Permit „ CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' COMMUNITY DEVELOPMENT Permit#: FPS2022-00036
Date Issued: 3/3/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 365
Project: PCC Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm permit-add(1)fire alarm notification device.AFFIDAVIT SUBMITTED.
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES
5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/02/2022 $102.20
12%State Surcharge-Building 03/02/2022 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 03/02/2022 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 03/02/2022 $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: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $155.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,247.00
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
Issued By: Edgaroto-Mat/-ovt-ado- Permittee Signature: 522 a l i Ga�fi Qw
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 Applicatio,RECEIVED
Ift
Fire Protection System FEB 2 3 2022 rolz owlet usi:()NIA.
Cityof Tigard CITY OF TIGAR� Received D3 ,
DateBv: i
I 2 / Permit No.:5)s2O . 36
13125 SW Hall Blvd.,Tigard,OR 972?,� „ Plan Review ,J
. Phone: 503.718.2439 Fax: 503.598.1 LDING DIVISION DateBv: t✓ 4 Other Permit
TIGARD Inspection Line: 503.639.4175 Date ReadyBy: �7 See for
Internet: www.tigard-or.gov Notified/Method: A22 (v�7` Supplemental Information
ji / ii &rDV;
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 Demolition Permit fces*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY. OF CONSTRUCTION work indicated on this application.
ElI-and 2-family dwelling ElCommercial/industrial Valuation: S
ElAccessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:6650 SW Redwood Lane New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:365 Project name: PCC240 Suite 365 Spec 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.
Flee Alarm Notification Device Valuation: S2,247
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ® TENANT Number of stories:
Name:PCC240 Suite 365 Spec Space Type of construction:
Address:6650 SW Redwood Lane Suite 365 Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:( ) Fax:( ) New: ,
® APPLICANT ❑ CONTACT PERSON
NOTICE
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:bwilliamst✓pointmonitor.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Point Monitor Corp. (Please refer to fee schedule)
Permit fee:
Address:5863 Lakeview Blvd#100
City/State/ZIP:Lake Oswego,OR 97035 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal)
CCB lie.: 135901 Total permit fees:
Authorized signature:
Amount received: /56441
This permit application expires if a permit is not obtained
Print name:Ben Breit _ Date:2/23/2022 within 180 days after it has been accepted as complete.
* Fee methodology set by'Fri-County Building Industry
Service Board.
I\Building\Permits't'PS-PcrmitApp_031016.doe 440-4613T(I I/02/COMAVEB)
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: 1
/1 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 Device
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet D 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: $ 2,247
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 S310.05
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 (sec 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: $
C:\Users\bwilliams\Desktop\PERMIT FORMS\Fire permit-city of tigard.doc 2
RECEIVED
City of Ti Permit No.:
o FEB 2 3 2022 FPSZO2Z-Q0036'
Tigard
Ili 13125 SW hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.196 1TY OF TIGARD Date Received: O2n+Z' /20ZZ-
TIGARD Inspection Line: 503.639 4175 lUILDING DIVISION 1 O F TK �/��/�
7 O Internet: ����w.tigard-or.gov By: G� y
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS ONCE COPY
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: PCC240 Suite 365 Spec Suite Occupancy: Same
Job Address: 6650 SW Redwood Lane #365 Suite: 365
Contractor: Point Monitor Corp. Phone: 503-627-0100
Valuation of work: $2,247
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(mar s) /To be Relocated(max s)
Number of Proposed Manual Alarm Stations: To be Added(max s) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added,max 5) 1 /To be Relocated(mars)
I Ben Breit 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.
Signature: Date: 02/23/2022
Print Name: Ben Breit
L\Building\Forms\FireAlannAffidavit_071514.docx Page 1 of 1
{3 RECEIVED
' I ' 1 FEB 2 3 2022
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E $ CITY OF TIGNRL
I lUILDING DIVISION
OFFicE COPY
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— For only the work as described in:
4 PERMIT NO. FE2o2Z G
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By; Date:�j/V2'2
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i pcc240-365 Spec Office
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A PACIFIC CORPORATE CENTER
REFLECTED CEILING PLAN 'l Ze 6650 SW REDWOOD LANE #365
PORTLAND, OR 97224