Permit (109) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111----'•
COMMUNITY DEVELOPMENT
Permit#: FPS2019-00095
Date Issued: 07/16/2019
T I(_1A 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S134AD06201
Jurisdiction: Tigard
Site address: 10450 SW NIMBUS AVE R-2A
Project: Spec space Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: Fire sprinkler.Relocating(2)sprinkler heads for TI.
Contractor: FIRE SYSTEMS WEST INC Owner: KYLE LATTA
600 SE MARITIME AVE#300 10240 SW NIMBUS AVENUE, L-3
VANCOUVER,WA 98661 PORTLAND,OR 97223
PHONE: 360-693-9906 PHONE: 503-598-9980
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/15/2019 $102.20
12%State Surcharge-Building 07/15/2019 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 07/15/2019 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 07/15/2019 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 Design Area: 15478
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 $155.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,149.00
Residential Square Footage: 0
Fire Alarm Valuation:
$0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23.4.4.,_
Issued By: .ermittee Signature:
Call 50 .639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application E C E I V E D
Fire Protection System h t)I2 01,11(1 L SE ON 1.1
City of Tigard J U L 1 1 2019 Received 1vatea . - ti\ G o.Permit N
- k it 7
r 13125 SW Hall Blvd.,Tigard,OR 97223 Pian Review Otho Penni�� ?1,.. �,
Phone: 503.7182439 Fax: 503.598,t94TY OF TIGARD valla .
inspection lane: 503.639.4175 BUILDING DIVISION Date mr aids mSee Pap 2tor
Internet: www.tigard-or-gov Notified/Method: sopplemeatslInformation
3 :; ' . 1,.:;: r. ' 4,i/4 '.;�� i...'-:. .,....0 ... :+ REQUIRED A"*T,dI l+AND�'FA1►i[I;.XsiiY,E4
❑J New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
?eATEGO,RY OF teiii$FR J ON t "r work indicated on this application.
Valuation: $
❑1-and 2-family dwelling 0 Comtnercial/industrial
Number of bedrooms:
❑Accessory building 0 Multi-family
❑Master builder 0 Other: Number of bathrooms:
i #s'S I c carr .x h x y 'f
OBS 1 0_ Tfich Tl( i • Total number of floors:
Job site address-rtO 6100 r11001 &,3P, New dwelling area: square feet
City/State/ZIP: ete4.1474-14".011 OC 47001 Oarage/carport area: square feet
Suite/bldg./apt.no.: it....A., I Project name: $"ro t)t4 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
-, �I pifaij Q131�IAi R 0.r[15i --giT
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 the profit for the
A 3: Oi`3 A a) s ;;i ,Mai` work indicated on this application. N(y/t
a
W \l' • re -A-c- Valuation: S
cov GtLke, rt.r DJ Existing building area: square feet 1,647p0/
New building area: square feet I stv1(
«{ :G-Tg4:ar ta)hP*.tP Orln..^>1z. 1 S YNerr v c a 7- -7,'+ aq ,s5a { Number of stories: 2—
,:f'•' ARx3H•n 5 ntt. , �a.� a'.' yq'; . ,..t. . • - . ` s:�r 'i
Name: Type of construction: v B
Address: Occupancy groups: 'g'
City/State/ZIP: Existing: 6
Phone:( ) Fax:( ) New: 13
rr RAi s J yt' 1• 0LSCI �v �� '„ t 'W x'L .f.-.-1,-,,„._, � , " 1, , ,i xirt-,-_ii
,} w,,- .,
v: ". et,,w, ,, . 4,,,,,,,..i,,,.....,.,,-,..4,..,-„.,,,,,,, tr1n.,t-= v x};: ss ^ {l .. � 'qLly Ft ti„ r-. C
$
Business name: 6 �y^ "c.3 J[y All contractors and subcontractors are required to be
l_Wr—" ' ` licensed with the Oregon Construction Contractors Board
Contact Henle-
t LP. S'/S 'S W t M+C- trader ORS 701 and may be required to be licensed in the
Address:600 .S rnt7►rijurisdiction in which work is being performed.If the
.. /� 3666applicant is exempt from licensing,the following reasons
City/State/ZIP:V'iOn`n(jou,.VtX' t VOL i ig%C. t apply:Phone_ Fax::( )
E-mail:Rfro,�f. . „AtA3 % e
4'
•. a Alg k ;m 1 ; ` ,, A* €.-1,-;,.. . s = k' �3` i C'I Y}IPIG.P TZF ES,,€
3.�. X .- nr._ -.4.' �� � _ ._ ., ..i, e
x..asr..:k3n^ ,,:�n ;(Qk�`k�leR ttl� srktdulc)�', '.,.,.ti, .rr,. �e
Business name:fC1f►L•45 ys,4 cmS G1 As�,• Permit fee:
Address:6100 ``6� ]rye -i- i AV. _.
