Permit (171) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s ' COMMUNITY DEVELOPMENT Permit#: FPS2018-00168
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2018
T f e"�p O g Parcel: 25101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY,STE#20
Project: New Horizons Wellness Services Subdivision: VARNS ACRES Lot: 9
Project Description: Fire alarm permit:Altering(8)fire alarm devices for TI.
Contractor: WESTERN STATES FIRE PROTECTION Owner: TRIANGLE POINTE TWO LLC
17500 SW 65TH AVE 901 NE GLISAN ST,STE 100
LAKE OSWEGO,OR 97035 PORTLAND,OR 97232
PHONE: 503-657-5155 PHONE: 503-297-8791
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/06/2018 $134.48
12%State Surcharge-Building 12/06/2018 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 12/06/2018 $53.79
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 12/06/2018 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 12/06/2018 $7.50
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: Yes Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $213.91
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,800.00
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: ' .— ,„...4 _'� Permittee Signature: A
‘5.4,4/ "---------
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 FOR OFFICE USE ONLY
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Received _
City of Tigard ' Permit No.:
g r . ;' r 4 , '` Date/By: h S i A 7j"'.. ii,301�.f l .a)/6,8
Il a 13125 SW Hall Blvd.,Tigard,OR 97221 Plan Review / ,/ Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: I Iti'c .iCIi, Iyl✓
TIGARD
Inspection Line: 503.639.4175 I i 4 t `-115 Date Ready/By: , Juris: I gee Page!for
p 1 Notified/Method: l!(/ t ; Supplemental Information
Internet: www.tigard-or.gov
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r s , i'I _' ..if t :.
i ` s . �� " "P _�t l I° t',.0.-4,14'.2 t 1
❑New construction IS-I3enro7it o' ` '
liPermit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
k work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
a t e o e s Total number of floors:
Job site address:13333 SW 68TH PARKWAY New dwelling area: square feet
City/State/ZIP:TIGARD, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.noyej Project name:NEW HORIZONS WELLNESS Covered porch area: square feet
Cross street/directions to job site:66TH AVE AND SW HAMPTON ST Deck area: square feet
Other structure area: square feet
Ku
Subdivision: 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
f `l 13 s i a ° a n t work indicated on this application.4711
ALTER FIRE ALARM DEVICES FOR NEW TENANT BUILD OUT. Valuation: $5800.00
Existing building area: square feet
New building area: square feet
° :: : , :I :; r Number of stories.•
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
' W C
Business name:WESTERN STATES FIRE PROTECTION All contractors and subcontractors are required to be
Contact name:WILLIAM T STEWART licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:17500 SW 65TH AVE jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:LAKE OSWEGO,OR 97035
apply:
Phone:(503)407-0279 I Fax::( )
E-mail:WILLIAM.STEWART@WSFP.US
7..--...=_ ti °
�' ' � . � � '. ° C1B�iB� �
Business name:WESTERN STATES FIRE PROTECTION
Permit fee:
Address:17500 SW 65TH AVE
State surcharge(12%of permit fee):
City/State/ZIP:LAKE OSWEGO,OR 97035 0
FLS plan review(40%of permit fee):
Phone:(503)407-0279 Fax:( ) (Due upon application submittal.)
CCB lie.: 104570 Total permit fees:
Authorized signature: ‘,(7::::.
_ "—CFI
Amount received:
This permit application expires if a permit is not obtained
Print name:WILLIAM T STEWART Date:11-8-18 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
t:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(l1/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13333 SW 68TH PKWY STE 20, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00168
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor