Permit (91) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2017-00110
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2017
T C �'°'" 9 Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 300
Project: PacTrust Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm-modification to(6)or more devices for TI
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 07/25/2017 $102.20
12%State Surcharge-Building 07/25/2017 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 07/25/2017 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 07/25/2017 $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: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required: Yes
Total $157.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,659.00
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 c py of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
/,,b)
._% 40. Permittee Signature: 712AAAdi
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 Systifsm
City of TigardII ECEI�t
S ReceiveDate/By:
d 11 ll�
'
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review p�r�Ot7
Permit No.: r�j�£4
Phone: 503.718.2439 Fax:I 151Q3.528098�,7 Date/By: � � 7'�J _.)-7Other Permit: Age,7'��6
TI G A R D Inspection Line: 503.639.4173 Date Ready/By: / 7uris: Ea See Page 2 for
Internet: www.tigard-1JT I f TIC/t RD .ot/ifi�ed�/Methoi, �y/7 I Supplemental Information
Q�+�� � OF 17191-ilal . Liv v[� �,f/`,"'. Y ...,m.. ..,.
❑New construction ❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
l eye work indicated on this application.
s ..:. •a,_ , x r . . . _,.,, Valuation: $
0 1-and 2-family dwelling ®Commercial/industrial
ElAccessory building ❑Multi-family Number of bedrooms:
ElMaster builder ❑Other: Number of bathrooms:
w Wil` t a " ' OQN Total number of floors:
Job site address:15350 SW Sequoia PKWY New dwelling area: square feet
City/State/ZIP:Portland,OR Garage/carport area: , square feet
Suite/bldg./apt.no.:300 Project name:Pac Trust Ste.300 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no labor,overhead,and theprofit for the
Indicate the value(roundedto the nearest dollar)ofall
h � 1� "a t a) �€ work ndica ed_ equipment, ton this appli ati on.
Fire alarm notification devices Valuation: $$2,659.00
Existing building area: square feet
New building area: square feet
.y. :`,„t
Number of stories:
Name:Pac Trust Suite 300 Type of construction:
Address:15350 SW Sequoia PKWY Ste.300 Occupancy groups:
City/State/ZIP:Portland,OR Existing:
Phone:( ) Fax:( ) New:
APIPI DANT y.y 4
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#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
CO aiw
• BUILDING(Meow t e s*,
Business name:Same as above J'""
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.:135901 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:7/19/17 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:Building Permits FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
I
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only devices:
❑ New system Number of sprinkler heads: Number of alarm de es:
® Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affida ed 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 [E(36)+ devices: Plan review required and
(3) sets of plans. sets of plans.
Additional description of work:
ft):
iPii
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* ?4 A ,,;;;;;:'4,44a i e+V � 6 i "fi"4vEFf { t �T1e f vx �:' r0.i.
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes D No
Hazard Group
Density
Design Area
K. Factor
:E,13-rti--7-k:--
er Project Valuation: I $
?.,,f, .r;x.. , ... 'w.f'',"
i 4-'f'''''''' 4 k'ill.
# a ''''''n
a.' '*",xrL t
.�..� i >zs.E—,.-. s- xx.' ::y ..t,,, ,sem,,. ',• r'
Hood Project Valuation: $
- , x '... =
•, ,...
r,� t'',14:'!"'.'", i ` . a .-..r..._, �s '. `�z7 x... zv _.i xEf 3f' . u'r „ „sw .. 4 . r u:a� a,<Sax' , ® YesCr''''''.4:"!
- 'o- t J £ B;ttery Calculations ® Yes:,xlSubmittal shall Individual Componentinclude:
Cut Sheets
$
Fire Alarm Project Valuation:
D) f4 Wvlraw y. .� �';.. e$ys ) :
J
Square Footage: Permit Fee:
0 to 2,000 $198.75 � x
$246.45
2,001 to 3,600
3,601 to 7,200 $310.05
7,201 and greater $404.39Foota :,
Sprinkler Project Square ge: sq. ft.
., ;: ., 1 , .wr Fire Protecti n PermitPeck
...x� ,,,
Project valuation sul (see A,B &e Cabove): $
Permit fee based project valuation (see fee schedule): $
Permitasefee baseond on square footage (see D above): $
Surcharge (12% of permit fee): $
FLSState Plan Review(40% of permit fee): $
TOTAL: $
city of t gard.doc 2
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