Loading...
Permit (42) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit#: FPS2016-00137 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2016 Parcel: 2S113AB00600 Jurisdiction: Tigard Site address: 16125 SW 72ND AVE Project: St.Jude Medical Center Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30 Project Description: Relocating(1)sprinkler head. Affidavit submitted. Contractor: DELTA FIRE INC Owner: PACIFIC REALTY ASSOCIATES LP 14795 SW 72ND AVE ATTN: N PIVEN PORTLAND, OR 97224 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-620-4020 PHONE: FAX: 503-620-1058 FEES Description Date Amount Specifics: Permit Fee-COM 08/08/2016 $51.09 12%State Surcharge-Building 08/08/2016 $6.13 Type of Use: COM Plan Review-Fire Life Safety-MF 08/08/2016 $20.44 Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 08/08/2016 $0.50Occupancy Grp: Height: ft 11x17) Stories: Misc Administration Fee 08/08/2016 $1.50 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Hazard: LT Density: 1.0 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 $79.66 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $500.00 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 503.232.19 332.2344. Issued By: Permittee Signature: 6/314-0,•-' 7411. all 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. Sf‘ -�'" u i 1 d i n 2 Permit A ( ,k� .. L.,. pplicati Fire Protection System - �� ��11 '� �� � FOR OFFICE USE ONLY City of Tigard o ., il1'i Received q 13125 SW Hall Blvd.,Tigard,OR 97223 +Y` Sgt \`),.1,3 _PateB : )j Ill Permit No.: " s ' Phone: 503 718.2439 Fax: 503.5981940 ' +Sslan Review _ '� 1• - DateB Other Permit: 1 ^,4. ' TIGARD Inspection Line: 503.639.4175 `� � f 2 for Date Read/B 1 riJ Internet: www.tigard-or.gov r �`<if'S� ��'� Ready/By: ®See �age z for ro Notified/Method / , Al Wi ��'` �� 'h'����lAIsC got `�!typ�i " °�3r5 �� '�� 4 ���s 3i ;e�r��7"f> `t3z��a:"�a .:�,�w�q �o gy�'�. s10 � Information a E.i " '� ..,: G r q� aM5 �j ; `�, .s e @, , � ,zk . "1 0� V' � ISupplementalis sap;a -...a �..f�, i -5�. ,.Ai,ATM µµ _ Ko,P ,. ,44 „q1- ...‘,:,%E.,- 'W}'4,}Ili '`i fo ,,,I.'1- , New construction ❑Demolition Permit fees*are based on the value of the work performed. 0 Addition/alteration/replacement Indicate the value(rounded to the nearest dollar)of all ❑Other equipment, 11:i? X10 0 ;"i _ ATE�GOR OF CONS w I('y,'1� 's� i 3 !' i work indicatemad hislapplicat onead,and the profit for the IAPk El1-and 2-family dwelling Nj Commercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: 'soiro , ofim� P F ' , - F Total number of floors:iiigl� i � ;� M tfaN ? ,MItamoK , fil Job site address:16125 SW 72nd Ave. New dwelling area: square feet City/State/ZIP:Portland, Oregon Garage/carport area: square feet Suite/bldg./apt.no.:B I Project name:St.Jude Medical Center Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet rtz Subdivision: ��94,409:e yc , .? f l4" 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 u� 6�� sra �' n "sr ,a equipment,materials,labor,overhead,and the profit for the ,�:11441"i:����,a ' s a5" g� �'.�'l'i Yikea,r aklbp°w ,tti��.e�,u "sh.i l�tillau i „a..-_ n,AvA,r y , t . work indicated on this application. relocate sprinkler head due to new wall Valuation: $500.00 Existing building area: square feet New building area: t square e feet ft BO. � ' � 1 �fi lg d ol � }" Number of stories:as.,, .*0. u"* ..ar . amum "..,,� ,.," � I. t.j. � X, Name:Pacific Realty Address:15350 SW Sequoia Parkway Type of construction: Occupancy groups: City/State/ZIP:Portland, Oregon Phone:( ) Existing: Fax ( New:' � p � Niltikioikii a k $MNR #� 3 > L �Ex ` sa i arpatrw`Es Iai,s, . : ,zia ,e5, ro . f ° 31' A yr % a , � __ �� , " t ® ?