Permit (9) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I COMMUNITY DEVELOPMENT Permit#: FPS2019-00126
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2019
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 370
Project: Sellwood Consulting Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm for tenant improvement: Add(3)and relocate(1)device.
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES
5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE: 503-624-6300
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/30/2019 $64.54
12%State Surcharge-Building 09/30/2019 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 09/30/2019 $25.82
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 09/30/2019 $3.00
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: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required: Yes
Total $101.10
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $989.00
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:
0 Ai /9-7°fi G /C:1=77 C'Tal
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 RECEIVED Received c FOROFFIC'E USE()1�1.1
City of Tigard
`J / 3 girlie Permit No./5"!..c2619-00424.,
r 13125 S W Hall Blvd.,Tigard,OR 9722, Date/8 : • -SC ,serlie—r'
_ 94C 2 ry Z o'g Plan Review
11 Phone: 503.718.2439 Fax: 503.598.1 / Date: OtherPermt/t7 /C"(-0. ...39
TI C A It Inspection Line: 503.639.4175 Date Ready By: orris:
0 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
"T"YPE 9-1, .® ' IVIIII ` r, ii , ''U1EE11"DATM1�ANbi2 FAMILY:I)WE:.TNG'
❑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
' „,w ',, Y i„ll(.1”til "h q`C.ATEGORY,OF CONSTatieno�? , ',' work indicated on this application.
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
t OtA'W TION ANTI LOCATION" Pl!h Total number of floors:
Job site address:6650 SW Redwood Lane New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:370 1 Project name:Sellwood Consulting Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
ItQt1C
IRED DATA O.M1IERCIAL-CISE CTiEKEST
tEao•.ea",,ar ..
Subdivision: 1 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
iii4i , 9 � ir " M, ho*_ oRPI N o1 t14oRk work indicated on this application.
FIRE ALARM Valuation: $$989.00
Existing building area: square feet
New building area: square feet
0 PRO ERTY OWNER ., NTw 5- �"Fa"'''v ,
�' � �„��.� ��� �� ��•� Number of stories:
Name:PCC240 Bldg 16-Sellwood Consulting Type of construction:
Address:6650 SW Redwood Lane Suite 370 Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone ( ) Fax ( )
New:
3p'
►'t,,, , LIt:AIVi Nlr,,oito!lhNA30 " 1 CONTACT`P SON:' 91111,;-,
,a ,. . l , ,:,,P 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 j Fax::( )
E-mail:bwilliams®pointmonitor.com
sh . 0 h , !C,ONTRACFOR }i ' ;,far ii 1kliiii t,i, i� 1,,!
� i.,.hug i '. l3U)(LDAYCi PERMTT T'FES :.
Business name:Point Monitor Corp. (Please)4;44 io�ee sr/,eduki
Address:5863 Lakeview Blvd#100 Permit fee:
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:
o
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:9/27/19 within 180 days after it has been accepted as complete.
- * Fee methodology set by Tri-County Building Industry
Service Board.
I.Building•Pennit FPS-PermitApp_031016.doc 440.4613TO 1,02 COM.WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
I3esc4bc work.to a dQne * ,iN'.
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: 3
►1 Addition or 0 1-10 heads: Affidavit required and r 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 0 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: Fire Alarm
"I' 1 e of S ;stern Coni fete B "' il, d y
&
k
Sprinkler Type 0 Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes 0 No
Hazard Group
Density
Design Area
K.Factor
Sprinkler Project Valuation: $
�. 'T I a�HHood Fite Suppression Systexri � ;
Hood Project Valuation: $
"jl(')i�z)ISR
,91014r-= x��ii^�µ s L91�i `� ����i 1,2..k �,� �.�"`Hi P,
C.) F e,�A1arm �� 1�i,
��h,IHOa �. , _
-:, k, �i'�w�"��I''' �tirH',.,.�4, , iii 0"H��
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $ 989
'01114;;4,a,�ry Ag =-240,14a2:'_- t4�� Jl,li
l
IH Rest e $ rStan one J ste
Square Footage: Permit Fee:
0 to 2,000 $198.75 1;, � ty �a
2,001 to 3,600 $246.45
3,601 to
o 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq.ft,
Fite 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: $
(::\Users\bwilliams\Desktop\PERMIT FORMS\Fire permit-city of tigard.doc 2
RECEIVED
City of Tigard Permit No.: P/°--5-...2-C"9 —00/e2
,_ • 13125 SW Hall Blvd.,Tigard,OR 9722C E P 2 7 2019
Phone: 503.718.2439 Fax 503.598.1960 Date Received: / // F
Tlc:�icI) Inspection Line: 503.639.4175 CITY OF TIGARD
Internet. www,tigard-or.gov BUILDING DIVISION BY: �.
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Sellwood Consulting Occupancy: PCC240 Bldg 16
Job Address: 6650 SW Redwood Lane Suite: 370
Contractor: Point Monitor Corp.
Phone: 503-627-0100
Valuation of work: $989
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(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) 1
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 document with a copy of the sketch attached shall be available for all inspections.
Signature: dor Date: 9/27/19
Print Name: Ben Breit
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