Permit IN CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2021-00062
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6l24/2021
TIGARD 9 Parcel: 1 S136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE# 110
Project: Thrive Aesthetics Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Fire alarm permit-install(9)fire alarm notification devices
Contractor: POINT MONITOR CORPORATION Owner: PNWP LLC#2
5863 LAKEVIEW BLVD STE 100 PNWP LLC
LAKE OSWEGO, OR 97035 6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/22/2021 $134.48
12%State Surcharge-Building 06/22/2021 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 06/22/2021 $53.79
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 06/22/2021 $6.00
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: Alarm Type: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $210.41
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,097.00
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: H Permltteesignature:Holly
OAppatG_n
""",' V De/W w �.
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 �-5fi? 12
Fire Protection System R FOR OFFICE USE ONLY �/�'t
- City of Tigard MAY 7 �G's Received p �� .49
PennitNo.:�Pt' tJLI.�O�<OL
Date/By: O
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1Y OF TIGARD Date/By: 6 ' '2i r Other Permit:
63
T 1 G A R D Inspection Line: 503. 9.4175 Date Ready/By: 1 I ;• ^ la See Page 2 for
Internet: www.tiga3.63 ov BUILDING DIVISION fled Me hod / Supplemental Information
` 1
TYPE OF WORK z , 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 D Other: equipment,materials,labor,overhead,and the profit for the
P"` work indicated on this application.
CATEGORY OF COS' ' AIL
ElI-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:11850 SW 67th Ave. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:110 Project name:Thrive Aesthetic 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: I 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.
Fire Alarm Notification Devices Valuation: $$5,097.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
,44
Name:Thrive Aesthetic Type of construction:
Address:11850 SW 67th Ave.Suite 110 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( ) New:
rl APPLICANT ' S
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:bwilliams@pointmonitor.com
CONTRACTOR M BUILDING PERMIT FEES*
Business name:Point Monitor Corp. (vtease refer m fee schedule
Permit fee:
Address:5863 Lakeview Blvd#100
State surcharge(12%of permit fee):
City/State/ZIP:Lake Oswego,OR 97035 u
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal.)
CCB lie.:135901 Total permit fees:
Authorized signature:t:::: c:L..._......„_,
Amount received:
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:5/17/2021 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:1BnildinglPennita'FPS.PermitApp_031016.doc 440-4613T(ii/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done: s
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: 9
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
El 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 Com lete A, B, C or D as applicable): _`
Y ( Ppp )• � v
A.) Commercial Spun
Sprinkler Type ❑ Wet ❑ Dry.
Additional Standpipes
Information: Sprinkler Supply Line El Yes El No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 5,097
D.) Residential Sprinkler(Stand Alone System)
Square Foota.e: 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: $
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