Permit 14CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2020-00069
Date Issued: 06/10/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136DC03300
Jurisdiction: Tigard
Site address: 11734 SW 72ND AVE
Project: The 72nd Avenue Salon Subdivision: 72ND AVE APARTMENTS Lot:
Project Description: Fire alarm. Adding(2)devices for TI.
Contractor: DYNAMIC SERVICE FIRE SECURITY LLC Owner: 72ND AVENUE PROPERTY LLC
1041 FABRY RD SE BY RICHARD CASSINELLI
SALEM, OR 97306 4804 NW BETHANY BLVD#I-2
PORTLAND, OR 97229
PHONE: 503-302-7122 PHONE:
FAX: 503-990-7222
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/10/2020 $51.09
12%State Surcharge-Building 06/10/2020 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 06/10/2020 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 06/10/2020 $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 Req:
Battery Calcs Provided: Cut Sheets Required:
Total S78.16
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $300.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Ca 1503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System ft ::01 1(1 t ii t t C- I.\
City of Tigard Lintelity
Received 6'7-, •Zp 2();_1. ?
i *1 1312i SW Hall Blvd.,Tigard,OR 97223 Ptar+Review t/ 1/'
s ' Phone: 503.71 i32439 Fax: 503.598,19W Date./By: •+.i % (101 V
R.
t I1,n It 1) Inspection Line: 503.639.4175 Date Ready/By- / ]wv: WI See-Page 1 for
Internet: www.tigard-or.gov tioufied,Method ( / fir, s/y.%!1 Supplemental Information
TITS Of WORK • IEQUTR O Th4:1, tA FN404 D.1#Ci
D New construction ❑Demolition Permit fees'are based on the value of the work perforated.
titm/altetatiort/neplacernent 0 Other: n Indicate the value(rounded to the carest•dollar)of all
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF C , : work indicated on th s application.
❑ 1-and 2-family dwelling 0 Coramereiallindustrial Valuation: S
AccessorybuildingNumber of bedrooms:
❑ ❑Multi-family
❑Master builder ❑Other: Number of bathrooms:
. JlF*g f19FO1*MMATIfti$A{ilp pCATro i Total mtmber of floors:
Job site address: `/ 2 / t,/ es( A t/ . New dwelling area: square feet
City/StatelZlP: i Jii et,ird 9/ g.7...223 // Garage/earpart area: square feet
Suite/bldgiapt.no.: Project name:7/7f• *7 )n�AVa ..„/A t� Covered porch area: square feet
Cross street/directions to job site: ," Deck area: square feet
Other structure area: square feet
RE:QU[R"&OBN1TA.COM ilitit At..'E ,'rl'.
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
owcarnow cw.woitK. work indicated on this.application.
. .)cTe,nS/0 Y; A/,4c U../re.it Valuation: s 9a
Existing building area: square feet
New building area: square feet
. a, 131i . .Q �; Number of stories: 3
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
f A ICAN # a CONCAa,R$$RSON '
a ,
Business name: All contractors and subcounwions are required to be
Contact tame: licensed with the'Oregon Construction'Contractors Board
Address: under ORS 701 and may be-required to be licensed:in the
jurisdiction in which work is being performed.If the
City/State/ZiP: atpplicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax::( )
E-mail:
COMGTott AtTIIJ3klSC P} ` `-;
Business na e:J ii 1f2) 1!C r1//�'t� i' dlllnwir rk7 �ti:
Q� ` �� Permit fee.
Address: O'/ ��r- 7CA
.
. �^ State surcharge(12%of permit fee):
City/State/ZiPLS aley77 1 O'7Q 9 7 41 0
/ { FLS plan review(40%of permit fee):
Phone:1`03)30a� wag_
Fax:( ) (Due upon application submrlral.)
CCB lie.: /Q/ter"0 g .�'��%�i' Total permit fees:
vv Amount received:
Authorized signature:
This permit application tTnires if a permit is not obtained
Print name ���� ,,ro,,�� Date: G/ aO within 180,daysafter it has be®accepted as complete..
Q�B'� " Feemethodoiogy set by Tri-County Building Industry
Service Beard.
I-43uddmgWPermas\F PS-Pcrori1Ap_031016-doc 440-4613 110?COMl W FN I
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Irl7e"fli►irtlCtq he dttt3t '
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 ( -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: xie•7 ,
�14Y1 Or/v 4( Ci"ati 7t
Type•o£System-(Complete A,B, C or I)as applicable):
B.) :C.ommerdai"Spt nkler
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 Rood Fire Suppression System
Hood Project Valuation: $ p
f
,�,° "����'e-' 1. �$
'P a • u l"vx4 1 i�.kW%1`4a'4�,s*O.:'Ks' xl�4P:P4"-'; i�, 4v ,• f��tw „� sy, r; .n°T { "' - r/..+�-.� ,�n'ere 3ti i4t tia, xiir t
� . . ..v S '� �vV �3 � .f�� ..y.. [
Submittal shall (Battery Calculations ❑ Yes
include: i Individual Component ❑11 3 es 76,-ra 1V/ !' f/7/ tom
Cut Sheers tie/ / l/,
Fire Alarm Project Valuation: $ 30G'
Stand�i#lone T)«,� Rei,Ydcnual�cs(
Square Footage: Permit Fee: i
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 t+n Perimiit
Project valuation subtotal (see A,B&C above): $
Permit fee based on project valuation(see fee schedule): $
Permit fcc based on square footage (sec D above): $
State Surcharge(12%of permit fcc): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
7:\%actin,\retains\FPs_PernutApp_olols.d« 2
City of Tigard Permit No.: SoZG �Y,do6
rt 13125 SW Hall Blvd.,Tigard,OR 97223
e Phone: 503.718,2439 Fax: 503.598,1960 Date Received: (0/3 4.2.0
1'F C;A Ii t) Inspection Lino: 503.639'.417Y Internet: www.rigard-or.gov By: it,i1/ L_ )',n!'Cf , -^&.
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name:ThCLe.. Jt�� Occupancy:
Job Address: ] ,'`t J`1 L pue.,_, Suite:
Contractor: V3\a(�c- '(Yl ('l ` �(o rc to. 1-5 LLPhone: '�, 3a 1 1 ��
Valuation of work: S '
Type of System: (check one) 154Required :Non-required
(check one) XAutomatic ❑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 1 5> 0 /To be Relocated. 5) 0
Number of Proposed Manual Alarm Stations: To be Added F.s1 O /To be Relocated e sir
Number of Proposed Notification Appliances: To be Added(not s q /To be Relocated(.5)
I, � V Le`\[;l Oregon Construction Contractors.Board No1931
certify the following is true and amines 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 operateall.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 documentnt with a copy of the sketch attached shall be available for all inspections.
Signature: --‘c \C Date3\ MA` �Cj
I
Print Name:
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