Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111/1 s ' COMMUNITY DEVELOPMENT Permit#: FPS2015-00066
Date Issued: 04/07/2015
T I CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S1356C01100
Jurisdiction: Tigard
Site address: 11117 SW GREENBURG RD
Project: Kayu International Subdivision: OAKBURG Lot: 27
Project Description: Cap sprinkler main that feeds damages section of building. Reset all other systems.
Contractor: AFP SYSTEMS INC Owner: GREENBURG SPACE CENTER LLC
19435 SW 129TH AVE PO BOX 91305
TUALATIN, OR 97062 PORTLAND, OR 97291
PHONE: 503-692-9284 PHONE:
FAX: 503-692-1186
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/07/2015 $53.78
12%State Surcharge-Building 04/07/2015 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 04/07/2015 $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: $520.00
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 direc •. • • •UNC by calling 503.232.1987 or 1.800.332.2344.
Iss ed By: Permittee Signature:
_ l i ;lb I k
Call 503.639.4175 by 7:00 a.m.for the next available inspection •ate.
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 Applic TIECEIVEP q,>a
Fire Protection System I ,,,Z O, , 1( I I `l i i\I 1
14 City of Tigard Received 1/ 7 /s (:).,k) Permit No.: e/s— )66
13125 SW Hall Blvd.,Tigard,OR 7 2015 Date
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
1 1 c,A RI) Inspection Line: 503.639.4171:i fl,OF MCI f R 6 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov 1 V A vAI�L+ Notified/Method: 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.
❑ 1-and 2-family dwelling ❑Comercial/industrial Valuation: $
m
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1'1ti S\N G%a nbe r.. New dwelling area: square feet
City/State/ZIP:--VIC,I[�,C Lk_ V ti\ -i e Garage/carport area: square feet
Suite/bldg./apt.no.: J" Project name: o1/4.\,to Tr N , Covered porch area square feet
Cross street/directions to job site: 1 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.
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. !,)
5pr Intl_1Q r- �tA�n � Valuation: $ r C
CAp A; „ ::. __Qt� Existing building area square feet
(,l11C-(41r (/YAa d
5e ,-H on t all 1 oft( Su,*f"A5 New building area: square feet
❑ PROPERTY tiWNER I ❑ 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
Contact name: licensed with the Oregon Construction Contractors Board
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 FEES*
Business name: i � `�� �j/n S (Please refer to fee schedule)
G 't T" Y�, Permit fee: 65, 7g
Address: 1_ 1--k s� �2_I 1y-, Av C
State surcharge 12%of permit fee): .4 5
City/State/ZIP: OR Gl� ( � )
����n r OR aG2 FLS plan review(40%ofpermit fee): di S/
Phone:(5 33 Z_Q ni-..i , Fax:( ) (Due upon application.)
CCB lic.: (a 75-3 Total permit fees:
Authorized signature:_ �� Amount received: 8 j. 7qf
This permit application expires if a permit is not obtained
Print name: /�,,,,�� �� Date: within 180 days after it has been accepted as complete.
(ems • Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(I1/02/COM/1WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
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: $
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: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
I:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 2
City of Tigard CEIVEP Permit No.: /45 A/6---DDD&(p
111
13125 SW Hall Blvd.,Tigard,OR
a Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 0/
T t G A K I] Inspection Line: 503.639.4175 APR R 7 7 0 5
Internet: www.tigard-ocgov A By: CD Qh_* _ "_t
FIRE SPRP I !4¼ AVIT FOR ALTERATIONS
a - .
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: K JJ. Occupancy:
Job Address: 5G) 0..M. a-0 Type of Construction:
Suite: J
Contractor: Dk wDI� 60.061—. iP �y.h
(1 0. Phone: 5-63 4,9 2
Number of Proposed or Altered Heads: if?..-7---
Type: Hazard: Density:
y/3e__ Oregon Construction Contractors Board No. 7 5-3�
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: 3.ellesi d�� Date: y 7/C---
Print Name: C32,014_
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of I