Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2014-00075
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2014
Parcel: 2S 101 AA02900
Jurisdiction: Tigard
Site address: 12123 SW 69TH AVE
Project: Capital One-Building A Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Fire alarm modifications. Affidavit received,(4)notification devices added,(4)notification devices relocated.
Contractor: ADVANCED ALARM SYSTEMS INC Owner: TIGARD CORPORATE CENTER LP
1030 NW CORPORATE DR 15325 SW BEAVERTON CREEK CT
TROUTDALE, OR 97060 BEAVERTON,OR 97006
PHONE 503-550-0999 PHONE:
FAX: 503-492-3413
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/28/2014 $69 92
12%State Surcharge-Building 04/28/2014 $8.39
Type of Use: COM Plan Review-Fire Life Safety-COM 04/28/2014 $27.97
Class of Work: ALT Type of Const:
Occupancy Grp: 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 $106.28
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,167.00
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 ques• • •UNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: .es�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. L�/L
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
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard Received ii/B / 0 /1 �� 7 Permit No.:14.31, -a s
13125 SW Hall Blvd.,Tigard,OR 97 2 8 2014 Plan Review
. 0 Phone: 503.718.2439 Fax: 503.598.1617 Date/By: Other Permit: /6‘.4 PAVI-nifleV9g7
TI G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK r REQUIRED DATA: 1-AND 2-FAMILY DWELLING
❑New construction ❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑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: 12123 SW 69th Ave New dwelling area: square feet
City/State/ZIP:Tigard OR. Garage/carport area: square feet
Suite/bldg./apt.no.: a04 A. Project name:Capitol One 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 alterations for tenant TI Valuation: $$1,167.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Capitol One Type of construction:
Address: 12123 SW 6th Ave Occupancy groups:
City/State/ZIP:Tigard OR. Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Advanced Alarm Systems Inc. Structural plan review fee(or deposit):
Contact name:Scott Sullivan
FLS plan review fee(if applicable):
Address: 1030 NW Corporate Drive
Total fees due upon application:
City/State/ZIP:Troutdale OR.97060 y
Phone:(503)550-0999 Fax::(503)492-3413 Amount received: tl /C6,.'��
E-mail:scotts @advancedalarmsystemsinc.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive ins . lation of
CONTRACTOR roof-te•mounted Photo Voltaic Solar P.• System.
Business name:Advanced Alarm Systems Inc. Submit 2)sets of roof plan ': connection details
and fire depa • -nt access • g with the 2010 Oregon
Address: 1030 NW Corporate Drive Solar Installation - e ty Code checklist.
City/State/ZIP:Troutdale OR.97060 Permit f Inclue 'Ian review $180.00
and administra • ees):
Phone:(503)550-0999 Fax:(503)492-3413 States o of permit fee $21.60
CCB lie.: 186615
Total fee due upon application: $201.60
Authorized signature: �ia�. \'� This permit application expires if a permit is not obtained
any [_J within 180 days after it has been accepted as complete.
Print name: rr valvA, Date: 1.1.2d-ty * Fee methodology set by Tri-County Building Industry
Service Board.
l:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440.4613T(11/02/COM/WEB)
City of Tigard Permit No.: r 5 9ot y-()7L
13125 SW Hall Blvd.,Tigard,OR 97223
174 s Phone: 503.718.2439 Fax: 503.598.1960 Date Received: z(bO y
T I G A tu) Inspection Line: 503.639.4175 ( . -/
lnInternet: www.tigaz c r d-or.gov By: �yt.t-/-f
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: CAP 1to1._ b ti E Occupancy: 6
Job Address: 12 123 Sw let tH Ave reAL,Xj A- n Suite:
Contractor: ADvA+v+.e-6 A LA-04k SYSIANct S Phone:
Valuation of work: $ I /[n7.°°
Type of System: (check one) Required ❑Non-required
(check one) EAutomatic [Manual ljBoth
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) If /To be Relocated (max5) 14
I, � 7iT �j�riLtvl�✓ Oregon Construction Contractors Board No. I 'bb,c
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.
Signature: ��°'' Date: u, 23 I`1
Print Name: wk.—)
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