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Permit (162) NIS , CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT S. '> COMMUNITY DEVELOPMENT Permit#: FPS2016-00190 13125 SW Hall Blvd.,Ti Date Issued: 11/16/2016 3 [G��1t.L and OR 97223 503.718.2439 9 Parcel: 2S 113BA00400 Jurisdiction: Tigard Site address: 7632 SW DURHAM RD 320 Project: Allstate Insurance Company Subdivision: None Lot: None Project Description: Fire alarm-(5)devices to be relocated. Contractor: POINT MONITOR CORPORATION Owner: PORTLAND SW CENTER LLC 5863 LAKEVIEW BLVD STE 100 BY FELTON PROPERTIES INC LAKE OSWEGO, OR 97035 ATTN: FELTON, MATT 520 SW 6TH AVE, STE 610 PORTLAND, OR 97204 PHONE: 503-627-0100 PHONE: FAX: 503-627-0110 FEES Description Date Amount Specifics: Permit Fee-COM 11/16/2016 $102.20 12%State Surcharge-Building 11/16/2016 $12.26 Type of Use: COM Plan Review-Fire Life Safety-COM 11/16/2016 $40.88 Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 11/16/2016 $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 $155.84 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $2,511.00 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 toQUNC by calling 503.232.1987 or 1.800.332.2344. E ! -____� Issu By: �+ OA I Permittee Signa�ure: , /e. //_E,1--, Call 503.639.4175 by 7:00 a.m.for the next available ins.•ction 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. .t,. t Building Permit Auplic , I i E� Fire Protection System FOR OFF ICI';USE ONLY City of Tigard NOV f 1. 4 2016 Receives qII 13125 S W Hall Blvd.,Tigard,OR 97223 Date/By: if /(F hk Permit No.: n N Plan Review Gpsaa��—�l7� Phone: 503.718.2439 Fax: 1 +'1{ Other Permit: Q A lD � i t R� DateBy: .8 4, 1!" -045 I'1 GAR U Inspection Line: 503.639.417 Date Read)B : Ea See Page 2 for Internet: www.tigard-ar:g i'y _ z y Dale hos: ions: uI LDIN( [A' .riOi I Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction 0 Demolition Permit fees*are based on the value of the work performed. ®Addition/alteration/replacement 0 Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑1-and 2-family dwelling TACommercial/industrial Valuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: 0 Master builder ElOther: Number of bathrooms: .LOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:7632 SW Durham Rd New dwelling area: square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: 3aO Project name:Allstate Insurance 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: 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 ail equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Fire alarm notification devices Valuation: $2,511 Existing building area: square feet New building area: square feet 0 PROPERTY OWNER ►i TENANT Number of stories: Name:Allstate Insurance Type of constructions Address:7632 SW Durham Rd.3rd Floor Occupancy Pa y groups: City/State/ZIP:Tigard,OR 97224 Existing: Phone:( ) Fax:( ) New: APPLICANT 0 CONTACT PERSON NOTICE Business name:Point Monitor Corp. All contractors and subcontractors are required to be Contact name:Brooke Williams licensed with the Oregon Construction Contractors Board Address:5863 Lakeview Blvd#100 under ORS 701 and may be required to be licensed in the 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::( ) E-mail:bwilliams@pointmonitor.com CONTRACTOR BUILDING PERMIT FEES* Business name:Same as above (Presse refer to fee schedule Address: Permit fee: City/State/ZIP: State surcharge(12%of permit fee): FLS plan review(40%of permit fee): Phone:( ) Fax:( ) (Due upon application submittal.) CCB lic.:135901 Total permit fees: e Authorized signature: Amount received: /5-5, gT This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Ben Breit Date:11/14/16 * Fee methodology set by Tri-County Building Industry Service Board. 1..Building Permits\FPS-Permit App_031016.doe 440-4613TO 1'02'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 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: Type of System(Complete A,B,C or D as applicable): A.) Commercial Sprinkler Sprinkler Type 0 Wet 0 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 ED Yes Cut Sheets Fire Alarm Project Valuation: $ 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: r$ C:\Users\ \Desktop\PERMIT FORMS\Fire permit-city of tigard.doc 2 City of Tigard Permit No.: /j1.d/ —x/90 III 11 13125 SW Hall B1vd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 Date Received: //h9/j(o TIGARD Inspection Line: 503.639.4175 Internet: www.tigard-or.gov By: FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (MAXIMUM OF 5 DEVICES WITHOUT PLANS) Project Name: Allstate Insurance Occupancy: Same Job Address: 7632 SW Durham Rd.,Tigard 97224 Suite: 3rd Floor Contractor: Point Monitor Corp. Phone: 503-627-0100 Valuation of work: $2,511 Type of System: (check one) ❑Required QNon-required (check one) ❑Automatic []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(max 5) /To be Relocated(max5) Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated tmax 51 Number of Proposed Notification Appliances: To be Added 0max5) I To be Relocated on.5) 5 I, Ben Breit Oregon Construction Contractors Board No. 135901 certify the 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: • 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 document with a copy of the sketch attached shall be available for all inspections. AIM Signature: -- 11/14/16 Date: Print Name: Ben Breit I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1