Permit (177) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2018-00111
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2018
AR f� 9 Parcel: 2S115AA00100
Jurisdiction: Tigard
Site address: 16194 SW 108TH AVE
Project: Brightwaters at Red Hawk Subdivision: WILLOW-BROOK-FARM Lot: 36
Project Description: Fire Alarm. Replacement of fire alarm.
Contractor: FIRE SYSTEMS WEST INC Owner: DHP BRIGHTWATERS LLC
600 SE MARITIME AVE#300 32 MEADOW HILL DR
VANCOUVER,WA 98661 TIBURON, CA 94920
PHONE: 360-693-9906 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-MF 09/19/2018 $112.96
12%State Surcharge-Building 09/19/2018 $13.56
Type of Use: MF Plan Review-Fire Life Safety-MF 09/19/2018 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 09/19/2018 $3.00
Occupancy Grp: R-2 Height: ft 11x17)
Stories:
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: Yes Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $174.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,500.00
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 503.23.1987 or 1.800.332.2344.
Issued By: ' r/r� � � Permittee Signature: 1 a
s�J' l )/fA •
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.
(ye'-i---7,4>r-Tri
Building Permit Application
Fire Protection System .
FOR OFFICE USE O\L\
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 S E P 1 0 20I:; Date/B : i i /
I C. Phone: 503.718.2439 Fax: 503.598.1960 y I ( M ' Other Permit:
T I G A R D Inspection Line: 503.639.4175 CITY OF I I.AL~1 T e Ready/By: Jug ® See Page 2 for
Internet: www.tigard-or.gov BUILDING 'rI'f .1 �ed/Method: Supplemental Information
TYPE OF WORK�7L REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
ddition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling mmercial/industrial Valuation: $
Co
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ,fit 1(( (9 4 -5 (08,14-, Q_ New dwelling area: square feet
'Z City/State/ZIP: C 3 of c 0Yc. 912 Z.C/ Garage/carport area: square feet l
Suite/bldg./apt.no.: Project name: r, K b+-gt. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
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.
,/'t Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT:# . ..,• Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
APPLICANT trCONTACT PERSON
NOTICE
Business name: 0.1t. Sr S�,M 5 W4:2 it All contractors and subcontractors are required to be
Contact name: V�.A 1 licensed with the Oregon Construction Contractors Board
'`a S under ORS 701 and may be required to be licensed in the
Address: vt jurisdiction in which work is being-0-j SC...". �a.J"t�l .4„.t. �✓-C 3CYD Performed.If the
City/State/ZIP: /A applicant is exempt from licensing,the following reasons
VQ.A c of ✓ lr' Q& 't ( apply:
Phone:(r-.&,4 ) 7' s-� Fax: :( )
E-mail: ix /177. 'Y rt- 5"7(54L WF'-it 'a41"------
CONTRACTOR BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.: C(-9 7 3 Z op Total permit fees:
Authorized signature: / ®----' Amount received:
1 n This permit application expires if a permit is not obtained
Print name: t( Date: within 180 days after it has been accepted as complete.
Mme. c.-1—a— YYY 777111/// 1 (210(f3(210(f3 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
El New system Number of sprinkler heads: Number of alarm devices:
El Addition or El 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
El 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,C or D as applicable);
A.) Commercial Sprinkler
Sprinkler Type El Wet El Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes El No
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 El 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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16194 SW 108TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00111
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor