Permit ff CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
00- COMMUNITY DEVELOPMENT Permit#: FPS2015 00174
use ai4'' Date Issued: 11/02/2015
:TIGARD_ 13125 SW Hall Blvd ,Tigard OR 97223 503 718 2439
,0 Parcel: 2S112DA01400
Jurisdiction: TIGARD
Site address: 15350 SW SEQUOIA PKWY 105
Project: Jessica Conwell, PsyD Subdivision. 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm modification for TI,add(1)device&relocate(1)device
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES
5863 LAKEVIEW BLVD STE 100 ATTN N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE 503-627-0100 PHONE
FAX 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/02/2015 $77 99
12%State Surcharge-Building 11/02/2015 $9 36
Type of Use COM Plan Review-Fire Life Safety-COM 11/02/2015 $31 20
Class of Work: ALT Type of Const• Info Process/Archiving-Sm$0 50(up to 11/02/2015 $2 50
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 $121 05
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 is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon
Utility Ns ification Cent- Those rules are set forth in OAR 952-001-0010 through OAR 952-001-04'+ 4u may obtain a copy of the rules
or dir t questions to OUN .y . _43 232 1987 or 1 800 332 2344
Iss ed By: , ,I Permittee Signature: /
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.
Building Permit Applicatio n
Fire Protection System !' b €
�n IxOlt 01 1€A USI Pn�L.I 4 a"
- 4 � City of Tigard
Received � -0 ern `"o
'g ,® 13125 SW Hall Blvd.,Tigard,Oi� 7223 Date/B : /'� CZ.-e- Permit No.: FPSpbi S`00/7
Phone: V Plan Review
hone: 503.718.2439 Fax: 503.598.19602 2015
i t�nfltij' Inspection Line: 503.639.4175 Date Ready/By: Other Permit: ` 690/5---60 e
sa Internet: www.tigard-or.gov�1 �/ �a,;s:
IGA Notified/Method:
Supplemental See Page 2 for
T trxm,r, l Information
PP to
emv r e 1 ‘ [
s' , : , :_Pt fees*axi.ased on the value of the work performed.❑New construction ❑Demolition
II Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all
rtv'` ,s o ac � 7 s ,O,, equipment,materials,labor,overhead,and the profit for the
� . � t` � s s � � work indicated on this a lication. P
❑ 1-and 2-family dwelling
115 Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other
Number of bathrooms:
. M` �_ € . �ry s -," €1 N Total number of floors:
ter,_. 7.: n -., x ��
Job site address: � � ��_�;k� _..�:._« , .�..: ,
3. O�LA New dwelling area: square feet
City/State/ZIP: 1
Suite/bldg./apt.no.: Garage/emport area: square feet
%' ' Project name: ` / SS(Ca_ vI '/,
Cross street/directions to job site: CO l . Covered porch area: square feet
Deck area: square feet
Other structure area:
square feet
. rSar ' 4'; r e e ,Subdivision:
Lot no.: Pemlit fees*are based on the value of the work performed
Tax map/parcel no _ Indicate the value(rounded to the nearest dollar)of all
_ � V Ftr € P r'b;, fet "` equipment,materials,labor,overhead,and the profit for the
- "t ar�. =''-' r� � .[ fS�fi�Z 'a,- �Er��,�+,,,r '�'�{,7 �L�i`�.
lirj� /��: -o ° :'Fgg`.. ,:`>y p ,- g --' work indicated on this ay�lication.
V
Valuation: i g a $
Existing building area: square feet
New building area:
square feet
.. .. `,. Number of stories:
Name: �= ,�? -:�
■
Address: Type of construction:
City/State/ZIP: Occupancy groups:
Phone:( ) Existing:
Fax:� �� Fax ( )
Business name: ♦ .v4 ' khr ` � �
h i't'C0 k ( /l/ t a fie � r�
All contractors and subcontractors are required to be '
Contact name: / V / i licensed with the Oregon Construction Contractors Board
Address: f � I `� , ' ,n �' under ORS 701 and may be required to be licensed in the
wit/ c r�Dp jurisdiction in which work is being performed.If the
t, a>L Q lam- '"70 applicant is exempt from licensing,the following reasons
Phone: 0 ) apply:
i —0 /0 0 Fax::( )
E-mail: v ea-eft) e 7
I �E Uy 1 iV
'�' Z� ,p ,3
r 4 4 ,
16 �s ' ? � °A —K e 'y�� ; t �[ej � x 6.4'�% �� � % ��� , _ . . 51r,? �P ��A
��Business name: Q I I � Permit fee:1, / 7 -u V(,wV n V
City/State/ZIP: ' v / ' q 7U State surcharge(12%of permit fee):
i
Phone:(90?) a` — / ( ) FLS plan review(40%of permit fee):
Fax:
Due uion alIlication.
Total permit fees: MINN
Authorized signature /
� / Amount received: �'./A/ O
I Print name: This permit application expires if a permit is not obtained
OI / i° Date: ���] within 180 days after it has been accepted as complete.
U
* Fee methodology set by Tri-County Building Industry
I:\Buildm\
gPermitsVRpg_PApp.doc Rev 01/05/2012 Service Board.
440-4 613T(11/02/COM/WEB)
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
15350 SW SEQUOIA PKWY 105, TIGARD, OR,
97224
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00174
Chip Barnett
Violation Summary:
Inspector Contractor