} � � �Fi `Business name: Delta Fire, Inc. All contractors and subcontractors are required to be Contact name:Melissa Boughton licensed with the Oregon Construction Contractors Board Address: 14795 S W 72nd Ave. under ORS 701 and may be required to be licensed in the jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP: Portland, OR 97224 Phone:( 503) 620-4020 I Fax::(503 ) 620-1058 apply: E-mail:melissab©deltafire.com .;, tb m+l o, ar, �rY h €amu . -e.,� s r s N. �- E��ks, tayinw a� " gyt 4i,, �ryit s �69��o � s 8FBusiness name: Delta Fire,Inc. Address: 14795 SW 72nd Ave. Permit fee: State surcharge(12%of permit fee): City/State/ZIP: Portland, OR 97224 Phone:( 503) 620-4020 I Fax:(503) FLS plan review(40%of permit fee): 620-1058 (Due upon application submittal) CCB lie.: 64174 Total permit fees: Authorized signature: Melissa Boughton Amount received: This permit application expires if a permit is not obtained Print name:Melissa Boughton DI within 180 days after it has been accepted as complete. ate:7-27-16 * Fee methodology set by Tri-County Building Industry Service Board. I:\BuildinglPermits\FPS-PerirtitApp_071514.doc 440-4613T(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information �s�, 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: Nf ❑ New system Number of sprinkler heads: 1 Number of alarm devices: Addition or I 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and Alteration (3) copies of sketch showing to existin area (3) copies of sketch showing area t seem g of work within building structure of work within building structure Y ❑ 11+heads: Plan review required and ❑ 6+ devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work: ® oaf S Complete A, B y{ �] ia�e 9 fw Er p3 a ! E! wd ]' J , H xL .y 3r. "'"m 's 7r''plr pEEIiPE l01: E061 d�: 1,11 .2 L`f r E°S"' �'1 :: $ �i�c3o��, �-,�, ��' .� ���l� �ga `v,�h� ],3' .. x�l� G�� a aria e �NArgit V .,.lifi k. 1 0 tf , S - ° &' 4,�"S� ,lyu��_ ,,gyp �, moo, ,. E�3E Ee��i�. P.. l�Els .€ 'i#if ',5€�s § r '_ —'fit .t.„. �_ �` rte! ei� �''°'�fl Wet ❑ Dry , Additional Standpipes Information: Hazard Group Density //b Design Area K. Factor Sprinkler Project Valuation: I $500.00 , ; TY E� �Idad Flee bib}�` 're $ ! "al �f W� iY r; e a,..,. ,... YP $, ,� 31, sa +.. � � �� 14� q kill a . • l ,�. Hood Project Valuation: I $ :, Eti "�'� el��P �. , �s iR0 iEE rN ''�''f tsg,-R 1. E t 4 !4 ,, s E33ssz g r E ¢` t -? 10s 0 G. __�* l rt! s'# , 3• 9 l 1 pp��� p��!� >� !_,' } l9� ° `�' �+." V 1 } a3 "ok .a3 rlu�'�,'F �' xe-.hgRII 4..9!{14S,E �9 14 3 E Submittal shall Battery Calculations 0 Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: I $ l � EA[� g""h¢" W',NArs lai s. lts f' � 3 # WCK r�+ r i .�� �rNgittNo td ;kd aGJ $tg1 S hi, ri�� , 04 , 1t0 �r k � ti� . at4lSquare Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 ,, �. �Efid,<�r � }��r` ��ki +i'�� 3,601 to 7,200 $310.05, °''° �� � ia 't� r ]� t! Y , 7,201 and greater y ry € u $404.39 _'4`'T��E'r,. ���k a � � �S LIQ��lrI l,fia "4,,rnE i,.. ` .Rda" °F'ss g NY.a,,,,3 cn� Sprinkler Project Square Footage: I sq. ft 3p PP€ ��i�.�g�f ��'$yiR l�+R+�3�e �`c :.- Ar�g 3Mr'Sd '4 f .s .d a..:ra"... ,ar:..".u..st ! ..l. €a ! , as p, 0 }re t i#e tii'� it ' , ��� .,9 7,.'rrf '_.:�,bnd',eA�triS 6 •ra`t�! .._3110116.,,_"1, 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: $ C:\Users\heidis\AppData\Local\Temp\FPS_PermitApp.doc 2 (IVO)) t O)..> City of Tigard � 13 7 ' 13125 SW Hall B1vd.,Tigard,OR Vt,,,VA -1 3 t� CC Permit No.: --Cr,2, Phone. 503.718.2439 Fax 503.598.1960 60 i `-'' Date Received: -7/a 7 iJ`' "I`IG - Inspection Line: 503.639.4175 J� Internet: www.tigard-or.gov B _ e//- —^ q FIRE SPRINT > r\DAVIT FOR ALTERATIONS O TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: St. Jude Medical Center Bldg. B Occupancy: Job Address: 16125 SW 72nd Ave. Portland, OR Type of Construction: Suite: Contractor: Delta Fire, Inc. Phone: 503/620-4020 x118 Number of Proposed or Altered Heads: 1 Type: Wet Hazard: Light Density: 1.0 I Delta Fire, Inc. Oregon Construction Contractors Board No. 64174 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. Melissa Boughton ° .�uw°aW° Signature: 9 b.,oso,°, sz o, n.wm.°.s Date: 7/27/16 Print Name: Melissa Boughton I:\Building\Forms\Fi reSprinklerAffidav it_071514.docx Page 1 of 1