Permit w CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s COMMUNITY DEVELOPMENT Permit#: FPS2014-00056
j G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/27/2014
-F
Parcel: 1 S 135BC01100
Jurisdiction: Tigard
Site address: 11117 SW GREENBURG RD
Project: Kayu International Subdivision: HILLSBORO Lot: PTS 1-2
Project Description: Fire alarm-add(1)horn strobe to existing system.
Contractor: AMERICAN SECURITY ALARMS, INC. Owner: GREENBURG SPACE CENTER LLC
5411 SE MCLOUGHLIN BLVD PO BOX 91305
PORTLAND, OR 97202 PORTLAND,OR 97291
PHONE: 503-231-0303 PHONE:
FAX: 503-230-1044
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/27/2014 $61.85
12%State Surcharge-Building 03/27/2014 $7.42
Type of Use: COM Plan Review-Fire Life Safety-COM 03/27/2014 $24.74
Class of Work: ALT Type of Const:
Occupancy Grp: B Height: ft
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 Calcs Provided: Cut Sheets Required:
Total $94.01
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $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 c the rules
or direct q ions • •UNC by calling 503.232.1987 or 1.800.332.2344.
Issued y:
(t(...t.iiiimitai66„,
Permitte e 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 Syste � ojC I t} 4 clll It I I tit (1\
1 1 L . i
City o f Tigard Received G� Permit
,.i/ -tkZ DateB : ■ ..i
13125 SW Hall Blvd.,Tigard,OR 97223 2 14 Plan Review
Phone: 503.718.2439 Fax: 503.598.196 Date/By: Other Permit: 4, a0/l�.dQO/d
1 [GAR ID
Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov ' Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
- Indicate the value(rouided 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.
❑ l-and 2-family dwelling giCommercial industrial
Valuation: S
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: //// 7 )yx/ iy,eQM j,f,L/5 /2r1. New dwelling area: square feet
City/State/ZIP: 77,G-z/ ,Z 5 7 �^ Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: / %7Ct jr)7 - 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.
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.
nP) �,/ /r , -17 5 rniJ�6 . Valuation: s F'gb
/�I ,1 C ((il/ /7 ° .fie M / v Existing building area square feet
New building area: square feet
PROPERTY OWNER I TENANT Number of stories:
Name: Type of construction:
Address: £ Occupancy groups:
City/State/ZIP:
Existing:
Phone: , Fax:(,S- ) New:
((APPLICANT C5 CONTACT PERSON NOTICE
Business name: ��/.- ri Cow, SC--rtif r-,=,-, /h C . All contractors and subcontractors are required to be
Contact name: /2 1G h /�'1 //�� licensed with the Oregon Construction Contractors Board
Q / under ORS 701 and may be required to be licensed in the
Address: S�// ft /4C (11)-A*6-1 8( V jurisdiction in which work is being performed.If the
City/State/ZIP: /' v1 /s� �� 7? 24Z applicant is exempt from licensing,the following reasons
apply:
Phone:(5e5) 2 j/ c:10-5 Fax: :(, ) 2?G 1 0 4 CI
E-mail: r(.�in G5 cc(.1c,r14v1{„ C-0`)'"-
CONTRACTOR BUILDING PERMIT FEES*
Business name: 5( u / (Please refer to fee schedule)
Address: Permit fee: �( g S
City/State/ZIP: /00�,('(. -,.61 v'- C('7 a..0-2— State surcharge(12%of permit fee): 7.�'2.
f FLS plan review(40%ofpermit fee):
Phone:($25) 7 31 0 3-43 Fax:(, r- Z 3 0 1 t 4 L (Due upon application)
2 L •711
CCB lie.: 5L 4 0 Total permit fees: 94.0
Authorized signature: C---T L j f Amount received: g/ci
�
f This permit application expires if a permit is not obtained
/2
Print name: e+ , "�/`.Y Date: 3 - 2-7• f within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:t Building\Permits\FPS-PermitApp.doe Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: 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: $
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: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
1:\Building\Permits\FPS_PemritApp.doc Rev 01/05/2012 2
I MINIENIONINI
KEYNOTES FLOOR PLAN GENERAL NOTES
Oi ..IE)NEU,STA..STS WAFT,
O)(NO(E)St.9 NNE OOELMO M,TS ENTIRETY or ROME a._-
)EW(E)CONCRETE O.4E.5■mp,DEO. =. OMOm(OS M■7O COVER O.0
0 O SEf Sra./(IUMt FOR p0�li0wy IXrN;S OTTOlE
1 MEO■E•.■DiMO■1 So OVAL K.wv)r:.,,E'v5
min=F YMW■1 fO.rPTOf 4
I .. INC WNW mE0UI.(MET a E■MIOMNOr M■ORE. I^
cow s S.S ONNCIO.N C 0104 Mn AKE WORM ATM�..
