Permit (235) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
f Permit#: FPS2017-00195
. COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/16/2018
T 6 R.L 9 Parcel: 28101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 500
Project: Centene Corporation Subdivision: None Lot: None
Project Description: Fire alarm permit for TI.
Contractor: POINT MONITOR CORPORATION Owner: GK TRIANGLE CORPORATE PARK III L
5863 LAKEVIEW BLVD STE 100 ATTN KBS REALTY ADVISORS
LAKE OSWEGO, OR 97035 P 0 BOX 28270
SANTA ANA, CA 92709
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/16/2018 $156.00
12%State Surcharge-Building 01/16/2018 $18.72
Type of Use: COM Plan Review-Fire Life Safety-COM 01/16/2018 $62.40
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 01/16/2018 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 01/16/2018 $5.00
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: No Smoke Detectors Req: NO
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $246.12
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $7,705.00
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 f the rules
or direct questions to OUN y calling 50 .232.1987 or 1.800.332.2344.
Issued By: r ///�/� Permittee Signature: 1 / `TD
...el , d:ir �fi /// �j-��� f
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 SystemF E IO R o F F.,, •, l SL 011,1
'City of Tigard Received /
U 13125 SW Hall Blvd.,Tigard,OR 97223
DEC � � 2 017 Date/By: (� (� Permit No.: �r,�ii( � L,L�1 ,
C Phone: 503.718.2439 Fax: 503.598.1960 Plan Revte �
{�t��y�^�, Date/By ► \{j Other Permit: l'1�d�2/' evA6
for
T 1 G A R t) Inspection Line: 503.639.4175 CITY 0 f" 11 d�rAn u Date Read, :
Internet: www.tigard-or.gov `` 1 Ir., r11 f @ �Alotified/Methsd: ePene
z Li S 9 ,1‘,.n t,6 9 !4..J�°B `/ SupplementalInformation
t,
-t��a as .:' .,.0
. . .. ., i� � x „"�. � . mo ' °= - � � �, sl��i " f�� e;' It �^r�,r;9�t•:Ptt
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
®Addition/alteration/replacement ❑Other Indicate the value(rounded to the nearest dollar)of all
�• �, s R �� r ,� ;" ,� equipment,materials,labor,overhead,and the profit for the
.
t t- t `". ,t t ; ° ' fi work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
,,, x to
i:. 1 " i s s T Total number of floors:
Job site address:13221 SW 68th Pkwy. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223
Garage/carport g arport area: square feet
Suite/bldg./apt.no.:500,520 I Project name:Centene
Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
, ter„
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
l=}" .F I ' t t -ff m work indicated on this application.
Fire Alarm Notification Devices Valuation: $$7,705.00
Existing building area: square feet
sNew building area: square feet
I . , J . " Number of stories:
Name:Centene
Type of construction:
Address:13221 SW 68th Pkwy Suite 500 and 520
Occupancy groups:
City/State/ZIP:Tigard,OR 97223
Existing:
Phone:( ) Fax
( )
Newr . l e ea.
'` ". t 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
applicant is exempt from licensing,the following reasons
City/State/ZIP:Lake Oswego,OR 97035
Phone:(503)627-0100 I Fax:: apply:
E-mail:bwilliams@pointmonitor.com
... t
Business name:Same'as, above
. ,,, ,� ?jer" scer7e? .
Address: Permit fee:
City/State/ZIP: State surcharge(12%of permit fee):
Phone:( ) I Fax: FLS plan review(40%of permit fee):
( ) (Due upon application submittal.)
CCB lic.:135901 Total permit fees:
Authorized signature r Amount received:
V �r N-- This permit application expires if a permit is not obtained
I Print name:Ben Breit I Date:12/19/17 I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
I:\Building\Permits\FPS-PermitApp031016.doc Service Board.
440-4613T(11/02/COM/WEB)