Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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COMMUNITY DEVELOPMENT Permit#: FPS2017-00047
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/10/2017
Parcel: 1 S 135CA02600
Jurisdiction: Tigard
Site address: 11130 SW GREENBURG RD
Project: Good Neighbor Center Subdivision: None Lot: None
Project Description: Fire alarm-Add(1)smoke/heat detector,add(1)notification.
Contractor: ON ELECTRIC GROUP INC Owner: EAST WASHINGTON COUNTY SHELTER
1709 SE 3RD AVE PARTNERSHIP COUNCIL
PORTLAND, OR 97124 DBA GOOD NEIGHBOR CENTER
11130 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503-234-9900 PHONE:
FAX: 503-234-1001
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/07/2017 $64.54
12%State Surcharge-Building 04/07/2017 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 04/07/2017 $25.82
Class of Work: ALT Type of Const: VBInfo Process/Archiving-Sm$0.50(up to 04/07/2017 $0.50
Occupancy Grp: S-1 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 $98.60
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,000.00
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: Permittee Signature: (5_
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 Application
Fire Protection System 1 1. 1(lli Ol l l( 1. Ii5l 0v1.N
Cityof Tigard Received
7 a/-7 C )..Q, Permit No,; p- „..t --(rz
� 13125 SW Hall Blvd.,Tigard,OR 97223 ,' r;1/ Plan Review Other Permit:
• Phone: 503.718.2439 Fax: 503 598.1960 Date/Bv:
i i,,T. 1 i Inspection Line: 503.639.4175 Date Ready/By: Turn: 21 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
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TYPE ON' WORK 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
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORYOF CONSTRUCTION work indicated on this application.
Valuation: S
❑1-and 2-family dwelling ®Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:11130 SW Green burg road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport arca: square feet
Suite/bldg./apt.no.: Project name:Good Neighbor Addition Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
13i VI DAt CO ERCW,-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
bcriCR11 HON OF"WORK
W, work indicated on this application.
Add one smoke detector and one strobe to fire alarm system Valuation: $1000
Existing building area: square feet
New building area: 400 square feet
Y O ;'‘ 0¢TENANT .' Number of stories: 1
Name: Type of construction: New Addition
Address: Occupancy groups: t
City/State/ZIP: Existing: ,
Phone:( ) Fax:( ) New: E
_ ❑ APPLICANT„ ; tt' `0 INTACT PERSON '.NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: apply:
Phone:( ) Fax::( )
E-mail:
r , CONTRACTOR BUILDING PERMIT FEES*
(PhismoffeeMiiiesOlketioki
Business name:On Electric Group
Permit fee: 64.54
Address:1709 SE 3rd Ave.
State surcharge(12%of permit fee): 7.74
City/State/ZIP:Portland,OR 97214
FLS plan review(40%of permit fee): S-
Phone:(503-)234-9900 Fax:(503)234-1001 (Due upon application submittal))
CCB lie.:203 4.50 A La.H. G Total permit fees: ,so 42:28-'
Amount received: 4g too
Authorized signature: f (/�/'s
,.; This permit application expires if a permit is not obtained
Print name:Mark Weinbender Date:3/29/17 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermilApp_031016.4oc 440-4613T(11/02/COM/WEB)
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: 2
® 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 ❑ 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 Sprinlder
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I- Hood3Fire Suppression-Sys
Hood Project Valuation: $
C ;' e
s a
Submittal shall Battery Calculations 0 Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1000
1'441
Reential .P it(S'
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 . r.
Sprinkler Project Square Footage: sq.ft.
11
Fire`g."40tectipli Fees
Project valuation subtotal(see A,B&C above): $ 1000
Permit fee based on project valuation (see fee schedule): $ 64.54
Permit fee based on square footage (see D above): $
State Surcharge(12% of permit fee): $ 7.75
FLS Plan Review(40% of permit fee): $
TOTAL: $ 72.28
C:\Users\Mark.Wcuibcndcr\Doctunents\Jobs\Good Neighbor Center\FPS_Pem itAp 3oc
10589 4
City of Tigard Permit No.: M -a17 -004 4"?
• 13125 SW Hall Blvd.,Tigarg,94 97223. Date Received: T 3! 7
f =Phone: 503.718 2439 ak 50 U98.1960
Inspection Line: 503 639.A115 n e
I c n k 5 Internet: www.tigard-or.gov By: l -lX '
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Good Neighbor Center addition Occupancy: E-Classroom
Job Address: 11130 SW Greenberg Road Suite:
Contractor: On Electric Group Phone: 503-234-9900
Valuation of work:$1000
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 on.5) 1 /To be Relocated cm.5)
Number of Proposed Manual Alarm Stations: To be Added on.5) /To be Relocated 0,..5)
Number of Proposed Notification Appliances: To be Added camx 5) 1 /To be Relocated c a.x 5)
I, On Electric Group Oregon Construction Contractors Board No. 203
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 cop of this d• 4 m t with a copy of the sketch attached shall be available for all inspections.
Signature: Date: March 29,2017
Print Name: Mark Weinbender
I:\Building\Forma\FireAlannAffidavit_071514.docx Page 1 of 1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11130 SW GREENBURG RD, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00047
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor