Permit (45) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
aCOMMUNITY DEVELOPMENT
Permit#: FPS2016-00141
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/16/2016
Parcel: 2S 102AA04100
Jurisdiction: Tigard
Site address: 12230 SW MAIN ST 100
Project: Paddle Palace Subdivision: None Lot: None
Project Description: Fire sprinklers-Installation of(8)sprinkler heads
Contractor: PARKER FIRE PROTECTION INC Owner: HOBO PROPERTIES LLC
30205 SE KELSO RD PO BOX 8087
BORING, OR 97009 PORTLAND, OR 97280
PHONE: 503-663-6278 PHONE:
FAX: 503-663-7297
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/16/2016 $75.30
12%State Surcharge-Building 08/16/2016 $9.04
Type of Use: COM Plan Review-Fire Life Safety-COM 08/16/2016 $30.12
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 08/16/2016
Occupancy Grp: Height: ft 11x17) $1.00
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 $115.46
Valuations:
Required Items and Reports(Conditions)
Sprinkler Valuation: $1,400.00
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 952-001-009. You may obtai - copy of the rules
or direc •. ions . OUNC by calling 503.232.1987 or 1.800.332.2344.
Iss ed By: /, /` ' � Permittee Signature: � ,
Call 503.639.4175 by 7:00 a.m.for the next available inspe• ion 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 RECEIVED FOR OFFICE USE ONLY
City of Tigard
G �+ 2016 Received ; .iii, ii,
/ zl
II . Dateiv i / Permit No.:
13125 SW Hall Blvd.,Tigard,OR 972 1 O Plan Review
Ill Phone: 503.718.2439 Fax: 503. gg110Other Permit:
C1 l f__AR U Date/B :
T I GA KD Inspection Line: 503.639.4175 jrI II 1144..ii �+! Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
s arc. ,c - Ddb I'` , ' F I '° ,z!o-"-'-t r- tl uREQUIREDDATA: -€;rte �, , „&r
0 New construction 0 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
" 7ie ',EGOS ,'. p� — -rte' # work indicated on this application.
1?�";
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
6 I+ r ilr D gA` I' ' ;i �' x Total number of floors:
Job site address:12230 SW Main Street New dwelling area: square feet
City/State/ZIP:Tigard,Or Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Paddle Palace Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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
: 0 'ION F WORK1 F X work indicated on this application.
install 8 sprinklers Valuation: $$1,400.00
Existing building area: square feet
New building area: square feet
xi µ ROP TOW El d �, t
Number of stories:T.,,, ----,,; - 4
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
Business name:Parker Fire Protection All contractors and subcontractors are required to be
Contact name:Robert Parker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:30205 SE Kelso Road jurisdiction in which work is being performed.If the
City/State/ZIP:Boring Oregon 97009 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)663-6278 Fax::(503)663-7297
E-mail:pk.fire@comcast.net
flsr l At #5iig
iam�` N CTOi� ltI tR .� r � ' � � �lal PE �� +S*
, �k.
� � .Business name:Parker Fire Protection Inc.
Permit fee:
Address:30205 SE Kelso Road
City/State/ZIP:Boring Oregon 97009
State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)663-6278 Fax:(503)663-7297 (Due upon application submittal.)
CCB tic.:124300 Total permit fees:
Authorized signature: f7e1 ,
Amount received: �il`S. 4
eg.e., This permit application expires if a permit is not obtained
Print name:Robert rk ' Date:8/16/2016 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_031016.doc 440-4613T(11/02/C0M/WEB)
-;
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Q 1 n 117-7:117."'''''7-Y • i ili�h�o'� 4t nTi aRi;�M := yi�S Ii 1, �'x `+ idrd. °I
=f .a Cts _ =a ,, ` -, P flit' '
, = X14
1.) Type of Work. 2.) Addition/alteration only to sprinkler heads. 3.) dd106(1)3't1)5s.on/alteration only to alarm devices:
0,__,,
New system Number of sprinkler heads: 8 umber of alarm devices:
❑ Addition or ® 1-10 heads: Affidavit requited and devices: Affidavit required and
Alteration (3) copies of sketch showing area copies of sketch showing area
to existing of work within building structure f work within building structure
system
❑ 11+ heads: Plan review required and + devices: Plan review required and
(3) sets of plans. (3ets of plans.
Additional description of work:
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x g} '' y -Y rrrY6� q — -;1' pY - ti riG -rll io r ° .�'. e s
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rill rt, 4, i�W ., s -tl
Sprinkler Type ® Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 1400
-tri A ® B -: ,'G"a- }. a.. -_ 9° cr r q iE
,;..'-*4-12.1i,.' �"� *= 1 .�*�Slf)� �4a �.., int ... i ik�*i OIi -..` w � } 1 -` a �• ,. r .ai �,'
Hood Project Valuation: $ �
°' yy r: I r a-E V �N d i d `,iir 6 to bio i i 19 -1: n
�+$ N '4it Ods iii 'r i 'I w ii I'tia� ,,-e 4 ,_} u� 4k _ le ,e ii}
usai kf ': . `t� ij' ;i � t Ix n ` .- ., £ �'` a"=w i' I .
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
g } ” , piF @J rte v —1
i - �i, a�q s 7 4 h� '°� iii d. , -.Y„r i) n ti ,
q_ . !A .z� err ir� A ' i � ir �
Square Footage: �� '
Permit Fee: �, :_,,,,i,
0 to 2000 iz,,:,,0,0NA
2 001 to 3 600 �
3,601 to 7,200
$310.05 ,� '
7,201 and greater $404.39 ,- _ ',
t. , Z ,' * Aik,tile_
Sprinkler Project Square Footage: sq. ft.
a ��. ,„� ��i <,rx _, it0z€stectt4 ;P0�1t a �._ aTr
,
Project valuation subtotal (see A,B&C above): $ 1400
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: $
J:\FPS_PermitApp.doc 2
1,1 .- City of Tigard ICEIVEDPermit No.: 45 c9-0/6-6,0/V/
13125 SW Hall Blvd.,Tigard,OR9-5CEIVED
Phone: 503.718.2439 Fax: 503.598.1960Date Received: k/l& //6
Inspection Line: 503.639.4175 AUG 6 Z Q 1 6 ( l
Internet: www.tigard-or.gov By: r -C4�ttL /,
CITY OF TIGARD V
FIRE SPIRTWADAlfiVAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: /* Le f c I- i c Occupancy:
Job Address: / . Z.3 ) Sce) ,4 '& Type of Construction:
Suite:
Contractor: -1914,< K c Fi.4 e 14ra,o-t c.2f,o w Phone: s o 3 6 6 27 g
Number of Proposed or Altered Heads: S'
Type: S". Hazard: L,/5 L. t Density:
I, fZb, eKT PAR r Oregon Construction Contractors Board No. ) a
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 o his document with a copy of the sketch attached shall be available for all inspections.
Signature:
Date: res - / 6 - ac o t 4
Print Name: R0 e R T (ro4 R .k f<Z,
I:Building\Forms\Firesprinklerdavit 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
12230 SW MAIN ST 100, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2016-00141
Chip Barnett
Violation Summary:
Inspector Contractor