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Permit p CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 111 s, COMMUNITY DEVELOPMENT Permit#: FPS2014-00111 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/23/2014 Parcel: 1 S136DB00201 Jurisdiction: Tigard Site address: 11565 SW PACIFIC HWY Project: Fred Meyer Subdivision: 2000-025 PARTITION PLAT Lot: 2 Project Description: Add delay-access hardware to egress doors in apparel department,tied into fire alarm system. Contractor: APPLIED TECHNICAL SYSTEMS INC Owner: FRED MEYER INC 7015 SW MCEWAN RD STORE#375 LAKE OSWEGO, OR 97035 1014 VINE ST PROPERTY TAX 7TH FLOOR CINCINNATI,OH 45202 PHONE: 503-684-9611 PHONE: FAX: 503-598-0498 FEES Description Date Amount Specifics:. Permit Fee-COM 06/23/2014 $64.54 12%State Surcharge-Building 06/23/2014 $7.74 Type of Use: COM Plan Review-Fire Life Safety-COM 06/23/2014 $25.82 Class of Work: ALT Type of Const: Occupancy Grp: Height: ft 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 $98.10 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $950.00 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 Notifi . ••• 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 direc •uestions to'UNC • calling 503.232.1987 or 1.800.332.2344. Iss ed By: Permittee Signature: f�� Call 503.639.4175 by 7:00 a.m.for the next available i spection 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 ONL1 RcpcivED IReceived i/ , Permit No.. /5`�II City of Tigard � DateB : � �/`f t,.e` —C29// ■ 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review Phone: 503.718.2439 Fax: 503.5911L1 40 2 3 2014 e/B : Other Permit: e-4 tQ9,,,!4/- 3, T I C A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for Internet: www.tigard-or.gov CITY O -fIGARD Notified/Method: Supplemental Information 111111.111111111.11111.1== 1PrIMMII . ''' ❑New construction ❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGO work indicated on this application. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: O ATI Total number of floors: Job site address:11565 SW PACIFIC HWY New dwelling area: square feet City/State/ZIP:TIGARD,OR Garage/carport area: square feet Suite/bldg./apt.no.: I Project name:FRED MEYER Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet SQUIRED DATA COMMERCIAL-USE CHECKLIST Subdivision: I 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 DESCRIPTION OF WOR work indicated on this application. ADD DELAY-EGRESS HARDWARE ON SINGLE SET OF EGRESS DOORS IN THE Valuation: S Fsn'— APPAREL DEPARTMENT. Existing building area: square feet New building area: square feet '1E1 PROPERTY OWNER Number of stories: Name:FRED MEYER Type of construction: Address:3800 SE 22ND AVE Occupancy groups: City/State/ZIP:PORTLAND,OR 97202 Existing: Phone:(503)797.7439 l ax:( ) New: ® APPLICAi: ® CONTACT PERSO Business name:APPLIED TECHNICAL SYSTEMS All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address:7015 MCEWAN RD. 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)684-9611 I Fax::( ) E-mail: Business name:SAME AS ABOVE j Permit fee: ei ,5 Address: �/ City/State/ZIP: State surcharge(12%of permit fee): 7.7 T - FLS plan review(40%of permit fee): Phone:( ) Fax:( ) (Due upon application.) e-S 2 CCB lie.: Total permit fees: Amount received: ' 9/O Authorized signature- This permit application expires if a permit is not obtained Print name: 167,3"�� ���- Date: / * within 180 days after it has been accepted as complete. Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits1FPS-PermitApp.doe Rev 01/05/2012 440-4613T(11/02/COM/WEB) City of Tigard Permit No.: c/"r'c7l 1/ 13125 SW Hall Blvd.,Tigard,OR 97223 / Phone: 503.718.2439 Fax: 503.598.1960 Date Received: CO a3 /s" TIGARC� Inspection Line: 503.639.4175 Internet: www.tigard-or.gov By: a�Q--�"� / FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (MAXIMUM OF 5 DEVICES WITHOUT PLANS) Project Name: r/. #442._J---- Occupancy: ,/.jeJ '� Job Address: //J65 fcv Ad,'c.. ' '/ P9 Suite: Contractor: 1/9/Eel . - ftih,(,sld�6fe,.,4- 1e. Phone: c 3) ,7/z_-7 ? g y Valuation of work: $ 9,5� Type of System: (check one) ❑Required ©Non-required (check one) Automatic OManual ❑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 (max5) /To be Relocated(max 5) Number of Proposed Manual Alarm Stations: To be Added (max5) /To be Relocated (max 5) Number of Proposed Notification Appliances: To be Added (max5) / /To be Relocated (max 5) I, v;.0'4' ernh- Oregon Construction Contractors Board No. (91:5// certi y e 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: • A sketch attached to this document and the building permit showing the area of work within the building's structure, • A copy of this document shall be available for the authority having jurisdiction, and • Electrical permit. Signature: / _. � Date: e,Z 3/ °'` Print Name: 4';1-st- v -°-C I:\Building\Forms\FireAlarmAffidavit_022514.docx Page 1 of 1 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11565 SW PACIFIC HWY, TIGARD, OR, 97223 Commercial - Fire Protection System 998 Alarm Final PASS - No C of O FPS2014-00111 Chip Barnett Violation Summary: Inspector Contractor