Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'' �1 . COMMUNITY DEVELOPMENT Permit#: FPS2021-00056
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/21/2021
Parcel: 1 S 136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE#110
Project: Thrive Aesthetics Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Fire sprinkler permit-add 3 sprinkler to existing Fire Protection System.AFFIDAVIT SUBMITTED.
Contractor: AFP SYSTEMS INC Owner: PNWP LLC#2
19435 SW 129TH AVE PNWP LLC
TUALATIN, OR 97062 6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-692-9284 PHONE:
FAX: 503-692-1186
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/13/2021 $102.20
12%State Surcharge-Building 05/13/2021 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 05/13/2021 $40.88
Class of Work: ADD Type of Const: Info Process/Archiving-Sm$0.50(up to 05/13/2021 $0.50
Occupancy Grp: B Height: ft 11x17)
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0.1 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 $155.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,363.00
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. Thos r les 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 c i g 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: f/ //��,7,-,,� %
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. r G u �tJ1�/
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 -Sll/2,
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard MAY 1 1 2021 De e/Bvey d 5 12 2.024 ''7 j—l'�Z02I-OCR 0 5�
R / Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• Phone: 503.718.2439 Fax: 503.598.196 Date/By: Other Permit:��ZQ� -b QQ 9j7
TIGARD
Inspection Line: 503.639.4175 �;ITY OF TIGARD Date Read B / ttif Jana. ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Ml' % Supplemental Information
'Wade 448173
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
rg Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ElI-and 2-family dwelling DA Commercial/industrial Valuation: $
0 Accessory building El Multi-familyNumber of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11850 SW 67TH New dwelling area: square feet
City/State/ZIP: TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: 175 Project name:THRIVE AESTHETICS 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.
Valuation: 2363 g
ADD 3 NEW SPRINKLERS TO EXISTING FIRE PROTECTION SYSTEM
Existing building area: 19000 square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories: 1
Name: Type of construction: 3-B
Address: Occupancy groups: B
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: ROB DUNKLE licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax: : )
E-mail: PERMITS@AFPSYS.COM
AFPSYS.COM
CONTRACTOR BUILDING PERMIT FEES*
Business name: AFP SYSTEMS INC (Please refer to fee schedule)
Permit fee:
Address: 19435 SW 129TH 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.)
CCB lie.: 67534 n-e //� Total permit fees:
Authorized signature:
Ag Pi Amount received: �y.$�
This permit application expires if a permit is not obtained
Print name: ROB DUNKLE Date: 5/11/21 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
P\Building\Permits\FPS-PermitApp_031016.doe 440-4613T(I I/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: 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
Density
Design Area
K. Factor _
Sprinkler Project Valuation: $
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 Foota c: 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_PemritApp_031016.doc 2
CityTi RECEIVED
of Tigard PermitNo.: FPS2O2I 0OO5
■ 13125 SW Hall Blvd.,Tigard,OR 97223 NAY i 1 202i Phone: 503.718.2439 Fax: 503.598.1960 Date Received: v h 5—1 1"2021
T 1 G A tt D Inspection Line: g .4175 CITY OF TIGARD ��-r1 d F �C� J
Internet: www.ti anrd-or.d-or.g ov BUILDING DIVISION By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS) OFFICE COPY
Project Name: Thrive Aesthetics Occupancy: B
Job Address: 11850 SW 67th Type of Construction: 3-B
Suite: 175
Contractor: AFP Systems Inc Phone: 503-692-9284
Number of Proposed or Altered Heads: 3
Type: Wet Hazard: Light Density: 0.1
I Rob Dunkle 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.
sRob Dunkle DtC;U,E=OObgned by R°'°°O" /6/21
Slgriature. DNo2021 05 08 10 14 44-cOm,WAFPSswmsl Inc..CN�RabDunkb Date:
QaM:2021 L5.0810:14:44-0Tfp'
Print Name: Rob Dunkle
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1