Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111111 Y - COMMUNITY DEVELOPMENT Permit#: FPS2015-00089
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/26/2015
TIGARD Parcel: 25101 BD00100
Jurisdiction: Tigard
Site address: 7650 SW BEVELAND RD 170
Project: OMEP Subdivision: 1994-025 PARTITION PLAT Lot: 2
Project Description: Fire alarm,add(3)new devices and relocate(1)device.
Contractor: POINT MONITOR CORPORATION Owner: PNWP LLC#2
5863 LAKEVIEW BLVD STE 100 PO BOX 2206
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97075
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/26/2015 $80.68
12%State Surcharge-Building 05/26/2015 $9.68
Type of Use: COM Plan Review-Fire Life Safety-COM 05/26/2015 $32.27
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 05/26/2015 $3.00
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 Calcs Provided: Cut Sheets Required:
Total $125.63
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,600.00
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
issua , is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
• y Notification Cente T ose rules are set forth in OAR 952-001-0010 through OAR 952-001- . ou may obtain a copy of the rules
or direct questions to OUN ..y c)lin. 503.232.1987 or 1.800.332.2344.
Issued By: ! Permittee Signature:
iZt/4 , _!
Call 503.639.4175 by 7:00 a.m.for the next available inspectio 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 Applicati-RECEIVED
Fire Protection System FOR OFFICE USE ONLI
MAY 2 6 2015 _�y� q
City of Tigard Date�Bed 5 Permit No.: 1 r(i � f
• 13125 SW Hall Blvd.,Tigard,OR 9M3_ TIGARD Plan Review
= Phone: 503.718.2439 Fax: 503.59 Y OF Date/B ; Other Permit: � xs�l3
T I G A R D Inspection Line: 503.639.4175 BUILDING NG DIVISION Date Ready/By: kris: HI 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(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.
❑ 1-and 2-family dwelling Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
MLJOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 7 0 V l',7t txe kvi New dwelling area: square feet
City/State/ZIP: 1 ' 1.,2// / Q t* ' 7>- %� Garage/carport area: square feet
Suite/bldg./apt.no.: ) / (/ Project name: a flld Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:( rIMERCIAL-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 p.
DESCRIPTION OF WORK j work indicated on this application.
do( \ 3, N t7�,YI{CR.-I/ / �,1.7.6 v'� ( I ) Valuation: /6900 $
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER -^ ENANT Number of stories:
Name: / ' 1 `� Type of construction:
Address: V-7 6, 0 / 7( t`La&in d Occupancy groups:
City/State/ZIP: T// l O>e jg 7 a---37- Existing:
Phone:( ) Fax:( ) New:
IX r ANT ( V C�if CONTACT PERSON All contractors and subcontractors Business name: �OPL ( ( (�
' ntractors are required to be
Contact name: "t (IN - licensed with the Oregon Construction Contractors Board
"`� r� under ORS 701 and may be required to be licensed in the
Address: (,O 77 a C� !i 'P, Y�I id jurisdiction in which work is being performed.If the
City/State/ZIP: 1.'CT le on a 4 T 70 3 c applicant is exempt from licensing,the following reasons
apply:
Phone:(l O3) vas-)`DI 00 Fax::( )
E-mail: ---1('C0 ecf-l0 7-vi Vf f (44 co f ✓. tan
CONTRACTOR RflILDING PERMIT PEES*
(Please refer to fee schedule)
Business name: j 0� il ti G�4 f -It/✓ cuv
Address: cif L N(6; V( -€.V f/l/ Permit fee:
! �� State surcharge(12%of permit fee):
City/State/ZIP: L i te-3
17036 (40%FLS plan review(40/a of permit fee):
Phone:(90 6.77—0/01-0
Fax:( ) (Due upon application.)
CCB lie.: i 3VJ/a / Total permit fees: x
Authorized signatur • i�, a
Amount received: it/A 5",0'3
^ This permit application expires if a permit is not obtained
Print name: —P RI/ T ed� Date: /94---// CJ, within l80 days after it has been accepted as complete.
�'! I * Fee methodology set by Tri-County Building Industry
Service Board.
I:�Building�PermusFPS.PennitApp.doc Rev 01'052012 440-4613T(II/02/COM/WEB)
City of Tigard i C�vED Permit No.: A59,0/5--p )C 'Q
:� 13125 SW Hall Blvd.,Tigard,0 C
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 51544//
1 1 , \r I Inspection Line: 503.639.4175 MAY 2 6 2015 ^
Intemet: www.tigard-or.gov By: Ck ) [2f��,
CITY OF TIGARD
FIRE ALA $' STEM:AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: 0 - Occupancy: E Job Address: - V20 5't, ) 6e l/-e (arid Suite: / 7 p
Contractor: 12Q j W + C4"btt(4-017 Phone: .7(:) 3 - c(2.0 -7-011 00
Valuation of work: $ i i- 00
Type of System: (check one) ❑Required ❑Non-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)c3 /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) /To be Relocated (max5)
I, l q;Z// /Vair(/L -- Oregon Construction Contractors Board No. / 3 ,o/
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:��� /,/ / 5
Date:
Print Name: 1 Hii Tilg{d-e(I
I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1
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
7650 SW BEVELAND RD 170, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00089
Jeff Grove
Violation Summary:
Inspector Contractor