Permit (27) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IN . COMMUNITY DEVELOPMENT Permit#: FPS2019-00001
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/02/2019
i GAR D9 Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 70
Project: Bi-Mart Subdivision: None Lot: None
Project Description: Fire alarm. Adding(3)devices for upgrade of fire alarm and security system.
Contractor: VISION SECURITY SERVICE Owner: ROIC OREGON LLC
10874 SW ROLAND CT 8905 TOWNE CENTRE DR, STE 108
WILSONVILLE,OR 97070 SAN DIEGO, CA 92122
PHONE: 503-502-3909 PHONE:
FAX: 503-200-2907
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/02/2019 $112.96
12%State Surcharge-Building 01/02/2019 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 01/02/2019 $45.18
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 01/02/2019 $2.00
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 Calm Provided: Yes Cut Sheets Required: Yes
Total $173.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,500.00
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 r. -. adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y. •b a copy of the rules
or direct questions to OUNC b calling 503. .2.1987 or 1.810.332.2344. /
Issued By: j Permittee Signature: r -
tet/
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
Fire Protection System ro,I ` E FOR OFFICE USE ONLY
1111111 City of Tigarde ug n t3 'i`: Date/ReceiB �AM �
13125 SW Hall Blvd.,Tigard,OR 97223 G �'` Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : II
Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov f.. i LE; 0;11.'0101° Notified/Method: Supplemental Information
, TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING`
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
. ddition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
Fx N ` work indicated on this application.
CAIEWE Ari CONSTRUCTION ..
El 1-and 2-family dwelling 'Commercial/industrial Valuation: $
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATIONANDLOCATION Total number of floors:
Job site address: 1 ✓ P caw pc‘c, 'k--\W\)\*-1-O New dwelling area: square feet
City/State/ZIP: 1 i ,ZP___EZ, i CJI"" Ci ikaa3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 5‘ M,t> r---c- 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.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
1 �('' 5 DESCRJPTION OP WORKS work indicated on this application.
v�e Car q' ".. . - Valuation: $ 3500
5r y1KJe N-- Existing building area: square feet
New building area: square feet
PROPERTY OWNER
�;❑ 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
❑'APPLICANT Q CON ACT PERSON
NOTICE : ;
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax::( )
E-mail:
CONTRACTOR _°n BUILDING PERMIT FEES*
,
Business name: `' i.3 ,:' lPleq a r achcds(e
aV 11-50 `��� + C'
Permit fee:
Address: \0 L7A-L f �' D ZO.A� -,
State surcharge(12%of permit fee):
City/State/ZIP: \50,%...)vo..4,j , OR- ()1-0 FLS plan review(40%of permit fee):
Phone:(505 G .,), o ck Fax: )acDC)i apt 01. (Due upon application submittal.)
CCB lic.: \1.1 5.- I4 7 r Total permit fees:
6
Authorized signature:
ellAmount
received:
This permit application expires if a permit is not obtained
Print name:IT N D, ,,./2__ Date: t-'a-00 A 0l within 180 days after it has been accepted as complete.
111 VVV * Fee methodology set by Tri-County Building Industry
Service Board.
1:,Building`Permits,FPS-PennitApp_031016.doc 440-4613T(I I i02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work"fp 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:
.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:
Type of System (Complete A,B,C or D as applicable):'
A)A.)'
Commercial Sprinkler ,
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 Fire Suppression System, s`
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations - jYes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $
D. Residential rinkler(Stand Alone System)ryr
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," oteton Permit Fees
w.
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:ABuilding\Permits\1,PS_Pcrmitl\pp_031 U16.doc 2
City of Tigard RECENED
Permit No.: 1
• 13125 SW Hall Blvd.,Tigard,OR 97223
C Phone: 503.718.2439 Fax: 503.598.1960 JAN 2 2019 Date Received: AW/
Inspection Line: 503.639.4175
T I G A R I) Internet: www.tigard-or.gov ,
B tf tt 39 ;G ° N
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: "\ 111, Occupancy:
Job Address: \ (,)) 'PLC,kle Suite:
Contractor: V 6.CO). � *Ti tom\)i 5 Phone:
Valuation of work: $
Type of System: (check one) _- quired ❑Non-required
(check one) ['Automatic ['Manual . 1Booth
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) \ /To be Relocated(max 5)
-PQD Ge3kMni._ Oregon Construction Contractors Board No. VA" 5.r-3 c
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 • : ment v ti , • ' s y'of the sketch attached shall be available for all inspections.
Signature: _ Date: � �.,�e � �q
Print Name: ..\( 14---N-- atL am.r __
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