Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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3 COMMUNITY DEVELOPMENT Permit#: FPS2015-00097
Tic;A*RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/16/2015
Parcel: 25101 BD00100
Jurisdiction: Tigard
Site address: 7650 SW BEVELAND RD 120
Project: Mildren Design Group Subdivision: 1994-025 PARTITION PLAT Lot: 2
Project Description: TI
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 06/16/2015 $86.06
12%State Surcharge-Building 06/16/2015 $10.33
Type of Use: COM Plan Review-Fire Life Safety-COM 06/16/2015 $34.42
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 06/16/2015 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: No Sprinkler Type:
Standpipe Required: No Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $131.31
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,800.00
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 yo . follow the r -s adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-!'1-009'. You ma obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 o :•
Issued By: - /J • ittee Signature:
IMP'
Call 503.639.4175 by 7:00 a.m.for the next available inspecti. da e.
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 System
uoiz 01:1:I('1- 1 'NI'0\1 1
City of Tigard t L,i1(E1V'1j p Received e�
4 13125 SW Hall Blvd.,Tigard,OR 97223 1J Date/B : J Permit No„ � ,
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review .41);_t 5
1 I t A I(I Inspection Line: 503.639.4175 Date/B Other permit D
Date Read /B �' `Page �' 1
Internet: www.ti 1 A1 1 6 7511 Ready/By: Supplemental see Pa 2 for
gard-or.gov I`IN 1 V Notified/Method:
1 1 7— Supplemental Information
❑New construction ❑Demolition : 1 1 I Permit fees*are based on the value of the work
II Addition/alteration/replacement performed.
❑Other Indicate the value(rounded to the nearest dollar)of all
A - t equipment,materials,labor,overhead,and the profit for the
t ,i 1 t .._ t1 's 7 .tf �' y�4t, ,'"w work indicated on this application
p
7 :..."4,-,41,-..7.-•n s . t.. .. Y�rv*.. PP
ID I-and 2-family dwelling I Commercial/industrial
s
❑Accessory building
❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
F,
�z a
fi
7 s 4 All Total number of floors:
Job site address: &
New dwelling area: square feet
City/State/Z1P:
L'' Garage/carport area: square feet
Suite/bldg./apt.no. Project name: v
DP / tea Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
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
4 work indicated on this application.
ftlit A ' r Valuation: $ d=a-rr :6
Existing building area: C'�� square feet
New building area: square feet
p . .- Number of stories:
Name: '
," �• ��i
! i" Type of construction:
Address: l 't ,
City/State/ZIP:
Occupancy groups: '
OP
Existing:
ist
ing:Phone:( ) Fax ) New�F ` ft kia ° : TA 1, r il =C yi4t i1
EIMMIP .4. -° t #.4.,, �R .F ,° , . ,..c.-..?,;;!';4 4,, ,:V r 0 1�0i / r
Contact name: / / r All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Address: MOM!�� ,� 7 r�/i�' under ORS 701 and may be required to be licensed in the
(/ Y� jurisdiction in which work is being performed.If the
City/State/ZIP: f #d[ / a 4 P 70 applicant is exempt from licensing,the following reasons
Phone:( () ) /, —0 / 0 C.) , Fax::( ) / apply:
Ma vae -e ► i vni r✓. e
Business name: 'e 1 ' 0 1 w 7
t 11
Address: / �~
I" L a CP V( PiG� `/ Permit fee:
City/State/ZIP: / I / State surcharge(12%of permit fee):
i
Phone: 0 a` _ r /0 Far:( ) FLS plan review(40%of permit fee):
(Due upon application)
Total permit fees:
Authorized signature �/ , 6" Amount received: 3
((/� r This permit application expires if a permit ttttiis not obtained
Print name: --1-0 `]' ( ;n I fJ �� t within 180 days after it has been accepted as complete.
d '/ ! -1-?e (ter I Date: `�'
* Fee methodology set by Tri-County Building Industry
1:\Budding\Periods\FPS-PerApp.doc Rev 01/05/2012 Service Board.
ITS-Perm
440-4613T(11/02/COM/W EB)
City of Tigard Permit No.: ,�� S` q
:� . • 13125 SW Hall Blvd.,Tigard,OR 97223 ,k, 1/I I� ;• ,I y
Phone: 503.718.2439 Fax: 503.598.1960 Date Received:
I ,,�r i, Inspection Line: 503.639.4175
Internet: www.tigard-or.gov J N 1 6 2015 gy 4r.,
i
//
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: 6/ i (C4'VQ 0 Li Vita---- Occupancy: 16
Job Address: 7 to 3.-0 -tCl/)141 Suite: i,
Contractor: P 0 ( 11 + V1/1 C I `kr∎ Phone:
Valuation of work: $ I
Type of System: (check one) ARequired ONon-required
(check one) Automatic DManual OBoth
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(mix 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) I /To be Relocated(max 5) 140V WA°"A}Q
I, a414/ Tratid.,0 -- Oregon Construction Contractors Board No. I 3'"7 0
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: (,l/ / 511
Print Name: I aim( l/4PcLU- - `
1:1Building\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 120, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00097
Jeff Grove
Violation Summary:
Inspector Contractor