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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 1. COMMUNITY DEVELOPMENTiii Permit#: FPS2017-00191 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/07/2017 TIGARD 9 Parcel: 1 S 135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 150 Project: Corvel Healthcare Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Fire sprinkler permit:Relocating(2)sprinkler heads for TI. Contractor: PACIFIC FIRE SYSTEMS LLC Owner: LINCOLN CENTER LLC 6704 RIVERIA CT BY SHORENSTEIN PROPERTIES LLC WEST LINN, OR 97068 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503-710-6646 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-COM 12/07/2017 $61.85 12%State Surcharge-Building 12/07/2017 $7.42 Type of Use: COM Plan Review-Fire Life Safety-COM 12/07/2017 $24.74 Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/07/2017 $0.50 Occupancy Grp: Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: LT Density: .10 Design Area: 1500 K Factor: 5.6 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $94.51 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $854.00 Residential Square Footage: 0 Fire Alarm Valuation: $0.00 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: ` .9 Call 503.6 .4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. City of Tigard � "I 13125 SW Hall Blvd.,Tigard,OR 9722> Fit- 4,-.1:: o t , Permit No.: r,", ( .� �'`>/ ,. , A'' �2/��i7 Ili Phone: 503.718.2439 Fax: 503.598.19 0 Date Received: Inspection Line: 503.639.4175Q$C J '' T:G A R D Internet: www.tigard-or.gov ti t s C t! By: . ,�(eiv /ei.gr FIRE SPRIN4/Ut- .'I Imo' T FOR ALTERATIONS OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: G o;Z,,)r1 V U(0iZ?. Occupancy: c' Job Address: c LA,,T ,„ , rL o 2M ' , t > .J I J- Type of Construction: Suite: i 4'o Contractor: `Pavyrs c— t-, , Phone: 4"0-s 7 gp .. 1 Number of Proposed or Altered Heads: 1...- Type: ?oType: ?e,j>. Hazard: t..-t 4.wei Density: E t 0 I, k t.1.1.: -e:--zs1/4- Oregon Construction Contractors Board No. ($a t j 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. Signature: ,.t _,,—.— Date:Date: l 2-1 t 1 Print Name: ke. pkv . I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1 uildin Perit Fire Iiia lion rotection S .� ystem m 1C2ty°f Tigard SW T t ARD Phone: Hall Blvd T,;d OR 97 Internet: WLR h 503.639.4175 03.639 4 75 03'598.193 "9 '. Received t'OI d orgov lir E D �t14t : ��© OFFI��I; 1. _ ,.: - Plan RevieR, S� O\, � New DECry } DateB . w cOns�ctipn p DC ! ! ate Read t'ermit No.: +�tiddttio 00 '!.. Notified/Method: YthY: �alteratio replace 8 qui Method: runs OtherPerinir: e �' n/ 0l: L� Ment _'Iiia t ? _ . ® triageSee < /7 1" 0 other: 2 lot j and 2'famrl � Y Accessory buildiy ng '�?I�T �T� ` Permit fee�I#���„�t Ix � Supplemental Information mg Indic �e b �'�'�t 0 Master builder D nercial/j equipment,a the value(oed on the value e o ° ndusth� work materials,labor,did to the 4 Multi-family Gated p nearest do)e j performed. Job site adValuati n this application eat and the profit I dress: �Other: on: CI �� or the City/State/ZIP: f o� �k�"� ! Number of b $ Suite/bldg./apt. uite/bld 1 _ N �Opms: g/apt.np: es. 1�- = fiber of Cross © Y? bathrooms: s eet/directions to Project n Total number of job site: name: New floors: t� re:-L-....- Covered � w dwelling area. Garag%arport area: Subdivision: square feet T map/Parcel COveredPorch area: :::t Decno.: ROther earea: squfee t oN or K Pernut fees* DA1 : square feet Indicate are eor the value hied°n the vale ' wok menti materials,(rounded to the a arest dowEork llar It(}p Valuation: to this labor;overhead,nearest and the pr performed' �� �� profit for the Address: Existing S 8 City/State/ZIP: Iy ng build�g area: 5-4"'Oen Phone: �� New building a hone:( g area: square fee Numb t Number of stories: square feet Business name. l tNT Type of construction: Contact n occupancy groups: ami; r - 4_,...._„.6. � �, Address; City/State/ZIP: Phone. � Irk contractors and under licensed the Oregon are jurisdiction ied e 7 t and$°n Construction Contractors to B Address:ess name AUl appycant is exempt k s by be eurglaetO be licensed °ted L licensing ijlojnrejIflS rformed.If in City/State/ZIP: _ CCB lie.: , ( : a.1 477-c-_ • U1t • • AuthorizedO � �ftft* Signa titre: / State surcharge Permit fee: hint name: — li FLS ply review (12%o fpe t fee): Due (40%o f emit ) dui/dinBlPeRLitsIFPS_pennitgpP 031016 , t.ion a.•lication submittal. 31076doc Total pelt f Dare; L2.Z- -I _1 This iiiiiiiminiountrecived: ees:witrrnit aPplicatio * hid Igo n ex �o-�clarluio2icp F s if �wa) Service methodology Bette it has been accepted is not complete. lot Board. y Tri-County guild ng Industry lite ed City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information 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 ❑ 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 System(Complete B,<C or I)as applicable T A.) Commercial Sprinkler Sprinkler Type N Wet 0 Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group L.t e% Density i Design Area secs 0 K. Factor 4",t, Sprinkler Project Valuation: $ A D v .) Type I- Hood rite Suppression Sysiei'-ti Hood Project Valuation: $ .) Fire Marut Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D. Residential Sprinkler(Stand:lowstem SY ) 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 Sprinkler Project Square Footage: sq.ft. Fire Protection Permit Pees 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: $ C:\Users\kentm\AppData\Local\Temp\FPS_PermitApp-1.doc 2