Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'1 1 COMMUNITY DEVELOPMENT Permit#: FPS2019-00089
t i"A it f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Date Issued: 07/17/2019
F 9
Parcel: 2S101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE#10
Project: Oregon Academy of General Dentistry Subdivision: VARNS ACRES Lot: 9
Project Description: Fire sprinkler permit:Relocating(56)and adding(8)sprinkler heads for TI.
Contractor: AFP SYSTEMS INC Owner: TRIANGLE POINTE TWO LLC
19435 SW 129TH AVE 901 NE GLISAN ST, STE 100
TUALATIN, OR 97062 PORTLAND,OR 97232
PHONE: 503-692-9284 PHONE:
FAX: 503-692-1186
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/11/2019 $199.04
12%State Surcharge-Building 07/11/2019 $23.88
Type of Use: COM Plan Review-Fire Life Safety-COM 07/11/2019 $79.62
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 07/11/2019 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 07/11/2019 $3.00
11x17)
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 $307.54
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $11,500.00
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 0 C by calling 503. 2.1987 o 1.800.332.2344.
Issued By: 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 Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received
Date/By: f ` Permit No. (- 0/l.' ,)r 87
14 M 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review SS��
Phone: 503.718.2439 Fax: 503.598.1960 R E C E I V E ' DateBy: 7-Jo- i 9 1 Other Permit �)i1 ii 1-a
TI CARD Inspection Line: 503.639.4175 RECEIVE Date Ready/By: Juris eee�P4agge 2 for
Internet: www.tigard-or.gov JUL 1. 2U19 otified/Meth.; 2 `C ` ---ii-- .., Supplemental Information
L `� t��
❑New construction ❑DiN 6 V • ' 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
� a f work indicated on this application.
a J I; t t � PP
El1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ElMulti-familyNumber of bedrooms:
❑Master builder ElOther: Number of bathrooms:
RW� ., ;, 1 � I � � �• � � Total number of floors:
Job site address:13333 SW 68th Pkwy. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 . Garage/carport area: square feet
Suite/bldg./apt.no.:010 Project name:Oregon Academy of Genera/ A .,•6 Covered porch area: square feet
Cross street/directions to job site:lower level Triangle Pointe / Deck area: square feet
Other structure area: square feet
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.:
F / equi equipment,materials,labor,overhead,
and theprofit for the
t � Zla� etM ;2'.?'os ti4:.� � y; work indicated
on this application.
•
Relocate 56&add 8 sprinkler head drops off of existing wet system to cover Valuation: $$11,500.00
new floor plan. Existing building area: 8,202 square feet
New building area: square feet
':-2 a -
,7`� s s :: y T�A1 T~ _ 4 Number of stories: 3
< .,�,. a n ,.,. _ ',,:44,-,- --,,,-
Name:
„
Name: Type of construction: II-A
•
Address: Occupancy groups:
City/State/ZIP: \ Existing: B
Phone:( ) Fax:( ) New:
APPLICANTO , C .. ottrtw::---::7:.-,,---vN',34-oii&rAlruurr
Business name: St" t , ` All contractors and subcontractors are required to be
Contact name: 1--c v\V"JS i-�S'J� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: k6:14- SW p5:1-***”' p.} jurisdiction in which work is being performed.If the
City/State/ZIP: '; %( I / V 'fou,L applicant is exempt from licensing,the following reasons
pir
--
Mone: )Lean_ .. at Li LFax::( )
E-mail:breanna@afpsys.com l
.':Zei-MkrI "<' itIV % . N g-3, I IL}1 ,14 a , : i ,i . a i4MA-€Plaserefer:anes
e .
Business name:AFP Systems Inc.
Permit fee:
Address:19435 SW 129th Ave
State surcharge(12%of permit fee):
City/State/ZIP:Tualatin,OR 97062
FLS plan review(40%of permit fee):
Phone:(503)692-9284 Fax:(503)692-1186 (Due upon application submittal)
CCB lic.:67537 7‘..1/.),_L `�) Total permit fees:
Amount received:
Authorized signature: . j
This permit application expires if a permit is not obtained
Print name:Steve Frost Date:07/01/2019 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
-11777,,,,.. IIMBREEMENOM
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: 64 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 El 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
® Wet ❑ Dry
Additional Standpipes none
Information: Hazard Group Light hazard
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: I $ 11,500.00
Hood Project Valuation: I $
s�
'i�,/i,_. ` ��' �.. iii„ ,rr /i . .... 1t� .�,..r, - .ou�0....u�\`\y •\a..`' : \� .;�'�,�,„.
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: I $
n _ ,PRN ,\��3 ,� mak h v 2f _ f
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,r,.:ri/.f .,',•!:. ?:. h :'k�`�. �c,�ys �a„ 3s\�`w�`...� `�� � ��' ��
,��.-,,, spy/
Square Footage: Permit Fee:
0 to 2,000 $198.75 N � y
2,001 to 3,600 $246.45 \4�
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Project valuation subtotal (see A,B &C above): $ 11,500.00
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\OAGD TI FPS_PermitApp.doc 2