Permit (219) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
INa COMMUNITY DEVELOPMENT Permit#: FPS2018-00060
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2018
Tic l C� g Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 380
Project: PrimePay Subdivision: ASHBROOK FARM Lot: 5
Project Description: Fire alarm:Adding(1)devise and relocating(1)devise for TI
Contractor: POINT MONITOR CORPORATION Owner: PLAZA WEST OWNER LLC
5863 LAKEVIEW BLVD STE 100 BY CHIEF FINANCIAL OFFICER
LAKE OSWEGO, OR 97035 680 FIFTH AVE 20TH FL
NEW YORK, NY 10019
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/13/2018 $64.54
12%State Surcharge-Building 06/13/2018 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 06/13/2018 $25.82
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 06/13/2018 $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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Gales Provided: Cut Sheets Required:
Total $98.60
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $931.00
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
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By:
, / rmittee Signature:
its 1'
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 ECAVE
Fire Protection System JUN 1 9 2018 rc)R OFFICE CSE ONLY
CITY
� i OF 3 p�4 z� )1 i Received /� �p ) �}��
City of Tigard i i N c i`1E"t t • Date/By: L e /� I /R5- Permit No.;F/45,401 POO 0 V.,4
• 13125 SW Hall BIvd.,Tigard,OR' � { g�l A_.!� ? P d t?r P Plan Review _` �fu�� � ��
C 503.
Phone: 718. 2439 Fax: 503.59B11980'-'.` Date/sy:-71
Other Pern"t;�C?
Ti c A R D, Inspection Line: 503.639.4175 Date Read)By: Juris: 65 See Page for
Internet: www.eigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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
CATEGORY OF CONSTRUCTIONwork indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9600 SW Oak Street New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:380 Project name:Prime Pay 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.
Fire Alarm Devices-Relocates Valuation: $$931,00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER bd TENANT Number of stories:
Name:Prime Pay Type of construction:
Address:9600 SW Oak St Suite 380. Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( ) New:
Li APPLICANT 0 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
applicant is exempt from licensing,the following reasons
City/State/ZIP:Lake Oswego,OR 97035WIT
Phone:(503)627-0100 Fax::( )
E-mail:bwilllams(apointmonitor.com
CONTRACTOR BUILDING PERMITFEES*
Business name:Point Monitor Corp. (pie Yefer 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:
Amount received:
Authorized sgnature:ti -syr This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Ben Breit Date:6/6/18 * Fee methodology set by Tri-County Building Industry
Service Board.
1.Building4P°rmits PPS-PermitApp_031014.doc 440.4613701,02 COM/ EB)
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:
El New system Number of sprinkler heads: Number of alarm devices:
►t Addition or El 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 0 6+ devices: Plan review required and
(3)sets of plans. (3) sets of plans.
Additional description of work: Fire Alarm Devices
Type of System (Complete A,B,C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type 0 Wet El 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 El Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 931
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 Ai 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 C40% ofpermit fee): $
TOTAL: $
C:\Users\bwilliams\Desktop\PERMIT I ORMS\Dire permit-city of tigard.doc 2
RECEIVED
City ofTigard JUN 12 2018 Permit No.: PP/5k 0 -GiG)06,6
13125 SW Hall Blvd.,Tigard,OR 97223
C Phone 503.718.2439 Fax 503.598.196CIT y 'GARD Date Received: 7/ g
ribAR inintsrmettionwNizmsaor3:03,9g4ovos
8IJILDING DiViSIONy: raft i011i /rio.
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: PrimePay Occupancy: Same
Job Address: 9600 SW Oak Street Suite: 380
Contractor: Point Monitor Corp. Phone: 503-627-0100
Valuation of work: $913
Type of System: (check one) ['Required [1Non-required
(check one) DAutomatic [Manual IDBoth
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(.5) /To be Relocated(.5)
Number of Proposed Manual Alarm Stations: To be Added(max S) /To be Relocated(.5)
Number of Proposed Notification Appliances: To be Added( 5) 1 To be Relocated(n=5)
1, 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.
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.
o A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: Date: 6/6/18
Print Name: Ben Breit
1\BuildingWonneiFireAlarmAffidavit_071514 docx Page 1 of I
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9600 SW OAK ST 380, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00060
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor