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Permit (164) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT ' COMMUNITY DEVELOPMENT Permit#: FPS2019-00048 T-I(;Al,,f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/04/2019 Parcel: 2S 101 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 300 Project: Centene Subdivision: None Lot: None Project Description: Fire alarm. Relocating(3)fire alarm horn strobes. Contractor: PROTEK SYSTEMS Owner: GK TRIANGLE CORPORATE PARK III L 305 SE CHAKLOV DR SUITE 111 #361 ATTN KBS REALTY ADVISORS VANCOUVER,WA 98683 P 0 BOX 28270 SANTA ANA, CA 92709 PHONE: 360-314-2017 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-COM 04/04/2019 $102.20 12%State Surcharge-Building 04/04/2019 $12.26 Type of Use: COM Plan Review-Fire Life Safety-COM 04/04/2019 $40.88 Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 04/04/2019 $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 Calcs Provided: Cut Sheets Required: Total $157.34 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $2,425.00 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: Permittee Signature: q ,,,-.4. -----,26,(1.6.7 0_,,...,?,.. , ?---' Call 503.639.4175 by 7:00 a.m.for the next available inspection date. O 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 7City of Tigard , ... _ ,, Received (... LfyAW,M1:FF11MgnjylM , "I 1 -.1 Date/B 13125 SW Hall Blvd.,TiTigard,OR 97223 : Plan Review Ilrilt0.,m. I : M Phone: 503.718.2439 Fax: 503.598.1960 :" ) Date/B : Other Permit: TIGAR.D Inspection Line: 503.639.4175 a,‘,...:,1 D.,:.,,..,i i,,,,, ..- ,, Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov '''''''-' 1 Notified/Method: Supplemental Information TYPE OF WORK REQUIRED DATA:1-4p 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 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the ATEGogy•OF CONSTRUCTION ' 4 work indicated on this application. C ''-'-:', Valuation: $ 0 1-and 2-family dwelling Commercial/industrial 0 Accessory building 0 Multi-family Number of bedrooms: 0 Master builder 0 Other: Number of bathrooms: .,„,;.., Total number of floors: JOB SITE INFOR1 .,44,,TION AND LOCATIRN, :44, Job site address: \ 32.Z. I 3 1.,./ ‘,0, 74, pi4,..,L. New dwelling area: square feet City/State/ZIP: .1"' ., •N ot r A, cz, e.. 9 i z z, i Garage/carport area: square feet Suite/bldg./apt.no.: Project name: c,.g': ,y •-r- e" N 6- Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet RE . i n- 4c ti ,ItiP -IAL.'USECTILKGKLIST:, I -',.. —--44,..,A.' ", 217; 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 work indicated on this application. , -, , - ....tS1.4.,I.F1j., ---,!--.3rt,.,:i.1;•;, .,VA.!--.1:4,-,-,%:"'.•- ' ,,, - Valuation: $ 2_ I r-'r .- (4),,rox Existing building area: square feet New building area: square feet iv.AIROPEIiWbWNF* 11:10 :20''''g- d FF NAM' , 4 Number of stories: -•„-,,t '•'' -... ,..tlt,•. , ' o' J~, Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: :47141CAN1' 1 .-. 0 6.."' ' CT PERSON ''''' --:: ' 7 '' '4''''V -,•'~to;....- -.. "4-, ....*, '.....4.15.434 K., ''.....'it'' .....6it',, ':, NOTICE Business name: f ,g.,b '1"E- k 5 't'''-5 T Ni.& , Z. e... 'Z-. All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: A ek a fiA 5...., c_,,‹. under ORS 701 and may be required to be licensed in the Address: -5 42:.5 i e cilk it,/ t, Dc- 5 s...x. e.... 7)/ A3t., / jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP: v a‘,‹..,,_,,,....( 1.., C.b' I apply: Phone:( c.) 3/1( - 2 t...•,/ Fax: :( ) E-mail: ei., ,_.,dic , '''y 5".. .. , 1 p ,;„,,,.e-)ri.(. it- , L !.,1 co 1 , el OR ,,, -7-it '..44-•'-SUILDINr4ITRMIT FEESifP'- ---'' .‘4,,'...-41- ...... (Please refer Io feekedule) Business name: S , .... A i),,A) ,. 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.: -7,/ (f, 5 7/ Total permit fees: Amount received: Authorized signature: ac1/4„,..... 7 This permit application expires if a permit is not obtained Print name: S - Date: — , within 180 days after it has been accepted as complete. A d,t,,,,,v ..-• ,. , 21 L/9_ -. * 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: n 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: 3 [tg 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 o f System B, C .Vis:appli Vie) 1 x 7 ; �. ercaai� Sprinkler Type ❑ Wet ❑ Dry Additional Standpipes Information: Sprinkler SuLine ❑ Yes ❑ No Hazard Grouppply Density Design Area K. Factor Sprinkler Project Valuation: $ B.) . f.'die - Ho©d Fire,Suppression System Hood Project Valuation: $ ,.,,,:i4:,,,,,,,,,t:::.4.,,,,..ill:.,,,,,,,,,,,,,.: C.) F14 Submittal shall Battery Calculations ElYes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ '-'1.....,', ' �( Z$ ®� ,,`A.) Resi®, n}ial Sp F` Alone system) s :_... � + ? fi . ¢ . „ tom' Square Footage: Permit Fee: ' 0 to 2 000 $198.75 x 2 001 to 3 600 $246.45 3,601 to 7,200 $310.05 x 7,201 and greater $404.39 .. . . ,.. . Sprinkler Project Square Footage: sq. ft. ` ire Protection Pero t It. vall (see ,B &C bove): $ Permit fee based on project valuation (Asefee schedule): $ PerPromit fee based on square footagee(see Ds aabove): $ State Surcharge (4102°°//o° 12%of permit ffee): $ FLS Plan Review(40% of permit ee) $ TOTAL:: $ 2 I:\Building\Permits\FPS_PermitApp_031016.doc City of Tigard _ Permit No.: . 4 , _ F r 13125 SW Hall Blvd.,Tigard,OR 97223 Pt P 2 0 'PIPhone: 503.718.2439 Fax: 503.598.1960 Date Received: Inspection Line: 503.639.4175 C i_ , .7 1 I( \I I) Internet: www tI and-or. ov E L.,' ` ; ` t 4" / g g dE i v > , / .�. RW. iljr FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (MAXIMUM OF 5 DEVICES WITHOUT PLANS) Project Name: CENTENE Corporation Occupancy: Job Address: 13221 SW 68th Parkway Suite 300 Suite: Contractor: PROTEK SYSTEMS, LLC Phone: Valuation of work: $2,425.00 Type of System: (check one) ['Required ['Non-required (check one) ['Automatic ['Manual ['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(m 5) /To be Relocated(max s) Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(m.5) Number of Proposed Notification Appliances: To be Added on.5> /To be Relocated cm.5) 3 I, PROTEK SYSTEMS, LLC Oregon Construction Contractors Board No. 216574 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 document with a copy of the sketch attached shall be available for all inspections. Signature: Date: 4/4/19 Print Name: Adam Sweet 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: 13221 SW 68TH PKWY 300, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Fire Protection System FPS2019-00048 Inspection Type: Inspector: 998 Alarm Final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor