Permit (96) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
sCOMMUNITY DEVELOPMENT Permit#: FPS2018-00095
Date Issued: 08 08 0/ /2 18
T f C;A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 300
Project: Therapeutic Associates Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Fire alarm:Relocating(4)horns and adding(1)strobe.
Contractor: LAKE ELECTRIC CONTRACTOR INC Owner: G&S FC LLC
PO BOX 1550 16083 SW UPPER BOONES FERRY RD,
TUALATIN, OR 97062 STE
TIGARD, OR 97224
PHONE: 503-234-3044 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/08/2018 $67.23
12%State Surcharge-Building 08/08/2018 $8.07
Type of Use: COM Plan Review-Fire Life Safety-COM 08/08/2018 $26.89
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 08/08/2018 $1.00
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 Gales Provided: Cut Sheets Required:
Total $103.19
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,100.00
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: / /^A 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.
' Building Permit Application
CommercialReceived„-), 1.-tmoiici t S L()NIA
City of Tigard
■ 13125 SW Hall Blvd Tigard OR 97223 A u,,i- c 2013
• e Phone: 503-718-2439” Fax:'503-598-1960 --
7 Date/B :
Plan Review
Date/B : IW4' ''7270711 MIA41
TIGARD
Inspection Line: 503-639-4175 1`. ' ') Date Ready/By: Juns. n See Page 2 for
Internet: www.tigard-or.gov —, , „ , ,., ,, Notified/Method: Supplemental Information
TYPE OF 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
X..kddition/alteration/replacement 0 Other:
equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
/Kc...,,ommercial/industrial Valuation: $
0 1-and 2-family dwelling
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: IC,0 F3 5--,...) vrezrac..-8-, rte-,-7 tiee( New dwelling area: square feet
City/State/ZIP: -75 r (:) ,e„ "--7 7 2_5 Garage/caiport area: square feet
Suite/bldg./apt.#: Project name: .7 -T-- Covered porch area: square feet
Cross street/directions to job site: 7 7 ‘,.._ 4 kr e_ 1
Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot#: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#:
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
e.,._ (:),,,_ i-to rt..- 1-f-1-6 e.,'> r .4(-J1 I Valuation: $ it 00
4 . , _S-J-r. .-- Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 1 0 TENANT Number of stories:
Name:
Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) I Fax:( )
New:
..,,Q,..APPLICANT J0 CONTACI" PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: 1 .C. -- L ,,,_,_ Cs,..„.4.1,=,.(7,,,-5 1...J2—
Structural plan review fee(or deposit):
Contact name: 5(... r(-- (3,,
FLS plan review fee(if applicable):
Address: (0 (3C)( (5-5-Z2
City/State/ZIP: Tr0--(a—ek194
(... ay7,96-2__ Total fees due upon application:
Phone:(53) -z,3 if. 30(f i I Fax::( ) Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: S„0.-{-f--, 6,,(f (A,.... rec., Av.-‘co v..._
`--- I N4RA " Commercial and residential prescriptive installation of
(...., CO CTOB
roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: )c-t,,--c__
and fire department access,along with the 2010 Oregon
Address:
Solar Installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP:
$180.00
and administrative fees):
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB Lic.: C 5--3 g 1 ijoixe)
Total fee due upon application: $201.60
Authorized signature: Z
ci. .....\...„)
/149 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 5c,,kr 6, \ ( Date: S' 4 7123( * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BupCoMpetAppdoc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five percent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom:
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
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:
El New system Number of sprinkler heads: Number of alarm devices:
A 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.
Additional description of work:
Type System(COMP- A,$� C of 1 .as ppiica�le):
Sprinkler Type ❑ Wet ❑ Dry.
Additional Standpipes
Information: Sprinkler Supply Line El Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
e 3ood ire oppression System
Hood Project Valuation: $
..
+ ", rx Rb he,}
C) ElreMa
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ (u,(c 0
D) Residentta � L (Stand Alone System "` 3 ._e .� 3 s k
Square Footage: Permit Fee: *-
O to 2 OOO � �ro-S��` '+fig-� �r��` i r� 4
$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.f,,.
... pure Protectl<on Permit Fees 4 �-�; -A-
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: $
I:\Building\Permits\FPS_PermjtApp_031016.doc 2
City of Tigard Permit No.:
1111 � 13125 SW Hall Blvd.,Tigard,OR 97223
C Phone: 503.718.2439 Fax: 503.598.1960 Date Received: F/7/f Y
Inspection Line: 503.639.4175 T
I 1 G A R D Internet: www.tigard-or.gov By: Xe f Y ir4 k L It*0./
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIO C`
OR TENANT IMPROVEMENTS AUG C 2013
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: � r✓ � Occupancy:
s y
Job Address: /r(�(O 5'v,I Up?1 o„...7 , [ ( Suite:'
Contractor: l 6_ el R-G 'Dvi't. -T� �M� .done: Sp 3--23L('307`"T
Valuation of work: $ ( . CCD
Type of System: (check one) Ergequired ONon-required
(check one) Xf.Automatic DManual ['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 on.5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(mix 5)
Number of Proposed Notification Appliances: To be Added(max 5) 1 /To be Relocated(.5)
5 .o c3,/ Oregon Construction Contractors Board No. 6 O j
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 do' '`ent with a cop of the sketch attached shall be available for all inspections.
Signature: Zj
�i► e
Date:
11
Print Name: cgv
I:\Building\Forms\FireAlarmAffidavit 071514.docx Page 1 of 1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16083 SW UPPER BOONES FERRY RD 300,
TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00095
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor