Permit (48) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00070
T!GA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/12/2019
Parcel: 2S 101 DD00401
Jurisdiction: Tigard
Site address: 6955 SW SANDBURG ST
Project: Pape Material Subdivision: SALEM FREEWAY SUBDIVISION Lot: 1
Project Description: Fire Alarm. Adding(6)devices to fire alarm system for sprinkler monitoring.
Contractor: ACTION TECHNOLOGY SYSTEMS LLC Owner: PAPE PROPERTIES INC
835 SE 17TH AVE ATTN LANCE JORGENSEN
PORTLAND, OR 97214 355 GOODPASTURE ISLAND RD STE 30
EUGENE, OR 97401
PHONE: 503-231-1992 PHONE: 541-334-3437
FAX: 503-231-1402
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/12/2019 $112.96
12%State Surcharge-Building 06/12/2019 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 06/12/2019 $45.18
Class of Work: ALT Type of Const: VA Info Process/Archiving-Lg$2.00(over 06/12/2019 $4.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 06/12/2019 $12.50
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $188.20 j
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,200.00
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 503.232.19872344.
Issued By: �� ature: ?f...)
C. .39.4175 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.
Bui_ldi Permit Application11
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Fir)
re Protection System m FOR OFFICE USE ONLY
Cl of TigardReceived ,,,,-
Date/By: �: • ��_��/)�?6
`J g ��I d -3 2 (7 i
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review, /
' " . Phone: 503.718.2439 Fax: 503.59 1 b Date/By: �� c' J 0 a j�_/?I"6 r
P 9 1I 'IrAllE `
Inspection Line: 503.639.4175 i Date Ready/By: ('2 �A Juris: See Page 2 for
T I G A R D Internet: www.tigard-or.gov 8 U 1 LD I 't G D i3 I'S'O I iL` otified/Method: l Supplemental Information
fry..,_..
-' .tart x x:: 4 u , x 4V-P .0:14 O *. ' S
❑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 0 Other: equipment,materials,labor,overhead,and the profit for the
t' work indicated on this application.
CA.�t'EGOItY OF Oj CI4; I t
Valuation: $3,200.00
❑ 1-and 2-family dwelling ®Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
Total number of floors:
Job site address:6955 SW Sandberg Street New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: TiINP-- t'1J t_14, t- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
z y
rI1x C .t C i 'a#1.. *$'. +I`UECRUS.T<
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.: as
Q yy �T c#PAI��� equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
Valuation: $
— DC�zt-�
FIRE ALARM SYSTEM,SPRINKLER MONITORING Existing building area: square feet
New building area: square feet
.:. �. .. `. ,.,; Number of stories:
] i0> Y tl lwl a,., A, . , ',4,,: .
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
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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:
y:
Phone:( ) Fax::( )
E-mail: "S `{ -1t4--C-'c \ -k-tN OLQ C,---"V . (_53w• -
x�.>. ., txfxu mg : ' g 5 a x
oggu *aa ` $* olivoi 7 ' � � Mc, 4 -wV3 1 44 *A' i 'rgP` i
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Business name:ACTION TECHNOLOGY SYSTEMS LLC
Permit fee:
Address:835 SE 17TH AVENUE
State surcharge(12%of permit fee):
City/State/ZIP:PORTLAND OR 97214 0
FLS plan review(40%of permit fee):
Phone:(503)231-1992 Fax:(503)231-1402 (Due upon application submittal.)
CCB lic.:157630 Total permit fees:
- fro
I Amount received:
Authorized signature: A
This permit application expires if a permit is not obtained
Print name: .. -r._ 1)„ ,.‘"),,..) j - 1Ft2”( Date: (�r '3 j°I within 180 days after it has been accepted as complete.
County Building Indaatry
Service Board.
t:\Building�Permits�FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
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City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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T) st yo 4etr •s ., o „r
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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:
❑ 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 'R 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: CONNECTION TO SPRINKLER DEVICES FOR MONITORING AND 2-
HVAC DUCT DETECTORS
'Type oaf Syst n X1'41 het+ A, , o`er f a s a 1kabt3 I lr t f lT
1 F �� ..S>t��s e: � ��e 4� Jp f
OatgtttaltOM
rNMOPMVSSEaMi
... � $ r' :n {bg ' * # eaM3uxaLx
Rogiit � t 6111t , yx e r sor o 49 ' s 4
.
. , .. .b � < < :.. Et „ , .: , , ,. ,. n . .:s", ` te :-,1, :n4..; , r . . , . . _
Sprinkler Type ❑ Wet El Dry
Additional Standpipes
Information: Sprinkler Supply Line El Yes El No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
r� .w � �e{.+. ,�
fl. er1 t xod ie.�, a ?te,: 1 o .� y: to . s , , .. ,: : w ., :.`.v x� *r 7 ...nfi o. e ...
Hood Project Valuation: $
r ' < »"r ,:5` R s ti ' ;> s' �,^`` 3 1 'v ,.' t "` z f0''.,' .ua x' ",<.9,s,t..:' f-r,� ;;? " y 14 fir^"` '" ,+
*.ay. `k,r� �` u _�.+. y S�aa' Y� y,x��ay,�kv`? f,,..t„ ;�$�� Ysnx.* 3�„ w 3 oa ,t.,%"x'r �,?�,r8s`�:`�#*{Y,*,^s�'7�7.rx`x�� Y:�3 'st r �: `�� �. ky
`` art a .aY t� .yj; a t r x'" 3s*. '`.; # x 4 a s l :,^3y h t \YM ^.':q, 01 a �v,,, w t `P
>ttws h�t !�' rW*.'t t ^:. x zq fl :3,o`i�: Y' '. 0 rj €f :+: y' x 3 t { 4;`l a? ''','"q * 4 .* r
+ f '._, k"J'`>..':iy 3`:k .,.. 4'`.' c t .:..: ., ..:.:.a%,,.. .6S, , ...,,..:",: :h''ktto...:"o.:.,,..4 ..,..t: t.. .!rsk .,.„.w.A. ...x.
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $
777,777777K17777
✓7
77777
x:. yamWvb1 ` ,F3 n $ s , aac3 ANO s $ ` *
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y har ai e ~ rfvegt rk * jvYJt0t w R c > i }
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' . Square Footage: Permit Fee: `$ r , , M '
0 to 2,000 $198.75
2 001 to 3 600 $246.45
3,601 to 7,200 $310.0imgo5 f
7,201 and greater $404.39 wiitai`,,m.. =Dt. ttts�..a,iftitare . .., ..
Sprinkler Project Square Footage: sq. ft.
..,, t s`` vFh3 A x vT. .°'^.+t'x#`v.�,#;t,,.yt+:t%:#*°fi+C '`t�'l, rnst:� #."+' ,+ !*',� rh f �''x,'E :§. ` 'a+ s '�°'�Sr ="`”`r3 s
��,.�;.,..7. 'a x.:'*t.�; a:L.,,.#.rtA .�..M..� !c: n,,: '.,. ..<.<:#Fm� �,#* � J4 ,n'�r�:�..„:.,..s.�:..,. ...:rs� '.. .,. ...,..,,....,,... :,,..... ...., , ..,.
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): $
C:\Users\STEVEB-1\AppData\Local\Temp\FPS_PermitApp.doc 2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
6955 SW SANDBURG ST, TIGARD, OR, 97223 June 13, 2019 at 12:09:30 PM
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00070
Inspection Type: Inspector:
998 Alarm Final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor