Permit IIICITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
ii
I. . COMMUNITY DEVELOPMENT Permit#: FPS2014-00144
T E G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2014
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 380
Project: Kforce Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinklers-relocate(6)heads
Contractor: PACIFIC FIRE SYSTEMS LLC Owner: LINCOLN CENTER LLC
6704 RIVERIA CT BY SHORENSTEIN PROPERTIES LLC
WEST LINN, OR 97068 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO,CA 94104
PHONE: 503-710-6646 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/28/2014 $53.78
12%State Surcharge-Building 08/28/2014 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 08/28/2014 $21.51
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
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 $81.74
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $568.00
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 •'tain a copy of the rules
or direct.-- ions to •• C by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature: ,r /'/��
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 ApplicatCEIVEp
Fire Protection System FOR OFFICE USE ONLY
Received I �//� _Oa
- City of Tigard //��II''rr 8
Date/B : 2j , r Penuit No.: 580/ l
-" 13125 SW Hall Blvd.,Tigard,OR 974 it 8 2014 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.gov DUiLDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: I-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
4ddition/alterJion/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling IC ommercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION J Total number of floors:
Job site address: t(�� 4 0 X , hr.Cvt49 fr C New dwelling area: square feet
City/State/ZIP: !,-Q l OA— / Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: to Font,e 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.
Valuation: $ 05-6 F,��
/l /{-1•� Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER I 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: 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:
CONTRACTOR BUILDING PERMIT!'-/I FEES*
� (Please refer to fee schedule
Business name: �•l#r 7 ZL S�4'T c r- Permit fee: 6 3, 7
Address: 7 Z) [// a t ✓! e t C' U � 8- -
City/State/ZIP: �� •7 7—��h K �� State surcharge(12%of permit fee): � -�S
/ FLS plan review(40%ofpermit fee): Off,- S/
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.: ! O 2O/q ) Total permit fees:
Amount received:
Authorized signature: ( //'�` y
�j
This permit application expires if a permit is not obtained
�_ within 180 days after it has been accepted as complete.
Print nam - �y
Date: � * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS- -.'tAPp_071514.doe 440-4613T(I1/07/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:
❑ Ne 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
❑ Wet ❑ Dry
Additional Standpipes
Information: 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: I $
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): $
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_071514.doc 2
1
City of Tigard Permit No.: /9501-61/11- 0/447
13125 SW Hall Blvd.,Tigard,OR 97[ (� .
'� Phone: 503.718.2439 Fax: 503.598.19b, c 2$ �Q1 Date Received: ci/p/c(//a
I I Inspection Line: 503.639.4175 Ih� C\
Internet: www.tigard-or.gov "! ` By:
INO
FIRE SPRI 1111'� AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(I to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: 7e "7:3P2.c< Occupancy:
Job Address: /0,2 to 0 �x 1 (Ai/Le, ,e_6._J Type of Construction:
Suite:
Contractor: �','6t'/c i¢e Sys 72 A.c Phone: 3C)3 —7/D `f
Number of Proposed or Altered Heads:
I/Or� !L� q
Type: .� Q Hazard: I?Gt Density: _&_1 0
I, iz f-mac / ; e Sy 7' 4 C? Oregon Construction Contractors Board No. /7-CV 170
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 docum ith a copy of the sketch attached shall be available for all inspections.
Signature: / / Date: oZ;--/`;/
Print Name: • j � -
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1