Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
r F
COMMUNITY DEVELOPMENT e>R?4 `471'IN
Permit#: FPS2017-00077
T IGAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 It. ff. `^ ? ` /� Date Issued: 06/12/2017
� ��
Parcel: 2S101DA01900
Site address: 7000 SW YARNS ST Jurisdiction: Tigard
Project: Madrona Recovery
ivision: VARNS
Project Description: Fire alarm-modification of(54)devices. 9/12/17:REPRINT to change address from 6996 toCRES Lot: 3
000 SW Varns.
Contractor: OMLID AND SWINNEY FIRE PROTECTION
157 S 47TH ST Owner: NELSON VIAL LLC
SPRINGFIELD, OR 97478 7155 SW VARNES ST#120
TIGARD, OR 97223
PHONE: 541-741-1775 PHONE:
FAX: 541-741-0347
Description Date
ecfics: Amount
Spi
Permit Fee-COM 06/12/2017
12%State Surcharge-Building $231.32
Type of Use: COM 06/12/2017 $27 76
Class of Work: ALT Plan Review-Fire Life Safety-COM 06/12/2017
Type of Const: VB Info Process/ArchivingL 2.00 over $$6.00
Occupancy Grp: R-4 Height: ft 11x17) 9$ ( 06/12/2017 $6.00
Stories: 2 Info Process/Archiving-Sm$0.50u to
11x17) ( p 06/12/2017 $22.50
Commercial Sprinkler Svstem_:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm S stem:
Fire Alarm Required: Yes Alarm Type: Automatic
Pull Station Required: No Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $380.11
Valuations:
Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $15,000.00
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, 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:
e...o /Lz;z0 Permittee Signature:
GC 61-1 l L°AA01
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. r
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.
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
r Fl a COMMUNITY DEVELOPMENTPermit#: FPS2017-00077
.rte '',/ Date Issued: 06/12/2017
T t G k 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ,,, .
� +�t , /,� Parcel: 2S101 DA01900
.:-..: 011/11 Jurisdiction: Tigard
Site address: 7000 SW VARNS ST ` O
Project: Madrona Recovery Subdivision: VARNS ACRES Lot: 3
Project Description: Fire alarm-modification of(54)devices. 9/12/17:REPRINT to change address from 6996 to 7000 SW Varns.
Contractor: OMLID AND SWINNEY FIRE PROTECTION Owner: NELSON VIAL LLC
157 S 47TH ST 7155 SW VARNES ST#120
SPRINGFIELD, OR 97478 TIGARD, OR 97223
PHONE: 541-741-1775 PHONE:
FAX: 541-741-0347
FEES
Description Date Amount
Specifics:, Permit Fee-COM 06/12/2017 $231.32
12%State Surcharge-Building 06/12/2017 $27.76
Type of Use: COM Plan Review-Fire Life Safety-COM 06/12/2017 $92.53
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 06/12/2017 $6.00
Occupancy Grp: R-4 Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 06/12/2017 $22.50
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: No Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $380.11
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $15,000.00
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, 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 b calling503.23 1987 or 1.800.332.2344.
,
Issued By: / Permittee Signature: 4
.I Ad AI -4.14 itlitlir ' 50- veie-a.7re-'
/ 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.
INCITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a:: ' COMMUNITY DEVELOPMENT Permit#: FPS2017-00077
RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/12/2017
T(t`'" 9 Parcel: 2S 101 DA01900
Jurisdiction: Tigard
Site address: 6996 SW VARNS ST
Project: Madrona Recovery Subdivision: VARNS ACRES Lot: 3
Project Description: Fire alarm-modification of(54)devices.
Contractor: OMLID AND SWINNEY FIRE PROTECTION Owner: NELSON VIAL LLC
157 S 47TH ST 7155 SW VARNES ST#120
SPRINGFIELD, OR 97478 TIGARD, OR 97223
PHONE: 541-741-1775 PHONE:
FAX: 541-741-0347
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/12/2017 $231.32
12%State Surcharge-Building 06/12/2017 $27.76
Type of Use: COM Plan Review-Fire Life Safety-COM 06/12/2017 $92.53
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 06/12/2017 $6.00
Occupancy Grp: R-4 Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 06/12/2017 $22.50
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: No Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $380.11
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $15,000.00
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, 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 50 987 or 1.800.332.2344.
Issued By: �y Permittee Signature:C '`Y�-'-- Call 503.6 9.4175 by 7:00 a.m.for the next available inspec'- date. (((
This permit card shall be kept in a conspicuous place on the job site un '/mpietion of the project.
Approved plans are required on the Job site at the time . •ach Inspection.
Buildini Permit Application R
Fire Protection System HECEL Y`,Eta" l )tt()I:FIC: USE:ONLY
Il City of Tigardy 2 2 2017 nates d�7 /. g.. •« r i-7
13125 SW[call Blvd.,Tigard,OR 9722 Plan Review /�_ Do?d�7
Phone: 503.718.2439 Fax: 503.5 8+, OF TiGARD D,t� , 1�IAt� ��'� other Permit: �d{I- �-
1.1(3 A it D Inspection Line: 503.639.4175 v ' t n Data heady s p 11 7urit: 56 see Page J for
Internet: wwwa gard-or.gov BUILDING DIVISION Notified/Method: ' p supplemental Information
kt { ; r i t4fl plli J, ra .'Y '4 -aatDID XPE )17 ORiC: ' < 'i' .1.1'i:::'11''''. :;:47;s ' _ �® DlNi}2 Fli3� Ia
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to thenearest dollar)of all
Addition/alteratton/repiaccment 0 Other: equipment,materials,labor,overhead,and the profit for the
'; 4 :� "O 10, " q work indicated on this application.
