Permit (39) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IN-. COMMUNITY DEVELOPMENT Permit#: FPS2019-00005
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/29/2019
T t A R.Dg Parcel: 2S101AA02900
Jurisdiction: Tigard
Site address: 12123 SW 69TH AVE
Project: Compass Oncology Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Fire alarm permit:(133)fire alarm devices.
Contractor: CAPITOL ELECTRIC CO INC Owner: MCKESSON SPECIALITY HEALTH
11401 NE MARX STREET 10101 WOODLANDS FOREST DR
PORTLAND, OR 97220 THE WOODLANDS, TX 77380
PHONE: 503-255-9488 PHONE: 281-863-4723
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/25/2019 $572.70
12%State Surcharge-Building 01/25/2019 $68.72
Type of Use: • COM Plan Review-Fire Life Safety-COM 01/25/2019 $229.08
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 01/25/2019 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 01/25/2019 $17.50
11x17)
Misc Administration Fee 01/29/2019 $5.00
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $899.00
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $55,100.00
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: - '�y.��� i` ature: / GLI
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 RECEIVED FOR OFFICE L/SE ONLY
No.:/:
761960.-62.1.;;C:35---
City of Tigard Received v
Date/By: Permit No.: �--
13125 SW Hall Blvd.,Tigard,OR 97223 IAN '� 2019 Plan R vie � �r� p � 5
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: I' " p Other Permit:J 220!g Gt
TIGARD Inspection Line: 503.639.4175 t TIGARDDate Ready/By: Fa SeeeePage 2 for
Internet: www.ti and or. ov CITY i a • Notified/Method: /� Supplemental Information
g g 'BUILDING D V SIO
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:, 'f • .. '... E ;,t .. ttE 111 AAI k"1 $ ,FA r I,'4 ELLII G
❑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
I . „ work indicated on this application.
1=11-and 2-family dwelling Z Commercial/industrial Valuation: $
ElAccessory building ❑Multi-family Number of bedrooms:
El Master builder CI Other:
Number of bathrooms:
.,r �r Gy a ort I a ;."" Ira14II 0 11.1rSW IkEoe 4'[bN^ o Total number of floors:
Job site address:12123 SW 69th Avenue New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:100/200 Project name:Compass Oncology Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
f �p 14f 4 I I 43 n+ I rypq�Ji�yn �
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
,r '(
sIrrl ( �Ili work indicated on this application.
Install fire alarm devices per submitted plans. Valuation: $5.5,100.00
Existing building area: square feet
New building area: square feet
1,44F. ..' . . _. ❑ � r Number of stories:
Name:Shorenstein Realty Services Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
.: PI l r#NT ❑ OISTAC I PERSON , �. �
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:
Business name:Capitol Electric Company,Inc.
Permit fee: 572.70
Address: 11401 NE Marx Street
State surcharge(12%of permit fee): 68.72
City/State/ZIP:Portland,OR 97220
FLS plan review(40%of permit fee): 229.08
Phone:(503)255-9488 Fax:(503)255-1966 (Due upon application submittal.)
CCB lic.:48748 Total permit fees: 870.50
S-P Amount received:
Authorized signature: This permit application expires if a permit is not obtained
Print name:Shane Tercek Date:01/03/19 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 440-46131(1 I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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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: 133
® 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 ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: r
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Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
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7* N[el --::,-,7:11'.'7.':1,V11
Hood Project Valuation: I $
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Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 55,100
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Square Footage: Permit Fee: I Yr
0
to 2,000
$198.75 +, NV
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2,001 to 3,600 $246.45 : -4:7 ah O 4nY ^
3,601 to 7,200 $310.05 k
'
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7,201 and greater $404.39 I
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Sprinkler Project Square Footage: sq. ft.
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Project valuation subtotal (see A,B &C above): $ 55,100
Permit fee based on project valuation (see fee schedule): $ 572.70
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 68.72
FLS Plan Review(40% of permit fee): $ 229.08
TOTAL: $ 870.50
Q:\Fire Alarm\FA Jobs\zz181900-45 Compass Oncology @ TCC-A\1 FPS_PermitApp2017.0126.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12123 SW 69TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00005
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor