Permit (25) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
iCOMMUNITY DEVELOPMENT Permit#: FPS2017-00041
Date Issued: 03/20/2017
--f G1 p D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Clean Water Services Subdivision: None Lot: None
Project Description: Adding(5)fire alarm devices: (2)heat detectors and(3)elevator monitor modules for the freight elevator. No
notification appliances will be added or modified. Affidavit submitted.
Contractor: PORTLAND ELECTRICAL CONST INC Owner: BURLINGTON NORTHERN INC
1019 7TH STREET PROPERTY TAX DEPT
OREGON CITY, OR 97045 PO BOX 961089
FORT WORTH,TX 76161
PHONE: 503-655-2281 PHONE:
FAX: 503-655-5033
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/20/2017 $134.48
12%State Surcharge-Building 03/20/2017 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 03/20/2017 $53.79
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 03/20/2017 $2.00
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_CalcsProvided: Cut Sheets Required: Yes
Total $206.41
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,800.00
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 dire uestions to ` NC b calling 503.232.1987 or 1.800.332.2344.
Iss ed By: , I , Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio 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.
,A,
i l
$uilding Permit Application
Fire Protection System FOR OFFICE USE ONLY
'1
Y Received III
Permit No.: r/ r ',7.2,i
City of Tigard DateB : „it AMER
lig r. " 13125 SW Hall Blvd.,Tigard,OR 97223 1 '< Plan Review 'l
1.
Phone: 503.718.2439 Fax: 503.598.1960 Date/13 : Other Permit: it -
Inspection Line: 503.639.4175 k ',t � Date Ready/By: ® ® See Page 2 for
TIGARD
Internet: www.tigard-or.gov t , Notified/Method: �f►7r�� Supplemental Information
;.
�: 1 ,. REQUIRED DATA:'1J2 li A1441LT UWYELLINC
a Tl (IF Wt71R11 '1
0 Demoli ion. Permit fees*are based on the value of the work performed.
0 New constructionx Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
, CATEGORY OR t o CONSTRU T101� :
. `` Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
❑Accessory building ❑Multi-family
Number of bathrooms:
❑Master builder 0 Other:
1 Total number of floors:
�, .• 4.JQB STTE;INtOR(4MA lON AND toCiiTI+[)Pii
Job site address:16580 SW 85th AVE New dwelling area: square feet
City/State/ZIP:Portland/OR/97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Solids Bld.Freight Elev. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Work is located in the solids building freight elevator machine room and shaft Other structure area: square feet
near the lower basement incinerator room REQUIRED DATA:COMMERCIAL-USEiCI:IECKI'IST
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.:2S113B000600 equipment,materials,labor,overhead,and the profit for the
1: 44
DESCRIPTION OF WORK.
work indicated on this application.
Valuation: $$5,800.00
Installation of(2)new heat detectors and(3)elevator CR/Monitor modules
for the Solids building freight elevator modifications. All devices installed
Existing building area: square feet
to existing SLC loop. No notification appliances are being added or modified New building area: NA square feet
I1 PROPERTY OWNER 0 TENANT Number of stories:
Name: 13,,,,./'1 i 1 -kr% /v';'t titivi TA t,. Type of construction:
Address: pl i 2,, -7c,r0g(1 Occupancy groups:
City/State/ZIP: r`,,1;. t D,-tir,7 .e'f 6/&( Existing:
•,.1-! Fax:( ) New: NA
APPLICANT x CONTACT I P)RUI ' NOTICE
Business name:Portlande Electrical Construction Inc. All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:Corey Donohue under ORS 701 and may be required to be licensed in the
Address:1019 7th St. jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:Oregon City/OR/97045 apply:
Phone:(503)655-2281 Ext 11 Fax::(503)655-5033
E-mail:corey@portlandelectrical.com
4 CONTRACTOR -. BUILDING PERMIT gFEES* .,
(Pfeasere.Jeito.Jeeschedute1 '. ,
Business name:Portland Electrical Construction Inc. Permit fee:
Address:1019 7th St. State surcharge(12%of permit fee):
City/State/ZIP:Oregon City/OR/97045 FLS plan review(40%of permit fee):
Phone:(503)655-2281 Ext 11 Fax:(503)655-5033 (Due upon application submittal.)
Total permit fees:
CCB lic.:51764
,., Amount received: f4iet:u..11/
Authorized signature: �t:..._._'. /7,, - This permit application expires if a permit is not obtained
Date:3/20/17 within 180 days after it has been accepted as complete.
Print name:Corey Donohue * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
1
A
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to b&done z k,,. •
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: NA Number of alarm devices: 5
® 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: Install(2) Heat Detectors, Shunt Trip Control Relay,Power monitoring relay and
Fire Fighter Hat Flash control relay to new elevator controller and disconnect.
Type of System (Complete A,B,C or Dias applicable)• .: . . u •
A4 Commercial Spnn der
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ NA
B)> Type I Rood Fire Suppression System "
Hood Project Valuation: $ NA
C) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 5800
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 andeater
� $404.39
ti
Sprinkler Project Square Footage: NA sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A,B &C above): $ 5800
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): $
Z:\Projects\432&433-Durham Building\Solids Building\Permit\Elevator Fire Alarm\Durham Solids Building Elevator FA Permit App.doc
City of Tigard Permit No.: fi)vZO("7°'CC `f,
14 13125 SW Hall Blvd.,Tigard,OR 97223 Date Received: 3/ 7
Phone: 503.718.2439 Fax: 503.598.1960
InspectionLine: 503.639.4175 By: j%A�/ eN
T1G�`R�?. Interneernet:: www.tigard-or.gov fJ�
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Solids Building - Freight Elevator Modifications Occupancy:
Job Address: 16580 SW 85th Ave/ Portland/OR /97224 Suite: Solids Building
Contractor:
Portland Electrical Construction Inc. Phone: 503-655-2281 Ext 117
Valuation of work: $5800
Type of System: (check one) •Required ❑Non-required
(check one) DAutomatic ❑Manual DBoth
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) 5 /To be Relocated(max 5) 0
Number of Proposed Manual Alarm Stations: To be Added(max 5) 0 /To be Relocated(max 5) 0
Number of Proposed Notification Appliances: To be Added(max 5) 0 /To be Relocated(max 5) 0
I Corey Donohue Oregon Construction Contractors Board No. 51764
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.
_ _,_._•._ -S_1z� ' A -72.
- ra:rta raran.tia:rxruzesuiws_ani �=sz---•_.�_
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority avmg
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.
Signature:
4) /"2. Date: 3/20/17
Print Name: Corey Donohue
Page 1 of 1
I:\Building\Forms\FireAlazmAffidavit_071514.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16580 SW 85TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00041
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
NFPA 72 record of completion received
Send copy of monitoring record to the city
Violation Summary:
Inspector Contractor