Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IIICOMMUNITY DEVELOPMENT
Permit#: FPS2018-00123
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/13/2018
T i C ;ti Iz.f7 9 Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 750
Project: CNH Finance Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm. Relocate(1)devise.
Contractor: POINT MONITOR CORPORATION Owner: LINCOLN CENTER LLC
5863 LAKEVIEW BLVD STE 100 BY SHORENSTEIN PROPERTIES LLC
LAKE OSWEGO, OR 97035 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100 PHONE: 503-412-4800
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/13/2018 $77.99
12%State Surcharge-Building 09/13/2018 $9.36
Type of Use: COM Plan Review-Fire Life Safety-COM 09/13/2018 $31.20
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 09/13/2018 $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 Cates Provided: Cut Sheets Required:
Total $119.05
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,466.00
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 503.23 .1987 or 1.800.332.2344.
Issued By: %i Permittee Signature: 5.-r �LCGG%' 7
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.
,
Buildin2 Permit Application
Fire Protection System I 01(01 Ult F l '4 0\1.1
SEP 1 3 2.013 Received
City of Tigard
DateJB : WIA: Permit No.. '. $)4 7-, 2
11113125 SW Hall Blvd.,Tigard,OR 97223 - '. Plan Review 1111 Phone: 503.718.2439 Fax: 503.598.1960 c,, Da, : : OtherP AO , .- , A
, ,(, ,, Inspection Line: 503.639.4175 Jun= S5 See Page 2 for
' 'I) Internet: www.tigard-or.gov Notified/Method: Supplemental Information
-0_,-„,
Permit fees*are based on the value of the work performed.
0 New construction 0 Demolition
Indicate the value(rounded to the nearest dollar)of all
r,g]
Addition/alteration/replacement 0 Other equipment,materials,. labor,ioverhead,and the profit for the
..,- —." ,:::tivf,". . . . „ ,; . 40ii7;,..0,,,,7ElatIp%.,itqtia",,--,..„"t1,',-; . -„:".,4 work indicated on this app Ica r .
,•," ..f.."'.., 1:"..,,"f--,..,...21.:,%,,. '------•-,--,—""••• ''.-' - ' - --• '''''44'''t '''' 724''''''t'' '"fl'''''-- ''' Valuation: $
0 1-and 2-family dwelling 13 Commercial/industrial
0 Accessory building El Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
.•-••. " '',V-44u,-"-.• ,:. '',.'" :1131,$*'' i' • ''', 411-, .-, .; ,..4.., ,'T4f,A:er" -,- Total number of floors:
Job site address:10200 SW Greenburg Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
SuitelbldgJapt.no.:750 1 Project name:CNH Financial - Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
.!::::ikt ,
Subdivision: I 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
work indicated on this application.
Valuation: $1466
Fire Alarm-Notification Devices-Relocates Only
Existing building area: square feet
New building area: square feet
-•••'' -'''''' Ek'n'0- ,J1C,' a...ii:,kr 3, 5...,,,,r,-.::.i,..6-1,..: lirtr -,,,-* ;it,,,„., Number of stories:
Name:CNH Financial Type of construction:
Address:10200 SW Greenburg Rd Suite 750 Occupancy groups:
City!State/ZIP:Tigard,OR 97223
Existing:
Phone:( ) Fax:( ) New:
-;-..**.r- .-- - ' .e."',..---".-----• - , — "'''— "k",'••••••- ' ' ''''' --"'"'''''- ' " '''''' ',....:-..„?..";,,,,kt - 1,,,,,t .., „.t!...7X--,, ., —,,,,,,,,,,,
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 Fax::( )
E-mail:bwilliams@pointmonitor.com
CONTRACTOR ''• BUILDING PERMIT FEES, '•• „t' '
Business name:Point Monitor Corp.
Permit fee:
Address:5863 Lakeview Blvd#100
State surcharge(12%of permit fee):
City/State/ZIP:Lake Oswego,OR 97035
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal) ,
CCB lic.:135901 Total permit fees:
•
.' ------'''' e:Z;r-- Amount received:
Authorized signature.