Ji' ,-+.,—QItX a COi,-_, ,UCfibi ,,lith "'1,111111 'i .._. PP
❑ 1-and 2-family dwelling Commercial/industrial
Valuation: S
❑Accessory building 0 Multi-family Number of bedrooms:
❑ /Maastteer builder ( 0 Other: t� Number of bathrooms:
ti '4 4il�iiii 'III "N r T, ° '7'^('v l4 - w , -
ti w JOti i E Fo `S ON�A T,OGA''i, uM n d -2 Total number of floors:
Job site address: 0trgNV Varns'St New dwelling area: square feet
City/State/ZIP: Tiagrd Garage/carport arca: square feet
Suite/bldg./apt.no.: Project name: Madrona Recovery Center-3 Covered porch area: square feet
Cross,street/direetions to job site: Deck area: square feet
Other structure area: square feet
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
,ip(' 4p C " i V to .14 r. �4 ' work indicated on this application.
/- , r 11 Valuation: $ (5
poc
Existing building area: square feet
New building area: square feet
0 su
PR4' RTX E '�d il''iI i` �9iil�l'� ���
4 -t-,-,,,.ak lk+10' 1-1;,,M,1 AIrT It Number of stories:
Name; Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone Fax:(
):4 A LICA i ' re k 6. J'Wril uiEl`CQ AE "rliERS) ,''''''g''' A' yl�I 1 i no A,1Al`�' (r'',i v i" .".i-.� '� 1 1;
W v 14f, € it ,,b '
Business name: Omlid and Swinney Fire Protection All contractors and subcontractors are required to be
Contact name; Reliant Johnson licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 157 S 474 Street jurisdiction in which work is being performed.If the
City/$tate/ZIP; Springfield,OR 97478 applicant is exempt from licensing,the following reasons
. apply:
Phone:(:(541)741-1775) Fax::(541741-0347
E-mail:
t o,, ' �NfRA,c t "'NI, , ( 4 „„'t i, -I'44" t ;
l ( dla .� .' :�� ll ,7�� �< di��i' 111�1»D�CrP � `���, IG{� h '�n
/ , etP/e/steel i whetter! , -4 z ,x
Business name:O Omttd and Swinney Fire Protection i (0Ai -S wieri
` 1 Permit fee
Address: 157 S 4714 Street ,i f lP.t'
State surcharge(12%of peanut fee):
City/State/ZIP: Springfield,OR 47478 FLS plan review(40%of permit fee):
Phone:(541) 741-1775 Fax:(541)741-0347 (Due upon application submittal.)
CCB lie.: 104570 Total permit fees: . SO• i I
Authorized signet • jiG rl r f- y-� Amount received:
/'L%jr / This permit application expires if a permit Is not obtained
Print name: Ke`ant Johnson Date: 7 within 180 days atter It has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:lauadingg'PennIt FP3•Per,nitApp_O110i6.doc 440-613T(t I/O2ICOMIWEI)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work.to b.e 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: 5
0 Addition or 0 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
0 11+ heads: Plan review required and ® 6+ devices: Plan review required and
(3)sets of plans. (3)sets of plans.
Additional description of work:
Type of System (Complete A, B,G oral as applicable): 4 t'
A) Commercial Sprinkler 't
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K.Factor
Sprinkler Project Valuation: $
B,) 'Type Y mood Btre Suppre.sskon Systetr>t :.
Hood Project Valuation: $
C..) Fire Alarm.
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 15,000.00
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.
Fite Protection Permit Fees ..
Project valuation subtotal (see A,B&C above): $ 15,00.000
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: $ 201.60
C:\Users\Tia.Clay\17eskrop\FPS_PermitApp_031016 north.doc 2
157 South 47th Street
Springfield,OR 97478 Sip
Phone:(541)741-1775 0 „ ,v
Toll Free:(800)503-1775
Fax:(541)741-0347
www.omlidandswinney.com FIRE PROTECTION&SECURITY OR CCB NO.104570
a division of WSl7
Letter of Transmittal
TO: City of Tigard DATE: May 12, 2017
Attn: Building Permits JOB NO.:
13125 SW Hall Blvd. SUBJECT: Madrona Recovery Center-North
Tigard, OR 97223 6996 SW Varns Street
WE ARE SENDING YOU THE FOLLOWING:
Copies Date No. Description
3 5/12/17 Fire Alarm System Drawings
2 5/12/17 Fire Alarm Equipment Information
1 5/12/17 Building Permit Application
THESE ARE TRANSMITTED AS CHECKED BELOW:
For approval For review & comment i As requested For your use Other:
REMARKS:
If you can please return one (1) set of the approved plans to our office in the provided envelope, we
would appreciate it. If you should have any questions, please do not hesitate to contact me at (541)
744-3545 or via email at keilani.johnson@omlidandswinney.us Thank you.
Copy to: File Signeditilfr71
Keilani oh n