Permit (219) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
- COMMUNITY DEVELOPMENT
Permit#: FPS2016-00203
and OR 97223 503.718.2439 Date Issued: 12/01/2016
f_t ';ti I D13125 SW Hall Blvd.,Tigard Parcel: 1S126DC03300
Jurisdiction: Tigard
Site address: 9900 SW GREENBURG RD 110
Project: Server Logic Subdivision: LEHMANN ACRE TRACT Lot: 4-5
Project Description: Fire sprinklers-Relocating(10)heads
Contractor: METRO SAFETY&FIRE INC Owner: ATHERTON REALTY PARTNERSHIP
PO BOX 33650 2100 S WOLF
PORTLAND, OR 97292 DES PLAINES, IL 60018
PHONE: 503-231-2999 PHONE:
FAX: 503-256-4691
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/01/2016 $102.20
12%State Surcharge-Building 12/01/2016 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 12/01/2016 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/01/2016 $0.50
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 $155.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,749.00
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 No' . 10 --nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire, questions to O► C by .- 'ng 503.232.1987 or 1.800.332.2344.
Issued By: /, 0, / Permittee Signature: I/ .)— L 1. (-
/
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
Fire Protection System - _ pr'"1-4it FOR OFFICE USE ONLY
rittCity of Tigard ` RDateBey: 1st 7 /40 «, PermitNo.:�ij052vito-OD, 3
'" 13125 SW Hall Blvd.,Tigard,OR 97 Plany
Phone: 503.718.2439 Fax: 503.598. 960 1
?016 Review
Date/B : Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: E7 See Page 2 for
Internet: www.tigard-or.gov CH to• Notified/Method: Supplemental Information
ax`* x f TYP 'Ol! � REf>JIREIkArA.I F1'Dt'E G
El 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
G GORE 0 TR1 IO x work indicated on this application.
El1-and 2-family dwelling ®Commercial/industrial Valuation: $
Number of bedrooms:
ElAccessory building ❑Multi-family
❑Master builder 0 Other: Number of bathrooms:
z 7 `1 f?I Sins INFOR14fATIQ - LOCATIOIS , ' Total number of floors:
Job site address:9900 SW Greenburg Rd. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:100 Project name:Columbia Business Center Covered porch area: square feet
Cross street/directions to job site:SW Coral St. 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.:1S126DC03300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
a
! d 9 6RI t ` work indicated on this application.
We are relocating 10 Sprinkler heads to obtain coverage. There are no new heads Valuation: $2749.00
being added just relocates only. Existing building area: 5,285 square feet
New building area: 5,285 square feet
►+ ROP 31 j Number of stories: 2
Name:Atherton Realty Partnership Type of construction: commerical
Address:200 SW Market Street,Suite 200 Occupancy groups:
City/State/ZIP:Portland,OR 97201 Existing: Office Space
Phone:(503)279-1726 Fax:( ) New:
.tea I �►� rP i
Business name:Metro Safety and Fire All contractors and subcontractors are required to be
Contact name:Derek Langel licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 14324 SE Stark St. jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97233 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)231-2999 Fax: :( )
E-mail:Derek@MetroSafetyandFire.com
Business name:Ro •rt Todd Constructio� go
Address:4080 SE Inte tional W. uite B-113 Permit fee: 177.52
State surcharge(12%of permit fee): 30
City/State/ZIP:Milwauki ;OR 9 FLS plan review(40%of permit fee):
71.01
(Due upon application submittal.)
Phone:(503)653-5 i4 Fax:(503)653-5729
Total permit fees: 269.83
CCB lic.:98
Amount received: # 155•
Authorized signature: \r‹.///r-,--),) /7 ( This permit application expires if a permit is not obtained
h— within 180 days after it has been accepted as complete.
Print name:Derek Langel Date: 11/30/16 * Fee methodology set by Tri-County Building Industry
Service Board.
I:/Building\Permits\FPS-PermitApp_031016.doc 440-4613T(1 I/02/COM/WEB)
City of Tigard K > Permit No.: 05 dote-bo 2-03
13125 SW Hall Blvd.,Tigard, 97223 ` /
• Phone: 503.718.2439 Fax: MI¢98.19(10 2016 Date Received: ,a I/ 1,
Inspection Line: 503 639.4175 ('
j,
TIGARDW .Internet: www.tigard or \• � t kBy: Z. er- val-,-
FIRE SPRINKLE° AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Columbia Business Center Occupancy: Office Space
Job Address: 9900 SW Greenburg Rd. Tigard,OR 97233 Type of Construction: Commercial
Suite: 100
Contractor: Metro Safety and Fire Phone: (503)231-2999
Number of Proposed or Altered Heads:
10
Type: Commercial Hazard: Light Density: 0.1
Yp Y
I, Derek Langel Oregon Construction Contractors Board No. 63651
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.
Derek Langel �'" °"° e�' 11/30/16
Signature: ��p,a,, ,, o,� �a�F o ,� °.�����"a,.om�e Date:
Print Name: Derek Langel
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work.to be;done -,14; - , .
1.) Type of Work 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration onlyto alarm devices:
❑ New system Number of sprinkler heads: 10 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 We are relocating 10 Sprinkler heads.No new additional heads will be added.
Type of System (Complete=A,.B,'C or D as appbcable
Commercial Sprinkler .
Sprinkler Type ® Wet El Dry
Additional Standpipes No
Information: Sprinkler Supply Line ® Yes ❑ No
Hazard Group Light
Density .1
Design Area n/a
K.Factor 5.6
Sprinkler Project Valuation: $ 2,749.00
B.) Type I- Hood%Fire uppression System f -
Hood Project Valuation: $
arm f
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
I ) R .-de{n SP _ Cr(Stand Aloe SJ Vim) ..
Square Footage: Permit Fee:
0 to 2,000 $198.75 e
2,001 to 3,600 $246.45 ;
3,601 to 7,200 _ $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Flee rQtectt er tt Iee,
Project valuation subtotal(see A,B &C above): $ 2,749.00
Permit fee based on project valuation(see fee schedule): $ 177.52
Permit fee based on square footage (see D above): $ 0
State Surcharge (12% of permit fee): $ 21.30
FLS Plan Review(40% of permit fee): $ 71.01
TOTAL: $ 3,018.83
http://wwwtigard-or.gov/document center/Building/FPS_PermitApp.doc 2
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
9900 SW GREENBURG RD 110, TIGARD, OR,
97223
Record Type:
Commercial - Fire Protection System
Inspection Type:
999 Sprinkler final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
December 6, 2016 at 10:40:23
AM
Record ID:
FPS2016-00203
Inspector:
Chip Barnett
Contractor