Permit (154) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a: Permit#: FPS2018-00010
COMMUNITY DEVELOPMENT Date Issued: 03/05/2018
T I CGAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 350
Project: Williston Financial Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Fire alarm:Adding or altering(12)fire alarm devices.
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES
5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/05/2018 $102.20
12%State Surcharge-Building 03/05/2018 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 03/05/2018 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 03/05/2018 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 03/05/2018 $10.00
11x17)
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: No Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $167.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,999.00
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 180ij1ays of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by tf Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a c pyf f the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. r1 l
Issued By: \ Permittee Signature`. J 4 l /
Ste `' .i (...---;:e.----- l /
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
Fir Protection System FOR OFFICE USE ONE)
City of Tigard
e : PennitNoRECEI%'E .ate/B : -/ 1 1 I , l i
13125 SW Hall Blvd.,Tigard,OR 97223 T Ian Review
' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Cp 3- � — ► � --� /���aj 7�GL�3c�I
Inspection Line: 503.639.4175 {-1.-B 1 4 /n i Date Ready/By: Juns: See Page 2 for
T 1 G ARD Notified/Method: Jhi/ni
IST I Supplemental Information
Internet: www.tigard-or.gov
TYPE OF awl/lam-NG REQUIRED DATA-•
1-AND 2-FAMILY DWELLING
0 New construction El Demolition arviSJO 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
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
❑Accessory building 1:1 Multi-family
Other: Number of bathrooms:
12 Master builder 0
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:12909 SW 68th Parkway New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:350 Project name:WFG W3 a r S v oyr,jt,,4 ateim,p 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.
Fire Alarm Notification Devices Valuation: $$2,999.00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ® TENANT Number of stories:
Name:WFG Type of construction:
Address:12909 SW 68th Parkway Suite 350 Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 CONTACT PERSON NOTICE
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
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 lic.:135901 Total permit fees: , /.6 7.
Amount received:
Authorized signature: 1
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:2/13/18 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)
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: t81
® Addition or ❑ 1-10 heads: Affidavit required and El 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.
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 El Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes El 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: $ 2,999
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
Branden Taggart
From: Branden Taggart
Sent: Thursday, February 22, 2018 12:39 PM
To: 'Brooke Williams'
Cc: #Building Permit Technicians
Subject: RE:WFG Affidavit Permit Application
Importance: High
Hi Brooke,
I needed a completed fire alarm affidavit form in order to issue your permit. We received the application already. The
previous application we received lists(2) alarm devices, and this new application lists (5) devices. If you can send me a
completed copy of the fire alarm affidavit with the correct number of devices on it, I will process this permit for you
today.
Thanks,
Branden Taggart
spiv M City of Tigard
Senior Permit Technician
Community Development
7 WART) 13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
bra ndent KD tigard-or,gov
From: Brooke Williams [mailto:bwilliams@pointmonitor.com]
Sent:Thursday, February 22, 2018 12:29 PM
To: Branden Taggart<brandent@tigard-or.gov>
Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject:WFG Affidavit Permit Application
Thanks Branden!
Brooke Williams
Project Coordinator — TI Dept.
Point Monitor Corp.
971-246-5312 (Direct)
............................ .
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1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12909 SW 68TH PKWY 350, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00010
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
F
Violation Summary:
Inspector Contractor