Permit (2) 111 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
lg.' COMMUNITY DEVELOPMENT Permit#: FPS2020-00001
T t GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/09/2020
Parcel: 1 S 126DC03300
Jurisdiction:
Site address: 9900 SW GREENBURG RD 140
Project: Spec Space Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Fire sprinkler permit: Relocating(4)and adding(4)sprinkler heads. Affidavit submitted.
Contractor: WESTERN STATES FIRE PROTECTION Owner: MEADOWS 196 LLC
17500 SW 65TH AVE 5665 MEADOWS RD STE 140
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503-657-5155 PHONE: 503-225-0701
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/09/2020 $102.20
12%State Surcharge-Building 01/09/2020 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 01/09/2020 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 01/09/2020 $2.00
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: No Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area:
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 $157.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,943.00
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 opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. a tai a copy of rules
or direct questions to OUNC by calling 503.232.1987 0 . 0 992z13 4. .2
Issued By: `` Si nature:
Cal 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
i I 1 F1 vr_ htiec7h2.W 5 'akr • FOR OFFICE USE ONLY
City of Tigard RECEIVED ReceivedlIZEIRIM
II " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
. Phone: 503-718-2439 Fax: 503-598-1960JAN 9 2020 Date/B : EZELlirMaMPA
TIGARD Inspection Line: 503-639-4175 Date Ready/By. ilagi
See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supnplemental Information
' Ili n!Nf; nI\n 1 IN
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fccs*arc based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
IX]Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
III1-and 2-family dwelling InCommercial/industrial Valuation: $
ElAccessory building El Multi-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
': Total number of floors:
JOB SITE INFORMATION AND i.00ATION.; i 9'
Job site address: 9900 SW Greenburd Rd New dwelling area: square feet
City/State/ZIP: Tigard OR, 97223 Garage/carport area: square feet
Suite/bldg./apt.#: ��+5 ./110 Project name: WCI Hospitality Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Relocation of four (4) sprinkler heads and addition of four (4) Valuation: 2,943 $
sprinkler heads Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: WCI Inc. 'type of construction:
Address: 6800 SW 105th Ave., Suite 101 Occupancy groups:
City/State/ZIP: Beaverton OR, 97008 Existing:
Phone: ( ) Fax:( ) New:
IX] APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: Western States Fire Protection i. (Please refer,o fee se schedule)
Structural plan review fee(or deposit):
Contact name: Chandler Streuli
FLS plan review fee(if applicable):
Address: 17500 SW 65th Ave.
Total fees due upon application:
City/State/ZIP: Lake Oswego OR, 97035
Phone:(503)941-6278 Amount received:
Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Western States Fire Protection Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 1 7500 SW 65th Ave. Solar Installation Specialty Code checklist.
City/State/ZIP: Lake Oswego OR, 97035 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)657 5155 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lie.: l Jh$70 Total fee due upon application: $201.60
Authorized signature: Chandler Streuli '•a�•�E-^r^-�•«�-ate=«���««����M This permit application expires if a permit is not obtained
. ...-0—,..— within ISO days after it has been accepted as complete.
Print name: Chandler Streuli Date:1/9/2020 * Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building1 Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:;; r_g` asp
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 I"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: e(�c- 5t -q cr f y o c-CIA - c - In & 1--4e ( Cte l
C.>C- C t-t'
Type of System(Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type LI Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ® No
Hazard Group L c't 1 I Za, .-o4
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations LI 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 •iu.
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_PermtApp_031016 mtlpp_031016.doc 2
114 City of Tigard RECEIVED Permit No.: /`�� --Cx SU
• 13125 SW Hall Blvd.,Tigard,OR 97223
@ Phone: 503.718.2439 Fax: 503.598.1960 JAN 9 2p20 Date Received: //C1/gyp
Inspection Line: 503.639.4175
Ttt'ARD Internet: www.tigard-or.gov „ITY OF TIGARD By: ( df ��
),1�)ILUNG DIVISION l/
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: WCI Hospitiality Occupancy: Light Hazard
Job Address: 9900 SW Greenburg Rd Type of Construction:
Suite: 150
Contractor: Western States Fire Protection Phone: 503-657-5155
Number of Proposed or Altered Heads: 8
Type: Wet Hazard: Light Density: •1
I Chandler Streuli Oregon Construction Contractors Board No. 104570
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.
'64a,.2..d w cm Sb.w
Signature: Chandler Streuli ,,_ -e asoz .�,°. FP.�,.P,a�°.���^° ,.�„�. Date: January 9, 2020
Print Name: Chandler Streuli
L\Building\Forms\FireSprinklerAffrdavit_071514.docx Page I of 1