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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT a COMMUNITY DEVELOPMENT Permit#: FPS2021-000 2 9 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/25/2021 T f[;A R D g Parcel: 1S134AA02100 Jurisdiction: Tigard Site address: 10340 SW NIMBUS AVE NC Project: Scholls Business Center Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3 Project Description: Fire sprinkler permit-add(1)and relocate(3)new standard spry pendents to accommodate new walls and ceiling per NFPA13,State and Local Codes.FIRE SPRINKLER AFFIDAVIT SUBMITTED. Contractor: PHOENIX FIRE PROTECTION LLC Owner: DIETRICH, NANCY BISHOP 4130 AIRPORT RD ROBINSON, JERRY CHRISTOPHER TRUST NAMPA, ID 83687 ROBINSON, LYNN ET AL 9701 SE MCLOUGHLIN BLVD MILWAUKIE, OR 97222 PHONE: 208-468-9115 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-COM 03/24/2021 $88.75 12%State Surcharge-Building 03/24/2021 $10.65 Type of Use: COM Plan Review-Fire Life Safety-COM 03/24/2021 $35.50 Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 03/24/2021 $2.00 Occupancy Grp: Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Wet Standpipe Required: Hazard: LT Density: .1 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 $136.90 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $1,900.00 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: ` `t ` `c4nv-)�' \,e5 Permittee Signature: wCall 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 E - a j (7 2-t Fire Protection System RECEIVED FOROF'FICE USE ONLY 7 City of Tigard Received a /B 03 Permit No.: S OGI � INI13125 SW Hall Blvd.,Tigard,OR 97223 MAR 1. 7 2021 �� T-1° Z Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: � HSee Paget for Internet: www.tigard-or.gov Notified/Method: Supplemental Information 3UILDINC DIVISION 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 ®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El1-and 2-family dwelling ®Commercial/industrial Valuation: $ D Accessory building ['Multi-family Number of bedrooms: El Master builder CI Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:10340 SW Nimbus Ave. New dwelling area: square feet City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Scholl's Business Center Ste TI 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 no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Add(1)and relocate (3)new Standard spray pendents to accommodate new Valuation: $1,900.00 walls and ceilings per NFPA13, State& Local Codes. Existing building area: 200 square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories:1 Name: RGIP Type of construction: II B Address:10300 SW Nimbus Ave. Ste P-C Occupancy groups:B, S-1 City/State/ZIP:Portland, OR 97223 Existing:Yes Phone:( ) Fax:( ) New:N/A ® APPLICANT ❑ CONTACT PERSON NOTICE Business name:Phoenix Fire Protection All contractors and subcontractors are required to be Contact name:Teri Cruickshank licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address:4130 Airport Rd, jurisdiction in which work is being performed.If the City/State/ZIP:Nampa, ID 83687 applicant is exempt from licensing,the following reasons apply: Phone:( 208)468-9115 Fax: :( ) E-mail: CONTRACTOR BUILDING PERMIT FEES* Business name:S/A (Please refer to fee schedule) Permit fee: Address: State surcharge(12%of permit fee): City/State/Zll': FLS plan review(40%of permit fee): Phone:(208-1468-9115 Fax:( ) (Due upon application submittal) CCB lic.: 181692 Total permit fees: Authorized signature: rite; l/��Qeeeeeg ,_/ Amount received: u�f� This permit application expires if a permit is not obtained Print name:Teri Cruickshank Date:3.17.2021 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I:\Building.PrnniO FPS-PmnitApp_031016.doc 410-46137(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2-Supplemental Information Describe work to be 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: 4 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 ❑ 11+heads: Plan review required and ❑ 6+ devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler Sprinkler Type ® Wet ❑ Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ® No Hazard Group Light Density .1 Design Area n/a K. Factor 5.6 Sprinkler Project Valuation: $1,900 B.) Type I - Hood Fire Suppression System Hood Project Valuation: $N/A C.) Fire Alarm Submittal shall Battery Calculations El Yes include: Individual Component El Yes Cut Sheets Fire Alarm Project Valuation: $N/A 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: N/A sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A,B&C above): $1900.00 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: $ 1:\Building\Permits\IPS_PermitApp_031016.doc 2 RECEIVED &!AR 17 2021 Owner's Information Certificate CITY OF TIGARD Annex A BUILDING DIVISION Name/Address of property to be protected with sprinkler protection: C l2S-9 1O*3tim ILA► i r3 ) 5 Hv, c..91 0,7'2-2-73 Name &Address of Owner: tee,\( 1 —2,6)3 "`ten, J Ail 013.3S /U4- Existing or planned construction is: O Fire resistive or noncombustible ❑ Wood frame or ordinary (masonry walls with wood beams) ❑ Unknown Describe the intended use of the building: t,\./���(= fZ� Note regarding speculative buildings: The design and installation of the fire sprinkler system is dependent on an accurate description of the likely use of the building. Without specific information, assumptions will need to be made that will limit the actual use of the building. Make sure that you communicate any and all use considerations to the fire sprinkler contractor in this form and that you abide by all limitations regarding the use of the building based on the limitations of the fire sprinkler system that is eventually designed and installed. Is the system installation intended for one of the following special occupancies: Aircraft Hanger ❑ Yes jNo Fixed guideway transit system ❑ Yes X.-No Race track stable 0 Yes R No Marine terminal, pier, or wharf ❑ Yes .K No Airport terminal ❑ Yes No Aircraft engine test facility 0 Yes No Power Plant ❑ Yes i No Water-cooling tower 0 Yes No If the answer to any of the above is"YES," the appropriate NFPA standard should be referenced for sprinkler density/area criteria. Indicate whether any of the following special materials are intended to be present: Flammable or combustible liquids ❑ Yes X No Aerosol products ❑ Yes jg,No ©2015 National Fire Protection Association NFPA 13 (p. 1 of 3) 2016 Edition Nitrate Film El Yes IF(No Pyroxylin plastic ❑ Yes g No Compressed or liquefied gas cylinders ❑ Yes 1ST No Liquid or solid oxidizers El Yes No Organic peroxide formulations 0 Yes 14 No Idle Pallets ❑ Yes idNo If the answer to any of the above is "Yes," describe type, location, arrangement, and intended maximum quantities. Indicate whether the protection is intended for one of the following specialized occupancies or areas: Spray area or mixing room 0 Yes Or No Solvent extraction ❑ Yes D 'No Laboratory using chemicals El Yes 'No Oxygen-fuel gas system for welding or cutting ❑ Yes Oi(No Acetylene cylinder charging ❑ Yes KNo Production or use of compressed or liquefied gasses ❑ Yes <No Commercial cooking operation ❑ Yes t2(No Class A Hyperbaric chamber ❑ Yes No Cleanroom ❑ Yes KNo Incinerator or waste handling system ❑ Yes KNo Linen handling system ❑ Yes rtKNo Industrial furnace ❑ Yes No Water-cooling tower ❑ Yes X No If the answer to any of the above is"yes," describe type, location, arrangement, and intended maximum quantities. Will there be any storage of products over 12ft (3.7 m) in height? ❑ Yes No lithe answer is"yes," describe product, intended storage arrangement, and height. ©2015 National Fire Protection Association NFPA 13 (p. 2 of 3) 2016 Edition Will there be any_ sttgrage of plastic, rubber, or similar products over 5ft (1.5 m) high except as described above? ❑ Yes No If the answer is "yes," describe product, intended storage arrangement, and height. Is there any special information concerning the water supply? ❑ Yeso If the answer is "yes," provide the information, including known environmental conditions that might be responsible for corrosion, including microbiologically influenced corrosion (MIC). The following is a part of the fire service design. Please sign at the bottom to confirm the parameters. If the choices below are not acceptable, please indicate "other", Please note that any changes in the below may result in additional charges. Head Finish CI White L' Chrome 0 Brass Escutcheon Finish i White Chrome 0 Brass Head Type 0 Semi-Recessed Concealed (Additional cost if not in specifications) 1 ti ____. I certify that I have knowledge of the intended use of this o and that the above information is correct. Signature of wney's representative or agent: Date: 2..qe / '7i/ /- � Name of owner's representative or agent cqmpleting certificate (print): � — 1 I ( Relationship and firm of agent (print): 1 .t 27Vy .uA ^ FIGURE A.23.1 (b) Owner's Information Certificate ©2015 National Fire Protection Association NFPA 13 (p. 3 of 3) 2016 Edition City of Tigard /"�C �/lr /1 r Permit No.: FPS2 2/-OcoZ9 III i • 13125 SW Hall Blvd.,Tigard,ORE L/G f Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 03 17 2021 Inspection Line: 503.639.4175 MAR J.7 2021 `" '` ' Internet: www.tigard-or.gov By: WY Of 77 47f4 CITY OF TIGARD FIRE SPRINKINERIA11111DAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (1 t0 10 SPRINKLER HEADS WITHOUT PLANS) OFFICE COSY Project Name: Scholl's Business Center Ste. TI Occupancy: B, S-1 Job Address: 10340 SW Nimbus Ave, Tigard, OR Type of Construction: II B Suite: Contractor: Phoenix Fire Protection Phone: 208-468-9115 Number of Proposed or Altered Heads: 4 Type: QR Hazard: Light Density: .1 1 Phoenix Fire Protectio Oregon Construction Contractors Board No. 181692 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: ?ti Cuize._../erzilada Date: 3.17.21 Print Name: Teri Cruickshank I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page I of 1