Permit (4) •
III CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2022-00044
T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/8l2022
Parcel: 2S101 BB01300
Jurisdiction: Tigard
Site address: 11958 SW GARDEN PL
Project: Zoom+Care Subdivision: CROW PARK 217 Lot: 1
Project Description: Fire sprinkler permit-relocate(2)sprinkler drops off existing wet system to cover new floor plan.AFFIDAVIT
SUBMITTED.
Contractor: AFP SYSTEMS INC Owner: BKM PARK BC 252 LLC
19435 SW 129TH AVE BY SLK GLOBAL SOLUTIONS AMERICA
TUALATIN, OR 97062 2727 LBJ FREEWAY STE 806
DALLAS,TX 75234
PHONE: 503-692-9284 PHONE:
FAX: 503-692-1186
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/08/2022 $51.09
12%State Surcharge-Building 03/08/2022 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 03/08/2022 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 03/08/2022 $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 $78.16
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $300.00
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: Edgardo-Ma(do.ado- Permittee Signature: ye,e.
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 ApplicationRECEIVED
Fire Protection System FOR OFFICE USE ONLY
City of Tigard MAR 2 2022 Received '/� �Z022—� 4k
DateB 03/d8101Z Permit ND.: fl
• 13125 SW Hall Blvd.,Tigard,OR 97223 4I I Y OF CI(GAHU Plan Review
Date/By:
1111 II Phone: 503.718.2439 Fax: 503.598.I969Other Permit-.
7IGARD Inspection Line: 503.639.4175 'UILDING DIVISION' Date Ready/By: 3 ® See Page2tor
Internet: www.tigard-or.gov Notified/Method: G
Supplemental Information
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 dwellin Valuation: S
g ®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: 11985�g S W Garden Place New dwelling area: square feet
City/State/ZIP: TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ZoomCare Billing T1 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.
RELOCATE 2 SPRINKLER HEAD DROPS OFF OF EXISTING WET SYSTEM Valuation: $300.00
TO COVER NEW FLOOR PLAN Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1
Name:
Type of construction:III-B
Address: Occupancy groups:B
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
® APPLICANT 0 CONTACT PERSON
NOTICE
Business name:AFP SYSTEMS INC All contractors and subcontractors are required to be
Contact name: KAYLA JOHNSON licensed with the Oregon Construction Contractors Board
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
City/State/ZIP: TUALATIN,OR 97062 applicant is exempt from licensing,the following reasons
apply:
Phone:( 503 ) 692-9284 Fax::( )
E-mail: permits@afpsys.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:AFP SYSTEMS INC (Please refer to fee schedule
Address:19435 SW 129TH AVE Permit fee:
City/State/ZIP: TUALATIN,OR 97062 State surcharge(12%ofpermit fee):
FLS plan review(40%of permit fee):
Phone:(503 )692-9284 Fax:( ) (Due upon application submittal.)
CCB lie.:67534 Total permit fees:
ugn*Iq signed by xeve Frost
Authorized signature:
Steve Frost ONcn=skive Frost,c AFPsystems.ou,
email=sieve@afpryuum,c=us Amount received:
Date:n022.o3.0 nao:4a8ao' This permit application expires if a permit is not obtained
Print name:STEVE FROST Date: 03/02/2022 within 180 days after it has been accepted as complete.
— " Fee methodology set by Tri-County Building Industry
Service Board.
1aBuilding\Permits\FPS-PermitApp 031016.doc 440-4613T(1 1/02/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:
El New system Number of sprinkler heads: 2 Number of alarm devices:
[ Addition or In 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 0 Yes 11 No
Hazard Group LIGHT
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 300.00
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)
S.uare 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): $
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
iECEIVEr
City of Tigard MAR 2 2022 Permit No.: FPS 2.D22-C904+
• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960L.IIY OF TIGARIJ Date Received: 03-02-2022-
i I)I Internet: Line: 503.639.4175 BUILDING DIVISION By: Ct,TV of TIGA-2O
Internet: www.tigard-or.gov
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS ®
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: ZoomCare Billing TI Occupancy: B-office
Job Address: 11958 SW Garden Place, Tigard, OR 97223 Type of Construction: III-B
Suite:
Contractor: AFP Systems Phone: 503-692-9284
Number of Proposed or Altered Heads: 2
Type: wet Hazard: light Density: 0.10
1 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 signed by Steve Frost
Steve Frost DN:cn=Steve Frost.o=AFP Systems,
Signature: ou,email=steve@afppsys.com,c=US Date: 03/02/2022
Uate:lU21.U6.U1 I I:Ul:1U-ua UU
Print Name: Steve Frost
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