S RE T T Oc 6 I.OMW mOU■F mMECNE sEM -T
nE Rec«OWES Ymrt)■sEE7ra
= MT/ NOT MIS OM AV MWE Of RCP.(11171.1.
0 .0 moos loc s TN REcu ctEi o.TUS You.GE
� '�p �I — uo,, �FU...a q o„=).
a. - ¢I RCP GENERAL NOTES
I ,5111111,11111 'I' 0 ETE▪CN001 CONIRKrUVTO..[a:-WM.w EM`OILtµv 000
_ rrrtM'rvw.r a+os T v
```wOwE noM eEC+c(NL lunw.r ao(r `na
e� .2 R• uROEeu IwMaTC. OF
•LEGEND
Off► PARTIAL FLOOR PLAN L ®. Row oaf•NMO.
yr.r-r 0 (n COCOON Wu
_ (0)WORM ROL
A ® O (��MERm..1E m.EMMN
La
W b; r-.'n ,r-s'/2 0 . arsE ttOxca.o
IC I
O
r II �=Pril=
Q� � E� =Ti �I■�=I O 0 � R a NT I R M ..
m a (N..•nuO(SCENT LIG.M E O-' .:21411. ® Q— — �I mil
. 11 ` 1 D° C I II I'�S'JI
=�j=�� �E ' O
� . UE ..M o ME:
az
11 0 07 II===I o o.^▪ m4EEoo.o_ s _
`/�7 LJ I�a�a�■iii
j.. r■ (.1 ..
Jam' A 1�im∎■ WALL TYPES AP V Q— — _ — .� .0_..._ I 1 —r .a q.E:..:IAN*In.;AZ=
SW r WARD OCR, TO r J
(( ATANE MAO.SR 0[I.µS/.1.=.
v` b T•e:4%••�• ,•,.. OMS•Aura.'..C./OE,URN CI) TON WED
SO-RATER;MONT CON.EOARO ETON
sroE TO DOTTOIA OF NE*Q PARTIAL FLOOR PLAN o ,(.,.= O
�1 PARTIAL REFLECTED CELNG PLAN ® PARTIAL FLOOR PLAN o
Or•,-o O C nNeNM;vaE-Wu.FIRM L ov.Nns MIMI'/e'-,' �,-oON MONN WE wri.SREESSm C T7
N
.EawE:o,m('MNNC of cEtMC U N
/r AO Stm THE c-POUT C N a.
Z M=.�. N(n_ MT mNN 1 a �_
TOOT MATO.0. 1 Rm _ Z
m W °
s a y i orN ..AT rtcno, = W W o
Q E I® .MLR oMaE U d
1.w.m /_'[ Tq
`` sTEET rE*.L cwMEl '
&;,..W \ E .� V �/ H
M (I I +s }
-1I a .�. a
-rl �, _1�__ SIMM OM N(ONFE
00M[i--.TTMM IO WEEKO In.ROLL•.0
,IME,R■TT�(RMN/ • _
' N®RE WC ■
(9 MsuurtM cw.c .., _
I.
1(.. '11 (A .M,rtugrmpgwl ^ .•
1� C[NrtRK or snw • , uE sTnEnMM r 'w S
l AI COMREE - Nu
ti a M•wN
t C.N '—
(z-1,,, NEW WALL AT(E)STOREFRONT MULLION ell RAMP RETAINING WALL W/ GUARDRAL Joe To Tr0,02
"
4 G
City Tigard ri E ' I :I .-.¢ ,
INty' f g Permit No.: 4:5P5(904-00057 y
13125 SW Hall Blvd.,Tigard,OR 97223 ,�
Phone: 503.718.2439 Fax: 503.598.X960 . 1 Date Received: 19 7/i
i 1 Inspection Line: 503.639.4175 1
Internet: www.tigard-or.gov ! R° By: (.931,39-7//
�JJJ s 0
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: XA',a /) P wA Occupancy: 4
Job Address: /Of 7 a A//3 -e2Pr Ri Suite:
Contractor: 41-L12/7/ . SC-e-ez.-5., IA-LC Phone: 3 — a-3 / — O 30 2)
Valuation of work: $ 8 4)-z)
Type of System: (check one) 'BRequired fNon-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) 1 /To be Relocated(max 5)
I, 44 fit //A7 Oregon Construction Contractors Board No. ,.5—k&,- "i
g �C7
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:
• A sketch attached to this document and the building permit showing the area of work within the
building's structure,
• A copy of this document shall be available for the authority having jurisdiction, and
• Electrical permit.
i s Z 3 Grit /oi31
Signature: ��' "i� " Date: _?- 2 7•
Print Name:
I:\Building\Forms\FireAlarmAffidavit_022514.docx Page 1 of 1
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11117 SW GREENBURG RD, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
2014-03-31 00:00:00
FPS2014-00056
PASS - No C of O
Violation Summary:
Inspector Contractor