Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
•11111
COMMUNITY DEVELOPMENT Permit#: FPS2021-00068
13125 SW Hall Blvd.,Tigard OR 97223 503.718,2439 Date Issued: 6/2/2021
T t[, I:n 9 Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 198
Project: CRA Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire Sprinkler permit-relocate(2)and add(1)sprinkler head drops to cover new floor plan-AFFIDAVIT
SUBMITTED.
Contractor: AFP SYSTEMS INC Owner: PACIFIC REALTY ASSOCIATES
19435 SW 129TH AVE ATTN: N PIVEN
TUALATIN, OR 97062 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-692-9284 PHONE:
FAX: 503-692-1186
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/01/2021 $61.85
12%State Surcharge-Building 06/01/2021 $7.42
Type of Use: COM Plan Review-Fire Life Safety-COM 06/01/2021 $24.74
• Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 06/01/2021 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0.1 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 $94.51
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $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: Permittee Signature:
4-{o711y VafvV ei L11e je O vv AppLi-cato n
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 Application ,i✓_S/2S/Z
Fire Protection System RECEIVED FOR OFFICE I'S E ONLY
City of Tigard �y 5 $U2i Received / �� FPS2o2J OOO(e re
• 14AY 2 Re Date/By: /�1 Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �I
• Phone: 503.718.2439 Fax: 503.598.196 Date/By: ,t A -!/ Other Permit:
Inspection Line: 503.639.4175ITYOFTIGARD DateReadB �/, 2TIGARU Internet: www.ti ardor. ov BUILDING DIVISION Notified/Method�/�/��/ ® SeePent l for
g g � � Supplemental Information
TYPE OF WORK REQUIRED DATA:1--AND2-FAMILY DWELLING
❑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
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRU work indicated on this application.
0 1-and 2-family dwelling ElCommercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
' :# ' Total number of floors:
JOB SITE INFORMATION AND LOCATION =k,:
Job site address:15350 SW Sequoia Pkwy New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:198 I Project name:CRA TI Covered porch area: square feet
Cross street/directions to job site:Pacific Corporate Center Bldg.17 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 profit for the
'. DESCRIPTION OF WORK work indicated on this application.
sx
Valuation: $$900.00
Relocate 2&add 1 sprinkler head drops to cover new floor plan. Existing building area: square feet
New building area: square feet
IIIIIMIIROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction: II-B
Address: Occupancy groups:
City/State/ZIP: Existing: B-office
Phone:( ) Fax:( ) New: no change
® APPLICANT ® CONTACT PERSON NOTICE -
Business name:AFP Systems Inc. All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:Rob Dunkle under ORS 701 and may be required to be licensed in the
Address:19435 SW 129th Ave jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:Tualatin,OR 97062 apply:
Phone:(503)692-9284 I Fax::(503)692-1186
E-mail:permits@afpsys.com
' BUILDING PERMIT FEES*
i ,' . (Please refer to fee schedule)
Business name:AFP Systems Inc. Permit Ice:
Address:19435 SW 129"Ave State surcharge(12%of permit fee):
City/State/ZIP:Tualatin,OR 97062 FLS plan review(40%of permit fee):
Phone:(503)692-9284 Fax:(503)692-1186 (Due upon application submittal)
Total permit fees:
CCB lie.:67534 —
Digitally signed by Steve Frost Amount received:
Authorized signature: Steve Frost DN:cn=Steve Rost o-AFP Systems.as,
.a email=sieve@alpsyscom,c=US This permit application expires if a permit is not obtained
Date-zozlas.z4 uao:ar m•ao within 180 days after it has been accepted as complete.
Print name:Steve Frost Date:05/24/2021 * Fee methodology set by Tri-County Building Industry
Service Board.
I\Building1PermitsWPS-PermilApp_071514.doe 440-4613T(1 1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done:
1.) "1'ypc of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 3 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
El 11+ heads: Plan review required and El 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.) Comncial Spri
® Wet ID Dry
Additional Standpipes
Information: Hazard Group LH
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: I $ 900.00
B. T I - ''
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
D.) Residential Sprinkler (Stand Alone
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.
1.111111111 - Fire Protection Permit Fees
Project valuation subtotal (see A, B&C above): $ 900.00
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: $
N:\Steve\Prints TI\CRA pcc 241 TI\CRA TI submittal\CRA TI FPS_PemutApp.doc 2
City of Tigard RECEIVED PermitNo.: FPS202-i- 000(0�
• 13125 SW Hall Blvd.,Tigard,OR 97223 MAY r 5 1011 u h
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: S/25/2-02.)
Inspection Line: 503.639.4175 CITY OF TIGARD ��!!� �p
t I` Internet: www.tigard.or.gov By: lN� OF 11t.?e r)�A
3UILDING DIVISION
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS OFFICE COPY
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: CRA TI Occupancy: B-office
Job Address: 15350 SW Sequoia Pkwy, Tigard, OR 97224 Type of Construction: II-B
Suite: 198
Contractor: AFP Systems Phone: 503-692-9284
Number of Proposed or Altered Heads: 3
Type: wet Hazard: light Density: 0.10
I Steve Frost/AFP Systems Oregon Construction Contractors Board No. 67534
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.
Digitally mooed by Steve Frost
Steve Frost omall=s as/psysc mFP SU ms
Signature: Date.3@1.U5.24114947 7'00' Date: 05/24/2021
Print Name: Steve Frost
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page I of I