Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00100
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/30/2019
Parcel: 1 S 134AA02100
Jurisdiction: Tigard
Site address: 10300 SW NIMBUS AVE PB
Project: Saibri Cooper Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: Fire sprinkler permit:Adding and relocating(5)sprinkler heads for TI. Affidavit submitted.
Contractor: FIRESTOP CO Owner: DIETRICH, NANCY BISHOP
3203 NE 65TH ST#2 ROBINSON, JERRY CHRISTOPHER TRUST
VANCOUVER,WA 98663 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 360-718-8604 PHONE: 503-245-7100
FAX: 360-718-8603
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/30/2019 $177.52
12%State Surcharge-Building 07/30/2019 $21.30
Type of Use: COM Plan Review-Fire Life Safety-COM 07/30/2019 $71.01
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 07/30/2019 $2.00
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 0
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 $271.83
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
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.
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
�� eceived
. City of Tigard - Permit No.: _ .��lt '
111111- 13125 SW Hall Blvd.,Tigard,OR 97223 `Plan R : 7� t1y
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 "�°: —��. Other Permit: f
TIGARD Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.govNotified/Method:
t' a .. Supplemental Information
ii 1i i" 5 " t "! : ! B e 9 V-tf <, > '� ., fi 41 .9m -
❑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 0 Other: equipment,materials,labor,overhead,and the profit for the
7 , ; 'f"E - ;fl, 4' *, 4 ' work indicated on this application.
❑ 1-and 2-family dwelling rCommercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
i i FOR -AAJo,° =,_ / c ' `
iieltTotal number of floors:; t�_ .. t
Job site address:10300 SW NIMBUS AVE-BLDG P New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:SALBRI COOPER T.I. Covered porch area: square feet
Cross street/directions to job site:SW NIMBUS Deck area: square feet
Other structure area: square feet
j * „:* !S ,!_. 'mac ,
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
equipment,materials,labor,overhead,and the profit for the
r " I )S P I dim io ' ' T,t , �, ..
work indicated on this application.
TENNANT IMPROVEMENT.FIRE SPRINKLER HEAD RELOCATION,AND Valuation: $89,809.00
ADDITION. Existing building area: 12361 square feet
New building area: 12361 square feet
`,4 °�r Number of stories:
Name:SCROLLS BUISNESS CNETER Type of construction:
Address:10220 SW NIMBUS AVE Occupancy groups:
City/State/ZIP:TIGARD,OR 97223 Existing:
Phone:( ) Fax:
( t _
New:
Business name:FIRESTOP COMPANY `' „
All contractors and subcontractors are required to be
Contact name:MARTIN MORALES licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:3203 NE 65TH ST SPACE 2 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:VANCOUVER,WA 98663
apply:
— ----------- Fes::f -1
E-mail:martin.morales@firestopco.com
*"*.witirro
Business name:FIRESTOP COMPANY ' ���,� "�'`., � lh� ie' a �,�, "v
Address:3203 NE 65TH ST SPACE 2 Permit fee:
City/State/ZIP:VANCOUVER,WA 98663 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(360)718-8604 Fax:( ) (Due upon application submittal)
CCB lie.:OR/1832"7G( Total permit fees:
Authorized signature: Amount received:
/�,� IL��- This permit application expires if a permit is not obtained
AA
Print name: t Pe l6(...-46_____Date: t- /ry q' within 180 days after it has been accepted as complete.
( * Feemethodology set by Tri-County Building Industry
Service mBoard.
I:\Building\PermitsWPs-PermitApp_o31016.doc 440-4613T(11/02/COM/WEB)
1
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
fi .0 haw ii j ` rJ '� 4
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
1:-] 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:
' ' `_ to � 'a' ' - - .' , ._ -
"' - ' 4T � e i�� r it + II i$' 1-1-119iy j '-+,-,-
a ,.,i imp Fig �
' � 1.044 iif;
b
�, �i-;,..1--- d �_i��r. �" _il � U E_**,-1,1**** ..�'4. '��[��ii �,'�fi,;�' iii�J4, ii '� �� `_i .i � �i�?
Sprinkler Type ® Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group LIGHT
Density .10
Design Area
K. Factor 5.6
Sprinkler Project Valuation: I $ 9,809
i, ' a ,,� M U k a,^� 11;‘44'
�ti' '''''"I''.
ii .-F-P.� 3 Izp4 4P *� I ? .�d`""' i
Hood Project Valuation: $
i
Submittal shall Battery Calculations ❑ Yes
include: Individual Component CI Yes
Cut Sheets
Fire Alarm Project Valuation: I $
.3*:-„,_-_'17-7-10--„ -*_,*.--t--.,.,' --:,---r-,... .i
, ,, , ,,,_ -, , -..I.-4 `.* - -, -7 °'. '''''L. '''''r .. ''''' . ''''7*,1, - .' 7 -44-'L 7 - * ,1', '
Square Footage.
qPermit Fee:
0 to 2 000
-46 �, _ ��
$198.75
2,001 to 3,600 ,
$246.45 � o
3,601 to 7-26f1
7,201 and greater $404.393
Sprinkler Project Square Footage: sq. ft.
1=� _r - ii ` p 9,._' - �`. moi` a (i ti- Vi ? -PP i, `�"-�
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: $ 271.83
https://firestopco-mysharepoint.com/personal/martin_morales_firestopco_com/Documents/Desktop/JOBS/SCHOLLS BUISNESS/SUBMITTAL/FPS_PermitApp.doc
City of Tigard _
Permit No.: f" — iC !4`(j
13125 SW Hall Blvd.,Tigard,OR 97223
I: Phone: 503.718.2439 Fax: 503.598.196011 , Date Received: -7/30/i
TIGARD Inspection Line: 503.639.4175 .1 L /
Internet: www.tigard-or.gov By: 615 elf- 7-'471- 1
FIRE SPRINKLER AF 'IT AVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: SAILBRI COOPER T.I Occupancy: COMMERCIAL
Job Address: 10300 SW NIMBUS AVE - BLDG P Type of Construction:
Suite:
Contractor: FIRESTOP COMPANY Phone: 360-718-8604
Number of Proposed or Altered Heads: 5
Type: PENDANTS Hazard: LIGHT Density: 0.10
1, MARTIN MORALES Oregon Construction Contractors Board No.
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_subjeC1 o nsit_e_tests_al3Jinspection%.
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.
Martin Morales Digitally signed by Martin Morales
Signature: Date:2019.07.30 09:07:80-07'00 Date: 07/30/19
Print Name: MARTIN MORALES
I:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1