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Permit (49) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMEN •' T Permit#. FPS2016-00179 T[GAR j 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2016 Parcel: 2S113AB00101 Jurisdiction: Tigard Site address: 16101 SW 72ND AVE 200 Project: Perlo Subdivision: Project Description: Fire alarm modification of(2)devices for stair and lobby TI None Lot: None Contractor: CAPITOL ELECTRIC CO INC Owner: PACIFIC REALTY ASSOCIATES LP 11401 NE MARX STREET ATTN: N PIVEN PORTLAND, OR 97220 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-255-9488 PHONE: FAX: 503-257-7121 FEES Description Date Amount Specifics: Permit Fee-COM 10/13/2016 $51.09 12%State Surcharge-Building 10/13/2016 $6.13 Type of Use: COM Plan Review-Fire Life Safety-COM 10/13/2016 Class of Work: ALT Type of Const: $20.44 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 $77.66 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $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 Notifies - _:. er. 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..estions to OU by 'ng 503.232.1987 or 1.800.332.2344. Issued /, Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available ins • ion 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 System ln . ty� 1 �' l - a FOR OFFICE L'SE ONE 1" City of Tigard Received 1111 '11 13125 SW Hall Blvd.,Tigard,OR 9 223 Date/B : /D /3 � Permit No.: i —^ s Phone: 503.718.2439 Fax: 503.5 K %:,, Plan Review / �/� Nd l 7 (19 0 .. .I',r, T 1 C A R D Inspection Line: 503.639.4175 Date/B Other Permit: Interna,ternet: Line: 03.63. 4v a a Date Ready/By: www.tigard-or.gov li q_i'a z (i; \ ,t,,3 Notified/Method: kris: See Page 2 nr Supplemental Information 0 New construction REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 Demolition Permit fees*are based on the value of the work performed. n Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all 0 Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION ❑ 1-and 2-family dwelling Valuation: $ Commercial/industrial ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION- Total number of floors: Job site address: 6 . 6 `' c�fA /RJNew dwelling area: square feet City/State/ZIP: -11 Its.• C'/A 2,4 y Garage/carport area: square feet Suite/bldg./apt.no.: .odii. Project name: 6/Z i_o COitia,'rxvi /0"/ Cross street/directions to job site: _ Covered porch area: square feet Deck area: square feet Other structure area: square feet Subdivision: REQUIRED DATA:COMMERCIAL USE CHECKLIST 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 DESCRIPTION OF WORK equipment,materials,labor,overhead,and the profit for the �/ work indicated on this a..lication. Ct 1--(25 ,� iI W /492 -".'/Z E7*/� Valuation: $ .cc) w5 p Existing building area: square feet IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII New building area: square feet 0 PROPERTY OWNER 'P TENANT Number of stories: Name: (.0 yvfr6,7-R-4ii no.-l1 Address: /9(��� Type of construction: 2/1// ; Gr City/State/ZIP: 1 DV 9-6P° Occupancy groups: !L• e = . ?,ZiY Phone:(.34tfLY 6Z,Yw —7,nr� 0 Existing: �/ Fax:( ) APPLICANT New: 0 CONTACT PERSON Business name: NOTICE Contact name: All contractors and subcontractors are required to be Jr. /'OA/ licensed with the Oregon Construction Contractors Board Address: Ski / 60,13'2,...,c) Y T`J under ORS 701 and may be required to be licensed in the City/State/ZIP: , tel/ jurisdiction in which work is being performed.If the Phone: �^ `./ ©/2 ' 723 r applicant is exempt from licensing,the following reasons 03 �j Z 20 19 Fax::( ) PP Y E-mail: L '1 1 i+..♦_ alb CONTRACTOR Business name: __Ai.,° "L., i BUILDINGPERMIT FEES* V(�r` L. 'lease re er to ee schedule Address: l ( ,f G ` ` 2k sr Permit fee: City/State/ZIP: O/L/ Og, -9„2.1 State surcharge(12%of permit fee): Phone: O. 4* J v FLS plan review(40%of permit fee): ✓ / Fax:( ) CCB lic.: Z./ a 7 i Due u.on a..lication submittal. Total permit fees: • Authorized signature: 0 Amount received: Print name: `.:, fi�,� Aysefreric This permit application expires if a permit is not obtained Date: rWriii within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry I.\ uilding\Permits\FPS-PermitApp_0310i 6.doc Service Board. B 440-4613T(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information Describe work to be done: 1. Te of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: yl� ❑ New system Number of sprinkler heads: Number of alarm devices: ❑ Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and copies of sketch showing area Alteration (3) copies of sketch showing area of work within building structure to existing of work within building structure system6+ devices: Plan review required and ❑ 11+heads: Plan review required and ❑ (3) sets of plans. (3) sets of plans. Additional description of work: T.4.e of S stem Com s tete B,C or 0 as a• .licable A.) Commercial Sprinkler ❑ Wet ❑ D S.rinkler T Ape Additional Stand.i.es Information: S.rinkler Su..1 Line ❑ Yes ❑ No Hazard Grou. Densi Desi: Area K. Factor S•rinkler Pro'ect Valuation: $ B. T it e I - Hood Fire Su• •ression S stein Hood Pro'ect Valuation: $ C.) Fire Alarm ID Yes Submittal shall Batte Calculations include: Individual Component ❑ Yes Cut Sheets Fire Alarm Pro'ect Valuation: $ 0.) Residential Sprinkler(Stand Alone System) _ S.uare Foota:e: 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 : eater $404.39 Sprinkler Project Square Footage: sq.ft. Fire Protection Permit Fees Pro'ect valuation subtotal see A,B &C above : $ Permit fee based on .ro'ect valuation see fee schedule : $ Permit fee based on s•uare footate see D above : $ State Surchar:e 12%of .ermit fee : $ FLS Plan Review 40% of •ermit fee : $ TOTAL: $ I:\Building\Permits\FPS_PermitApp_031016.doc 2 RFCF1 i4/ li 11 City of Tigard Permit No.: S /��6 1;11 II 13125 SW Hall Blvd.,Tigard,OR 97223 6 /7 9 Phone: 503.718.2439 Fax: 503.598.1960f['T 1 3 ?016 Date Received: /03//0 r I c.; \I;Il Inspection Line: 503.639.4175 Internet www.tigazd-or.govgov -. t 8 it t Uo a�;!.1 By: a Q44 �! FIRE ALARAS ; AAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (MAXIMUM OF 5 DEVICES WITHOUT PLANS) Project Name: poi.-19 ?(4'z4% 2/ ,-/A S Occupancy: Job Address: WO/ sk2 -FZ 4/.0 4t/8 Suite: Z130 Contractor: f a Phone: rs C4p/T01..- tg-t, 67cri am'ct3 2-c3'cs- Valuation of work: $ oC �y86 Type of System: (check one) / ,Required ONon-required (check one) A_ utomatic OManual 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(max 5) /To be Relocated(max 5) I Number of Proposed Manual Alarm Stations: To be Added(max 5) I To be Relocated 0.5) Number of Proposed Notification Appliances: To be Added 0.5) /To be Relocated(max 5) I, Sh6/1/ 11-1_4_&IZ Oregon Construction Contractors Board No. 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: )' f O// Date: 4G Print Name: c57��52k&'4/ 4-1-45-72... I:\Building\FormsWireAlannAffidavit 071514.docx Page 1 of 1 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 16101 SW 72ND AVE 200, TIGARD, OR, 97224 Record Type: Commercial - Fire Protection System Inspection Type: 998 Alarm Final Result: PASS- NoCofO Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: December 28, 2016 at 9:16:37 AM Record ID: FPS2016-00179 Inspector: Chip Barnett Contractor