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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 11 . COMMUNITY DEVELOPMENTIII Permit#: FPS2020-00029 Tf GAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/27/2020 Parcel: 1 S 136DC03200 Jurisdiction: Tigard Site address: 11714 SW 72ND AVE Project: Dirt By Design Subdivision: Lot: 8 Project Description: Fire sprinkler permit:Adding and relocating(3)heads for TI. Affidavit submitted. Contractor: CROMWELL PLUMBING Owner: 72ND AVENUE PROPERTY LLC 25599 SW 95TH AVE STE B 4804 NW BETHANY BLVD STE 1-2 WILSONVILLE, OR 97070 PORTLAND, OR 97229 PHONE: 971-224-5304 PHONE: FAX: 503-266-4792 FEES Description Date Amount Specifics: Permit Fee-COM 02/27/2020 $102.20 12%State Surcharge-Building 02/27/2020 $12.26 Type of Use: COM Plan Review-Fire Life Safety-COM 02/27/2020 $40.88 Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 02/27/2020 $0.50 Occupancy Grp: Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: ORD1 Density: .15 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 $155.84 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $2,500.00 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 OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ..- Permittee Signature: 1 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 y 13125 SW Hall Blvd.,Tigard,OR 9722 E C E I V Date B : p (jJ !' L.. J .. Plan Review ' , Other Permit: 1 I 4,_ .—d ! ' II Phone: 503.718.2439 Fax: 503.598.19. , r qryry DaleB 1 G:ARD Inspection Line: 503.639.4175 —� U 2U L U Date Ready/By: ®See Page 2 for Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: I ,ramEXI Supplemental Information TYPE OF lU1IILDING DIVISION an, REQUIRED DATA:1-AND 2-FAMILY DWELLING El 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 Addition/alteration/replacement ❑Other equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ElI-and 2-family dwelling Commercial/industrial ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: l f 71�[ - 7 2.n✓l AV,f New dwelling area: square feet City/State/ZIP: 'r/e7c,r 6A /0 f.,r 9 / c 7 2 9 3 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: 0 i ? 9-Cc' �� 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 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 DESCRIPTION OF WORK work indicated on this application. A A / I Valuation: $'_5;, yl-(�✓' at!r1 rc tl n / (9c~[)^r 6 0 rr, p. i j z r. I S', Existing building area: square feet New building area: square feet 0 PROPERTY OWNER ❑ TENANT Number of stories: Name: l C lel PnS'S VI C I I : Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT 0 CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name:to A I,A S tri licensed with the Oregon Construction Contractors Board under ORS 701 and maybe required to be licensed in the Address: jurisdiction in which work is being performed.If the City/State/ZIP: applicant is exempt from licensing,the following reasons c� apply: Phone:(b 3 ) 71e . i c Fax::( ) E-mail: t o,n/t i( 1 ( C r2 vv. . t i n v. CeJ,n CONTRACTOR BUILDING PERMIT FEES* Business name: (c-c,✓1'1 Irv-L / I 1 �� (Please refer to fee schedule) , n Permit fee: Address: v 95 ol ot S (v p1 1"v 2 5 ;n t } State surcharge(12%of permit fee): City/State/ZIP: 1 �v^t1 Y 1 W.t / r t 9 G^ / 1 70 7° a FLS plan review(40%of permit fee): Phone:(9 7I) _y).W _ 17 3 C'-! Fax:('C(71 ) - �].LI — rj 31 .5 13 (Due upon application submittal.) CCB lic.: Li Ly 7/ -) Total permit fees:' Authorized signature:• " _ Amount received: r6"- This permit application expires if a permit is not obtained Print name: f ^^ Date: n `� , within 180 days after it has been accepted as complete. �fI✓, I L Lr��r 4 r✓1 4/ Zy��C�G7 * Fee methodology set by Tri-County Building Industry Service Board. IdBuildmglPecmitalFPS-PermilApp_031016.doc 440-4613Tt.i iIo/COM/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: 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 El 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 Type of System(Complete A,B, C or D as applicable): A.) Commercial Sprinkler Sprinkler Type ji Wet El Dry Additional Standpipes Information: Sprinkler Supply Line El Yes ❑ No Hazard Group Q Density 0. IS Design Area K. Factor G . (p(` Sprinkler Project Valuation: $ 2 Sop 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_Pemtiulpp_03101G.doc 2 City of Tigard RE r9I /EDPermitNo.: J��p _ ,? 'r 13125 SW Hall Blvd.,Tigard,OR 97223 V L V Phone: 503.718.2439 Fax: 503.598.1960 Date Received: /}6120 Inspection Line: 503.639.4175 FEB 2 6 2020 TIGARD Internet: www.tigard-or.gov By: [A�ij if .7-. ...1 e CITY OF TIGARD © FIRE spiumatoaligiVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: D ;.--1.- ti .0e5 ) 5 n Occupancy: iti ikc< Job Address: ( I 7 l-1 i 73--,to 44 Type of Construction: 1-4 Suite: Contractor: ro ,.,1, A �1 I M,, , Phone: 7/ — Z 2 cf. -- 5 (-,,,-/ ej ,-- - 73r' — 'TT . `ic Number of Proposed or Altered Heads: 1 Type: t Hazard: 0 LI Density: n, Z 5j I, L roM et.-.t./( I:1 r c Oregon Construction Contractors Board No. 1-/`/ 7/ ) 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: �Y� Date: 2 ,'2 5,:---c 7 CD Print Name: tone,'-t L al, 5-e,-7 I:1Building\Forms1FireSprinklerAfdavit_071514.docx Page 1 of 1