Report CITY OF TIGARDIII FIRE PROTECTION SYSTEM PERMIT
II. COMMUNITY DEVELOPMENT Permit#: FPS2019-00141
T i G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2019
Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD
Project: One Embassy Centre Subdivision: None Lot: None
Project Description: Fire sprinkler. Adding(9)pendent heads to accommodate TI.
Contractor: FIRE ONE FIRE SYSTEMS INC Owner: TOWMAN ONE EMBASSY CENTRE LLC
PO BOX 734 BY TOWMAN LLC
OREGON CITY, OR 97045 25425 BASCOM AVE STE 230
CAMPBELL, CA 95008
PHONE: 503-557-9050
PHONE: 503-294-0400
FAX: 503-557-9268
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/18/2019 $86.06
12%State Surcharge-Building 11/18/2019 $10.33
Type of Use: COM Plan Review-Fire Life Safety-COM 11/18/2019 $34.42
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 11/18/2019 $2.00
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 Design Area: 1500
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 $132.81
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,750.00
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 se forth in e R 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC . . ling 50 .232.19 or 1.V32.2344.
32.2344.
Issued By: ' '� ^4 �t Permittee Signature: 41e..
�` , - '�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.
,r
NOV 1 8 2019
CITY :ARD
BUILDIi3(.i DIVISION
City of Tigard Permit No.: / - l G/
13125 SW Hall Blvd.,Tigard,OR 97223
_ Phone: 503.718.2439 Fax: 503.598.1960 Date Received: / j' 4
Inspection Line: 503.639.4175 / 'M
T 1<;,� D. Internet:www.tigard-or.gov By: � �'-i��,�
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: EV1?)hSSY C Fu ri-Q C bt..veio#35 Occupancy:
Job Address: -62.0 LS 14t4"TO jJ Type of Construction:I x C;t--6
Suite: C tic)
Contractor: �%(Z'PL e5 f J 12.i! 5Phone: 5 2j S57-9 05 Lj
Number of Proposed or Altered Heads: )
Type: (.L Hazard: L1(,Fl-r Density: ° (a
I, I•11(1l 1/ntafif..1-7 CFI a- ODf.)Oregon Construction Contractors Board No. e I L
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 cop his document '% a copy of the sketch attached shall be available for all inspections.
MA-(0V /
Signature: r , �411
Date: V
Print Name: I 0CC hr0- 7)
I:\Building\Fortns\FireSprinlderAffidavit 071514.docx Page 1 of 1
REEl CEIV
NOV 1 8 2019
s um,,, I.,.iF 1;i:3APD
BUILtfNG D)IVIS ON
Building Permit Application
Fire Protection System 1(11t(I i i i( i I 1 (0.1
1
City of Tigard Received i1� IZedirwGi
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• Phone: 503.7182439 Fax: 503.598.1960 Dere/ Other Permit:
T i . R D Inspection Line: 503.639.4175 Date Ready/By: See: 113 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
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
EL Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑1-and 2-family dwelling R.Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9 O 2.0 5.., AAs 14*nt c jroa New dwelling area: square feet
City/State/ZIP: \..l.=paw i o a- 1-i 2'2-3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: .Nta r.E,S,f &-R.- L b toTria IA 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: 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 protit for the
DESCRIPTION OF WORK work indicated onthisapplication.
0.
�T .I) 1't?' rk&iG S To AILD 2'^obi iC Valuation: 1...-n1::::,°$
/�,I1( ,r i -19(ZJ30Q1. .1 Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER a'TENANT Number of stories: 5
Name: -E,,,v.,e.,�.1 c ret___ Type of construction: --r--- --- 6
Address: Cto a 5 IA_.)A'SYvtr.74"JOS Occupancy groups: Li 6 u-7 14 A-74e--D
City/State/ZIP: 16?s(Z'). Q___ 9.7Z2_3 Existing:
Phone:( ) Fax:( ) New: , 1-12.75
l APPLICANT ®CONTACT PERSON NOTICE
Business name: �1(2,� "Ullir.__- \--142$,S y51-4.../%05, /Ilk— All contractors and subcontractors are required to be
Contact name: JAI C3L, rp cc,1441-17> licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: !j' A. 7314 jurisdiction in which work is being performed.If the
City/State/ZIP: 0 ZLi 1 Jw, coy, Q e 9 7�4 5 applicant is exempt from licensing,the following reasons
apply:
Phone:(503) '7` , 5 -9'C?5ts Fax::( )
E-mail: 1 \\C_t.. Q ior'4&..u'ne•r,r
CONTRACTOR BUILDING PERMIT FEES*
Business name: S'b}A4 A-5 A D�p��. (i'hasee jeeachedrts)
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lis.: 1$I 4-j j) l Total permit fees:
Authorized signature: ( i " Amount received:
2 This permit application expires if a permit is not obtained
Print name: �1 Up c 1it-r� Date:/? `!) within IN days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
T:\Building\Permds\FPS-PermitApp 031016.doc 440-4613T(11/a3/COM/WEB)
c
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Descie vvorkto done
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 7 Number of alarm devices:
cit 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
❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Tempe of System (Complete A,B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type Q Wet ❑ Dry
Additional Standpipes (i!
Information: Sprinkler Supply Line ( Yes ❑ No
Hazard Group 1 &1
Density i C)
Design Area 1 e»c.
K. Factor
Sprinkler Project Valuation: $ ( 7 1 t-,
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone System)
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): $
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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2