Permit (148) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2018-00002
Date Issued: 01/10/2018
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE# 100
Project: Xerox Subdivision: VARNS ACRES Lot: 9
Project Description: Fire alarm permit:Adding(3)notification devices. Affidavit submitted.
Contractor: COCHRAN INC Owner: TRIANGLE POINTE TWO LLC
7550 SW TECH CENTER DR#220 901 NE GLISAN ST, STE 100
TIGARD, OR 97223 PORTLAND, OR 97232
PHONE: 503-234-6564 PHONE:
FAX: 503-238-2098
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/10/2018 $112.96
12%State Surcharge-Building 01/10/2018 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 01/10/2018 $45.18
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
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:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $171.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,500.00
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 1.83 -
Issued By: Permittee Signature:
Call 503.639.4 75 by 7:00 a.m.for the next available inspection •- €—
This permit card shall be kept in a conspicuous place on the job site until completion of t,e project.
Approved plans are required on the job site at the time of each inspection.
Rif
City of Tigard /" Permit No.: FPS S 111'"l,t)1C;J
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 1/160
Inspection Line: 503.639.4175 JAN
Ir-4�
�It;f1ItL? Internet: www.tigard-or.gov gov , � y• a
FIRE ALARM S,t; A '`1lc RIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Xerox/Conduent Occupancy: B
Job Address: 13333 SW 68th Parkway Suite: 100
Contractor: Cochran Electric Phone: (503)718-6010
Valuation of work: $$3,500
Type of System: (check one) ['Required 'Non-required
(check one) DAutomatic '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(max 5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) 3 /To be Relocated(max 5)
I, Cochran Incorporated Oregon Construction Contractors Board No. #72942
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.
Al" Date: 1-10-18
Signature: � Jfr
Print Name: Dana Arnzen r
I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1
Building Permit Application
Fire Protection System FOR OFFICE USE ONE.)
City Of Tigard Received -
Permit No.: rr
114
13125 SW Hall Blvd.,Tigard,OR 9722 Plan ReviewI ..
= Phone: 503.718.2439 Fax: 503.598.1 Date/B : Other Permit: ' ,/ a lye, A
TI G A R D Inspection Line: 503.639.4175 WI •� 14 Date Ready/By: See Page 2 for
Internet: www.tigard-or.gov ,)A I', 1 G Notified/Method: �It Supplemental Information
TYPE F W � Y - 4 rldt? f O v a _
❑New constructiona
t�t.• th 61VI ��t�s REQUIRED DATA 1-AND 2-FAMILY DWELLING
[ demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
.NL-Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling k,Commercial/industrial Valuation: $
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
n
Job site address: ) 3 3 3 3 S W r9 4�y`` t" k, 7 New dwelling area: square feet
car Ni Ut'
City/State/ZIP: `1 J (9 U z Z Garage/carport area: square feet
I cam..
Suite/bldg./apt.no.: name: >v✓�' C�
�� Project '� CvieL/r✓b T'" Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIREDATA: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 all
;; .- ��.. • equipment,materials,labor,overhead,and the profit for the
• DESCRIPTION OF WOR ,
� ,` work indicated on this application.
DO
Valuation: $ j Ul)SFA i) ) c�
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER , ', ❑=TENANT Number of stories:
Name: x (:I.2 e CC?,A).)0 1,.4-' 7 Type of construction:
Address: 1 33 3 5,,Q C S r" P-,,--16,-,/ Occupancy groups:
City/State/ZIP: �c a i(x( (- '/ 7 22 3 ( Existing:
Phone:(L .')j) 7/g' (fit)!U Fax:( )
r APPLICANTS �fi ';',t-.... ❑ CONTACTPE
RSON ' x.. 07ICEes i
Business name: 7,(4—s/N G ,41 .4—, ,)vk-e--- All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax::( )
E-mail:
` CONTCTOxt , R ; '� BUILDING PERMIT,FEES* m.
Business name: GC�t` N � � " - (Please refer:tofee schedak),
Address: 7 c-,-co j(,o �L 4 e.L N I— .t (Z Permit fee:
City/State/ZIP: 'fl I (- �4-�0 ct t t 7 �a 3
State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(j ) -7 15 6,01 C% Fax:( ) (Due upon application submittal.)
CCB lic.: - 4 Z Total permit fees:
171- ZtS
Authorized si: -. „� ,:� Amount received:
This permit application expires if a permit is not obtained
Print name: / `ANA ;,,,/ , 4_,./ Date: /—/() , within 180 days after it has been accepted as complete.
U * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information,
to
lb
ivoi4c - done:
,escribe
1.) Type of Work: 2.) ''.Addition/alteration only to sprinkler heads:Number of sprinkler heads:
3.)
) Addition/alterationonlyto alarm devices:
El New system Number of alarm devices:
0 Addition or 0 1-10 copies
hpeadss: Affidavit required andea 0 1-50(3f) op
wcorkwith
devices:iesof sketch
irbuilding
Affidavittcshwln
igreosqtruuicrga
structure required d
Alteration (3) of sketch
showinga r
to existing of work within building structure
system
1=1 11+ heads: Plan.review required and
(3) setsplans.Plan review required and
ofplans. D(36)+sedtesviocfe s:
n of work:
Additional description
System C or D as APP4*c•--ai',--le)11
(CompleteA B •.• , .. s. - .„...
. $
Type of•
A, CSprinkler- • .'',5`,.. ==I= 1 '
1
iitiimere4a Sp
2'4 Wet 0 Dry
4
rinkler Type
0 Yes 0 No
Additional Standpipes
Sprinkler Supply Line
Information:
Hazard Group
Density
Designac tor Area
K. Factor
$
B
,..,,t.
, .
. . .
ttirt Sprinkler Project Valuation:
,
,
B.) Type
d
F/ o
. Fire SuppressionS.y
Hoo,..d Project Valuation: $
_
C.) Fire Alarn•I ••,' - ' 1 l ti 0 Yes
0 Yes
Submittal shall
:
-.,
include BatteryIndividual CaCc uo ma poouns e n t
Cut Sheets
— ,
0 ,
Aii0 ,•,,,,,,,,s_yste
Fire Alarm Project Valuation: $
. ,
• 0—n Permit
*detitta ap
- • 1 iiiiier(Stand
D RtS1 Square Footage:
0 to 2,000
$246.45
$ 1198.7F5ee:
2,001 to 3,600
-
3,601 to 7,200 $310.05
and greater
Square
7,201 $404.39
Footage: sq.ft.
,
Sprinkler Project
LIN
,
firo,t
eel*,
subtotal(see A,B &C above): $
,
Project valuation
fee schedule): $
Permit fee based on
fire ai. atioon nl) nnit Fs
onPro
Permit fee bascetdv
square
uject valuation (see fee
footage (see Drintt fee): $
above): $
State Surcharge ((10/020°/0 oof fe
p
FLSPlanlan
Review 4TOTAL:
permitfee): $$
2
ts\FPS mitApp_031016.doc
I:\Budding\Penni -Per
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13333 SW 68TH PKWY STE 100, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00002
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor