Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2022-00043
Date Issued: 3/21/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101BB01300
Jurisdiction: Tigard
Site address: 11958 SW GARDEN PL
Project: Zoom+Care-Billing Subdivision: CROW PARK 217 Lot' 1
Project Description: Fire alarm system-modify existing fire alarm system to support remodeled space. (22)new devices and relocate
(6)existing devices.
Contractor: POINT MONITOR CORPORATION Owner: BKM PARK BC 252 LLC
5863 LAKEVIEW BLVD STE 100 BY SLK GLOBAL SOLUTIONS AMERICA
LAKE OSWEGO, OR 97035 2727 LBJ FREEWAY STE 806
DALLAS, TX 75234
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/18/2022 $134.48
12% State Surcharge-Building 03/18/2022 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 03/18/2022 $53.79
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 03/18/2022 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 03/18/2022 $17.50
11x17)
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 Calcs Provided: Yes Cut Sheets Required: Yes
Total $225.91
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,500.00
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: Permittee Signature: !!
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 RECEIVED
43
Fire Protection System MAR 2 2022 FOR OFFICI: USE ONLY
07
City of Tigard CITY OF TIGAHb o e `ey 63 0 22. Permit No.:F 2Z
'Pt13125 SW Hall Blvd.,Tigard,OR 97223'i'i p Plan Review
• 11 , Phone: 503.718.2439 Fax: 503.598.196VILDING DIVISIO\ Date/By: 3 -'js--, 22 it) Other Permit:
I I t i A K 1) Inspection Line: 503.639.4175 Date Ready/By: { to• ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: ,I// / ,�. ,10, I le" Supplemental information
.1 ter`,✓ .s'
TYPE OF WORK l REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 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
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
v3
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling {a Commercial/industrial
Number of bedrooms:
❑Accessory building 0 Multi-family
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11958 SW Garden Place New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Zoom+ Care- Billing Covered porch area: square feet
Cross street/directions to job site: SW Garden Place, South of Pacific Hwy 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 work indicated on this application.
Modify existing fire alarm system to support remodeled space. valuation: $ 5500.00
Existing building area: square feet
New building area: square feet
.„ „_ ,qa. FTY_OWNER 0
TENANT Number of stories:
•
Name: Type of construction:
•
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
2 APPLICANT 0 CONTACT PERSON NOTICE
Business name:Point Monitor Corporation All contractors and subcontractors are required to be
Contact name: Freddie Caoile licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 5863 Lakeview Blvd 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: FCaoile@pointmonitor.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Point Monitor Corporation (Please refer to fee schedule,
Permit fee:
Address: 5863 Lakeview Blvd 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 permit fees:
lic.: 135901 �
j_____ Amou
nt received:
Authorized signatw Nth e: I l This permit application expires if a permit is not obtained
Print name: Freddie C oile Date: 3/2/22 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
(:\Building\Permits\FPS-PermitApp_031016.doc 440-4613-R I I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
a ^sa;2 .m 1 s M Y` ` ' :`` .'... `,sa:. .: ".:a g.git n.. ,. S` WW- _ ..a 3.,4 .. _. .
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:
0 Addition or ❑ 1-10 heads: Affidavit required and 0 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
0 11+heads: Plan review required and 0 6+devices: Plan review required 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 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppf ss gSystem
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 5500.00
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 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: $
I:\Building\Pemvts\FPS_PermitApp_031016.doc 2