Permit r CITY OF TIGARD j FIRE PROTECTION SYSTEM PERMIT
s • COMMUNITY DEVELOPMENT e Permit#: FPS2015-00009
T IARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/21/2015
G
Parcel: 1 S135ACO2500
Jurisdiction: Tigard
Site address: 9388 SW MANDAMUS CT
Project: The Reserve At Ashbrook Subdivision: ASHBROOK FARM Lot: 25
Project Description: New fire alarm communicator for existing fire alarm system. Affidavit submitted. 2/3/15,reprinted permit to correct
address from 9482 to 9388 SW Mandamus.
Contractor: PERFORMANCE SYSTEMS INTEGRATION CORP Owner: MACH 1 GE-ASHBROOK LLC
7324 SW DURHAM RD 851 SW 6TH AVE#1500
PORTLAND, OR 97224 PORTLAND,OR 97204
PHONE: 503-641-2222 PHONE:
FAX: 503-641-1464
FEES
Description Date Amount
Specifics: Permit Fee-MF 01/21/2015 $77.99
12%State Surcharge-Building 01/21/2015 $9.36
Type of Use: COM Plan Review-Fire Life Safety-MF 01/21/2015 $31.20
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 $118.55
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,500.00
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 qu- s o•I •- by calling 503.232.1987 or 1.800.332.2344.
Issue. By: / / / Permittee Sig attire:
Call 503.639.4175 by 7:00 a.m.for the next available ins ction 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.
q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2015 00009
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/21/2015
Parcel: 1S135ACO2500
Jurisdiction: Tigard
Site address: 9482 SW MANDAMUS CT
Project: The Reserve At Ashbrook Subdivision: ASHBROOK FARM Lot: 25
Project Description: New fire alarm communicator for existing fire alarm system. Affidavit submitted.
Contractor: PERFORMANCE SYSTEMS INTEGRATION CORP Owner: MACH 1 GE-ASHBROOK LLC
7324 SW DURHAM RD 851 SW 6TH AVE#1500
PORTLAND,OR 97224 PORTLAND, OR 97204
PHONE: 503-641-2222 PHONE:
FAX: 503-641-1464
FEES
Description Date Amount
Specifics: Permit Fee-MF 01/21/2015 $77.99
12%State Surcharge-Building 01/21/2015 $9.36
Type of Use: COM Plan Review-Fire Life Safety-MF 01/21/2015 $31.20
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 $118.55
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,500.00
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: r Signature:
f
Call 503. . 175 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.
iBuildingPermit Application
REC'EIN Ev L Fire Protection System FOR OFFICE USE ONLY
ErCity of Tigard Date`ved Permit No.:^/
y g 015 Date/B : / .,�� . .� t,l , - 4,-
13125 SW Hall Blvd.,Tigard,OR 97223 JAN 2 Plan Revie
Phone: 503.718.2439 Fax: 503.598.1960 `� Al D Date// : Other Permit:
T I G A R D Inspection Line: 503.639.4175 C11 VV 1IG Date Ready/By: RI See Page 2 for
Internet: www.tigard-or.gov l i iV1SII otified/Method: n Supplemental Information
/AWING l7
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
®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 ®Other:R-2(Apts.) Number of bathrooms:
ciu , JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address;-9494-5W Mandamus Court New dwelling area: square feet
City/State/ZIP:Tigard/OR/97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:The Reserve at Ashbrook Covered porch area: square feet
Cross street/directions to job site:SW Greenburg Rd and SW Shady Ln 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.
New fire alarm communicator for existing fire alarm system Valuation: $$1,500.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER f 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: R-2
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Performance Systems All contractors and subcontractors are required to be
Contact name:Edward Chiong licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:7324 SW Durham Rd jurisdiction in which work is being performed.If the
City/State/ZIP:Portland/OR/97224 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)641-2222 Fax::(503)641-1464
E-mail:edward @psintegrated.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Performance Systems (Pltatanjerto fee schedule)
Permit fee:
Address:7324 SW Durham Rd
City/State/ZIP:Portland/OR/97224 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)641-2222 Fax:(503)641.1464 (Due upon application submittal.)
CCB lic.:150747 Total permit fees:
Amount received:
Authorized signature
Z This permit application expires if a permit is not obtained
Print name:Edward Chiong Date: 12/30/2014 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 440-461 3T(l I/02/COM/WEB)
ti
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 ❑ 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
❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: New fire alarm cellular communicator to existing fire alarm system.
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: _ $
C) Fire Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1,500
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: $
I.:\—work\Reserve at Ashbrook 123014\Bldg 2-9494 Mandamus Court\Phasel (DMP Qellular Communica tor)\Job Mgmt psig11661 9494 Phascl\Permits-PSIQI1661\FPS-
PcnnitApp 9494.doc
t 3125 W Tigard �T�`7�j� Permit No.: FPSaO tf 5 —c
� 13125 SW Hall Blvd.,Tigard,OR 97 _
Phone: 503.718.2439 Fax: 503.598. Date Received: 16415
d, Inspection Line: 503.639.4175
Internet: www.tigard-or.gov
JAN O 20+5 By:
FIRE ALARM R 'T4J( IDAVIT FOR ALTERATIONS
(IITIM ' PROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: A; vnk-- Occupancy: Z
Job Address: t�r�nll lvs Gr Suite:
Contractor: 1.
�,2c-oce.et Phone: 5c3 61{l -Z2.?7
Valuation of work: $ 1)500.
Type of System: (check one) 4equired ❑Non-required
(check one) ['Automatic ❑Manual ,Both
1JE vs) T-A co M,.A v,.„c
Total number of devices added or moved under this permit process is 5 to al per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(m.5) /To be Relocated(max5)
Number of Proposed Manual Alarm Stations: To be Added 0.5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) /To be Relocated(max 5)
I, ,,,, ( .Art,t,-•.■( Oregon Construction Contractors Board No. 1 S v 4
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 document with a copy of the sketch attached shall be available for all inspections.
Signature: Date: i 2-0/2.o l 5
Print Name:
1:\Building\Forms\FireAlarrAffidavit 071514.docx Page 1 of 1