Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
.11114
2, COMMUNITY DEVELOPMENT Permit#: FPS2017-00184
T A D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/07/2017
Parcel: 2S101AB03100
Jurisdiction: Tigard
Site address: 12115 SW 70TH AVE 201
Project: Advanced Endodontics Subdivision: 2012-009 PARTITION PLAT Lot: 3
Project Description: Adding(13)devises:Horn/strobes,strobes,and duct detector monitoring for TI.
Contractor: POINT MONITOR CORPORATION Owner: TIGARD TRIANGLE PARTNERS LLC
5863 LAKEVIEW BLVD STE 100 18187 SIERA DR
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97034
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/07/2017 $112.96
12%State Surcharge-Building 12/07/2017 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 12/07/2017 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 12/07/2017 $12.50
Occupancy Grp: B 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: Yes Alarm Type: Automatic
Pull Station Required: Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $184.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,436.00
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 th=- Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy the rules
or direct questions to OAUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
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.
Btglding Permit Application
Fire Protection System RECEIVED Foiz OFFICE. ISE 0y1.1
City of Tigard Recegiew
/
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 NOV 2 2 2017 Da n , Z f1 /,Z; OtherPermit:� � ��//
I I G q 1\D Inspection Line: 503.639.4175 1.,ITY OF I GAI D Date Ready/By: Ju is: See Pae 2 for r`w
Internet: www.ti and-or. ov BUILDING DIVIS!O f2/ �7 g
g g otified/Method: Supplemental Information
, ._ "
❑New construction 0 Demolition Permit fees*are based on the value of the work performed. ,r
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
r ' work indicated on this application.
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
E]Accessory building ❑Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
<� Total number of floors:
Job site address:12115 SW 70th Ave. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:201 Project name:Advanced Endodontics 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.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
—
Fire Alarm Notification Devices,Se_--�snn Valuation: $3,436
(13) /,?r el!f'GS Existing building area: square feet
New building area: square feet
Number of stories:
Name:Advanced Endodontics-Dr.Barry Type of construction:
Address:12115 SW 70"`Suite 201 Occupancy groups:
City/State/ZIP:Tigard,OR 97223
Existing:
Phone:( ) Fax:
New:
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
applicant is exempt from licensing,the following reasons
City/State/ZIP:Lake Oswego,OR 97035
apply:
Phone:(503)627-0100 I Fax::( )
E-mail:bwilliams@pointmonitor.com
Business name:Same as above a .
Address: Permit fee:
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:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
nt name:Ben Breit Date:11/22/17 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
"ermits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
•
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 to alarm devices:
0 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
El 11+ heads: Plan review required and ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
15 l7e✓icsS
Additional description of work:
IMERMI1111111111110 Wet ❑ D
Additional Standi.es
Information: EIIIZEZEMEIMMMMI0 Yes 0 No
Hazard Grou.
Densi
Desi: Area
K. Factor
S. '0 , - ' o'- . • ;. ,: $
Hood Pro'ect Valuation: $
Submittal shall Batte Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
mmmmmmimmmmmmmimmmimmFire Alarm Pro'ect Valuation: $ $3,436
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.
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 foota.e see D above : $
State Surchar.e 12% of.ermit fee : $
FLS Plan Review 40% of.ermit fee : $
TOTAL: $
C:\Users\bwilliams\Desktop\PERMIT FORMS\Fire permit-city of tigard.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12115 SW 70TH AVE 201 , TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00184
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor