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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT s COMMUNITY DEVELOPMENT Permit#: FPS2014-00164 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2014 Parcel: 1 S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 110 Project: Fidelity National Title Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Moving(1)sprinkler head. Affidavit submitted. Contractor: CROWN FIRE SYSTEMS INC Owner: LINCOLN CENTER LLC 7402 SE JOHNSON CREEK BLVD BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97206 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503-777-5030 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-COM 10/14/2014 $51.09 12%State Surcharge-Building 10/14/2014 $6.13 Type of Use: COM Plan Review-Fire Life Safety-COM 10/14/2014 $20.44 Class of Work: ALT Type of Const: Occupancy Grp: Height: ft Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Yes Hazard: LT Density: 0 Design Area: 1000 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 $77.66 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $250.00 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 i OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1. 0.332. Issued By: rmittee Signature:- OW AO Call 503.• .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 '� FOR OFFICE USE ONLI _ Er City of Tigard * /lJ Permit No.: F CC*� O`(o !�J Date/By:13125 SW Hall Blvd.,Tigard,OR 97223? , Plan Review �/ 7 `''» �1D1 Phone: 503.718.2439 Fax: 503.598.1960 V\ik Date/By: Other Permit: T I GA R D Inspection Line: 503.639.4175 `�Cj 1 1 Date Ready/By: 1�s B See Page 2 for Internet: www.tigard-or.gov U �,,�sQ(1 Notified/Method: (, I Supplemental Information _ +.' r %. -`vim .1 TYPE OF W±�? * REQUIRED DATA:1-AND 2-FAMILY DWELLING ;Is Permit fees*are based on the value of the work performed. ❑New construction • ► anion P Indicate the value(rotded to the nearest dollar)of all 4 ddition/alterationheplacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling �Q'C ommercial/industrial Valuation: $ SO ❑Accessory building ❑Multi-family Number of bedrooms: ❑Mastef builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 a roar ,r& 6140,,,a i- -RD New dwelling area: square feet City/State/ZIP: T �,a t� _ Garage/carport area: square feet Suite/bldg./apt.no.: ,l , Q I Project name: bieeidw ri) . Covered porch area square feet Cross street/directions to job site: Lee,"r G/^1LD LIB CTII~_-i 4;6..5- x.E 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: S Dp / SPPR/^'x-L t4$— re+E ,t/EH/ f Tt T/D/J Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT GreONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: 7ZrAird eY7£gra,vrrT3 licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be lcensed 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:(603) f-3 se/e> I Fax::( ) E-mail: CONTRACTOR BUILDING PERMIT FEES* Business name: AI N 7 RE:S fcST in S (Please refer rotes Permit Address: 7 4 ,..s ." 3 e i-f—n G� &VI27 Permit fee: S'1' .V�1 City/State/ZIP: P eia� D�_ 4 7 Zo G State surcharge(12%of permit fee): 3 D FLS plan review(40%ofpermit fee): (� j Phone:(.<03) 7 77-502 e7 Fax:( ) (Due upon application submittal.) , Lilt CCB Iic.: /403 b- 0 Total permit fees: "?`7 Cp(o Authorized signs Amount received: This permit application expires if a permit is not obtained Print name:7��¢u.3 ORPF,R014 j Date: /6 l '�/r within 180 days after it has been accepted as complete. / * Fee methodology set by Tri-County Building Industry Service Board. I.\Building\PamiMFPS-PermitApp 071514.doc 440-4613T(I1/02/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: 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 '6$ Information: Hazard Group eIgh'r Density Design Area K. Factor S, Sprinkler Project Valuation: $ zsD, 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 City of Tigard k Permit No.: -42p/I/— (oil 13125 SW Hall Blvd.,Tigard,0' ! �' � s Phone: 503.718.2439 Fax: 503. .. .,� Date Received: / - 1D/ y0 Y irk \rI) Inspection Line: 503.639.4175 ` 1 �l Internet: www.tigard-or.gov O� V By: et-0406--• 7 405,a,.y .- FIRE SPRIN FIDAVIT FOR ALTERATIONS OR ENANT IMPROVEMENTS 4 (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: G ?fJ Al2gvr TP Occupancy: Job Address: la 000 5(,f 6-R6,�,)a t'i 7.-S) Type of Construction: 40p row Suite: 1/ cy Contractor: j i i 1 J 7 .2 x s. 4.5 Y 5 r f,,�- Phone: s 63 -- p J--3 F1`D Number of Proposed or Altered Heads: l Type: C©,ve.ea,/ E Hazard: ell Density: Sr (2 I, /2;f7.0 4'7 2m' Oregon Construction Contractors Board No. / 6 -3 kZa 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. Signature: �- Date: / -1-Y---/ Print Name: E ©Pj ,Ritti/O 1:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1 1 1 1 1 1 1 1 I .! 1 I -1 - t _1 -r . l T J L I 1 , I I I L \ts %.*ww*-‘-‘%-m� ��� I I I L\\\‘‘,VANVS1 1 , I ' •-i....11 th, ka,§1 1,44...,,,,, . NNss, 4si 4 ,si L Iii I i tell_ •_\li r I 1 , 1 I I 1 1 I 1 1 1 1 -1.- --1----!--_-, 1 I I p m I 1 I 1 1 1 I 1 1 1 1 1 1 I I J L u 1 L E OCT 1 4 2014 CITYOF rD r r 1 1 I 1 1 O 1 I I I 1 1 1 1 I 1 I 1 I I I I I I I r fJ //✓LOz.,/L) Cj!✓/ / /JZ" sw G E1B ' D. 77 ieD OR/ 9722 f/iz s /l „Cr- //,P T 1 \\ 1 , I 1 1 � 1 I • I I 1 1 • 1 '. a 1 I 1 I Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 10200 SW GREENBURG RD 110, TIGARD, OR, 97223 Commercial - Fire Protection System 999 Sprinkler final PASS - No C of O FPS2014-00164 Jeff Grove Violation Summary: Inspector Contractor