Permit %
City of Tigard 1i
Permit No.: BPS 2020 — O0 10-Z)
71
• 13125 SW Hall Blvd.,Tigard,OR 97223
s Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 9/d2//�
Inspection Line: 503.639.4175 /
I1 A RI' Internet: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS RECEIVED
OR TENANT IMPROVEMENTS SEP 22
(1 to 10 SPRINKLER HEADS WITHOUT PLANS) 202E
CITY OF TIGARD
BUILDING DIVISION
Project Name:Target 0345 Occupancy: M
Job Address: 9009 SW Hall Blvd Type of Construction: Type 111, B
Suite:
Contractor: Signaling System Solutions Inc. Phone: 360-694-9199
Number of Proposed or Altered Heads: 8
Type:QR Hazard:Light Density:0.10 GPM
I Frank Beebe Oregon Construction Contractors Board No. 173274
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.
Signature: r Date: 9/21/2020
Print Nam oore
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