Permit (73) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11,1
COMMUNITY DEVELOPMENT Permit#: FPS2018-00171
T I GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/28/2018
Parcel: 1S 134AD06201
Jurisdiction: Tigard
Site address: 10450 SW NIMBUS AVE RB1
Project: KRUGER OPTICAL Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: Fire alarm permit:Adding and altering(20)devices for TI.
Contractor: POINT MONITOR CORPORATION Owner: DIETRICH, NANCY BISHOP
5863 LAKEVIEW BLVD STE 100 ROBINSON, JERRY CHRISTOPHER TRUST
LAKE OSWEGO, OR 97035 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/28/2018 $145.24
12%State Surcharge-Building 11/28/2018 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 11/28/2018 $58.10
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 11/28/2018 $10.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 11/28/2018 $10.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: No 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:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $241.27
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,322.00
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 he rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/
Issued By: Permittee Signatur :
_
Call .3.•!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.
'Fire Protection System FOR OFFICE USE ONLY
City of Tigard nCT I 7 23 Receivedilar
�_iii Permit No.: iiro it,' -
Date/B
IN . 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _ i
e Phone: 503.718.2439 Fax: 503.598.1)60 Date/B : / 'd 1,. j i f Other Permit:
Inspection Line: 503.639.4175 Date Read /B
TIGARD Ready/By: / r� S SeePage2for
Internet: www.tigard-or.gov Notified/Method: /� 7 fes_ ' Supplemental Information
.� ( (,441f 4.,.;..
TYPE O1 WORK , _ .REQUIRED DATA:I-AND 2- 'AMMIIIY"DWS AVG, ,`
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
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
AFEGORY OF CO STRUCTION ft,;x work indicated on this application.
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
JOB STYE-1NFORMATIOI AND LOCATION ' Total number of floors:
Job site address:10450 SW Nimbus Ave.R-1 New dwelling area: square feet
City/State/ZIP:Tigard,O 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: 1 fir,,/ Project name:Kruger Optical Covered porch area: square feet
Cross street/directions to job site:'
\ ie Deck area: square feet
8 1 Per:,i# e()t(-e',, 7// Other structure area: square feet
t�
' - REQUIRED DATA:COMMERCI tIAJSE CHECKLIST"
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicatethe value of all
Tax map/parcel no.: (rounded to the nearest dollar)
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION UP' ,4„,,'
II' work indicated on this application.
Fire Alarm-Notification Devices Valuation: $$6,322.00
Existing building area: square feet
New building area: square feet
Ar''' 0 OR'ER'I'Y OWNER ,r ,:, 0 TEN •s R 3 -j Number of stories:
Name:Kruger Optical Type of construction:
Address: 10450 SW Nlmbus Ave.R-1 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( )
New:
c APPLICANT i Q CON't'AC I' PERSON
M " " , 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
;y'''' CONTR CTO .'' BUILDING PERMIT FEES*
(Please refer(aim schedule
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:
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name:Ben Breit Date: 10/16/18 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/con 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:
El New system Number of sprinkler heads: Number of alarm devices: 20
® 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
❑ 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 Alarm Notification Devices
T '` of System(Complete A,B %C.or D as applicable)
A.) Commercial Sprianlder ;ham . ;
5
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B•) Type I- Hood F,rc.Supp System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 6,322
D.) Residential Sprinkler(Stand Alone Sys
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:AUsers\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:
10450 SW NIMBUS AVE RB1 , TIGARD, November 29, 2018 at
OR, 97223 9:00:02 AM
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00171
Inspection Type: Inspector:
998 Alarm Final Chip Barnett
Result:
PASS - NoCofO
Comments:
NFPA 72 received
Violation Summary:
Inspector Contractor