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:9/13/18
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(l11)2,COM'WEB)
4
City of Tigard Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223
■ Phone: 503 7182439 Fax: 503.598.1960 Date Received:
Inspection Line: 503.639.4175
`'n It I' Internet: www.tigard-or.gov By:
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: CNH Financial Occupancy: Lincoln 5
Job Address: 10200 SW Greenburg Rd. Suite: 750
Contractor: Point Monitor Corp. Phone: 503-627-0100
Valuation of work: $1,466
Type of System: (check one) ORequired ONon-required
(check one) DAutomatic DManual OBoth
Total number of devices added or moved under this permit process is 5 total a er tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max 5) /To be R= ocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To b: Relocated(.5)
Number of Proposed Notification Appliances: To be Added(max 5) /T. be Relocated(max 5) 1
I, Ben Breit Oregon Constructio ontractors Board No. 135901
certify the following is true and defines the scope of work for th': project:
a) All work complies with the current state-adopted NFP' 72 and the authority having jurisdiction.
b) All notification appliances are located in accordance ' ith the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with cum' state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until in .ected.
e) Final approval shall be subject to on-s' • tests and inspections.
f) Voltage drop is adequate to operate al .ppliances.
g) Battery supplies are capable of sup.•rting the system modifications.
h) Compatibility of appliances and .evices are in accordance with the FACP manufacturer's specifications.
In addition, I understand the foil, ing is required:
• Submit(3)copies o • sketch showing the area of work within the building's structure.
• Building fire pro •ction system permit.
• Electrical per ' .
• A copy of thi document with a copy of the sketch attached shall be available for all inspections.
Signature: ♦,,, 'f" Date: 9/13/18
Print Name: Ben Breit
1:1Building\Fortes\FireAlarmAflidavit_071514.docx Page 1 of 1
w
City of Tigard: Fire Protection Permit Checklist
Pa�gy�e� 2 Supplemental Information
1.) Type of Work: 2.) Addition/alterati
on only to sprinkler lerheads: 3.) Addition/alteration only to alarm devices:
0 New system Number of sprinkler heads: Number of alarm devices: .1.
® Addition or 0 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
❑ 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
(3)sets of plans. (3)sets of plans.
Additional description of work: Fire Mann Notification Devices
`®e e 8 - er e)e� e $ � die .i� i i e� '' X r ,'bw.}
t.; '' , . ,;. asps = Itf } '— ''..5 707:4',4-, -' 0..f.744W,'.7,,.i..:'.,..t'.V..!'..,.,-.,
�' `+a' € r
y a
.
Sprinkler Type 0 Wet ❑ Dry ,
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group
Density
Design Area
K.Factor j
Sprinkler Project Valuation: $
. ' . �T E, e rni° 5 � - Hood Project Valuation. $ ,. : w.
:$ E
1
PrP,
� 'jt` T'-,,,1-,.,.-_-,
vim., f -y .w.,; ' ...i `, o�''' "� `4-
L
Submittal shall Battery Calculations 0 Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Mann Project Valuation: I $ 1466
D) resident l l Stand 1.',,: S --tem) t -u ,
Square Footage: _ Permit Fee: `. ` '"
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
i 5 S`
7,201 and greater $404.39x:: fix.;
Sprinkler Project Square Footage: 8,7:ft
Fire.Protection Permit Fees ,
Project valuation subtotal (see A,B&C above): $
Permit fee based onproject 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\bailGams\I)csktop\l'liR\fi7'hOR\fS\hire permit-city of tigard.doc 2
S
t
Electrical Permit Application FOR 01 URA I. Oyl.1
City of TigardB Recei
II4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 Date lit : Related Permit 8:
Inspection Line: 503.639.4175 Ready Date/By: WI See Page 2 for
I 1 G.a R LD Internet: www.tigard-or.gov Notified/Method: ® Supplemental Information
p,
®New construction ®Addition/alteration/replacement Please check a that apply(submit 2 sets of plans w.'items checked):
0 Service o -.er 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: where e available fault current 0 Marinas and boatyards.
M" ..4 - trt. .!:,,,LO 0 Net 4,1 i)! ,_ • 11-7,,, exc •s 10.000 amps at 150 volts or 0 Floating buildings.
❑ I-and 2-family dwelling cg Commercial/industrial 0 Accessory building le. .ground,or exceeds 14.000 ❑Commercial-use agricultural
a,...for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other. ■ ire pump. ❑Installation of 150 KVA or
, '- l''-'4 , `JOB SITE tr _1111®=x1 ND, -2 A 40 r4 EnrergencYsystem. larger separately derived
■Addition of new motor load of system.
