Permit (68) 14- CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• COMMUNITY DEVELOPMENT Permit#: FPS2018-00163
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/15/2018
T I is;AIt Dg Parcel: 2S101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE#20
Project: New Horizons Wellness Services Subdivision: VARNS ACRES Lot: 9
Project Description: Fire sprinkler. Relocating(54)sprinkler heads at new ceiling to maintain coverage.
Contractor: CROSSFIRE SPRINKLER CO Owner: TRIANGLE POINTE TWO LLC
17400 SE 82ND DR 901 NE GLISAN ST, STE 100
CLACKAMAS,OR 97015 PORTLAND, OR 97232
PHONE: 503-210-5506
PHONE: 503-297-8791
FAX: 503-210-5538
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/14/2018 $166.76
12%State Surcharge-Building 11/14/2018 $20.01
Type of Use: COM Plan Review-Fire Life Safety-MF 11/14/2018 $66.70
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 11/14/2018 $2.00
Occupancy Grp: Height: ft 11x17)
Stories: Misc Administration Fee 11/14/2018 $5.00
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: ORD1
Density: 0.1 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 $260.47
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $8,366.00
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. ,. /ff,/(cW.//ai.Issued By: ' e . 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 Applicat'
Fire Protection System FOR OFFICE USE ONLY
City of Tigard N O V ^ ` 2018 Date/Bed !` 7 / i / Pei , • .."--r...6(40.3
- e 13125 SW Hall Blvd.,Tigard,OR 967 y
g *;* Plan Review eg
Ur i(ca'�,RD
Phone: 503.718.2439 Fax: 503. Date/B : � - •
Inspection Line: 503.639.4175 D 1NG D VIS ON Date Ready/By: Jure la See Page 2 for
TIGARD
Internet: www.tigard-or.gov gov N.ified/Metho.• Supplemental
/ ( ([ �. �� Information
/L/ /A.A574!
u✓'r>f RK RE 17 1 1 FATAL' 1 1?AI4 TT 1 DWE I.
❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
i CAT GOR s. t► ,, work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
•y " y Total number of floors:
.,ah , TUB ST F s Ti] T UCATIUIV
—
Jeb site address:13333 SW 68th Parkway New dwelling area: square feet
City/State/ZIP:Tigard,OR Garage/carport area: square feet
Suite/bldg./apt.no.:.C. „go Project name:New Horizons Wellness Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
RIEQUIIR)IjT11 ISA
9 . p 1 E
Subdivision: 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
oquipment,materials,labor,overhead,andthe profit for the
' D $ s $c " • work indicated on this application.
Relocate Sprinkler Heads at new ceilings to maintain coverage Valuation: $$8,366.00
Existing building area: square feet
New building area: square feet
ROPERTTf
(*N4(.5: \ Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
4. ► •
P NTTA T PERso . '
Business name:Crossfire Sprinkler All contractors and subcontractors are required to be
Contact name:Timothy A Bishop licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 17400 SE 82nd Drive jurisdiction in which work is being performed.If the
City/State/ZIP:Clackamas,OR 97015 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)210 5506 Fax::(503)210 5538
E-mail:timothy@crossfiresprinkler.com
'oa ,
Business name:Crossfire Sprinkler l e.
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lie.:174746 Total permit fees:
Authorized signature . Amount received:
This permit application expires if a permit is not obtained
Print name:Timothy A Bishop Date:10/31/18 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
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: 54 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:
CUrri lett '• �
A.)_CQt Sprinkler Type l tetci 8 ""�� //, ` / � ���
® Wet ❑/ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Light
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 8366.00
ilr
r 1t e 11 Cession S to as �/ ;! %.
Hood"Project Valuation: $
❑ Yes
Submittal shall Battery Calculations
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
--.i-, ,,/ 4.:, /„ -.. 3,•,,,-,,, // k
Residential Sp t k e a e y” ,-,, z \` 1 ,.
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 \ ,
sq. ft.
Sprinkler Project Square Footage:
!„/ %%% Fire Protf'L ' � ..
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:\Documents and Settings\CAD\MY Documents\Pemuts\tigard permit.doc 2 1, Mai Lt ‘-.: '
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13333 SW 68TH PKWY STE 20, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00163
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13333 SW 68TH PKWY STE 20, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00163
Inspection Type: Inspector:
910 Sprinkler rough-In Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor