Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• COMMUNITY DEVELOPMENT Permit#: FPS2014-00150
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/15/2014
Parcel: 2S112AA00600
Jurisdiction: Tigard
Site address: 6777 SW BONITA RD 100
Project: Earnest Images Subdivision: MILLMONT PARK Lot: 49
Project Description: Fire alarm,connect(1)sprinkler tamper switch and(1)water flow switch to an existing fire alarm system.
Contractor: SIGNALING SYSTEM SOLUTIONS Owner: WALTON CWOR NELSON 13 LLC
13504 NE 84TH ST#103-160 BY EQUITY OFFICE MANAGEMENT LLC
VANCOUVER,WA 98682 PO BOX A-3879
CHICAGO, IL 60690
PHONE: 360-694-9199 PHONE:
FAX: 888-511-7734
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/15/2014 $51.09
12%State Surcharge-Building 09/15/2014 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 09/15/2014 $20.44
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 Sys tem:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $77.66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $250.00
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 • • k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili' otification Ce -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You o e rules
o•direct questions to OU C • •.fling 503.232.1987 or 1.800.332.2344.
Issued By: / I Permittee Signature: X/
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.
City of Tigard 1ECEIVED Permit No.: /25c, 074{—
Dl SD
13125 SW Hall Blvd.,Tigard,072 2014
Phone: 503.718.2439 Fax: 50 1 Date Received: ?//c1"/
TIGARD Inspection Line: 503.639.4175 _
Internet: www.tigard-or.gov Gil Y lk I I�D By: CJ . 0.44(--41-2
mUILDIN(nivISION
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: g f2 41 ES i / IS Occupancy:
Job Address: 6 7 7 7 S 14/ .__Edt:1 i TA "4').601) Suite: /D o
-rra, k ri-o, c�2
Contractor: ,T.a,JAe/rJG .SYrs7 -irl .SOLU 7/o+JS Phone:'.) -- 9`-/- j . 9 9
Valuation of work: $ 0.2SD
Type of System: (check one) ERequired ENon-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 cmax 5)
Numb r of Pro ossed Manual Alarm Stations: To be Added on.5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added cm.5) /To be Relocated(ma,c 51
10,1-71/1-- 1 ) /.� /,E'L gwn eel
—
I, 1 ra„t_ S�e�er 55,.,-,11I SIS4ernSow�►w-r5 Oregon Construction Contractors Board No. 1-7 3 2--) "-\
certify the followi g 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 ofaskitch sho ing the area of work within the building's structure.
• Building fire protection syst permit.
• Electrical permit. '
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: /7„1,-- .3 6 3 6 L-4-f- Date: C1- Z l 6-)
Print Name: H9c, c- 51e
I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1
Building Permit Application
Fire Protection System RECFWIED FOR OFFICE USE ON L1
City of Tigard c Ep 15 2p14 Received Q 'L / Permit No.. /-16040/ --‘1:915-0
-" 13125 SW W Hall Blvd.,Ti gard,OR 97223 e R hew �S
Other Permit: �n
Phone: 5n Line: Fax: 503.598.1 fIGP � Date/By: Ili4514/dAype y 36
T I G A R D Inspection Line: 50!3.639.4175 C1 11V"(°1�n�) Date Ready/By: !uric: 65 See rage 2 for
Internet: www.tigard-or.gov ��1� I',1�.1 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(rounded to the nearest dollar)of all
J ddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling 2-Commercial/industrial
Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 6,77 7 6-14/ 8001 7-4 2 6 New D New dwelling area: square feet
City/State/ZIP: 7 4,,he D BQ 9 7 Garage/carport area: square feet
Suite/bldg./apt.no.:lG io f Project name: &read 7 /—A.Gi S• Covered porch area square feet
Cross street/directions to job site: 37irra�,TA v, .S e.ell 0 D i 4 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: $ (o-u.e/FCT � E S '&i. *Z.C� 7 r/t -e .SC//TCfr
Diu./D 0� � 7 `Logic) S ETC J/ 7-0 TZ. . Existing building area square feet
/-- %/ilL'CA �/Q6 x44 S YS-1-n44 • // New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name:
licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:slt�A, 4-t /AI 4 .s'7 S ! 6,A fp L07764.03- -fit!• Permit fee: 57,
Address: / SO'7/ Ai e- S 41:7511 S T *".1.1?"- 16 O State surcharge(12%of permit fee): /3
City/State/ZIP: /A'i„(CG v)r e..a ,(,tW A "F d,g Z . FLS plan review(40%ofpermit fee): y
�
Phone:,CU/j 4P`)S!- 9j / 7 7 Fax:( ) (Due upon application submittal.) '��
CCB lic.: /7s Z 7 nlligtio _ ' Total permit fees:
Authorized signature: Amount received: 77.d c
*� This permit application expires if a permit is not obtained
Print name 1, I e 5s 6 Date: �} /y A within 180 days after it has been accepted as complete.
/ * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(I 1/02/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 El 1-10 heads: Affidavit required and El 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
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
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 Protectlan 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:\Building\Permits\FPS_PemtitApp_071514.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
6777 SW BONITA RD 100, TIGARD, OR, 97224
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
September 19, 2014 at
8:53:46 AM
FPS2014-00150
Chip Barnett
Violation Summary:
Inspector Contractor