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Permit (86) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT °d COMMUNITY DEVELOPMENT Permit#: FPS2016 00107 Date Issued: 06/23/2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 251018801500 Jurisdiction: Tigard Site address: 12250 SW GARDEN PL Project: Medfocus Subdivision: CROW PARK 217 Lot: 3 Project Description: Add(1)sprinkler head and modify(5)existing sprinkler heads for TI Contractor: AFP SYSTEMS INC Owner: ICON OWNER POOL 1 WEST LLC 19435 SW 129TH AVE BY RYAN TUALATIN, OR 97062 PO BOX 460169 HOUSTON,TX 77056 PHONE: 503-692-9284 PHONE: FAX: 503-692-1186 FEES Description Date Amount Specifics: Permit Fee-COM 06/23/2016 $64.54 12%State Surcharge-Building 06/23/2016 $7.74 Type of Use: Plan Review-Fire Life Safety-COM 06/23/2016 $25.82 Class of Work: Type of Const: Info Process/Archiving-Sm$0.50(up to 06/23/2016 $3.50 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 $101.60 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: AB 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 RECEIVED Fire Protection System JUN i FOR OFFICE USE ONLY City of Tigard !U N 2 3 2016 Received Permit N .. `J g _ DateB : Z t_�I/ 9j2fa—0®161 . w 13125 SW Hall Blvd.,Tigard,OR 972244``� v PlanReview Phone: 503.718.2439 Fax: 503.598 9158 �i_. � �� Da /B : Other Perini `4,Q© ft? TI G A R D Inspection Line: 503.639.4175 blitilLDING DIVISION Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information ! C r ,, » 11 1 1 Ali �' '�': a rte`,'. ,... >.,',i ,fir,,, i, 11 1 i ❑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 0 Other: equipment,materials,labor,overhead,and the profit for the .; o r,' "`�' : '� work indicated on this application. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: C' tJOB 0121ATI� o rtA ! - ` . x Total number of floors:''''''. .0.-z- , - \� K ),,, mF. ,.. r ., _ ,,,, a Job site address:12250 SW Garden Pl.. New dwelling area: square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Medfocus TI Covered porch area: square feet Cross street/directions to job site:Park 217-Bldg.1 Deck area: square feet Other structure area: square feet 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 y- � ;, y ,OF 6 ll' t work indicated on this application. Add 1 new sprinkler head drop&relocate 5 existing sprinkler head drops Valuation: $$950.00 off of existing wet sprinkler system to cover new floor plan Existing building area:' square feet New building area: square feet VW' . C ! ERii/Fii .:. W, \SNF .. . .< n r ,a • Number of stories: 1 Name: Type of construction: II-B Address: Occupancy groups: City/State/ZIP: Existing: B-office Phone:( ) Fax:( ) New: B-office a �� r ' r XPFL 6k4i, r " ,k/r ' At Itisgr,101 r A cr - 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:karmen@afpsys.com \' E1 ",'} L1OR / 4:,, . riy "� Ii?I P z ,.. . �v f r ecs dulel; ;Business name:AFP Systems Inc. Address:19435 SW 129th Ave. Permit fee: State surcharge(12%of permit fee): City/State/ZIP:Tualatin,OR 970621 FLS plan review(40%of permit fee): Phone:(503)692-9284 Fax:(503)692-1186 (Due upon application submittal.) CCB lic.:67534 / Total permit fees: AftAmount received: Authorized signature: ,,'I\ yr This permit application expires if a permit is not obtained Print name:Steve Frost Date:06/22/2016 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information A 0 '� -,t, « _.. SJr 2`x \ --y�,C�t /'n ?\ _1)-'''''‘.,r i, F?._ \, _ - ;_ ; ," '-' 1.) Type of Workirk': 2.) Addition/alteration only to sprinkler heads. 3.) Addition/alteration only to alarm devices: ❑ New system Number of sprinkler heads: 6 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 El6+ devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work: f�st ��r� p er B, g---;Z%-ti J r / v ' r ' 2\ \ / / // / s\/ / c. 171 Wet Wet Dry Additional Standpipes 0 Information: Hazard Group light Density 0.10 Design Area 1500 K. Factor 5.6 Sprinkler Project Valuation: I $ 950.00 HH ' � ' r:.�.N� . luation. $*it"''''''''''u,' ''''''''' . Hood Project Va14yON-i Y`� s /d� ,f. /_ �� , i Win:: �� ,rrt go:m4,. ;' ,; Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: I $ Re t�I ttalS�rtrikle -Sit i d'Alae stem) y, II.' ram r Square Footage: Permit Fee: •0 to 2,000 $198.75 �„ '' 2,001 to 3,600 $246.45 y 3,601 to 7,200 $310.05' 7,201 and greater $404.39 Sprinkler Project Square Footage: I sq. ft. im, ilii' � lre�rceti'4e4ttes 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: $ \\SERVER02\Data\Permits Steve\Tigard\Jobs\medfocus TI FPS_PermitApp.doc 2 RECEWED City of Tigard JUN 2 3 2016 Permit No.: /9,5 20/6 — c90/07 • 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 - Date Received: w/03/10 . Inspection Line: 503.639.4175 CITI�T O F TI GA r[) TIC Al D Internet: www.tigard-or.gov BUILDING ISIE' FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: Medfocus TI Occupancy: B- office Job Address: 12250 SW Garden PI., Tigard, OR 97223 Type of Construction: Il-B Suite: Park 217- Bldg 1 Contractor: AFP Systems Inc. Phone: 503-692-9284 Number of Proposed or Altered Heads: 6 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 docume with a copy of the sketch attached shall be available for all inspections. Signature: •' Date: 06/22/2016 Print Name: Steve Frost I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1 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 12250 SW GARDEN PL, TIGARD, OR, 97223 Commercial - Fire Protection System 999 Sprinkler ﬁnal PASS - No C of O FPS2016-00107 Jeff Grove Violation Summary: Inspector Contractor