Permit (262) ilhf� CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
. ` COMMUNITY DEVELOPMENT Permit#: FPS2017-00196
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/21/2017
Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 350
Project: Williston Financial Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Relocate pendent sprinkler heads to maintain coverage for TI.
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 12/21/2017 $112.96
12%State Surcharge-Building 12/21/2017 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 12/21/2017 $45.18
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 12/21/2017 $0.50
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: 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 $172.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,600.00
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 • •UNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ~' Permittee Signature: /
G4/ . 7'W •e.� e --SON
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.
RECEIVED .
City of Tigard Permit No.: i"--1"..—C;4/ 7 —OO/9 ,
13125 SW Hall Blvd,Tigard,OR 97223 L $ Q /'
Phone: 503318.2439 Fax: 503.598.19'60gi
/ ry i /�ggp Date Received: /0//J// '7
Inteanet:InspLinection
'- 1 OF t91lTHY1
By:
BUILDING DIVISION
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Williston Financial Group Occupancy: Office
Job Address: 12909 SW 68th Parkway Type of Construction:
Suite: 350
Contractor: Crossfire Sprinkler Phone: 503 210 5506
Number of Proposed or Altered Heads: 10
Type: QR Pend Hazard: Light Density: .10
1, Crossfire Sprinkler Oregon Construction Contractors Board No. 174746
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.
t) 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 oflif.ocument ' ' : i ' o�etch attached shall be available for all inspections.
Signature: IAIIIIIIEP'r
Date: by lob I t-7
Print Name: Timothy A Bishop
1.•1Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1
Building Permit Applicati ofEcEprri,,''
If El"
Fire Protection System t7
y i�
IiEC 1 201-1 I t)It 111 11( I I �1 ri�l !
City of Tigard Received �,�.
q 1312$SW Hall Blvd.,Tigard,OR , OF 1'j( . Qs �'��ill •�" Permit r>oy�S /7 QQ�g
f� Plan Review
Other
Phone: 503.718.2439 Fax: 50
i 1 c ,1.i, Inspection Line: 503.639.4175 11iT, DIVISION' te Rea y/8y Permit
Internet www.tigatd-or.gov Notifed/MSetb3d: See Pent for
See
Information
New construction _ .r. ,._ .._ _....._
0 Demolition Permit fees*arc based on the value of the work performed.
®Addition/alteration/replacementOther. Indicate the value(rounded to the neatest dollar)of all
r
equipment,materials,labor,overhead,and the profit for the
:. _ workindicated on application.
��� thisappli ati n.
1-and 2-family dwelling IN Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
` Total num of floors:
t=,= -
+
Job site address:12909 SW 686 Pkwy New dwelling area:
square feet
City/State/ZIP:Tigard,OR
Garage/carport area: square feet
Suite/bldg./apt no.:350 I Project name:Williston Financial Group Coveredpo rch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
Subdivision:
Tax map/parcel no.: I Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
equipment,materials,
labor,overhead,and the profit for the
_ _
work indicated on this:d lication.
Relocate Pendent Sprinkler Heads to maintain coverage Valuation $3600.00
Existing building area: square feet
New building area: square feet
_
Number of stories:
Name:
Address: Type of construction: /i 6
City/State/ZIP:
Occupancy groups: L
Phone:( ) Existing:
Fax:(t —
)
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 82"Drive under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed.If the
City/State/ZIP:Clackamas,OR 97015 applicant is exempt from licensing,the following reasons
Phone:(503)210 5506 I Fax::(503)210 5538 aPPIY
E-mail:timothy@crossfirespr'inkk:r.com
Business name:Crossfire Sprinkler = , - -- � - ;
Permit t fee:
City/State/ZIP: State surcharge(12%of permit fee): --
Phone:( ) I Fax:( ) - FLS plan review(40%of permit fee):
-e ‘.n ar.,Hcation submittaL
CCB lic.:174746
Total permit fees:
Authorized signature: � tir
1 IIIMIlliiii Amount received:
IPrint name:Timothy A Bishop This permit application expires If a permit is not obtained
1 Date:12/13/17 I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
1:kBuadirglPermitSFrS•ramitApp031016.da Service Board.
440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
L) 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 alarm devices:
® ®
Addition or 1-10 heads: Affidavit required and ❑ (3)1-5 codpievices:es of sAffidketcavhit showrequingired area
Alteration (3)copies of sketch showing area of work within building structureand
to existing of work within building structure
system
0 11+heads: Plan review required and ❑ 6+devices: Plan review required and
(3)sets of plans. (3)sets of plans.
Additional description of work:
t
_-_ S.rinkierTA•e ® Wet ❑ D
Additional Stand•i. •s
Information: S•rinkler Su. . Line 0 Yes 0 No
Hazard Grou•
Densi , .10
Des.: Area 1500
K.Factor 5.6
. , , - 44 I $ 3600
Hood Pro'ect Valuation: $
.._._: .. ❑ Yes
Submittal shall Ba Calculations
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Pro'ect Valuation: $
_ . Permit Fee:
S•care Foo
MI 0 to 2,000 $198.75
2,001 to 3,600 $246.45
MI3,601 to 7,200 $310.05
7,201 and , eater $404.39 :--
Sprinlder Project Square Footage: sq•ft
-.. _. _ -- -- Pro'ect valuation subtotal see A,B&C above : $
Permit fee based on •ro'ect valuation see fee schedule : $
Permit fee based on s.uare foo . e see D above : $
State Surchar: 12%of .ertnit fee : $
FLS Plan Review 40%of.ermit fee : $
TOTAL: $
2
C:\Documents and Settings\CAD\My Documents\Pem its\tigard pennit.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12909 SW 68TH PKWY 350, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00196
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor