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Permit (59) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 41 2 '> COMMUNITY DEVELOPMENT Permit#: FPS2016-00140 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/16/2016 Parcel: 1 S135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD 530 Project: AG Spanos Corp Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Adding(3)sprinkler heads. Affidavit submitted. Contractor: PACIFIC FIRE SYSTEMS LLC Owner: LINCOLN CENTER LLC 6704 RIVERIA CT BY SHORENSTEIN PROPERTIES LLC WEST LINN, OR 97068 235 MONTGOMERY ST, 16TH FLOOR SAN FRANCISCO, CA 94104 PHONE: 503-710-6646 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-COM 08/16/2016 $56.47 12%State Surcharge-Building 08/16/2016 $6.78 Type of Use: COM Plan Review-Fire Life Safety-COM 08/16/2016 $22.59 Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 08/16/2016 $0.50Occupancy Grp: Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: LT Density: .10 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 $86.34 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $620.00 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. -/... .c.[K___ Issued By: Permittee Signature: r i Call 503.6 .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 ONLY City of Tigard Received Date/B arm Permit No.: i = ! / 13125 SW Hall Blvd.,Tigard,OR 9722ENE Plan Review 11111 C Phone: 503.718.2439 Fax: 503.598.19 0 Other Permit: r / •i. �,- Da[e/B i-1 Ci A I,1 Inspection Line: 503.639.4175 a r1(t 16 Date Ready/By: [oris: Internet: www.tigard-or.gov A01,3 1 LU j*' � See m en• Informationnr (� Notified/Method: � Supplemental ti TYPE OF WOkJ O1VLS O , REQUIRED DATA:I-AND 2-FAMILY DWELLING ❑New constructionmo ition Permit fees*are based on the value of the work performed. ddition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all `t _ equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION- '.- pp 0 1-and 2-family dwelling .�ki"Commercial/industrial Valuation: $ ❑Accessory building [IIMulti-familyNumber of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION:-,, Total number of floors: Job site address: t 0seicD !J `� -- New dwelling area: square feet City/State/ZIP: 6 __> Garage/carport area: square feet Suite/bldg./apt.no. 2!! Project name: ACovered porch area: square feet Cross street/directions to job site: 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. .461/4;-,:b -3 1 '� ,Jt�- &,..3 (,)P.,-1.5_JG-7 . .. _ Valuation: t(..,C74) 'O� t Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER 0 TENANT , Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: 0 APPLICANT y . . 0 CONTACT PERSON __ ,. r 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: ,Nv CONTRACTOR . BUILDING PERMIT FEES*, Business name: Tt� ase refer feeeschedule).u, t\x C./ -c:-::-'1—c--4 il°�-- Address: 7© - �t�v ( 'Z, �„y Permit fee: City/State/ZIP: 1✓i a-) (f3—F.... 9'1 O State surcharge(12%of permit fee): v"'� o Fax:( ) FLS plan review(40%of permit fee): Phone: (Due upon application submittal.) CCB lie.: Total permit fees: 11 i f Authorized signature: - Amount received: This permit application expires if a permit is not obtained Print name: N1/44.101›.-6::,1/4"-C, Date: qj-,\,(,,,,t/ within 180 days after it has been accepted as complete. Y * Fee methodology set by Tri-County Building Industry Service Board. is BuildingAPermits,FPS-PermitApp_031016.doc 440-4613T(I1/02iCOM,WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information 1eanbe +vcrr 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`Syste (Complete A, B,C or D a applicable) A.) Cgrn ►ercial~Sprinkler Sprinkler Type ❑ Wet ❑ Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I- Hood Fite Suppression System z .� Hood Project Valuation: $ C.) Fire Mann Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ �Mx 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 ; . : .g Sprinkler Project Square Footage: sq. ft. -s "l ?rot jon P r:n t Ee v ...f. v _1:0 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: $ 1:A Building\Permits\ATS_PermitApp_031016.doc 2 City of Tigard Permit No.: 031AG((a al/0 IIIa 13125 SW Hall Blvd.,Tigard,OR 9 ��aCENED _ Phone: 503.718.2439 Fax: 503.59 1`, Date Received: 131/6/i�i T I G n R U Inspection Line: 503.639.4175 --rte Internet: www.tigard-or.gov AUG 16 2p1� By: g c . FC FIRE SPR ' :► Z� I ç.. , ►NIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: 1R. �_r CN p S Occupancy: pt- 1 (A7--:7 Job Address: t 0'La© ', C,.. 3;c-C Type of Construction: Suite: '.-2, v Contractor: _ "?Pk, (.., \--='-‘ c V--L Z, - Phone: o 3 1 t LD - '. Q , Number of Proposed or Altered Heads: -3 Type: 13 _ Hazard: L,t. 6..1...17C- Density: . I 0 I, ;�c.)'C-- t-&A it-)z-4._ Oregon Construction Contractors Board No. \, 9,,,0\ 4-d 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 ofNFPA 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 ofNFPA 13. 0 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 ofNPFA 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: .____ ' It' k•\ Print Name: tC i=—r 't NA(s., r Z I:\Building'Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1