Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111
COMMUNITY DEVELOPMENT Permit#: FPS2021-00103
Date Issued: 9/9/2021
T r C;A 11 P 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101 DA00100
Jurisdiction: Tigard
Site address: 13010 SW 68TH PKWY 145
Project: Pacific Residential Mortgage Subdivision: YARNS ACRES Lot: 9
Project Description: TI within existing suite adding 4 office,a reception desk
Contractor: AFP SYSTEMS INC Owner: PACIFIC NW PROPERTIES LIMITED PARTNERSI
19435 SW 129TH AVE STERN FAMILY LIMITED PARTNERSHIP
TUALATIN, OR 97062 STERN FAMILY LLC
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 09/07/2021 $102.20
12%State Surcharge-Building 09/07/2021 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 09/07/2021 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 09/07/2021 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 09/07/2021 $1.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes 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 $158.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,150.00
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
Issued By: Holly via, Ve4Veee Permittee Signature: O rt.App .o-yl
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 ApplicatIO*99''[[CC ECEIVE x- `
Fire Protection System FOR OFFICE USE ONLY
- City of Tigard AUG 3 1 202� Dale By:d q7s/ �+ Permit N O5 Z4—eV/03
• 13125 SW Hall Blvd.,Tigard,OR 97223(,I n,OF TIGARU Plan
Phone: 503.718.2439 Fax: 503.598.19 Plan Review , Other Permit:
TICARD Inspection Line: 503.639.4175 'WILDING DIVISION Date Ready/By: �/5/ ) /l S See ental Inf
Internet: www.tigard-or,gov Notified/Method: e'7 C7 K,A7r Supplemental Information
1.1-iL he Ca
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.
Valuation: $
❑ I-and 2-family dwelling ®Commercial/industrial
ElAccessory 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: 13010 SW 68th Parkway New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:145 Project name:Pacific Residential Mortg Covered porch area: square feet
Cross street/directions to job site:Tigard Corp Park 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.
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.
Valuation: $$2,150.00
Relocate 7&add 2 sprinkler head drops to cover new floor plan. Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction: HI-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 Fax::(503)692-1186
E-mail:permits(a.afpsys.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:AFP Systems Inc. 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.)
Total permit fees:
CCB lic.:67534 -
----.4
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Steve Frost Date:08/31/2021 * Fee methodology set by Tri-County Building Industry
Service Board. ����yy,
I:\Building,Pemrits�FPS-PermitApp_0715 I4.doc 4404613T(11102/COM/WEa) I /yy( S ,-, 3 y
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) '1'N )C Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 9 Number of alarm devices:
® Addition or ® 1-10 heads: Affidavit required and 0 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 0 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
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group LH
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 2,150.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component 0 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): $ 2,150.00
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: $
X:\Pemtits Steve new\Tigard\Pacific Residential MortgageTI FPS_PermitApp.doc 2
Dianna Ornelas
From: #Building Permit Technicians
Sent: Sunday, September 5, 2021 9:59 AM
To: 'Permit Office'
Subject: FPS2021-00103 - 13010 SW 68th Pkwy - Pacific Residential Mortgage
Attachments: FPS2021-00103.pdf
Hello Rob,
This permit is ready to issue and the balance due is $158.34 (see attached invoice).
The fees can be paid online at https://aca-prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record
number FPS2021-00103 under the Building tab. Payment can be made by 'card'for a 3%service fee or select the 'check'
payment option and there is no service fee.
Please email the permit technicians at TigardBuildingPermits@tigard-or.gov once the fees are paid so that we can issue
the permit and make it available for pick up.
Thank you.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
1
RECEIVED OFF C! .t
City of Tigard �r Permit No.: fJ°S ZO u-40103
t 13125 SW Hall Blvd.,Tigard,OR 97223 iMtc? 1. �;
I'i Phone: 503.718.2439 Fax: 503.598.196g Date Received: 7/3 j/2-
Inspection Line: 503.639.4175 UITY OF TIGARD
Internet: www.tigard-or.gov BUILDING DIVISION By
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Pacific Residential Mortgage TI Occupancy: B-office
Job Address: 13010 SW 68th Parkway, Tigard, OR 97223 Type of Construction: III-B
Suite: 145
Contractor: AFP Systems Phone: 503-692-9284
Number of Proposed or Altered Heads: 9
Type: wet Hazard: light Density: 0.10
Steve FrostIAFP 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 signed by Steve Frost
Steve Frost DN:cn=Steve Frost,o=A csystems,ou,
Signature: email=Steve@afpsys.com,c=US Date: 08/31/2021
NL coa.s 1 u,:49:3o-07 00
Print Name: Steve Frost
1:\Building\Forms\FireSprinklerAffidavit_071514.docx Page I of