Permit (71) i
IL,
,4CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT
Permit#: FPS2017-00154
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2017
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 290
Project: Thenell Law Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Relocate(10)sprinkler heads for tenant improvement.
Contractor: CROSSFIRE SPRINKLER CO Owner: PACIFIC REALTY ASSOCIATES
17400 SE 82ND DR ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-210-5506 PHONE:
FAX: 503-210-5538
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/10/2017 $112.96
12%State Surcharge-Building 10/10/2017 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 10/10/2017 $45.18
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 10/10/2017 $1.00
Occupancy Grp: B Height: ft 11x17)
Stories: 4
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: 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 $172.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,480.00
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 QUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: /
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 RECEIVE
Fire Protection System
I (112 Ull l( 1 1 til U.1 )
City of TigardOCT 9 2017 Received r
13125 SW Hall Blvd.,Tigard OR 97223 y-�� Datem : fly /C i'7 f%/►— 'I L
. I Phone: 503.718.2439 Fax: 503.598.] Q �CITY IIGARD
PtanRevi• ew
I I i Inspection Line: 503.639.4175 I/ DING i�11 ISIn �a ' OtherPermi 7y 'G9cs�.
Internet: www.tigard-0r.gov 1+/ � S Paye 2 for
r T Y Supptemeatal tnfornlotba
❑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
- .._ __ work indicated on this application.
❑1-and 2-family dwelling ®Commercial/industrial _ ___..._^ Valuation: S
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
: Total number of floors:
Job site address:12909 SW 68th Parkway —_.
New dwelling area: square feet
City/State/ZIP:Tigard,OR
Garage/carport area: square feet
Suite/bldg./apt.no.:290 I Project name:Thenell Law Group
Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
Subdivision:
I 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
-.----. _ . - - work indicated on this application.
Relocate Pendent Sprinkler Heads to maintain coverage'— Valuation:
S$3,480.00
Existing building area: square feet
.- - - New building area: square feet
Number of stories:
Name:PacTrust
Type of construction: #
Address:
City/State/Zip: Occupancy groups: L7
Phone:( ) Existing:
Fax:( )
New:
•
Business name:Crossfire Sprinkler
All contractors and subcontractors are required to be
Contact name:Timothy A Bishop licensed with the Oregon Construction Contractors Board
Address:17400 SE$2'd Drive under ORS 701 and may be required to be licensed in the
City/State/ZIP:Clackamas,OR 97015 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
Phone:(503)210 5506 apply:
I Fax::(503)210 5538
E-mail:dmottty@crossfresprinkler,com
Business name:Crossfire Sprinkler -
_ 4_____._.�-. —
• -Y
Address:
Permit fee: _
Address:
_
City/State/ZIP: State surcharge(12%of permit fee):
Phone:( ) Fax: ) FLS plan review(40%of permit fee):
CCB lie.:174746 Ar��- 211/11a
I�� (Due upon aPPTotaonsubmr
Total permit fees:
AuthorizedT"� .
Amount received:
signature;
Print name:Timothy A Bishop This permit application expires If a permit is not obtained
I Date:10/5/17I within ISO days after it has been accepted as complete,
- * Fee methodology set by Tri-County Building Industry
1:1Buildiogtpe,n,gA -p,,rmitApp 031016.doe Service Board.
4613T(11/02/COM+W EB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
r _ _._ _-_____7.- -_---:7_-::--..-s- — ----__
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: 10 Number of al-
1-5 • •Ices: davit required and
® Addition or ® 1-10 heads: Affidavit required and ❑ ies sket , : area
Alteration (3)copies of sketch showing area of work •wilding s cture
to existing of work within building structure
system 6+devices: Plan nevi re ired and
0 11+heads: Plan review required and ❑
(3) sets of plans. (3) sets of plans.
Additional description of work:
:.
..r_ nId. i.:_.. ® Wet ❑ D
S.rinkler T p e
Additional Stand.i. s Yes II N°
Information: S•rinkler Su..1. Line ■
Hazard Grou.
Densi
D ' Area
K.Factor 3480.00
S, r ' u•'ect Valuation: $
- Hood Pro•- , . $
P-r
-- _....-. Sub. ittal shall - Batt C i culations ❑ Yes
nclude: Individ • Component 0 Yes
Adigilifillill
Cut S ets
Fire Alarm Pro, o �
AIMMITAIIIIIIIIIIIIIIIMIIIIIII,
z
C e,
p
_-_!.
---_.-:
,t to2,S�t _..-_.-__i:L. .,.,,,,___.::_,.____ _-_-_::::
I $198.75 _
I 2,00 to 3,600 $246.45 ry
_13,601 to 7,200 $310.05 _
— 7,201 and :eater $`404'.39 — "_
Sprinkler Project Square Footage: sq.h•
P 'ect valuation subtotal see A,B&C above . $
Permit fee based on .ro ect valuation see fee schedule : $
ro
Permit fee based on s.uare foots: see D above : $
State Surchar: 12%of .ermit fee : $
FLS Plan Review 40%of •ermit fee : $
TOTAL: m�
2
C;\Documents and Settings\LAD\uY Documents\Permits\tigard permitdoc
RECEIVED
City of Tigard _
lir • 13125 SW Hall Blvd.,Tigard,OR 97223 t� Permit No.: /i-/'Js ` —.00/-5-2
* Phone: 503.7182439 Pax: 503.598.1960 u /—__:___ ________:____z
p f Date Received: `�"—
T I i_�R�. inspection Line: 503.639.4175 r� y /,
Internet: www.tigard-or.gov
CITY OF TIGARD By. 41
BUILDING DIVISION Aim..
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Thenell Law Group
Job Address: 12909 SW 68th Parkway Occupancy: Office
Suite: 290
Type of Construction:
Contractor: Crossfire Sprinkler
Phone•- 503 210 5506
Number of Proposed or Altered Heads: 10
Type: QR Pend Hazard: Light
Density: -10
1, Crossfire Sprinkler
certify the following is true and reasonably definesContractorsregon Construction
the scope of work or this project:
rd No. 174746
a) All work is limited to drops and annoyers 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 buildingshall be equipped with Quick Response heads(see 2002 NFPA 13,
p
Section 8.3.3.1 for exceptions). p
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 1;. ;ocument wi
�/ � of the sketch attached shall be available for all inspections.
Signature: Th
---2____
Date: J __
Print Name: Timothy A Bishop
1:1BuildingTonnsTireSprinklerAf6davit 071514.docx
Page 1 of I
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12909 SW 68TH PKWY 290, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00154
Inspection Type: Inspector:
999 Sprinkler final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor