Permit (11) illi . qCITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IS
COMMUNITY DEVELOPMENT Permit#: FPS2019 00128
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/01/2019
Parcel: 1S135BB00501
Jurisdiction: Tigard
Site address: 10575 SW CASCADE AVE 100
Project: Biamp Subdivision: None Lot: None
Project Description: Fire alarm permit:Modifying an existing addressable central station fire alarm system which includes central station
off-site reporting,demolishing existing fire alarm cables, and adjusting horn/strobes and strobes. Scope of work
approved as an Affidavit permit by Building Official.
Contractor: POINT MONITOR CORPORATION Owner: ICON OWNER POOL 3 WEST LLC
5863 LAKEVIEW BLVD STE 100 BY INDCOR PROPERTIES
LAKE OSWEGO, OR 97035 2 NORTH RIVERSIDE PLAZA, STE 235
CHICAGO, IL 60606
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/01/2019 $102.20
12%State Surcharge-Building 10/01/2019 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 10/01/2019 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 10/01/2019 $4.00
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: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: No Cut Sheets Required: No
Total $159.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,281.00
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 952-001-0Q90:----4oi may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.80• - .
Issued By: �� 'ernai i nature?
_ ovl
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 FOR OFFICE USE O\l 1
City of Tigard ` 1r _ Received
� DateB : m Permit No.: �/� r ,
• 13125 SW Hall Blvd.,Tigard,OR 97223 ' /" `L t
Plan Review
! Phone: 503.718.2439 Fax: 503.598.1960 Dale/B : Other Permit: i ,A,111— ) , 1
I I(i A R t) Inspection Line: 503.639.4175 O C 1 1 2019 Date Ready By: H See page 2 for
Internet: www.tigard-or.gov Notified/Method: Egil Supplementallnformation
TYPE OF WORK REQUIRED DA7 A:1-AND 2-FAMILY DWELLING
❑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
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: g
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOC 4TION Total number of floors:
Job site address:10575 SW Cascade Ave. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:BiAmp-Cascade Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DAT 4: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
DESCRIPTION OF WORK work indicated on this application.
FIRE ALARM-No added devices or relocates.We might have to change candela Valuation: 5y}igge g0 a,
setting on some devices. Existing building area: square feet
New building area: square feet
0 PROPERLY OWNER 0 TENANT Number of stories:
Name:BiAmp-Cascade Type of construction:
Address:10575 SW Cascade Ave. Occupancy groups:
City/State/ZIP:Tigard,OR 97223 _ Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON
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
CONTRACTOR BUILDING PERMIT FEES*
Business name:Point Monitor Corp. (Please refer to fee schedule)
Address:5863 Lakeview Blvd#100 Permit fee:
City:State/ZIP:Lake Oswego,OR 97035 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal.)
CCB lie.:135901 Total permit fees: cc,, }
Authorized signature: Amount received: d �r
ii
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:9/25/19 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1 Building PertnIts FPS.PermiIApp_031016.dnc 440-4613T(11 02 COM F.TB)
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:
0 New system Number of sprinkler heads: Number of alarm devices:
® 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
0 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
T A,a of System(Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations 0 Yes
include: Individual Component ❑ Ycs
Cut Sheets
Fire Alarm Project Valuation: $ 2,281
D.) Residential Sprinkler(Stand Alone System)
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 .ro'cct 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\b.illiams\Desktop\PERMIT FORMS\fire Permit-city of tigard.doc 2
City of Tigard f' ,t' :
4 13125 SW Hall Blvd.,Tigard,OR 97223 k, ;w,.e 7 s Permit No.:
1111
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• Phone: 503.718.2439 Fax: 503.598.1960 Date Received: /41/1.1
c1
Inspection Line: 503.639.4175 i 1 1 2019 n 1 ty
T 1 G A R[) Internet �ev✓w.tigard-or V J
By:
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: BiAmp - Cascade Occupancy: Same
Job Address: 10575 SW Cascade Ave. Suite:
Contractor: Point Monitor Corp. Phone: 503-627-0100
Valuation of work: $2,281
4#1,,,, 74'
&e-
Type of System: (check one) ORequired ONon-required
one) �y-fi��� c-�J(checkc-.4-441❑Automatic ['Manual QBoth G'4 - L..v y- ' , ,i,pvv
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)
I 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.
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 documen ith a copy of the sketch attached shall be available for all inspections.
allk
Signature: - Date: 9/25/19
Print Name: Ben Breit
L\Building\Forms\FireAlarmAflidavit_071514.docx
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