Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 1 COMMUNITY DEVELOPMENT Permit#: FPS2020-00075
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/01/2020
T I i;A R D g Parcel: 2S109ACO2100
Jurisdiction: Tigard
Site address: 14850 SW 132ND TER
Project: Alberta Rider Elementary Subdivision: None Lot: None
Project Description: Fire alarm. Adding(2)and relocating(2)devices.
Contractor: PRIME ELECTRICAL SERVICES LLC Owner: TIGARD-TUALATIN SCHOOL DIST 23J
3312 SE BELLA VISTA PL ATTN: BUSINESS MANAGER
VANCOUVER,WA 98683 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-318-5170 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/24/2020 $61.85
12%State Surcharge-Building 06/24/2020 $7.42
Type of Use: COM Plan Review-Fire Life Safety-COM 06/24/2020 $24.74
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 06/24/2020 $0.50
Occupancy Grp: 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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Gales Provided: Cut Sheets Required:
Total $94.51
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $850,00
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 1.800.332.234 .
Issued By: �J441
.4 // A Permittee Signature:
1/41%, 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
City of Tigard C c V E Dammed 4 y
13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 •r i1 A.Inspection Line: 503.639.4175 J U N 11 2U2� Date/B : �j 7. � mot/i
T I G A R U p Date Ready/By: kris: & Page 2 for
Internet: www.tigard-or.gov �I7�,� OF TIGARD Notified/Method: Supplemental Information
TYPE OF % i.uINU i'. , Ci�` REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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
CATEGORY OF CONSTRUCTIONW.111 work indicated on this application.
❑ I-and 2-family dwelling ❑x Commercial/industrial Valuation: S 850.00
❑Accessory building El Multi-familyNumber of bedrooms:
❑Master builder ElOther: Number of bathrooms:
1111111111NJOB SITE INFORMATION AND LOCATION a Total number of floors:
Job site address: 14850 SW 132nd Ave. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Alberta Elementary School Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED D COMMERCIAL-USE CHECKLIST
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
DESCRIPTION OF WO - work indicated on this application.
Modify existing fire alarm system for new secured vestibule Valuation: $ 850.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER MK ,:,. 0 TENANT ' Number ofstories:
Name; Tigard-Tualatin School District Type of construction:
Address: 6960 SW Sandburg St. Occupancy groups:
City/State/ZIP: Tigard, OR 97223 Existing:
Phone:( ) Fax:( )
New:
® APPLICANT ❑ CONTACT PERSON Nt .
Business name: Prime Electrical Services All contractors and subcontractors are required to be
Contact name: Oleg Primachenko licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3312 SE Bella Vista PI. jurisdiction in which work is being performed.If the
City/State/ZIP: Vancouver, WA 98683 applicant is exempt from licensing,the following reasons
apply:
Phone:( 503)318-5170 Fax: :( )
E-mail: oleg.p@primeelectricalcu.com
CONTRACTOR BUILDING PERMIT FEES'"
(Please refer to fee schedule)
Business name: Prime Electrical Services
Permit fee:
Address: 3312 SE Bella Vista PI.
State surcharge(12%of permit fee):
City/State/ZIP: Vancouver, WA 98683 FLS plan review(40%of permit fee):
Phone:( 503)318-5170 Fax:( ) (Due upon application submittal.)
CCB lic.: 217825 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: Oleg Prlmachenko Date: 6/8/2020 within 180 days after It has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
l:\BaudingPe iiaRS-P°m,ilApp_oatot6.mr 440-4613Tt11ro2/convWEBl
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
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: 4
❑ Addition or El 1-10 heads: Affidavit required and j] 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:
Type of System (Complete A, B, C or D as applicable":
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm ...
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 850.00
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.
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\Pennits\IPS_PemtitApp_031016.doc 2
City of Tigard Permit No.: Pl�S�OzC>-GAG S
• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1911E r c \I CL) Date Received: tp(a`ll,Z(S
Inspectionerne: Line: 503-o .gov C`f M T�/j tii at7
T f G A k:D Internet: www.tigard-or.gov By: J r✓
I I IN 9 2929
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Alberta Elementary School Occupancy:
Job Address: 14850 SW 132nd Ter. Tigard, OR 97224 Suite:
Contractor: Prime Electrical Services Phone:
Valuation of work: $850.00
Type of System: (check one) *Required ❑Non-required
(check one) ❑Automatic ❑Manual *Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added try 5) 1 /To be Relocated(.5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated 0.5)
Number of Proposed Notification Appliances: To be Added(.5) 1 /To be Relocated(.5) 2
I Oleg Primachenko Oregon Construction Contractors Board No. 217825
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
f) Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
In addition, I understand the following is required:
• Submit(3) copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• Electrical permit.
• A copy of this docume with a copy of the sketch attached shall be available for all inspections.
Signature: Date: 6/8/2020
Print Name: Oleg Primachenko
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