Permit (128) CITY OF TIGARD 111FIRE PROTECTION SYSTEM PERMIT
Permit#: FPS2018-00020
" 7 . 4
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/21/2018
T[C Parcel: 2S 101 CA00200
Jurisdiction: Tigard
Site address: 7904 SW HUNZIKER RD
Project: Agilyx Corp. Subdivision: None Lot: None
Project Description: Fire alarm permit:Adding(1)manual alarm station. Affidavit submitted.
Contractor: FIRST RESPONSE SYSTEMS INC Owner: WALL STREET INDUSTRIAL LLC
4970 SW GRIFFITH DR#100 7900 SW HUNZIKER RD
BEAVERTON, OR 97005 TIGARD, OR 97223
PHONE: 503-207-5300 PHONE:
FAX: 503-207-5301
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/21/2018 $102.20
12%State Surcharge-Building 03/21/2018 $12.26
Type of Use: COM Plan Review-Fire Life Safety-MF 03/21/2018 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 03/21/2018 $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: $2,950.00
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 503132.1987 or 1.800.332.2344.
Issued By: A76..2...06....... Permittee Signature: e' `'— `✓'^
all 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 REC
Fire Protection System 1 oR Ul 11(-11 t ,I «yl.)
14 City of Tigard ',1A R 2018 Received
CITY
g ;y_ DateB : . i J/ r d
13125 SW Hall Blvd.,Tigard,OR 97223 CITY O(- i i GAR .•..Review Otl�er Permit fr .
Phone: 503.718.2439 Fax: 503.598.196 I. eB : r. 4/ Al i
tic, \L i") Inspection Line: 503.639.4175 :e Ready/By:
Internet: www.tigard-or.gov Notified/Method: It
TYPE OF REQUIRED' , iiD2 'A Y DWENG
� ,.0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
VrAddition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
, + „,,- * `,,Y S`1,R yi " ` '',„4:4i,:.:. Work indicated on this application.
E I-and 2-family dwelling ,1 Commercial/industrial Valuation: $
ElAccessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
SOB SITE,;INFORMATrI N AND', tY N IO Total number of floors:
Job site address: -1%4 B k.A u.c' .. kJ c Rd New dwelling area: square feet
City/State/ZIP:-110klard L eras Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ` tp- Covered porch area: square feet
Cross street/directions to job site: ` Deck area: square feet
Other structure area: square feet
REQUIRED s° ,, t`` '` VUSESCIHE IST
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
work indicated on this application.
� C>�ilr �r�>�`�ur�Itic o�.Q�b 5�---
L o ^ (e ( �"� t �- .�,3�1 Valuation: $
rl ir�f 10 Y�Ae\to a 1 / _)e. 0 JtJ Existing building area: square feet
C C New building area: square feet
s
ElPROPERTY O 0`TENANT ' Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 AP'PLICAN'', CO TACT<'.P) RSON TOTI E
Business name: F c Rpt eS All contractors and subcontractors are required to be
e`r licensed with the Oregon Construction Contractors Board
Contact name: �` h( r�
under ORS 701 and may be required to be licensed in the
Address: 4Q a 1...---.) ac;.. 42A-s jurisdiction in which work is being performed.If the
City/State/ZIP! }a�� ,/� 9 e-1.000--C— applicant is exempt from licensing,the following reasons�t1 � dr`. apply:
Phone:C ,�(_1(1 Fax::( ) / ,��n
E-mail:.r, . ' 5c a le.d u, lQr Cc-%Cl C.. (L �
CONTRACTOR BUILDING PERMIT FEES*
Business name: a �� refertcfeesc Tule)
c c& k-.)-\
)-\et rt ! r��-.. '(1 Permit fee:
Address: 44007 ; ��,/ ) Ccc,e I '�i ( , croTCQ o
c �-�� /�,�1 `"I.� State surcharge(12/o of permit fee):
City/State/ZIP: V R
FLS plan review(40%of permit fee):
Phone: ) w'"( (- (0-7Q S Fax:83) a Do-1-5 I (Due upon application submittal.)
Total permit fees:
CCB lio,: i�,1'- i l•3 5.--"". S h
Amount received:
Authorized signature: �^ �, n
T�Ir �/t This permit application expires if a permit is not obtained
Print name: `if- `A( 4 Date:(3t 14
1 K
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
l usctibe Ny k tq lie dunes
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
0 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:
tom
T r i* 6.o ie 11/`: x a� "1::2;4),
� r lr
44. >r_ F,N ds - � axr�'• x * ¢ i:. ,p ,` dx �
Sprinkler Type ❑ Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B) Type I 'Hood ire.Suppression stem '
Hood Project Valuation: $
Fire Al p
Submittal shall Battery Calculations , 0 Yes
include: Individual Component 13/ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone tem)
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): $ aS50 0-1
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: $
C::\Users\lauran\Desktop\FPS_PermitApp.doc 2
RECEIVED
City of TigardMill
J
.. I3125 SW Hall Blvd.,Tigard,OR 97223 MAR 1 201 Permit No.:
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: j/6'rr(
Inspection Line: 503.639.4175 CITY �c
TIGARI) BUILDING
���IGA11 d�q / ---r
m Internet: www.tigard-or.gov 3UJILDING DRI,SintOY: e/"�,474., �7,1--",—
FIRE
1--" ""FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: '=V iSt \ LJ k (i(` \ `J Occupancy:
Job Address: `I_i t'(.i L, ‘\ .(l \<<', i'1 . v,'(t Suite:
Contractor: \moit "7t_. \,.-_,.u.1,-.-0-,AY--,-1/4..__ Phone:
Valuation of work: $ •A({'t cyL..
Type of System: (check one) Required [Non-required
(check one) 0Automatic ❑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 on.5) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added on.5>
/To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) To be Relocated(max 5)
I, S.)..67--,,,, t�/�, Oregon Construction Contractors Boa d No. '
certify the following is true ander `Ones the scope of work for this project: 13
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 docs n th a copy of the sketch attached shall be available for all inspections.
Signature: / �.•-�""'"""_...
Date: j Li 'i
Print Name: 1\\* ,_,-4i-ft^.0
I:iBuilding\FormsTireAlannAtfidavit_071514.docx
Page 1 of I
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7904 SW HUNZIKER RD, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00020
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor