Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 u
II COMMUNITY DEVELOPMENT Permit#: FPS2016-00148
T EGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/01/2016
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 190
Project: Integrity Medical Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire sprinklers-Add/relocate(7)sprinkler heads
Contractor: AFP SYSTEMS INC Owner: PACIFIC REALTY ASSOCIATES
19435 SW 129TH AVE ATTN: N PIVEN
TUALATIN, OR 97062 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-692-9284 PHONE:
FAX: 503-692-1186
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/01/2016 $67.23
12%State Surcharge-Building 09/01/2016 $8.07
Type of Use: COM Plan Review-Fire Life Safety-COM 09/01/2016 $26.89
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 09/01/2016 $3.00
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 $105.19
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,100.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct ue;tions to NC b ca • 503.232.1987 or 1.800.332.2344.
Issued By: V Permittee Signat re: �_�1��.
Call 503.639.41751by 7:00 a.m.for the next available ins ction date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
AUG-31-2016 WED 02:53 PM AUTOMATIC FIRE PROTECT FAX NO, 5036921186 P, 01
Building Permit Application
Fire Protection SystemE [(it<t)i,l'lt I: t!51:()NI.)
Ci of Tigard Reee$' PermitNo.; /
� � Datc, : Sig Am 90,4,-r%)/490,4,-r%)/4_
1,11 " 13125 SW Hall Blvd.,Tigsutl,OR 97pr'''' 1 2016 Plan Review
Phone: 503,718.2434 Fax: 503.598.16 pew Penult: �� i '
1 1, ,1 It I, Inspection Line: 501639.4175 CITE' OF TI GAR s� Date Ready/By; Jura: rd Ser Page 2 for
Internet: www.tigard-ar.gov Notified/Method; Sapplemeetai Information
BUILDING DIVISION
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❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
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YR work indicated on this application.
_
Valuation: $
0 1-and 2-family dwelling ®Commercial/industrial
AccessorybuildingNumber of bedrooms:
Q ❑Multi-family
❑Master builder ❑Other: Number of bathrooms:
lSV
-. .
� � l ; �IEAYA �WWWdq � $ C3aYTotal number of floors:
Job site address:6650 SW Redwood Lane. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:190 I Project name:Integrity Medical Ti Covered porch area; square feet
Cross street/directions to job site:Pacific Corporate Center Deck area: square feet
— Other structure area: square feet
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Subdivision: 1 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
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this application.
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Add/relocate 7 existing liresprinkler spriner head drops due to floor plan change Valuation: $!61,100.00
Existing building arca: square feel
Ncw building area: square feet
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Name: Type of construction: 1I-B
Address: Occupancy groups:
City/State/ZIP: _ Existing: B
Phone:( ) Fax:( ) -
New: no change
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Business name: * rI 5 .& '1')-' (1 All contractors and subcontractors arc required to be
Contact name: �1W h to 5.-vi`/` 9,t/ licensed with the Oregon Construction Contractors Board
/ under ORS 701 and may be required to be licensed in the
Address: 144 5 „i) 1,� . . • jurisdiction in which work is being performed.If the
City/State/ZIP: - ' ,(,,{.�{,1, ,---j 0 () c u- applicant is exempt from licensing,the following reasons
appy:
Phone:( , a- . i Fax;:( / ) le l a' i I
E-mail:permitsc nipsys.com
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Business natio:AFP Systems Inc. Jit�;1 ,11°.:I:.:al,iilol::U;i%;il:i Fau a.roto,;ti'Yao,iFdadd/d'!'":,'1' 1;I;1'1r1�,;d�i11.1'�°I,r;iil;l
Address:19435 SW 129t1i Ave Permit fee;
State surcharge(12%of permit fee):
City/State/ZIP:Tualntin,OA 97062 FLS plan review(40%of permit fee):
Phone:(503)692-9284 Fax:(503)692-1186 (Due upon plication submittal.)
CCB Iic.:J,537” (9'753(-1 i Total permit fees:
Amount received: 11/05",14
Authorized signature:
_ This permit application expires if a permit is not obtained
Print name:Steve Frost Date:08/31/2016 — within 180 days after it has been accepted as complete.
h, Fee methodology set by Tri-County Building industry
Service Board.
1:1Buildia,\Ye•Iniu FPS-YermirApp o7)S14.doc 40.46Iriti l/OVCOM1WBB)
AUG-31-2016 WED 02:53 PM AUTOMATIC FIRE PROTECT FAX NO, 5036921186 P. 02
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
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1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
0 New system Number of sprinkler heads: 7 Number of alarm,devices:
iSi Addition or IN 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
Q 11+heads: Plan review required and 0 6+ devices: Plan review requited and
(3) sets of plans. (3) sets of plans.
—
Additional description of work:
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Wet 0 Dry
Additional Standpipes
Information: IIazarcl Group — LH
Density 0.10
Design Area 1500
_
K Factor 5.6
Sprinkler Project Valuation: 1,100.00
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aaluation: 1 $
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Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Pro'ect Valuation: $
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r�, r,�If���� ���f�'f"tf��'�'� .rr I9f�,,.�� ,��'�� �:';r�'�,�I;I,,,..�,:�,j.....("{I l;earl.il,�.r°�1.1r.h,.lEf� LL,rII,�����„1,'i�;,1�Yrr�hl�,.{t„1, .l;;a,ll„�,.,�:r',Irl�,,,r,:,,,,dr.r,..11r„Yrlh 1 1Y,1 r I ,�1,�
.P.,i.Al! u. 401 ririn,.rJl U"�'11'.11 r l",'C:' .,j! 11'zh"'w x':x i'''S 11°,r��1�� r I K.A Y '�t 1 d 11:1 `' '
Square Footage: Pormit Fee: Il9" 'a!fP l!( ` 9 !lI¢y ,, I��r bqX1i alSFrr1!I'
l,l
o to 2,000 `198.75 jI i �;�¢iYA16�; I!it.ii../r;;� ,rI �iS l,f'Ii` IYt� 1 ' f+li.�
I
1
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. )+.1'' 1 ,'' jIrtl, Y� f ,:f�' ri.O „t .2,001 to 3,600 $24G.45 !1,l11{i;!','N Le 'I "l'� ii; � 1,-r'i l,�Il1 i.,r..., "llra lh!lr�,'r'S1 '"4 `I¢i,Y:Bi[�� , ir-Elii .','. .t'l!1 ' ,iHl,;, r , I +
3,601 to 7,200 $310.05 i: q' , 1 r�{ fl�' jd { liilli
7,209and greater li4%+Ir1Y til .r ¢i1 1�e' lil,sity�6.i� �li fIf1}di.l 'f'' �7�`^t� �lrp„ ;4#I
@ „ri,�Ol A +iiilI1 { IYal, il .IlY bWi:
Sprinkler Project Square Footage: sq.ft.
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�.�.,�.., � .r:. r'.... ...'. � ,.r..,�..�„I �.,.�,�.,�...r li�I. � ,", ..�..� v�� .n)r,Li 11.L V:.:1.'I'.r' ,,:fi,:p.:.,l{;.:.:IQ� ndr,i:A.li' .r nd71Y :r 9.1. ,�!1'�li;l:� ,�Ii'' �:9, "I,!.
..',�'''r.,�a b.l.l i„!,...,i!6!r i„t,.,.,,,'., .r..'. .r,.. l,n,h,�,,'14,,� 1,q r I .,#, rj'if'?r.,�Y�': �,if,ylr” ,,,f 1�:. '„f�;'�c' ''t14: j Y,�r'','Ir
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-r+Yr r:'';Y� r I'r��11�d , .Q.,l,l.l r..�..�Q;ifVr., (r{' h1 {,+:dPpCla`!n,IY {a;1�1r. :1'i'�....hil!I�{,11';:'::ri'!! ',o,,.I'� ..l!`: iYF'll
..1,,�,},1:,�',�,.t,I,,,���,'r�r:1'..ilrf..,,r..,,,.,ll ' .r,r4, rl., 1 ..1.. i'1lr;i'' r p11�.OtG' .#�'.�”.� .��.�:��•.r:,��.��.hLcY.r.�.l,.�I��l.q,isl'a„Ilrilcii;,.,.�.r.{rA.i�l�..�l;�...,.led.,.,{I,:ii;:!iall;li".I,,r...l��'ll�!.Ii;.e.,a,t.,f6'.I!RU...o.,
.,,I,,it..1,t....,,,,.a.rl,il Ir....,..,,.r,..�{.I,..,L.l r., ..li.?I,,3 r1„L.ill.,....,....,Q,',.;.Q!,>r.,�`il.�:c.,rf.. . ..� � .,�
Project valuation subtotal(see A,B &C above): $ 1,100.00
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\Tigasd\lobst\inmgei y medical TI-FPS_Permit.App-dr9e
AUG-31-2016 WED 02 53 PM AUTOMATIC FIRE PROTECT FAX NO. 5036921186 P. 03
RECEIVED '/
City of Tigard Permit No.: cosd0/6—ODCZIg
■ 131255W Hail Blvd.,Tigard,OR 9722kUG 3 1 2016
Phone; 503.718.2439 Fax: 503.598.1960 Date Received: 51/3/// ,
Inspection Line: 503.639,4175 CITY OF TIGARD
I sI
(mane': www.tigard-or.gov By:
-.
BUILDING DIVISION
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Integrity Medical TI Occupancy: B
Job Address: 6650 SW Redwood Lane, Tigard, OR 97224 Type of Construction: II-B
Suite: 190
Contractor: AFP Systems Inc. Phone: 503-692-9284
Number of Proposed or Altered Heads: 7
Type: Wet Hazard: Light Density: 0.10
I, 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).
c) The area covered per sprinkler head is limited to the spacing requirements o'fNFPA 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.
a Building fire protection system permit.
• A copy of this ocument th a copy of the sketch attached shall be available for all inspections.
Signature; AI A I _ Date: 08/31/2016
"arT
Print Name: Steve Frost
1s\Building\FormslfiresprinklerAaTidaviL071514.docx Page 1 of 1