Permit (2) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019 00150
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2019
TIGARD 13125 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY G
Project: Spec Space Subdivision: 1994-028 PARTITION PLAT Lot: 2
Project Description: Fire sprinkler permit: Relocating(1)sprinkler head for new bathroom ceiling. Affidavit submitted.
Contractor: SOUND FIRE PROTECTION INC Owner: SN PROPERTIES PARTNERSHIP
10756 SE HWY 212 1121 SW SALMON ST
CLACKAMAS, OR 97015 PORTLAND, OR 97205
PHONE: 655-3775 PHONE:
FAX: 503-655-2990
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/12/2019 $51.09
12%State Surcharge-Building 12/12/2019 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 12/12/2019 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/12/2019 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
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 $78.16
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $450.00
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:
ids��. - _ _✓ —_ ._.
Call 503:839.4175 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
t
Fire Protection System FOR OFFICE USE ONLY
City of Tigard u ! "� ' eceived _ J
�ate/B : Permit No.:r
//I %� II Y"I_ '
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit: ! r
Phone: 503.718.2439 Fax: 503.598.1960 DEC ��1(t Date/B : ��,�/[ jg
Inspection Line: 503.639.4175 UJ Date Rcady/By: n See Page 2 for
Internet: www.tigard-or.gov4 y e Notified/Method: MI Supplemental Information
i e
i IF L r � ovfl IDDAAN04:4 FH.YD nt
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❑New construction EI 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
, workindicated onti
sapplicatton.4 � t st4 � �
1:11-and 2-family dwelling id Commercial/industrial Valuation: $
EIAccessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
� TION A. I'? L$ Total number of floors:
Job site address: 1(070 a S W .-)1G(:t i- (..1,41),:.), I New dwelling area: square feet
City/State/ZIP: ica.re� 0 Z crZj 4 �1I Garage/carport area: square feet
n� r
Suite/bldg./apt.no.: V I Project name:\i 3evd \c,0eke_ St LawCovered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
iEQ 11f* l ' ?fit., RCS-USE CHECKLIST
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
I r ' 1 ,. _ a tjwork indicated on this application.
K4igt.t eXi 5-}i✓l3 $ it 1 J lt-lc✓ d{pf Valuation: $ l� � cru
r AtbC ',Do py} ` t win .
Existing building arca: square feet
LI New building area: square feet
w� " . . ..., .__ ' ml
� � V0VDI R. .. � � ,; rti
w Number of stories:
Name:
Type of construction:
Address: Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( ) New:
Business name:- t I C+-i LS V t J h All contractors and subcontractors are required to be
Contact name: taS-Lt4 licensed with the Oregon Construction Contractors Board
�' 1 under ORS 701 and may be required to be licensed in the
Address: )p-1", s, t/ LI Z jurisdiction in which work is being performed.If the
City/State/ZIP: ��&�4 �� ��1� �_ applicant is exempt from licensing,the following reasons
epc"J -(3-7-) aPPIY
Phone: ) Fax::( )
Email ,L` c . _.
Business,m,w, ._ ._. . �,��- �,.,,o i t i T� :.
name.. . ,. . .,>, 2 w.. " =,:lim
C �'A�— Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lie.: 70 DD Total permit fees:
Ke.7,,,, (' Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: e tgie,�l Date: a/94= within 180 days after it has been accepted as complete.
l/� `/7 * Fee methodology set by Tri-County Building Industry
Service Board.
l:\Building\Permits..PPS-PcrmitApp_031016.doc 440-4613T(1 1/02ICOM/WEB)
'City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: I Number of alarm devices:
9/Addition or 0- 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:
Type of System (Complete A,B, C or D as applicable): 31'- :_
A.) Commercial S rinkler .
Sprinkler Type 2 Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group L. r-
Density , i 0
Design Area G v
K. Factor S. C.
Sprinkler Project Valuation: $ 171 '"
B.) Type I Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone System)
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
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2
}..:
City of Tigard ".avr .1. ' Pr Permit No.: FifroZ/y_- 157)
13125 SW Hall Blvd.,Tigard,OR 97223 a �_
I Phone: 503.718.2439 Fax: 503.598.1960 Date Received: /, /4--aJ`1
Inspection Line: 503.639.4175 DEC C 1 2 2019
1GAR1 Internet: www.tigard-or.gov t' L By: Lr' t � rys
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Tigard Towne Square Occupancy: B
Job Address: 16200 SW Pacific Hwy Type of Construction: V-B
Suite: G1
Contractor: Sound Fire Protection, Inc. Phone: 5036553775
Number of Proposed or Altered Heads: 1
Type: Wet Hazard: Light Density: •10
I Casey Archer Oregon Construction Contractors Board No. 70003
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.
1) 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 thi-ydocume with a copy of the sketch attached shall be available for all inspections.
y �
Signature: Date: /Oh'
Print Name: Case Archer ///
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