Permit (2) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2020-00021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/20/2020
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 160
Project: Ameriprise Financial Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm. Adding(2)devices and relocating(2)devices.
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:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/20/2020 $69.92
12%State Surcharge-Building 02/20/2020 $8.39
Type of Use: COM Plan Review-Fire Life Safely-COM 02/20/2020 $27.97
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 02/20/2020 $0.50
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 Reg:
Battery Calcs Provided: Cut Sheets Required: Yes
Total $106.78
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,183.00
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. 87 or 1.800.3 2.2344.
Issued By: // Permittee Signature: Cr //J9 9h e6;��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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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 Fox (1111 f
City of Tigard Received
i 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Dan R '
Review
Phone 503.718.2439 Fax: 503.598.1960 Dag : G JM
InspectionDate Ready By: lath:
Line: 503.639.41750 . Page 2 for
i Iii,1RU
Internet: www.tigard-or.gov Notified/Method. Supplemental lnformadon
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Is Addition/alteration/replacement El Other Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El1-and 2-family dwelling ElCommercial/industrial Valuation: $
❑Accessory building El Multi-familyNumber of bedrooms:
0 Master builder 0 Other. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:6650 SW Redwood Lane New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:160 Project name:Ameriprise Financial 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
DESCRIPTION OF WORK work indicated on this application.
FIRE ALARM Valuation: $$1,183.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name:Ameriprise Financial Type of construction:
Address:6650 SW Redwood Lane Suite 190 Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing:
Phone:( ) Fax:( )
New:
CO APPLICANT ❑ 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
aPp1Y:
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:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:2/17/2020 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I,Buildiag`Penaib FPS-Pe mitipp 031016 Mc 440-4613T(111eCOMIWEB)
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:
O New system Number of sprinkler heads: Number of alarm devices: 4
® Addition or 0 1-10 heads: Affidavit required and ►i 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
Type of System (Complete A,B,C or D as a .&cable :
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ 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: f
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Ycs
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1,183
D.) Residential Sprinkler(Stand Alone System)
Square Footage: Pen-nit 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: 1 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: $
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