Permit (2) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II la
COMMUNITY DEVELOPMENT Permit#: FPS2022-00036
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/3/2022
IS
` Parcel: 2S112DA01400
II t Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 365
Project: PCC Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm permit for TI-add(1)fire alarm notification device.AFFIDAVIT SUBMITTED. 5/2/22: REPRINTED to
include(1)additional notification device.
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: niitge 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
Fire Protection System FOR OFFICE USE ONLY
City Of Tigard Received + /�� _ _
b Date/By: /�i2� 4p_ Permit No.��?o i?„i.Q2
4 13:111111125 SW Hall Blvd.,Tigard,OR 9722 Plan Review `�" •d
11 Phone: 503.718.2439 Fax: 503.598.19R E C E I VE 1 Date/By: Other Permit:
T 1 GA R D Inspection Line: 503.639.4175 ' `` Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: tp�r Supplemental Information
'022
TYPE OF WOW
"1 ,, i REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction [ e'r�i L) VISION Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTIO ' a
1R 4 work indicated on this application.
0 1-and 2-family dwelling ❑ r Commerciaindustri. ' Valuation: $
❑Accessory building El Multi-familyNumber of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 6SO 61AJ 'PAU.)0c3A ' ) New dwelling area: square feet
City/State/ZIP: ---c-e% d OR._ Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: pcc, 2,40 `61J1•+,.. 3t e2S 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 work indicated on this application.
,-` r Valuation: $
i Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Lt. Name: Type of construction:
Address: Occupancy groups:
I City/State/ZIP: Existing:
; Phone:( ) Fax:( )
cy, New:
14, APPLICANT ❑ CONTACT PERSON
NOTICE
j Business name: ,.."�)� ' ,t j
{ ji'��" r``�'.7Yti"t-0t All contractors and subcontractors are required to be
Contact name: 1`--1 l r!‘ Saniz,S licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6ttp 3 L aµz-V t .S '
�j t�f'�, 1J pit_ I Do jurisdiction in which work is being performed.If the
City/State/ZIP: L l..t,Le_ OD �j0� 6119 applicant is exempt from licensing,the following reasons
Phone: (J apply:
(1c)3j) (i2 7 - 0100 Fax::( )
E-mail: --y\ `j �.)_ l)t A- flA j - ( • C/')YV\--
1 CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: `V -AP et) 4 J .._
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.: Total permit fees: j to/- . ?6
Authorized signature: I*.jezvsor- -> .... Amount received: 1 ,J
This permit application expires if a permit is not obtained
Print name: L� Date: rj` Z z within 180 days after it has been accepted as complete.
Jt ' ) * Fee methodology set by Tri-County Building Industry
Service Board.
0\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
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:
❑ 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:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type El \Vet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line El Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Mann
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
l-
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
tiSprinkler 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:ABuilding\Permits\FPS_PermitApp_031016.doc 2
City of Tigard Permit No.: O3 -4)---t,ick:);
13125 SW Hall Blvd.,Tigard,OR 97223
C Phone: 503.718.2439 Fax: 503.598. Date Received:
Inspection Line: 503.639.4175 �C E I V E D /�/, -
TIGARD Internet: www.tigard-or.gov By:
MAY 2 2022
FIRE ALARM sw&AfidaIDAVIT FOR ALTERATIONS
ORUEB1NNWISTAIPPROVEMENTS
(MAXIM ; 'I '. j ES WITHOUT PLANS)
Project Name: ?cc-2 Occupancy:
Job Address: CaCe '062 Suite:
Contractor: fb l �� ry in�-t azt Phone: (o 277 0(,OO
Valuation of work: $ � 302117
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(max 5) /To be Relocated(max 5)
—
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) OZ /To be Relocated(max 5) 03441
I, Oregon Construction Contractors Board No. J>
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: 5/Z/2
Print Name: j n J Orig.5
I:\Building\Forms\FireAlarmAffidavit 071514.docx Page 1 of 1
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
111 Transmittal Letter
r I It I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: c- DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: E2—';
CITY OF TiGARD
COMPANY: R� Y�C�Y\,(�COC BUILDING DIVISION _4)(5)
By: l .
PHONE: SOB 6 Z-1 Co�,
EMAIL: t SO'(V2—Se ( 1MIA,Pj f ,COWL.
RE: (,Q( C) A/0 W 05 Y\ -� --; pies ge -0( L3G
(Site Address) (Permit Num er)
VC.L2LO `\--e_. U1-SC_
(Project name or subdivision name and lot numb c V
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: A a&k c.1 ciao-t-
y-ex
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
Special
Instructions:
Reprint Permit(per PE): ❑Yes D No [Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions_073120.doc