Alarm Project Valuation: $ Z.;ESS,s e'
r A ,? fit .
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3 601 to 7 200
$310.05 ,,' 4 `�` -
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
y \a\ / a\
Project valuation subtotal (see A,B& C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see Dr above): $
State Surcharge (12% of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $
440-4613T(11/02/COM/WF.B)
I:\Building\Permits'FPS-PermitApp_031016.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10865 SW WALNUT ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00037
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor