Permit (201) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00209
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/14/2016
Parcel: 2S 113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 100
Project: Test Fit Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Install(2)recessed fire sprinklers for new wall.
Contractor: EXPRESS FIRE SYSTEMS INC Owner: G&S FC LLC
1913 41ST STREET 16083 SW UPPER BOONES FERRY RD,
WASHOUGAL,WA 98671 STE
TIGARD, OR 97224
PHONE: 360-953-8432 PHONE:
FAX: 360-953-8394
FEES
Description Date Amount
Specifics: Building Misc Fund(copies/prints) 12/14/2016 $1.50
Permit Fee-COM 12/14/2016 $67.23
Type of Use: COM 12%State Surcharge-Building 12/14/2016 $8.07
Class of Work: ALT Type of Const: IIB Plan Review-Fire Life Safety-COM 12/14/2016 $26.89
Occupancy Grp: B Height: ft Info Process/Archiving-Sm$0.50(up to 12/14/2016 $1.00
Stories: 11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
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 $104.69
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,070.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: <12i5-44 Permittee Signature: 0 A. /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
REcyivEi)
Building Permit Application
Fire Protection System DEC 1 3 2016 FOR OFFICE USE ONLY
Received /// 2 f f pcnnilNo f� � �
City of Tigard �, r • i'`f i tares:/c)//3/1/// ,
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Er
13125 SW Hall Blvd.,Tigard,OR 97223 C r 1 h I r on Review' Other Penult:
Phone: 503.718.2439 Fax: 503.598.19 n �` } ,y 1$y' Jurts: El See Page Z far
TIGARD Inspection Line: 503.639.4175 UIL a-3 1 PITO' �Rcady/By: Page2fararmarlon
Interact www.tigard-or.gov Notified/MaQtod:
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0 Demolition Permit fees*are based on the value of the work performed.
❑New constructionIndicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other. • equipment,materials,labor,overhead,and the profit for the
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, • ,, I.,t.,.,.m , ::.......:.•........::............ Valuation:
El 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms:
❑Accessory building ❑Multi-family
Number of bathrooms:
❑Master builder ElOther:
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Total number of floors:
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City/State/ZIP:Tigard/Oregon/97224 Garage/carport area: square feet
Suite/bldgJapt.no.:100 Project name:Test Fit AKA Fanno Creek 100 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
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work indicated on this application,”
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Valuation: ( $$1,070.00
Install 2 chrome recessed sprinklers for new wall.
Existing building area: square feet
New building area: square feet
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Name:Test Fit - Type of construction: //6
Address:16083 SW Upper Boones Ferry Rd. Occupancy groups; 6 LO,fib 4/2--
City/State/ZIP:Tigard/Oregon/97224 Existing: Light
Phone:( ) Fax:( ) New: Light
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Business name:Express Fire Systems All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:Heather Reeder under ORS 701 and may be required to be licensed in the
Address:670 S.28th St. jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/StatelZlP:Washougal/Washington/98671 apply:
Phone:(360)953-8432 Fax::(360)953-8394
E-mail:Heather@expresstiresystems.com
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Business name:Express Fire Systems Permit fee:
Address:670 S.28th St.
State surcharge(12%of permit fee):
City/State/ZIP:Washougal/Washington/98671 FLS plan review(40%of permit fee):
Phone:(360)953-8432 Fax:(360)953-8394 (Due upon application submittal)
CCB lie.:193272 Total permit fees:
Amount received:
Authorized signature:``'� /6/6
This permit application expires If a permit is not obtained
Date:12/13/16 within 180 days after it has been accepted as complete.
Print name:Heather Reeder * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Budding\PcnnhriPPSPe}•mitAPP 0310i6.doc 440-46131(11/O2/COM/WEO)
•
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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:
❑ New system Number of sprinkler heads: 2 Number of alarm devices:
® Addition or ® 1-10 heads: Affidavit required and D 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:
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Sprinlder Type ® Wet ❑ Dry
Additional Standpipes •
Information: Sprinkler Supply Line ❑ Yes El No
Hazard Group Light
Density
Design Area
K.Factor
Sprinkler Project Valuation: $ 1,070
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Hood Project Valuation: $ •
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Submittal shall Battery Calculations ❑ Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $ . .
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Square Footage: Permit Fee. iii! !ii t.
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198.75 iiilrI a {,...s;::;;:i;!
0 to 2,000 $ ...L.i,,....! .r ....i=i
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001 to 3 600 $246.45 !' ti?!I!I'ii'!7;i:3i:!,!:!::::::::r. :..!,:;',}gl:f,E!,:,:i!iii' 3:ail1:#,j•r�a!i :!.,;�!;{;.,i....,.,..,.1.
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3,601 to 7,200 $310.05 i!?!,'ri!!;:I!:±r.;:;n;::ri;{ }:;jj :....
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404.39 :.,:,?li 'i?,!:, i,::!.•s, ''!=ii .`
7 201 and greater !!;,!i,:}„i,rs±:!,iipigl:q!,::!i::::::.{.._..... }:.i;!::::!I:�:ii..i.i'.�!L.•„!!,,, ir.;,!!?.;i.i:!tt,;a:„}ns,!rr;:r}i!?i';i
Sprinkler Project Square Footage: sq.ft.
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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: $
SADcsign\ Express Jobs\S1G-134 Fenno Creel:Suite 100\FPS_PemvtApp_031016.citec
RECEIVED
DEC 1 3 2010
City of Tigard CM Of, i f' i .i)Permit No.:
/5k./5k. 20/ 'C1Q 't?J
E '. 13125 SW Hall Blvd.,Tigard,OR 97 Y /
Phone: 503.7I82439 Fax 503.598001 k °p,( ?�, s ti' ') ate Received: / /
T1GARD InsactionLine: 503.639.4175 �.
a Inteet: www.tigard-or.gov By;
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Test Fit Occupancy: Light
Job Address: 16083 SW Upper Boones Ferry Rd. Type of Construction: Alteration
Suite: 100
Contractor: Express Fire Systems . Phone: 360-953-8432
Number of Proposed or Altered Heads: 2
Type: N/A Hazard:Light Density:N/A
1, Heather Reeder (Jerry Denney) Oregon Construction Contractors Board No. 193272
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 bead 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.
Signature: / f i / / Date: 11-23-16
Print Name: Heather Reeder
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