Job#: I Job site address: 10200 SW Greenburg Rd 100HP or more. ❑"A"."E"."1-2","1-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#:750 I Project name:CNH Financial 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: .• .FEE CHE ,., ,„
Description I Qtr. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
•Tax map/parcel# 1,000 sq.ft.or less 16834 ' 4
Ea.add'I 500 sq.ft.or portion 33.92 1
"4,.. : y Limited energy,residential
Fire Alarm-Notification Devices-Relocates Only (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
s ® PROS Renewable Energy 0 See Page 2
. E.R�'OW=NER -� i•'` . " � " '_ -- --x. -_ Services or feeders installation,alteration,and/or relocation
Name:CNH Financial 200 amps or less 100.70 2
Address:10200 SW Greenburg Rd Suite 750 201 amps to 400 amps 13336 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2 ':
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being m •e on property that I own which is not 200 amps or less 5936 1
intended for sale,lease,rent,or exchange,accor.ing to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
' ,, Branch circuits—new,alteration,or extension,per panel
trt
Al'LICANT
, JO PERSON '" -. A.Fee for branch circuits with
Business name:Point Monitor Corp. above service or feeder fee,
7.42 2
each branch circuit
Contact name:Brooke Williams B.Fee for branch circuits without
Address:5863 Lakeview Blvd.Suit 100and/or
fee,circuit
City/State/ZIP:Lake Oswego,O'97035 Each add'l branch circuit 7.42 I 2
Miscellaneous(service or feeder not included)
Phone:(503)627-0100 Fax::( ) Each manufactured or modular 67.84 2
dweEmail:bwilliams@pointmo. tor.com Reconnect
t onlyserve and/or feeder
Reconnect 67.84 2
` CONTRACTOR lZ Pump or irrigation circle 67.84 2
Business name:Point i nitor Corp. Sign or outline lighting 67.84 2
Address:5863 Lake w Blvd.Suite 100 pinealcircuit(s)alteration,or extension. El See Page 2 1 2
panel, or extension.
City/State/ZIP:La e Oswego,OR 97035 Each additional Inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)62 1100 I Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bwill :ms@pointmonitor.com Industrial plant(t hr min) 78.18/hr
Inspections for which no fee is 90.001 hr
CCB Lic.' 135901 I Electrical Lic.: 34508CLE I Suprv.Lie.: 4460LEA specifically listed(h hr min)
ELECTRICAL PERMIT°FEES
Suprv. 'lectrician signature,required: Subtotal:
Prin ame: Ben Breit Date: 9/13/18 ❑Plan Review Required(25%of permit fee):
A. State surcharge(12%of permit fee):
i
Authorized signature: Rs1
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Ben Breit Date: 9/13/18 days after it has been accepted as complete.
Number of inspections allowed per permit.
I.Budding.Permits£LC_PermitApp_ELR_ERE.doc Rn 06 1'2015 440-4615T(11.05,COM'WEB
City of Tigard �._ , f P it No.: PPSs)f 7?JO/23
III13125 SW Hall Blvd.,Tigard,OR 97223 ' E ^ ?
Phone: 503.716.2439 Fax: 503.598.1960 Date Received: ,n,5//4jr
l!�'' l
Inspection Line: 503.639A 175 OTI 4 k4:)/
1 1` ';1' Internet:: www.tigard-or.gov By: �K '
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: CNH Financial Occupancy: Lincoln 5
Job Address: 10200 SW Greenburg Rd. Suite: 750
Contractor: Point Monitor Corp. Phone: 503-627-0100
Valuation of work: $1,466
Type of System: (check one) DRequired ❑Non-required
(check one) DAutomatic DManual DBoth
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(..x5) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added on.5) /To be Relocated(.5)
Number of Proposed Notification Appliances: To be Added(.5) /To be Relocated onus) 1
1, 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.
0 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: T;;;2—, Date: 9/13/18
Print Name: Ben Breit
1
I
1:\Building\Forms\FireAlarmAflidavit 071514.docx Page 1 of 1
1
r
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10200 SW GREENBURG RD 750, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00123
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor