Permit (46) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' COMMUNITY DEVELOPMENT711
Permit#: FPS2016 00158
T E GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2016
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 140
Project: US Investors International Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: (4)smoke/heat detectors. Affidavit submitted.
Contractor: POINT MONITOR CORPORATION Owner:
5863 LAKEVIEW BLVD STE 100 PACIFIC REALTY ASSOCIATES
LAKE OSWEGO, OR 97035 ATTN: N PIVEN
15350 SE 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
09/21/2016 $51.09
12%State Surcharge-Building 09/21/2016 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 09/21/2016
Class of Work: ALT Type of Const: $$0.50
Infx Process/Archiving-Sm$0.50(up to 09/21/2016 $0.50
Occupancy Grp: Height: ft 11x17)
Stories: Misc Administration Fee 09/21/2016 $2.00
Hourly Building Rate 10/13/2016 $180.00
Commercial Sprinkler System:
Hourly Building 12%State Surcharge 10/13/2016 $21.60
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 $281.76
Valuations:
Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,200.00
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 8a0.332.2344.
Issued By: .XPermittee Signature: r 1
eW:?--
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.
B zlc.._ �Idin Permit Ahcation
tireill Protection System ..�
City of Tigard t+ °, r triz(}l t'1cE
's 13125 SW Hall Blvd.,Ti f Received USE ONL}'
- Phone; gam,OR 97223
503-718.2439 Fax: 503.54$-19b0 C yy Dates
T t GA+lt i7 Inspeq.503.no: 503.639.4175 l .::..rap, Permit Noiii ,;
Intern 201 . " � . �r,�
Internet: www dgard-or goy
CITY
9 Date Randy By: /
`��d Y i� #6p t 7�@ Date
Read
construction 0 See Paget for '
�'F
supplemental tnformat]oa
�New E
on
0 LEI Demolition
REQD111 D DATA:4:Vii 2 F ..
Addition/alteration/replacement Permit fees* al+e of th work b pe ffo le
0 Other: Indicate the value based
(rounded to the nearest dollar)of all
CATEGORY}R] O ;CO" .. Aerformed.
CONSTRUCTION equipment,materials,labor,overhead,and the profit for the
❑i-and 2-family dwelling work indicated on this application.
kil Commercial/industrial
Accessory building •
Valuation
0 Multi-family
d Master builder Number of bedrooms:
0 Other:
JOS SITE INFORMATION' Number of bathrooms:
: `AN WCATION
Total number of floors:
Job site address:12909 SW 68th Parkway
City/State/ZIP:Portland,OR 97223
New dwelling area:
Suite/bldg,/apt,no.:140 square feet
Project name:Us Investors Garage/carport area:
Cross street/directions to job site: square feet
Covered porch area:
square feet
Deck area:
Others square feet
Subdivision: structure area:
square feet
l
Tax map/parcel no: Lot no.: t2EQJItEb A CaMERtaSl C
IndPeicate the value(rounded to the nearest dollar)it fees*are based on the value of the workpof lei
>SCR►rTrON""
Fire alarm nahfycation devices OJ WQR equipment,materials,labor,overhead,and the profit for the
work indicated on this a.plication.
Valuation:
$$2,200.00
Existing building area:
A �`I20FE12' O'CtU2V
square feet
,,,' New building
R ,,, g area:
Name:Us Investors ►� l~i11N( square feet
Number of stories:
Address:12909 SW 68th Parkway#140
Occupancy groups:
City/State/ZIP:POrtland,OR 97223 Type of constriction:
Phone:( )
1211111.11111111111111111.1._.t '>' ICANT • Existing:
alMallilillimmiliiiiii
conotorpER$ON,
Business name:Point Monitor Corp.
Contact name:Brooke Williams I+lOZICE
All contractors and subcontractors are required to be
Address:5863 Lakeview Blvd#100 licensed with the Oregon Construction Contractors Bo
City/State/ZIP:Lake Oswego,OR 97035 under ORS 701 and mayand
jurisdiction in which work is being
to be licensed in the
Phone:(503)627.0200 applicant is exempt from licensing the following reasons
IIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIII
E-mail;bwilliams@pointrnonitor.com Cpcintmonitor.com
+~ON i RAZOR
Business name:Same as above
Address:
BUrI:DINC PErtlyiiT tEES�
Metre re e?io^ee ichei ul
City/State/ZIP:
Phone:( } State surcharge(12%of e
FLS plan review(40% permit fee): (z)i
CCB Ile::135901 1■■ of permit fee):
Due u'on a,.licatfon submittal. MIN
Authorized signature: -~
'
t Total permit fees:
Print namo:Ben Breit
Date:
Amount received:
9/15/16 This permit application expires if a
within 180 days after it has been ac eP dermitias complete.
i.BuildinS' not Pcrte:FPS-PBreip7a_q,;t0lb,doc
* Fee methodology set by Tri-County Building Industry
440-4613T(ii'02 COM WEB) Sc rviCe Board.
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
1Descrtbe wotk 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 0 1-10 heads: Affidavit re uired and
Alteratinn � S 1-5 devices: Affidavit required and
to exitisting (3) copies of sketch showing area (3)copies of sketch showing area
t seem of work within building structure of work within building structure
Y
0 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:
T�4 e'cif S 'stein Com►fete A;l3,C or D as a. .b a e
r
�• C} erCia 1:�.M1 °r
Sprinkler Type
0 Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line El Yes ❑ No
Hazard Group
Density
Design Area
K.Factor
Sprinkler Project Valuation: j $
HooddFrte Suppression System
Hood Project Valuation: j $
Submittal shall Batte -Calculations Sri Yes
include: Individual Component C,1 Yes
Cut Sheets
Fire Alarm Pro'ect Valuation: $
11)
des dent:
! al SpnnIder(Stand Alone Systems ; „ •
Square Footage:g 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 t Square oot
Project Footage. � sq.ft.
Fite Ptotectinn"'°e ii"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•ermit fee : $
TOTAL: $
C:\Users\Un illiao s\Desktop\1'1'10,111'iF(.)R\!S\Fire permit-city of tigard.doc 2
City of Tigard _
13125 9W Hall Blvd.,'Tigard,OR 972 Pet7nit No.: , ,�^�Az,-
Phone: 503.718.2434 Pax: 503.598.1 4.-.,..11,1_,,,,,,,. �v A�
Inspection Line: 503.639:4175 Date Received: ���
co
7I `'1RI Internet: www.tigard-or.gov S
t, I. 4 2016 By:
` -�
FIRE ALARM '
3t1ILDiNo oh 1, ,
` ` `*1i i VIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: US Investors
12909 SW 68th Parkwa PorEfand 97223 occupancy: Same
Job Address: y
Suite: 140
Contractor: Point Monitor Corp.
Phone: 503-627-0100
Valuation of work: $2,200.00
Type of System: (check one) []Required *Non-required
(check one) [JAutomatic Manual EBotfi
Total number of devices added or moved under this permit process is 5 total per tenant sp ace.
Number of Proposed Smoke/Heat Detectors: To be Added(msz ax sl 4 /To be Relocated(ms) p
Number of Proposed Manual Alarm Stations: To be Added o sl /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max sl /To be Relocated(maz 5)
1, 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
g
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: d
Date: 9/15/16
Print Name: Ben Breit
1;\BuildingTorms\FireAlarmAffidavit 071514.docx
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