Permit (54) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
All COMMUNITY DEVELOPMENT Permit#: FPS2018-00005
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2018
Ttt�1^�R. � Parcel: 1S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 520
Project: Loan Depot Subdivision: ASHBROOK FARM Lot: 5
Project Description: Fire alarm permit:Adding(1)and relocating(1)fire alarm notification device. Affidavit submitted.
Contractor: POINT MONITOR CORPORATION Owner: PLAZA WEST OWNER LLC
5863 LAKEVIEW BLVD STE 100 BY CHIEF FINANCIAL OFFICER
LAKE OSWEGO, OR 97035 680 FIFTH AVE 20TH FL
NEW YORK, NY 10019
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/02/2018 $72.61
12%State Surcharge-Building 02/02/2018 $8.71
Type of Use: COM Plan Review-Fire Life Safety-COM 02/02/2018 $29.04
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 02/02/2018 $0.50
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:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $110.86
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,209.00
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 89Q.3322344.
Issued By: -Rermittee Signature: 1%? ' .-'
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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.
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City Of Tigard ...._
Permit No.: re.)thi I r—GOV 5
• 13125 SW Hall Blvd.,Tigard,OR 97223 1,`;', 9 r, ,
s Phone: 503 718.2439 Fax 503.598.1960 Date Received: /
Inspection Line: 503 639 4175 ,, ., �
I 1 t,A R I Internet: www.tigard-or.gov By: !3i:r =t✓ / ‘Y4—
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Loan Depot -Atrium West Suite 520 Occupancy: Same
Job Address: 9600 SW Oak Street Suite 520, Tigard, OR 97223 Suite: 520
Contractor: Point Monitor Corp. Phone: 503-627-0100
Valuation of work: $1,209
Type of System: (check one) Required ONon-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(max 5) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) 1 /To be Relocated(max 5) 1
I, 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
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_--- Date: 1/29/18
Print Name: Ben Breit
I:\Building\Forms\FireAlarmAffidavit_071514.doex Page 1 of 1
Building Permit Application
?ire Protection System 1 OR 01 1 1( 1. St:OM 'V
City of Tigard Received
Date/13 :
* - 1
!PI 41 13125 SW Hall Blvd.,Tigard,OR 97223 2U plan Review
Phone: 503.718.2439 Fax: 503.598.1966 Date/13 : Other Permit: Su t
c,A 1, Inspection Line: 503.639.4175 - Date Ready/By: See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental information
7.`
TYPE OF WORK REQUIRED DATA:1-AM)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
El Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
Valuation:
0 1-and 2-family dwelling ig Commercial/industrial
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9600 SW Oak Street New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:520 Project name:Loan Depot-Atrium West Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-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
DESCRIPTION OF WORK work indicated on this application.
Valuation: $1,209
Fire Alarm Notification Devices
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER El TENANT Number of stories:
Name:Loan Depot-Atrium West Type of construction:
Address:9600 SW Oak Street Suite 520 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON NOTICE
Business name:Point Monitor Corp. All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:Brooke Williams
under ORS 701 and may be required to be licensed in the
Address:5863 Lakeview Blvd#100 jurisdiction in which work is being performed.lithe
applicant is exempt from licensing,the following reasons
City/State/ZIP:Lake Oswego,OR 97035
apply:
Phone:(503)627-0100 Fax::( )
E-mail:bwilliams@pointmonitor.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Same as above
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lie.:135901 Total permit fees: fiat SZp
Amount received:
Authorized signatu :
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:1/29/18 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I\Bui1dingTermitsTPS•PermitApp_031016.doc 440-4613T(1 1/02/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 12 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
0 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: Relocate (1)Device-Add (1)Device
Type of System(Complete A, B,C or D as applicable);
A.) Commercial Sprinkler
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- Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ $1,209
D.) Residential Sprinkler (Stand Alone System)
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
Sprinkler Project Square Footage: sq.ft.
Fire Protection Permit 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 permit 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:
9600 SW OAK ST 520, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00005
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor