Permit (89) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT
Permit#: FPS2017-00106
Date Issued: 07/25/2017
f G,' RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S 134AD06201
Jurisdiction: Tigard
Site address: 10450 SW NIMBUS AVE RA
Project: Spec Space Subdivision: (KOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: Fire alarm modifications for(6)plus devices.
Contractor: POINT MONITOR CORPORATION Owner: ROBINSON,JERRY CHRISTOPHER TRUS
5863 LAKEVIEW BLVD STE 100 ROBINSON, MICHAEL WILLIAM
LAKE OSWEGO, OR 97035 HANSON, RONALD D ET AL
203604 EAST FINLEY RD
KENNEWICK,WA 99331
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/25/2017 $177.52
12%State Surcharge-Building 07/25/2017 $21.30
Type of Use: COM Plan Review-Fire Life Safety-COM 07/25/2017 $71.01
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 07/25/2017 $7.50
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: Yes Alarm Type: Automatic
Pull Station Required: Smoke Detectors Req: Yes
Battery Calcs Provided: Cut Sheets Required: Yes
Total $277.33
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $9,562.00
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: Permittee Signature:
1)},4411,LZDAil
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 LSE ONI.\
City of Tigard Received /
Permit No.: 3L 1'6�
.32E
Date/By: ? / !7 /'J� 7.00 1�r0
13125 SW Hall Blvd.,Tigard,OR 9 '! En Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 V Date Rev 7'O�O )7 Other Permit: eabi_ roota S
t I IZ D Inspection Line: 503 639 4175 JU� r Date Ready/By: huris: See Pant 2 for
Internet www.tigard-or.gov jj 1 ?017 Notified/Me�od. �� I Supplemental Information
ee.e
'' € *' ,�+y4 T { 4 * *F,a )# 3• iu I
❑New construction 0 Demolition V Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
''1=1'1'-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
Number of bathrooms:
0 Master builder ❑Other:
Total number of floors:
Job site address:10450 SW Nimbus Ave. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:Bldg.R I Project name:Scholls B.Center Bldg R Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: 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
' p work indicated on this a.slication.
Fire alarm notification devices Valuation: $$9,562.00
Existing building area: square feet
New building area: square feet
Number of stories:
Name:Scholls B.Center-Bldg R-Elevator Type of construction:
Address:10450 SW Nimbus Ave.Bldg.R Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( ) New:
, .:'
Business name:Point Monitor Corp. All contractors and subcontractors are required to be
Contact name:Brooke Williams licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5863 Lakeview Blvd#100 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 I Fax: :( )
E-mail:bwilliams@pointmonitor.com
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Business name:Same as above
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) Due uson a.slication submittal.
CCB lic.:135901 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:7/13/17 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp_031016.doc 440-46131(1102/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
i • Yr *:f'v�ii 'k w k Y 96�,_ry,�'y "..f r�: '�'[{ti:.;l',: ,',;',4.�.dray,.4.�,1'j5 q. y'i� t o;yiY r �,
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 El 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:
a xxty`
S.rinkler Tj.e El Wet ❑ D
Additional Stand i i.es
Information: EammummEgnEl Yes ❑ No
Hazard Grou.
Densi
Desi• Area
K. Factor
S.rinkler Pro'ect Valuation: $
Hood Pro Sect Valuation: $
YTat
Submittal shall Batte Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Pro'ect Valuation: $
_a Snpy 4 tl 4. 4 * r a
'0,4
fFA:
P, > ' < - �� " f ; 8 �,� •
` '. lYky � . 4
444.
"
,.uare Foota•e: Permit Fee:
0 to 2,000 $198.75 os
2,001 to 3 600 • ,' t
$246.45 A 4-
3,601 to 7,200 $310.05 x:
n...4„ t3` k S J 14.
7,201 and • eater
$404.39 7 , .
Sprinkler Project Square Footage: sq. ft.
,., tt ii ti
.,.^+,r 5 k_- n_"N'. i ou , . .r. ., r M'
Pro'ect valuation subtotal see A,B &C above : $
Permit fee based on .ro'ect valuation see fee schedule : $
Permit fee based on s.uare foota•e see D above : $
State Surchar•e 12% of sermit fee : $
FLS Plan Review 40% of s ermit fee : $
TOTAL: $
C:\Users\bwilliams\Desktop\PERMIT FORMS\Fire permit-city of tigard.doc 2