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Permit (177) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit#: FPS2015-00185 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/24/2015 Parcel: 2S101 BB01500 Jurisdiction: Tigard Site address: 12232 SW GARDEN PL Project: Apex Labs Subdivision: CROW PARK 217 Lot: 3 Project Description: Installation of(2)sprinkler heads in cooler and(1)sprinkler head in ceiling. Contractor: VIKING AUTOMATIC SPRINKLER CO Owner: ICON OWNER POOL 1 WEST LLC 3245 NW FRONT AVE BY RYAN PORTLAND, OR 97210 PO BOX 460169 HOUSTON,TX 77056 PHONE: 503-227-1171 PHONE: FAX: 503-227-1552 FEES Description Date Amount Specifics: Permit Fee-COM 11/24/2015 $72.61 12%State Surcharge-Building 11/24/2015 $8.71 Type of Use: COM Plan Review-Fire Life Safety-COM 11/24/2015 $29.04 Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 11/24/2015 $0.50 Occupancy Grp: Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $110.86 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $1,300.00 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 or direct qu ons to NC by calling 503.232.1987 or 1.800.332.2344. Issued / Permittee Signature: 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 rd Received City of TigarDate/Byd 0 Permit No.: : 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit: / y Phone: 503.718.2439 Fax: 503.598.1966 Dat e B Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov -Notified/Method: Supplemental Information TYPE-Alp RE9PIRED DATA.I-AND 2-FAMIL DW, LLING El New construction El 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 CONSTRUCTIONwork indicated on this application. El I-and 2-family dwelling ommerciat/industrial Valuation: $ El Accessory building El Multi-family Number of bedrooms: 0 Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: IZZ3 1 50 (4Af_Z)E/v pt, New dwelling area: square feet City/State/ZIP: '-1-1440), OWL q7ZZ3 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMWRCIAL-USE CHECKLLST'� 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. '55". laZ 'M Valuation: $ 13CO, 00 W Existing building area: square feet New building area: square feet OPROPERTY OWNER TENANT Number of stories: Name: Type of construcfion: Address: Occupancy groups: City/State/ZIP: Existing: Phone: Fax: New: APPLICANT CONTACT PERSON NOTICE Business name: J!AM?-tA1-tC -5?Z(NLLU_ All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board TZ47— under ORS 701 and may be required to be lbensed in the Address: AW �q-F � jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP: '?69_TLAt4, 6�_ q-7?,ID apply: Phone:(5b3) ZJ-7 - 11-71 Fax: '�_61 2-Z-7- 15S 2_ E-mail: CONTRACTOR BUILDING PEAMITFEES* Business name: Permit fee: Address: State surcharge(12%of permit fee): City/State/ZIP: FLS plan review(40%ofpertnit fee): Phone:( I Fax: (Due upon application submittal) CCB lic.: 9'3 7 A Total permit fees: ;::�17 Amount received: 4-1-10me Authorized[signature: e4 I This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name-1 Date: I I m Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\FPS-PemitApp_971514.dm 4404613T(I 1/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information Dere .b vork-f thine: 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 S fin Coin 'Ie&A B,C or D as applicable): A;) Commercial Sprinkler S ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ _e - Hood Fire Su cession System Hood Project Valuation: $ C.) Fire Atari � t Submittal shall attery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) X sidential Spnnl ter(Stand Alone System) A} ; Square Footage: Permit Fee: � ,zj 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 �_;�n ;, Sprinkler Project Square Footage: sq.ft. aid Fire Prq etai© ermit Fees Project valuation subtotal see A,B&C above): $ Permit fee based on project valuation see fee schedule): $ Permit fee based onsquare footage see D above): $ State Surcharge 12%of permit fee): $ FLS Plan Review 40% of permit fee): $ TOTAL: $ I:\Building\Permits\FPS_PemnitApp_071514.doc 2 City of Tigard Permit No.: a 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.7182439 Fax: 503.598.1960 Date Received: //1,-7 Inspection Line: 503.639.4175 T Internet: www.tigard-or.gov By: _;z> FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS t OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: Apex Labs Occupancy: Light Hazard Job Address: 12232 SW Garden Pl. Type of Construction: Non Combustible Suite: Contractor: Viking Automatic Sprinkler Co. Phone: 503-227-1171 Number of Proposed or Altered Heads: 3 Type: SSP Hazard:light Density: •10 I, Viking Sprinkler Oregon Construction Contractors Board No. 64837 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. SigC, Tim Carpenter � "" gnature: P "m'"°'"`�"a""`"`°'� Date: 1 5 Print Name: Tim Carpenter I:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1