Permit (72) Ni. CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
Fri s: '. COMMUNITY DEVELOPMENT Permit#: FPS2018-00030
IlD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/16/2018
I '''� g Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 350
Project: Academy Mortgage Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm:(3)notification devices for TI. Affidavit submitted.
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES
5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/13/2018 $72.61
12%State Surcharge-Building 04/13/2018 $8.71
Type of Use: COM Plan Review-Fire Life Safety-COM 04/13/2018 $29.04
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 04/13/2018 $1.50
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: Yes
Total $111.86
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,294.00 1
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 . 0 NC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: �f 86 7 C,1-7747 /
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 Applicatio 'E(..,i7.1v Er)
fli
FOR OFFICE USE ONLYFire Protection System
Received // Permit No.: (4,_?,City of Tigard �? ?018 DatcB : L
IIIw 13125 SW Flail Blvd.,Tigard,OR 97223 Plan Review Other Permit: / j Q i(�
Phone: 503.718.2439 Fax: 503.SI1(tJ i- i t� j } Date B ' )oris: See Page 2 for
InspectionLine: 503.639.4175 r �1 f„ r�4 1 t "",fit,: Date Ready By: RI See
llnformation
Ti G A l2 D Internet: www.tigard-or..gov . �•.,, t`.. l�4\ 1,, Non lied, etliad:
TYPE OF WORK 'REQUIRED,DATA:1 SND 2-FAMiLY'DWELLING
Demolition Permit fees*are based on the value of the work performed.
0
0 New construction Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
0 Addition/alteration/replacement ❑Other: work indicated on this application.
, CATEGORY 1OF,CONSTRUCTION Valuation: $
❑ 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms:
Accessory building 0 Multi-family
Number of bathrooms:
❑Master builder 0 Other:
JOB STTE INFORMATION ,'AND L,d' ATIoN` r. ` ^', I: Total number of floors:
New dwelling area: square feet
Job site address:6650 SW Redwood Lane feet
City(State/ZIP:Tigard,OR 97224 Garage/carport area: square
Suite/bldg./apt.no.:350 l Project name:Academy Mortgage
Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
'REtiUUIR'ED DATA:COMMERCIAL-USE CHECKLIST
I Lot no.: Permit fees*are based on the value of the work performed.
Subdivision: Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OP'WORk ,° ', ; `,. work indicated on this application.
Valuation: $1,294
Fire Alarm Notification Devices feet
Existing building area: square
New building area: square feet
1NT ! Number of stories:
❑.P1iOPERTy:OWNER - m. : TENA
Type of construction:
Name:Academy Nottage
Address:6650 SW Redwood Lane Suite 350 Occupancy groups:
City'State/ZIP:Tigard,OR 97224 Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT ,"ti, -❑--CONT'ACTt PERSON; :' NOTICE- = ',
Business name:Point Monitor Corp. All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:Brooke Williams 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
applicant is exempt from licensing,the following reasons
City/State/ZIP:Lake Oswego,OR 97035 apply:
Phone:(503)627-0100 I Fax::
E-mail:bwilliams@pointmonitor.com
BUILDING PERMIT,FEES* -«
CONTI2ACTOIt l 4 - ,
• w . " , w �'� �t v + � ' 4-r(Pledxe-refer°rrfd�sebeilniek
Business name:Point Monitor Corp. Permit fee:
Address:5863 Lakeview Blvd#100 State surcharge(12%of permit fee):
City'State/ZIP:Lake Oswego,OR 97035 FLS,plan review(40%of permit fee):
Phone:(503)627-0100 I Fax:( ) (Due upon application submittal.)
Total permit fees:
CCB lie.:135901
Amount received:
Authorized signature: ci e � sr This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Ben Breit Date:4/i1/18 j I * Fee methodology set by Tri-County Building Industry
Service Board.
t Building Permits FPS-PrnnitAPp_03 F OI6:dae
440.4613T(1 t,o2 COM WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 Supplemental Information
Describe work:to be:done ,
' t :- , ';.y' .try i i"; ,;" i
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only.i-,to alarm devices:
0 New system Number of sprinkler heads:
Number of alarm devices: 3
® Addition or 0 1-10 heads: Affidavit required and
Alteration ® 1-S devices: Affidavit required and
(3)copies of sketch showing area (3)copies of sketch showing area
to existing of work within building structure
system of work within building structure
0 11+ heads: Plan review required and 0 6+ devices: Plan review required and
(3) sets of plans.
(3)sets of plans.
Additional description of work: Fire Alarm Notification Devices
T f•a of S teColee B�CrD
a ° � cble � d � � d ,ll
if1. � i � 1
j' irn - ., , ft4 ,-,-,-.4-.-04� 4- 0 L 0T 'I " 61 " 46 Y '{� r ( r s � ; t
�)- 0 ` rp t t1r , ;A) Coininetiah Ssl t t 1 4 fcn
EIMEMIIIIIIIImm
0 Wet 0 D -
Additional
Stand.i.es IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIINuiml
Information:
.211Mana ❑ Yes 0 No
Hazard Grou.
Densi
Desi. Area
K. Factor
S.nnkler Pro'ect Valuation: IEIIIIIIIII_-
B. T Al e 1Hood Fire Sus iressjo iU1$ �� r r r o
stem x` t1 D 11 t 4=-' r r . rt
Hood Pro'ect Valuation: $
CFreAlr ,,,-4,,,,, r; > a t r
r
�.), iamr ' d1' 14u t �rTd a a �
;' 1yC , 0" i iyt Submittal shall Batte 'Calculations0 Yesinclude: Individual
Component IN Yes
Cut Sheets
Fire Alarm Pro'ect Valuation: � 1,294
t
44
� 1 " t 44 4' 41 44 a v u
-4, . 'i . t r . � h }�, y � h 3 � - , a *; r s , 4114
� yD) R�sidentialSprinkler Stand Alone S u a t 4 14- 1,1�." . 'r; r rC
7S•uare oota.e:
Permit Fee:
a
a
r
�O to 2,000 $198.75 � a o5 ' 4 �, ' 4 44� r -
t i
`2,001 to 3,600 $246.45 '" t � - 0 m4 r 4f4A71 "14401-41441441,11461r0 i 1i t �3,601 to 7,200
$310.05 ',:,,,,,,20-5."745 4tt4441 1ti , 4744 4 -,'.4k A, '7,201 and-realer $404,39 rrtf 14 rg '
11 Sprinkler Project Square Footage: `
sq.ft.
�1~ire"P
i ,04tection"Perm>ikt"Fees "t t t r r t 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: 110_11111111..
State Surchar•e 12%of'permit fee: $
FLS Plan Review 40%of 0 ermit fee : $
TOTAL: $
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