Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 ' COMMUNITY DEVELOPMENT Permit#: FPS2020-00106
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2020
Parcel: 2S101 DA00100
Jurisdiction: Tigard
Site address: 13010 SW 68TH PKWY 140
Project: Spec Space Subdivision: VARNS ACRES Lot: 9
Project Description: Fire alarm permit: Relocation of(3)horn strobe in Suite 140. Affidavit submitted.
Contractor: FIRE PROTECTION SERVICES Owner: PACIFIC NW PROPERTIES LIMITED PA
9950 SW ARCTIC DRIVE STERN FAMILY LIMITED PARTNERSHIP
BEAVERTON, OR 97005 STERN FAMILY LLC
6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-590-3732 PHONE:
FAX: 503-628-6214
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/16/2020 $59.16
12%State Surcharge-Building 10/16/2020 $7.10
Type of Use: COM Info Process/Archiving-Sm$0.50(up to 10/16/2020 $0.50
Class of Work: ALT Type of Const: 11x17)
Occupancy Grp: Height: ft Plan Review-Fire Life Safety-COM 10/16/2020 $23.66
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:
Pull Station Required: Smoke Detectors Req:
Battery Coles Provided: Cut Sheets Required:
Total $90.42
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $750.00
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: 77 Permittee Signature: /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. !'i1
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
CityTigardRECEIVED77�7 �
25 W Halt Blv .,Tigard,OR 97223 Plan Review • / 1r/1 -I ��../ /
Si
Phone: 503.7182439 Fax: 503.598.1960 S E P 2 5 2020 Date/13 : Other Permit ,ii I ]{
Inspection Line: 503.639.4175 a e ft1 . See Page 2 for
Notirled/htethud: /Q i Supplemental Information
Internet: www.[igard-ocgov �,t-�, a`)r (ir ��� /„/) L'I PM
=1;.'
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWI.'ING
❑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
I]Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: S
❑ I-and 2-family dwelling ' ❑Q Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:13010 SW 68th Parkway New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 . - Garage/carport area: square feet
Suite/bldg/apt.no.:140/ ryy<I Project name:i.Fmgtger N„a,d�r,Rtler I�rwmt Irrq/ruvenuent Covered pooch area: square feet
—
Cross street/directions to job site:_. Deck area: square feet
SW 68th Pkwy&SW 66th Ave. Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CRECKLIST
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.
kAl Valuation: $750.00
�.'l ` Removal and Relocation of 1 Audible Horn/Strobe in Suite 140
�_^_., t^ ri Rdrt.- e' of 9 AtuiihlP --tom•--�-'- -y,l Existing building area: square feet
d-t
Ii4 &C tti:'.iff(' tW 5,:te- Jtt0 per Evcvv 124,Ai: Ad.✓ New building area: square feet
El PRO RTY OWNER 0 TENANT Number of stories:
Name: /t r Type of construction:
Address: Occupancy groups:
-City/StatelZIP:
Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 CONTACT PERSON NOTICE
Business name:Fire Protection Services, Inc. All contractors and subcontractors are required to be
Contact name:David Phipps licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9950 SW Arctic Dr. jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/state/2IP:Beaverton,OR 97005 apply:
Phone:( )503-590-3732 Fax_:( )
E-mail:Fire2112@ymail.com / Oen/ 1'f PPJ00mctll.4ctevn
CONTRACTOR BUILDING PERMIT FEES*
"hoe refer also scArdub,
Business name:Fire Protection Services, Inc.
Permit fee:
Address:9950 SW Arctic Dr.
State surcharge(12%of permit fee):
City/State/ZIP:Beaverton,OR 97005 FLS plan review(40%of permit fee):
Phone:( )503-590-3732 Fax:( ) (Due upon application submittal)
CCB tic.:154333 ?'/y/ Total permit fees:
Amount received:
Authorized signature: ibts/� �t.�
//� �j�� This permit application expires it a permit is not obtained
Print name:David Phipps Date:10/6/2020 within 180 days after it has been accepted as complete.
• Fee methodology set by Tn-County Building Industry
Service Board.
IN3aildina\Pemils\FPS-PennitApp_031016.doc 40-4613T(11/02'COM/WEBI
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:
❑ 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 ❑ 6+devices: Plan review requited 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: $
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: $
D.) Residential Sprinkler(Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $2240.45
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: $
1:\Building\Permits\FPS_PennitApp_031016.doe 2
_
City ofTigard Permit No.: /Tj�SO�)iC1 Qc)/0�;
Eril
" 13125 SW Hall Blvd.,Tigard,OR 97223RECEIVED
Phone: 503.7182439 Fax: 503.598.19 IEP 2 5 2020 Date Received: °J /21)
TIGARD Inspection Line: 503.639.4175
Internet: www.tigard-or.gov CITY OF TIGARD By: G-7; r17i %1
BUILDING DIVISION Grip t/
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Triangle Corporate Center, Tenant Improvement Occupancy:
Job Address: 13010 SW 68th Pkwy. Tigard, OR 97223 Suite: -- ' is
Contractor: Fire Protection Services, Inc. Phone: 503-590-3732
Valuation of work: $750
Type of System: (check one) ['Required ONon-required
(check one) DAutomatic ['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(m.x s) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added(.5) /To be Relocated taw 5)
Number of Proposed Notification Appliances: To be Added t»,az 5) /To be Relocated(.5) 3
I David Phipps Oregon Construction Contractors Board No. 154333
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 t with a copy of the sketch attached shall be available for all inspections.
Signature: O*7 Date: 10/1/2020
Print Name: David Phipps
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