Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
`r1 COMMUNITY DEVELOPMENT Permit#: FPS2021-00148
TIC;A J. D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1/3/2022
Parcel: 2S 101 AA09100
Jurisdiction: Tigard
Site address: 12447 SW 69TH AVE
Project: Consumer Cellular Subdivision: WEST PORTLAND HEIGHTS Lot: A
Project Description: Fire sprinkler permit-add and/or relocate(8)sprinkler heads to accommodate new walls.AFFIDAVIT
SUBMITTED.
Contractor: FIRE ONE FIRE SYSTEMS INC Owner: MERIWETHER TIGARD LLC
PO BOX 734 BY BRISCOE, ROBERT
OREGON CITY, OR 97045 1136 NW HOYT ST STE 220
PORTLAND, OR 97209
PHONE: 503-557-9050 PHONE:
FAX: 503-557-9268
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/23/2021 $102.20
12%State Surcharge-Building 12/23/2021 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 12/23/2021 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/23/2021 $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: 8.0
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: $2,725.00
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: Eotgardo-Matotori.ado- Permittee Signature: S22
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
Fire Protection System gECE1VED FOR OFFICE USE ONLY
City of Tigard DEC 9 Z0Z1 DateBea/.?® > �� Permit No �2/�/
13125 SW Hall Blvd.,Tigard,OR 97223
g Plan Review /9 IV.! y, Other f�4 nOZ�3
111 l Phone: 503.718.2439 Fax: 503.598.19611"Y OF TIGARD Date/B : '
I 1 C,A R D Inspection Line: 503.639.4175 Date Ready/By: /C 7/ /7f ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method/ it G/ K/ linn Supplemental Information
7 PIT .
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 INCommercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12447 SW 69th Ave New dwelling area: square feet
City/State/ZIP: Tigard, Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:Bldg C Project name: Consumer Cellular 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.
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.
Add and/or relocate sprinkler heads to accommodate Valuation: $2,725.00
new walls Existing building area: square feet
New building area: +/- 1200 square feet
0 PROPERTY OWNER ® TENANT Number of stories: 2
Name: Consumer Cellular Type of construction: Tenant Improvement
Address: 12447 SW 69th Ave Bldg C Occupancy groups:
City/State/ZIP: Tigard, Oregon 97223 Existing: B
Phone:( ) Fax:( ) New: B
® APPLICANT 0 CONTACT PERSON NOTICE
Business name: Fire One Fire Systems, INC All contractors and subcontractors are required to be
Contact name: Nick Bocchetti licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: PO Box 734 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: Oregon City, Oregon 97045
apply:
Phone:(503)939-6117 Fax: :( )
F-mail: nick@fireone.org
CONTRACTOR BUILDING PERMIT FEES*
Business name: Same as above (Please refer to fee schedule
Permit fee:
Address:
City/State/ZIP: State surcharge(12%ofpermit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lie.: 98140 Total permit fees:
2 /t- �9t t Amount received: /5✓�-i"
Authorized signature: �/ `` d '
`lc, 1 This permit application expires if a permit is not obtained
Print name: Nick S Bocchetti Date: 09Dec21 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I\Building\Permits\FPS-PermitApp_031016.doc 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: 8 Number of alarm devices:
X❑ Addition or ❑X 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 X❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line X❑ Yes ❑ No
Hazard Group Light Hazard
Density .10
Design Area 1500 sf
K. Factor 8.0
Sprinkler Project Valuation: $ 2,725.00
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): $
i
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
RECEIVED
DEC 9 2021
City of Tigard Permit No.: �P`S'ZOZI /��UI DING DIVISION
;. 13125 SW Hall Blvd.,Tigard,OR 97223 iirzYtV.202/
Qr / jN
IIIPhone: 503.718.2439 Fax: 503.598.1960 Date Received: (
Inspection Line: 503.639.4175
1 .n�` tInternet: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS -+® '
lq
OR TENANT IMPROVEMENTS ���Ct�r
(I to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Consumer Cellular Occupancy: B-Office
Job Address: 12447 SW 69th Ave Bldg C Type of Construction: Tenant Improvement
Suite:
Contractor: Fire One Fire Systems,INC Phone: 503-939-6117
Number of Proposed or Altered Heads: 8
Type: Wet Pipe Hazard: Light Hazard Density: .1011500
I, Nick Bocchetti(Fire One Fire Systems,INC) Oregon Construction Contractors Board No. 98140
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'/oft this document with a copy of the sketch attached shall be available for all inspections.
Signature: N 141 /4/ J2Jtic Date: 09Dec21
Print Name: Nick S Bocchetti
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