Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2021-00036
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/20/2021
TIGARD 9 Parcel: 2S112DD00200
Jurisdiction: Tigard
Site address: 15862 SW 72ND AVE 100
Project: Easy Power Subdivision: None Lot: None
Project Description: Fire alarm permit-(8)Fire alarm notification devices
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES LP
5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/20/2021 $112.96
12%State Surcharge-Building 04/20/2021 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 04/20/2021 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 04/20/2021 $3.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1
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 Gales Provided: Yes Cut Sheets Required: Yes
Total $174.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,925.00
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 re 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 5 . 32.1987 or 1.800.332.2344. in 1/Issued By: Permittee Signature:
/Ili GAYmN'!/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
Ti 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 `J 8-4I1 2
Fire Protection System RECEIVED 'FOR OFFICE CSI.ONLY
City of Tigard APR 1 2021 Date By: e SZt72! �UrlgG
. - Received �'1-1 ,/,1� permit No.
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review' f [[ M/
Phone: 503.718.2439 Fax: 503.598.19 Date/By: -/ OtherPenn
TIGARD Inspection Line: 503.639.4175 (JITY OF TIGARD Date Ready/By: t' 'r See Page2for
Internet: www.tigard-or.gov '�IJILDING DIVISION Notified/Method: (_//g/ / /%i 1 lG Supplemental Information
d /f //,L_
TYPE OF WORK`' t 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
Additionialteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CON work indicated on this application.
Valuation: $
D 1-and 2-family dwelling ®Commercial/industrial
❑Accessory building
❑Multi-family Number of bedrooms:
❑Master builder ['Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION11..11
Total number of floors:
Job site address:15862 SW 72"Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:100 Project name:Easy Power-PCC210-100 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: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 WORK;.1.1111.111
work indicated on this application.
Fire Alarm Notification Devices Valuation: $$3,925.00
Existing building area: square feet
New building area: square feet
111. ❑ PROPERTY OWNER ® TENANT Number of stories:
Name:Easy Power-PCC210-100 Type of construction:
Address:15862 SW 72nd Ave Suite 100 Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:( ) Fax:( ) New:
tf APPLICANT ❑ CONTACT PERSON
Business name:Point Monitor Corp. All contractors and subcontractors are required to be
Contact name:Brooke Williams licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5863 Lakeview Blvd#100 jurisdiction in which work is being performed.If the
City/State/ZIP:Lake Oswego,OR 97035 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)627-0100 Fax::( )
E-mail:hwilliams@pointmonitor.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:Point Monitor Corp.
Permit fee:
Address:5863 Lakeview Blvd#100
State surcharge(12%of permit fee):
City/State/ZIP:Lake Oswego,OR 97035
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal.)
CCB lic.:135901 Total permit fees:
Amount received:
Authorized signature:
—� This permit application expires if a permit is not obtained
Print name:Ben Breit Date:3/31/2021 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
031016.doc 440-4613T(1 I O/COM/WEB)
I:Build"tg1Pennits\FPS-PertnitApp_
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: 8
® 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: Fire Alarm Notification Devices
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: $
C.) Fire Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: I $ 3,925
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 P.ees
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: $
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