Permit (15) CITY OF TIGARD ra/ - FIRE PROTECTION SYSTEM PERMIT
: COMMUNITY DEVELOPMENT Permit#: FPS2016-00109
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/05/2016
Parcel: 2S 112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 200
Project: Spec Space Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm modifications-Add(2)devices,relocate(1)device. 8/3/2016: REPRINT permit to correct suite address
from 240 to 200.
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: 503-624-6300
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/05/2016 $69.92
12%State Surcharge-Building 07/05/2016 $8.39
Type of Use: COM Plan Review-Fire Life Safety-COM 07/05/2016 $27.97
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 07/05/2016 $1.00
Occupancy Grp: Height: ft 11x17)
Stories: Hourly Building Rate 08/01/2016 $180.00
Hourly Building 12%State Surcharge 08/01/2016 $21.60
Misc Administration Fee 08/03/2016 $45.00
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 $353.88
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,104.00
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: _ Permiftee Signature:
e//t7 19,9/°4-1f 0 A
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 FIRE PROTECTION SYSTEM PERMIT
111
COMMUNITY DEVELOPMENT Permit#: FPS2016-00109
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 07/05/2016
Tr GARD9 Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 240
Project: Spec Space Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm modifications-Add(2)devices,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: 503-624-6300
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/05/2016 $69.92
12%State Surcharge-Building 07/05/2016 $8.39
Type of Use: COM Plan Review-Fire Life Safety-COM 07/05/2016 $27.97
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 07/05/2016 $1.00
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 $107.28
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,104.00
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 obt.in a copy of the rules
or direct questions to OUNC by calling 503.232.1987 oy1-SA 4.
Issued By:� •ermittee Signature: / f
#a — (moi,
//
- all 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 Application
Fire Protection SystemFOR OFFICE C L ONLY
City of Tigard EGFIVED n81eiBet! aZ9 /lo T, Permit No..115, •/�G6 l D`
13
IIII13125 SW Hall Blvd.,Tigard,OR 97223 t,' Plan Review
Phone: 503.718.2439 Fax: 503.598.196dUN 2 3 2016 Date/I3 : Other Permit:
Inspection Line: 503.639.4175 ^� Date Read)By: Jam: See Page 2 for
T i GA R D Internet: www.tigard-or.gov CI e T Or Notified/ Method: Supplemental Information
TYPE OF WORK 4 ''� I t UN REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
S
o 1-and 2-family dwelling ®Conunercial/industrial Valuation:
0 Accessory building 0 Multi-family Number of bedrooms:
CIMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:6650 SW Redwood Lane#240 New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:240 Project name:Pacific Corp.Center#240 Covered porch area: square feet
Cross street/directions to job site: 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.
Fire Alarm-notification devices Valuation: $$1,104.00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ® TENANT Number of stories:
Name:Pacific Corp.Center#240 Type of construction:
Address:6650 SW Redwood Lane Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 CONTACT PERSON NOTICE
Business name:Point Monitor Corp. All contractors and subcontractors are required to be
Contact name:Brooke Williams licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5863 Lakeview Blvd.Suite 100 jurisdiction in which work is being performed.If the
City/State:'ZIP:Lake Oswego,OR 97035 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)627-0100 Fax::( )
E-mail:bwilliams@pointmonitor.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Point Monitor Corp. (Herm refer Wee schedule)
Permit fee:
Address:5863 Lakeview Blvd.,Suite 100
State surcharge(12%of permit fee):
City/State/ZIP:Lake Oswego,OR 97035
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal.)
CCB lic.:135901 Total permit fees: 4/07• 9'4
Amount received:
Authorized signature: OW ''J� This permit application expires if a permit is not obtained
AND within 180 as days after it has been accepted complete.
Print name:Brooke Williams Date:6/23/16 y P
* Fee methodology set by Tri-County Building Industry
Service Board. s,;(1.
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I.Building'Permits FP S.PennitApp_031016.doc 440-46131(11,02 COM�WEB) -I-- `
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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 0 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
Sprinkler Type ❑ Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K.Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
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: $
C\Users\bwilliams\Desktop\PERMIT FORMS\FPS_PcnnitApp-'Pigrd.doc 2
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RECFIVEP
City of Tigard Permit No.: P50901 C2'r Od tO l
N - M 13125 SW Hall Blvd.,Tigard,OR 9J 2 3 2016
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: _ i .9-5y i
Inspection Line: 503.639.4175'1TY OF Mii ARD
T I G A R I) Internet: www.ti rd-or. ov F1, By: ,�Pog BUILDING DIV1 0
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
ct Name: Pacific Corp. Center#240 Occupancy:
Prole Same
Job Address: 6650 SW Redwood Lane Suite: 240
Contractor: Point Monitor Corp. Phone: 503-627-0100
Valuation of work: $1,104.00
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) /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) 2 /To be Relocated(max 5) 1
I, Ben Breit Oregon Construction Contractors Board No. 135901
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: 6/23/16
Print Name: Ben Breit
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