�..7G �� eState surcharge(12%of permit fee):
City/State/ZIP:Voan c.e t Au.e„r' it4ior eff5&6( FLS plan review(40%of permit fee):
Phone:(346)4 - GM C(p Fax:( ) (Due upon application submittal.)
CCB lie.:411 73a. Total permit fees:
� Amount received:
Authorized signature ���_��
�-
This permit application expires if a permit is not obtained
Print name: ��.q�` Date: 7/11/// w[Ihin 180 days after it has been accepted as complete.
R • WY\t * Fee methodology set by Tri-County Building Industry
Service Board.
1:iBudd V +\FPS-ParmitApp 031016,doe 440.4613T(11/02/COM/WBB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Dee��?i . ieo lliele.`
+ate 9?-�,it
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices:
Addition or 711-10 heads: Affidavit required and 0 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
0 11+heads: Plan review required and 0 6+devices: Plan review required and
(3)sets of plans. (3)sets of plans.
Additional description of work t'v7u) w:,‘\ +i"e.\ea.;c. Inca r1-S {•,p 0.C.(o►'-+ d0�
Y
Type of ystem(Com ilete�,;�, dr t a shsable a Y , .. r
+a }kdJVi11Ai1�14A �i7MLLI1lGt L�` t +s.Ty�"^ '".' it �"5?s� �f'oS ai..'X+'''e e
/ki '„'�.;,-�x ..z. •.d is ti.o>°�x:.. 2 *ae.. Y�,
Sprinkler Type XI Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group (ts&►r.}
Density .to
Design Area
K Factor 0";V(_
Sprinkler Project Valuation: $ 2.."- -
Hood Project Valuation: $
--+ .,.tom^ a- ,.:st x *?' -:-+ ^" - =-.m s^ •— ---4�'' �,—a- x
Submittal shall Battery Calculations ❑ Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
Rei Said A1on S s.
Square Footage: Permit Fee:
0 to 2,000 $198.75 tiA.
2001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39 •
Sprinkler Project Square Footage: sq.ft.
x ._ . Fire. rotecotl Pemtt
Project valuation subftotal(see A,B`&C above): ' $ '
Permit fee based on project valuation(see fee schedule): $ •
Permit fee based on square footage(sec D above): $ •
State Surcharge(12%of permit fee): $ .
FLS Plan Review(40%of permit fee): $
TOTAL: $
1:\Building\Permits\I‘PS_I'emutApp 03l016.doc 2
RECEIVED _ r
City of Tigard Permit No.: -GC.7. t�j
IN13125 SW Hall Blvd.,Tigard,OR 97223 JUL 1 1 2019
I Phone: 503.718.2439 Fax: 503.598.1960 Date Received: C;(
Inspection Line: 503.639.4175 CITY OF TIGARD
I lG'1t`t) Internet: www.tigard-or.gov BUILDING DIVISION By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Scholls BLDG R TI Occupancy: LIGHT
$045(1
Job Addre4984
$SW NIMBUS AVE Type of Construction: vb
Suite: R-2
Contractor: FIRE SYSTEMS WEST, INC Phone: 360-693-9906
Number of Proposed or Altered Heads: 2
Type: WET Hazard: LIGHT Density: •10
1, BRANDON WHITTAKER Oregon Construction Contractors Board No. 49732
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: t2B/Z'�Li/�` f.2 Date: 7/11/19
Print Name: BRANDON WHITTAKER
1:\Building\FormsWireSprinklerA111davit_071514.docx Page 1 of 1
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
10450 SW NIMBUS AVE R-2A, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00095
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor