Permit City of Tigard RECEIVEDPennitNo.: FPS 2022 -0004
• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 MAR 04 2022 Date Received: 03-Q4 2.Qu
Inspection Line: 503.639.4175 _
,. .-t� Internet: www.tigard-or.gov CITY OF TIGARD By: CiTY OF TlgAkD
BUILDING DIVISION
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1114XIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Clean Water Services Durham - Dry System Riser Occupancy:
Job Address: 16060 SW 85th Ave Suite:
Contractor: Point Monitor Corporation Phone: 503.627.0100
Valuation of work: $3,264.00
Type of System: (check one) � C
YP Required ❑Non-required
(check one) Automatic ❑Manual OBoth
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(may 5) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added (max 5) 1 /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) 2 /To be Relocated(max 5)
I Kristin Jones Oregon Construction Contractors Board No. 135901
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 document with a copy of the sketch attached shall be available for all inspections.
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Digitally signed by Kristin Jones
Signature: Kristin Jones pyec222.D3g0one%8Pg5-80050rwm,Clt=KristinJones Date: 3/4/22
Print Name: Kristin Jones
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