Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I COMMUNITY DEVELOPMENT Permit#: FPS2022-00154
Date Issued: 11/14/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE#220
Project: TOL Expansion-Phase 2 Subdivision: VARNS ACRES Lot: 9
Project Description: Fire alarm permit: Relocating(5)fire alarm devices. Affidavit submitted.
Contractor: PRIME ELECTRICAL SERVICES LLC Owner: TRIANGLE POINTE TWO LLC
PO BOX 872395 901 NE GLISAN ST, STE 100
VANCOUVER, WA 98687 PORTLAND, OR 97232
PHONE: 503-318-5170 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/14/2022 $102.20
12%State Surcharge-Building 11/14/2022 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 11/14/2022 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 11/14/2022 $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: $2,850.00
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.
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Building Permit Application RECEIVED
Fire Protection System
City of Tigard NOV 16 2022 Receiv 111014 �
Date/By:
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Permit No.: J c
� '�� i
11111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.196 Date/13y: / Other Permit: plot, �--0oi'��
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: -`� y ,Juuris::,/ See Page 2 for
71GARD Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method t�l tI ly {r`p Supplemental Information
TYPE OF WORK IVS R Q../•IL D DATA:1-AND 2-FAMILY DWELLING
❑ Demolition Permit fees*are based on the value of the work performed.
❑New construction 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 CONSTRUCTION work indicated on this application.
,.. Valuation: $
❑ I-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
0 Accessory building ❑Multi-family
0 Master builder
ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION , Total number of floors:
Job site address: 13333 SW 68th Parkway New dwelling area: square feet
City/State/ZIP: Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Ste_ 10 NiiProject name:Total Quality Logistics Covered porch area: square feet
Cross street/directions to job site: 2nd Floor 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.
Valuation: $2,850.00
Reconfigure existng fire alarm devices for new walls layout
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT `. Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State'ZIP Existing:
Phone: ( 1 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE <.
Business name: Prime Electrical Services LLC All contractors and subcontractors are required to be
Contact name: Oleglicensed with the Oregon Construction Contractors Board
Primachenko under ORS 701 and may be required to be licensed in the
Address: PO Box 872395 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/Z1P: Vancouver,WA 98687 apply:
Phone:(503 )318-5170 Fax: :( )
E-mail: oleg.p(cOrimeclectricalco.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: prime Electrical Services LLC
Permit fee:
Address: PO Box 872395
State surcharge(12%of permit fee):
City/State'ZIP: Vancouver,WA 98687 FLS plan review(40%of permit fee):
Phone:( 503 )318-5170 Fax:( ) (Otte upon application submittal.)
Total
lie.: 217825 / permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Date: 1 1/10/2022 within 180 days after it has been accepted as complete.
Print name: Oleg Primachenko * Fee methodology set by Tri-County Building Industry
Service Board.
I:\BuildingTertnil :PPS-Pere,itApp_U31016.d0c 440.4613T(I I,02ICOM/WEB)
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City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of\X'ork: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices: 5
❑ Addition or ❑ 1-10 heads: Affidavit required and x❑ 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:
Type of System Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ 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 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $ 2,850.00
D.) Residential Sprinkler(Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 S198.75
2,001 to 3,600 S246.45
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): $ 2,850.00
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\Permia\FPS_PennitApp_0310 16.doc 2
City of Tigard ECEIVEDPermit No.:
NOV ,�}}—���y
Er
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Iv /0 1U11 Date Received: Nab-)
Inspectionterne: Line: 50d-or.g4175 G , .7�
T I G A R D Internet: www.tigard-or.gov By: y (ail!
SWIM
CITY OF TIGARD
ALARM SWIM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Total Quality Logistics Occupancy: type B
Job Address: 13333 SW 68th Parkway Tigard, OR 97223 Suite: 210
Contractor: Prime Electrical Services Phone: 503-318-5170
Valuation of work: $2850.00
Type of System: (check one) nRequired ❑Non-required
(check one) ['Automatic ❑Manual ❑i•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 tmax 5) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(uax 5)
Number of Proposed Notification Appliances: To be Added(max 5) /To be Relocated(max 5) 5
I Oleg Primachenko Oregon Construction Contractors Board No. 217825
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 docume with a copy of the sketch attached shall be available for all inspections.
Signature: Date: 10/10/2022
Print Name: Oleg Primachenko
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