Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 a •'• COMMUNITY DEVELOPMENT Permit#: FPS2015-00058
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/15/2015
Parcel: 25101 BD00100
Jurisdiction: Tigard
Site address: 7650 SW BEVELAND RD 200
Project: Womens Healthcare Associates Subdivision: 1994-025 PARTITION PLAT Lot: 2
Project Description: TI for new tenant to Tigard. TI for offices,no medical.
Contractor: POINT MONITOR CORPORATION Owner: PNWP LLC#2
5863 LAKEVIEW BLVD STE 100 PO BOX 2206
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97075
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/15/2015 $177.52
12%State Surcharge-Building 04/15/2015 $21.30
Type of Use: COM Plan Review-Fire Life Safety-COM 04/15/2015 $71.01
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 04/15/2015 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 04/15/2015 $7.50
11x17)
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: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $281.33
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $9,812.00
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 .flow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-01 ••90. ou may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.•x2344.
Issued By: .-e Signature:
1
Call 50 . .4175 by 7:00 a.m.for the next available inspe ion 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 LSE ONLY
City of Tigard CE�v ED B / - Permit No.: -75--2C}/5--
L ►;
13125 SW Hall Blvd.,Tigard,OR 972 Pl. R
■ / Other Permit:
Phone: 503.718.2439 Fax: 503.598.1 Q�� Date/B : ' / — �V
T 1 t.;A Ill) Inspection Line: 503.639.4175 Dp 2 Date Ready/By: WI See Page 2 for
Internet: www.tigard-or.gov Ai t\ D Notified/Method: (�{,15— ., Supplemental Information
TYPE OF WO l c)tC',Cs r.4%.4 l REQUIRED DA'' ''ln 2-FAMILY;DWELLING
❑D'e1m4olition Permit fees*are based on the value of the work performed.
❑New construction Indicate the value(rounded to the nearest dollar)of all
IV Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF>CONSTRUCTION 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:
JOB SITE INFORMATION AND LOCATION --r Total number of floors:
Job site address: 7 CA 0 -J p,..t\;.e;∎C-1 y)c/ 5i-v -r- - New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet iii)
Suite/bldg./apt.no V101 R, Project name: \N V ON VI 3 49 I L Covered porch area: square feet
Cross street/directions to job site: l 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.
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 WORK work indicated on this application.
Valuation: $
- 1 v a J v i/I 9 �
I Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax: 1 I 'Neiv:
a APPLICANT ❑ CONTACT PERSON NOTICE
Business name: ¢/r, vi f 1/4014 ( fv v L(,r rr , All contractors and subcontractors are required to be
•Contact name: ri—�C��Q/L.l� ( licensed with the Oregon Construction Contractors Board
Contact under ORS 701 and may be required to be licensed in the
Address: C9 (, '3 a jg .�) ( i iot jurisdiction in which work is being performed.If the
City/State/ZIP: `'v
1 N F C C 70 3 applicant is exempt from licensing,the following reasons
e rl 0
apply:
Phone:( Q ) (/d,7—D I 0 0 Fax::( )I'� /,/�
E-mail: - r1 eC'1-e 11 �Oji� i wi CJ1 I NV . tan
(
1 ONTRACTOR BUILDING PERMIT FEES* "_
Business name: ° 2 1� Ill(/(4 I -f vl/ Cov (Please refer tojeeacliedxltl
Address: -0 3 Lti Ve V( -e- J f.�/t,� Permit fee:f l, ry�� �7 f State surcharge(12%of permit fee):
City/State/ZIP: l,'1 �j rti0(� v r` 9 / G�3�J FLS plan review(40%of permit fee):
Phone:( (2 �� "�— GC/ Fax:( ) (Due upon application.)
CCB lie.: j (� Ta / Total permit fees:
Amount received:
Authorized signature _
(/�/ This permit application expires if a permit is not obtained
•Print name: —7-0!11/ ` v. --e j/t Date: I I within 180 days after it has been accepted as complete.
J ! t' / * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-46131(11'02 COM'WEB)
•
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:
❑ New system Number of sprinkler heads: Number of alarm devices:
Addition or ❑ 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
❑ 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Grous
Density
Design Area
K. Factor-
Sprinkler Project Valuation: I $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Calculations LQ Y
include: Individual Component
Cut Sheets
Fire Alarm Project Valuation: I $ 11 Y LA_ `L
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 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: $
I:\Building\Permits\FPS_PermitApp_071514.doc 2
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
7650 SW BEVELAND RD 200, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00058
Jeff Grove
Napa 72 received
Violation Summary:
Inspector Contractor