Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
gi ` COMMUNITY DEVELOPMENT Permit#: FPS2020-00096
T7 GARE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/11/2020
Parcel: 2S101 DA00101
Jurisdiction: Tigard
Site address: 13190 SW 68TH PKWY 200
Project: Aspen Capital Subdivision: YARNS ACRES Lot: 9
Project Description: Fire sprinkler permit:Relocating(8)Sprinklers heads.
Contractor: PACIFIC FIRE SYSTEMS LLC Owner: PACIFIC NW PROPERTIES LIMITED PA
6704 RIVERIA CT STERN FAMILY LIMITED PARTNERSHIP
WEST LINN, OR 97068 STERN FAMILY LLC
6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-710-1482 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/09/2020 $102.20
12%State Surcharge-Building 09/09/2020 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 09/09/2020 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 09/09/2020 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 0
K Factor: 5.6
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: $2,872.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
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: �J i �^_ / Permittee Signature: eq� ,4��4 �}
/ T7 D/t�
r`K 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.
. laiert4teri. 5. Skni
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard FP U I 2020 Date/By:Received O9O2 2 Permit Pe tNa•:FP.f10Zd�Gc�'o?
14 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review
_ Phone: 503-718-2439 Fax: 503-tr rr-- F TIGARD � BY: Related P ?
TIGARD Inspection Line: 503-639-4175 Date Ready/By: �„I 7wic. ® See Pa 2 for
e, Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: ��((/3�� �(� I Supplemental Information
"E/vtia i�? 4t 1.-1'
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
_la-Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling Commercial/industrial
0 Accessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: .let,45 D !�V.) Le �c-� t�r���/ New dwelling area: square feet
City/State/ZIP: 1r U-f . �lZ- Garage/carport area: square feet
Suite/bldg./apt.#: '"2.-tS. rt•Firroject name: ��j VC-N C.--414 1.77kcL/ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel# Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
• e'-LiL/DG-'tit"c e) O Valuation: $ .2'") �� �.
Qt-(,4.-4-j 4. l.-.L�t ---c-c-
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer tofee schedule)
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Phone:( ) Fax::( ) Amount received:
E-mail: r� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
k�'� ` �`l '�1 VT Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: •� ' i4- l Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: cx qv ��.„,J N ‘.....-T Solar Installation Specialty Code checklist.
City/State/ZIP: J i `.kp)0 9 p(p j Permit fee(includes plan review $180.00
( �) and administrative fees):
e.
je) "" t Fax:( ) State surcharge(12%of permit fee): $21.60
Lic.: � �0 tk62
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ‘C.��/..3i.- tYli7-7 Date: —° e"VD * Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard Permit No.: 5/2irn -OW (Q
71 13125 SW Hall Blvd.,Tigard OR 97223 P/2,
• Phone: 503.718.2439 Fax: 503.598.1960 Date Received: ,V
Inspection Line: 503.639.4175 7'(;,1 a I) w Internet: ww .tigardor.gov By: aly ef
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FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: /\..4j a 0.-3 Ut? %iA-L,.. Occupancy: Obi L L
Job Address: 117 1,'l 0 /7 J Le,25- . ick- '0` Type of Construction:
Suite: 20 V-1.0.4a9Z
Contractor: 4�ik c.— ►cf .5-cr---6— Phone: 9Ti —I L2 l.A-422,Z
Number of Proposed or Altered Heads: 9/9
Type: E"/"-'—i- Hazard: I"t ` q-� Density: r k,CO
4,, ‘G `ram Oregon Construction Contractors Board No. I I
AVO
certify the following is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
b) Positions of sprinkler heads relative to architectural features such as soffits,beams,partitions,walls,etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop(exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads(see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
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.
• A copy of this document,/with a copy of the sketch attached shall be available for all inspections.
likignature: ! "`''co Date: ---' P
Print Name: \e---L*0' N1A- -
I:\Building\Forms\FireSprinklerAtfidavit 071514.docx Page 1 of 1
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