Permit (41) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
t 111COMMUNITY DEVELOPMENT Permit#: FPS2019-00037
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/20/2019
Parcel: 2S 112 DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 250
Project: Tru Independence Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire sprinkler permit:Adding(5)sprinkler heads to existing system. Affidavit submitted.
Contractor: AFP SYSTEMS INC Owner: PACIFIC REALTY ASSOCIATES
19435 SW 129TH AVE ATTN: N PIVEN
TUALATIN, OR 97062 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-692-9284 PHONE: 503-624-6300
FAX: 503-692-1186
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/20/2019 $51.09
12%State Surcharge-Building 03/20/2019 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 03/20/2019 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 03/20/2019 $0.50
Occupancy Grp: Height: ft 11x17)
Stories: Permit Fee-COM 03/20/2019 $40.35
12%State Surcharge-Building 03/20/2019 $4.84
Plan Review-Fire Life Safety-COM 03/20/2019 $16.14
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 $139.49
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,950.00
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 1.8 4. E -
Issued By: r ittee 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
Fire Protection System FOR OFFICE USE ONL\
City of Tigard ��C� DateB 3/C ` A Other
r itNo.:t-*.• ,tom * ?
lig M ■ 13125 SW Hall Blvd.,Tigard,OR 97223 G Plan Review
Phone: 503.718.2439 Fax: 503.598.196 DateB . ' ). .
T t G A RD Inspection Line: 503.639.4175 ® g019 Date ReadyBy: H See Page 2 for
Internet: www.tigard-or.gov MAR L Notified/Method: .PM Supplemental Information
#
❑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
VE:;113-111t,eil,< # Y OF C.# `��� Mwork indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
Gyp'. „/ % \�a mi
� � �r � � a Total number of floors:
�J3 t 1 # IATIOIwf" 4l # ',11%/01. .
�: - � /��. .,.U„ ..:/,>.Y.��,a ..... ���... � ,.,1,e•.
Job site address:l:}'3.50 SW Sequoia Pkwy. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:250 Project name:Tru Independence TI Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
# ,1 -? t # # y , m l,
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 theprofit for the
F, Ij1 � F %y 1j K r s s� �� d' work indicated on this application.
Add 5 new sprinkler head drops off of existing wet system Valuation: $$1,950.00
to cover new floor plan. Existing building area: square feet
New building area: square feet
ra7d4f ROPERTy O RIFA Number of stories: 3
Name: Type of construction: III-B
Address: Occupancy groups:
City/State/ZIP: Existing: B-office
Phone:( ) Fax:( ) New: no change
Q ?PIT �
. s _ % ` i1TP �i, :;
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax::( )
E-mail:breanna@afpsys.com
>.�tsgoW�Y::- � ......., ,e9le -.^: :.%i„„, ... ..�.. .....,..y.. -.t\ rrr, - t v,
Business name:AFP Systems Inc. \ �” 1cJ
Permit fee:
Address:19435 SW 129th Ave
State surcharge(12%of permit fee):
City/State/ZIP:Tualatin,OR 97062 0
FLS plan review(40%of permit fee):
Phone:(503)692-9284 Fax:(503)692-1186 (Due upon application submittal.)
CCB lic.:67537 Total permit fees:
Amount received:
Authorized signature: S A
This permit application expires if a permit is not obtained
Print name:Steve Frost Date:03/19/2019 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_071514.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
,i',9
r %' \ al` ` , k..
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
El New system Number of sprinkler heads: 5 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:
�.. "' ( ,�, t .,, ., B,C ori ..�.�.�.. . � 1e) "'a`n.. i`\� %5.4 a,° �,. y .moi ,•�\�:
1e.
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group LH
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: I $ 1,950.00
Hoo 1 int ; /?pi c t ' ,A y.,,, :: iii/"
Hood Project Valuation: I $
1xe 'ar i r �rii s�/yr a �\�� r
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
o
Square Footage: Permit Fee: yy
0 to 2,000 $198.75 `..
2 001 to 3,600 $246.45
3,601 to 7,200 $310.05 � 'i%
7,201 and greater $404.39b. �, h
Sprinkler Project Square Footage: sq. ft.
\\ " / i' ,tection Pe z� �` a ,r r
Project valuation subtotal (see A,B &C above): $ 1,950.00
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: $
X:\Permits Steve new\Tigard\tru independence TI FPS_PermitApp.doc 2
City of Tigard Permit No.: f j 1 6003 j 7
,711 'g 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: /1e'il c9
Inspection Line: 503.639.4175
IJ Internet: www.tigard-or.gov By: Cily cif .7141--4(
FIRE SPRINKLER AFFIDAVIT FOR ALTERATION E E!V E D
OR TENANT IMPROVEMENTS MAR 2 0 2019
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
CITY OF TIGARD
BUILDING DIVISION
Project Name: Tru Independence TI Occupancy: B-office
Job Address: 15350 SW Sequoia Pkwy.,Tigard,OR 97224 Type of Construction: 111-B
Suite: 250
Contractor: AFP Systems Phone: 503-692-9284
Number of Proposed or Altered Heads: 5
Type: wet Hazard: light Density: 0.10
1, Steve Frost/AFP Systems Oregon Construction Contractors Board No. 67534
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.
r Digitally signed by Steve Frost
Steve Frost Drt>acl steveeN:c=Steve Frost,o mF CSstems,
Signature: Date:2019.03.1908:46:36-07'00' Date: 03/19/2019
I
Print Name: Steve Frost
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
15350 SW SEQUOIA PKWY 250, TIGARD, April 10, 2019 at 9:06:43 AM
OR, 97224
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00037
Inspection Type: Inspector:
999 Sprinkler final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor