Permit (19) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' ' . COMMUNITY DEVELOPMENT Permit#: FPS2016-00082
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2016
T t t'"1 f.T7 9 Parcel: 2S101AA03800
Jurisdiction: Tigard
Site address: 12259 SW 69TH AVE
Project: Consumer Cellular Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Modifying horn strobes and strobes for existing fire alarm system.
Contractor: POINT MONITOR CORPORATION Owner: SDC TIGARD CORPORATE CENTER INC
5863 LAKEVIEW BLVD STE 100 ATTN:ANDREW HARPER
LAKE OSWEGO, OR 97035 101 CALIFORNIA ST,26TH FLOOR
SAN FRANCISCO, CA 94111
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-MF 05/18/2016 $123.72
12%State Surcharge-Building 05/18/2016 $14.85
Type of Use: COM Plan Review-Fire Life Safety-MF 05/18/2016 $49.49
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 05/18/2016 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 05/18/2016 $3.50
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: Yes Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $195.56
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $4,203.00
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 51 2.19:• - 44.
Issued By: n ittee Signature: ) , / /
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 FOR OFFICE USI:()NIA
City of Tigard � � Received • I �f`� `� /� �•�y�
2 / ._d Date/B L , Permit No.: F •I A. I0....c .)O
• P
13125 SW Hall Blvd.,Tigard,OR 9 Plan Revie. ��®ao��'�!d
C Phone: 503.718.2439 Fax: 503.598.1960 � Date/By: �I i�atherPermit:r �!
T I c.A R ll Inspection Line: 503.639.4175 Ap 2 e7 u U Date Rea. : / Juris: ® See Page 2 for 4
Internet: www.tigard-or.gov Notified/Method: 7 /4,„ -r-- G, I Supplemental Information
UU\ :a r"� litG 'cna lUlet ly it
TYPE OF .'a DIVISION .. REQUIREDDATA:1-AND 2-FAMILY DWELLING
o Permit fees*are based on the value of the work erformed.
❑New construction `` g emolition P
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONS 'RUC rION.
work indicated on this application.
El1-and 2-family dwelling ®Commercial/industrial Valuation: $
1:1Accessory building ElMulti-familyNumber of bedrooms:
El Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12259 SW 69th Avenue New dwelling area: square feet
City/State/ZIP:Tigard,OR.97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Consumer Cellular Bldg B 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: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S101AA03800 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.
Modify notification for an existing addressable central station fire alarm Valuation: $4,203.00
system which includes central stsation off-site reporting,horn/strobes Existing building area: square feet
and strobes. New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
APPLICANT 0 CONTACT PERSON NOTICE
Business name:Point Monitor All contractors and subcontractors are required to be
Contact name:Russell Ruhland licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5863 Lakeview Blvd 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 Fax::(503)627-0110
E-mail:rruhland@pointmonitor.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Point Monitor (Please re
Permit
fee schedule)
Permit fee:
Address:5863 Lakeview Blvd
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:(503)627-0110 (Due upon application submittal.)
CCB lic.:135901 Total permit fees:
—� l
7 Amount received:
Authorized signature: ��e. `f""--
�, `f This permit application expires if a permit is not obtained
Print name:Ben Breit Date:04/25/2016 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building'Permits\FPS-PermitApp_031016.doc 440-461311(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
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- Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ $4,203.00
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: $
C:\Users\rruhland\Desktop\FIRE ALARM PERMIT TIGARD.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
12259 SW 69TH AVE, TIGARD, OR, 97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2016-00082
Chip Barnett
NFPA 72 completion report received
Violation Summary:
Inspector Contractor