Permit (38) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
. ',; COMMUNITY DEVELOPMENT Permit#: FPS2016-00144
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/20/2016
Parcel: 2S102AD02900
Jurisdiction: Tigard
Site address: 12790 SW ASH AVE
Project: Burnham&Ash Apartments Subdivision: BURNHAM TRACT Lot: 5
Project Description: Building 2-Fire alarm.
Contractor: POINT MONITOR CORPORATION Owner: PREMIUM PROPERTY-TIGARD LLC
5863 LAKEVIEW BLVD STE 100 1015 NW 11TH AVE, STE 243
LAKE OSWEGO, OR 97035 PORTLAND, OR 97209
PHONE: 503-627-0100 PHONE: 503-226-1972
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/20/2016 $355.04
12%State Surcharge-Building 09/20/2016 $42.60
Type of Use: MF Plan Review-Fire Life Safety-COM 09/20/2016 $142.02
Class of Work: NEW Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/20/2016 $6.00
Occupancy Grp: R-2 Height: ft 11x17)
Stories: 3 Info Process/Archiving-Sm$0.50(up to 09/20/2016 $15.00
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $560.66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $26,850.00
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: /f//)544,67.4.€____ Permittee Signature: 2....0---'.......-----______
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 USE ONLY
City of Tigard Received q 2S
II ill 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 6 / Permit No.:l/�^ ��DO�(f�l
R Phone: 503.718.2439 Fax: 503.598,3 6 Plan Review �4 J `T
Inspection Line: 503.639.4175 p :'; Date/By: ` Other Permit: P 1 O� /GS
TIGAKD p `� � 4 � x Date Re.o. l D
Internet: www.tigard-or.gov ° ` '
on
Y q q / / � ' I J
Notified/Method: 7/4-0/��i I pp mentalIntor h
Ai/ ger
Su le a
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TYPk' G 26.2016 . 4 '
� t :.:. � t .".. n � REQUIRED bATA,1 .AND 2-FAMILY"1)W1wI�,y,I1V0
®New construction ,❑. ml+litiar Permit fees*are based on the value of the work performed.
‘4,(5 '" "
❑Addition/alteration/replacement Indicate the value(rounded to the nearest dollar)of all
01ier
it
equipment,materials,labor,overhead,and the profit for the
CA 'EGORY e �I 1 t work indicated on this application.
0 1-and 2-family dwelling 0 Commercial/industrial Valuation: $
0 Accessory building ®Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
JOB ITE INFORMATION AND LOCATION" : r Total number of floors:
Job site address:12790 SW Ash Ave.
New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223
Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name:Ash Street Apartments
Covered porch area: square feet
Cross street/directions to job site:Burnham&Ash
Deck area: square feet
Other structure area: square feet
Subdivision: REQDIIED DATA COMNIERCIrL-IIE CHECKI IST
I 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
DESGRIPTiON OF woiu ' ': work indicated on this application.
Install new fire alarm system. Valuation: $$26,850.00
Existing building area: square feet
New building area: quar e feet
PROPERTY OWNER
0"TENA .x
�:: NT :t Number of stories:
Name:
Type of construction:
Address:
City/State/ZIP:
Occupancy groups:
Phone:( ) Existing:
Fax:( )
NewAPPLICANT i❑ CiN ACT PERSON
(vn
Business name:Point Monitor Corporation
All contractors and subcontractors are required to be
Contact name:Robert Imamura licensed with the Oregon Construction Contractors Board
Address:5863 Lakeview Blvd. under ORS 701 and maybe required to be licensed in the
jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:Lake Oswego,OR 97035
Phone:(503)627-0100 I Fax::(503)627-0110 apply:
E-mail:rimamura@pointmonitor.com
t s
CONTRACTOR
BUILbING PERMIT FEES*
Business name:Same as above (PleaseJ-efer,tof¢e'scIledple) '° .
Address: Permit fee: 355.04
City/State/ZIP: State surcharge(12%of permit fee): 42.60
FLS plan review(40%of permit fee):
Phone:( ) I Fax:( )
(Due upon application submittal) 142.02
CCB lic.:135901
Total permit fees: 539.66
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:Robert Imamura I Date:8/24/16 I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
I:\Budding\Permits\FPS-PermitApp_031016.doc Service Board.
440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done: v: s
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: 83
❑ 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
0 11+heads: Plan review required and ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
ype of System. Complete B, C or D as''a® ®lteabie. ;
s
x:
=f.
i �.
•
..) CommercialS rimer
Sprinkler Type 0 Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.�) Type. Hood Firs Suppress nSyst m
Hood Project Valuation: $
,.
r x
C File Alarm
x,,
.
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 26850
D,) Residential Sprinkler(StandAltirie'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): $ 26850
Permit fee based on project valuation (see fee schedule): $ 355.04
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 42.60
FLS Plan Review(40% of permit fee): $ 142.02
TOTAL: $ 539.66
C:\Users\rimamura\Downloads\FPS_PernutApp.doc 2
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
12790 SW ASH AVE, TIGARD, OR, 97223
Record Type:
Commercial - Fire Protection System
Inspection Type:
998 Alarm Final
Result:
PASS- NoCofO
Comments:
NFPA 72 completion report received
Violation Summary:
Tel: 503.718.2439
Inspection Date:
Record ID:
FPS2016-00144
Inspector:
Chip Barnett
Inspector Contractor