Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I COMMUNITY DEVELOPMENT Permit#: FPS2020-00043
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/07/2020
TIGARD 9 Parcel: 1S134AA02100
Jurisdiction: Tigard
Site address: 10300 SW NIMBUS AVE PC
Project; KG Investments Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: Fire sprinkler permit: Relocating(10)sprinkler heads, Affidavit submitted.
Contractor: FIRE SYSTEMS WEST INC Owner: DIETRICH, NANCY BISHOP
600 SE MARITIME AVE#300 ROBINSON, JERRY CHRISTOPHER TRUST
VANCOUVER,WA 98661 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 360-693-9906 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/03/2020 $102.20
12%State Surcharge-Building 04/03/2020 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 04/03/2020 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 04/03/2020 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: No 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 $155.84
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,400.00
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: Permlttee Signature: ?' �
•
Cal 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.
RECEIVE®
Permit of Tigard p5d32D -c l n13
i 3 i 25 SW Hall Blvd.,Tigard,OR 97223 MAR 3 0 MO
0 • . Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 3/34,07.0
Inspection Line: 503.639.4175
TIGAILD Internet: www.ligard-or.gov CITY OF TIGARD y i f
BUILDING DIVISION I3 � �
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: " G ltb t e.S 131.1 is i+i i715 Gd-KiTtrk, Occupancy: 13
Job Address: 14>300 5w vas Type of Construction: V15
Suite: 1 P i 121 Surftr G
Contractor: PI12. S / 1tsr't.S -igS r Phone: ‘n 6fr 9 3 ?l°TO G
Number of Proposed or Altered Heads: I(--/
Type: CA)LTr Hazard: Lit,►i r Density:O. i
I, Fi 1'z S Y s-nsr4 s t,-/resr Oregon Construction Contractors Board No.49 7 3 2_
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: Date: 3-10-z
Print Name: .3 pis ae.t set eivsati
I:\Building\Poems\FireSprinklerAffidavit 071514.docx Page 1 of 1
Building Permit Application
Fire Protection System I V ED FOR OFFICE USE ONLY
City of Tigard r 2�2 Received
a. .. t
v 13125 SW Hail Blvd Tigard,OR 9/223. a Plan Review
i Ct Other Permit: e
1111 Phone: 503.718.2439 FaX 503:598.1060` DekB : //v r�'[Li— M
"
T I G A R ID Inspection Line: 503.639.4175 C SIGpRR Date Ready ey: l�See Page 2 for
Internet: www.tigard-or Ga i Q` @I Notified/Method: 5 Supplemental Information
U-DING 01
V1 JlQ
,7 YI'E OF WORK .REQUIRED➢ATA:1 AND 2,FA)YIq,KwELLDVG;;
❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CA.TEGOIRY,•,OF CQN0Rt1CTION work indicated on this application.
❑ I-and 2-family dwelling Commercial/industrial Valuation: $
0 Accessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1& oc Sc..) ki 1 ektuS Aver New dwelling area: square feet
City/State/ZIPrro g, e.d9 p IL-. 97 Z.2.3 {-7�n_`�^�S_ .}- Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:K4 x.p6�d Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
iBEQU R D DATA e9MMERCiALUSJt('IT CIfT.S
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
x ` DESC[tIPTION+QT WORK work indicated on this application.
1-�OC.P1-15 `J l'12-i LK L-6-S fee— �ZSW A-N'f`trostP(ztveloi r F Valuation: $ zy46Oac.a
Existing building area: square feet
New building area: square feet
)'RQPERTY i60-4 t. . ` n.l'LX ') aTF1VANT +' Number of stories:
Name: Y es ' N\loT fyyal.,,r3 Type of construction:
Address: 10, Z4Cs. Se.,) kv t t'rt 5 u5 NW( Occupancy groups:
City/State/ZIP: y ^ftt�p,OY— 41'72.0 Existing:
Phone:(Sa3 )24s' ` 1 b> Fax:( ) New:
P AN ' : A )'ERSOIQ
,„,`, . ?r . .: NOTICE ?,. ..
Business name: I" lite5 V 5'risr l 5 -'i r All contractors and subcontractors are required to be
Contact name:�(a °!J ('t!n�!Sony licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: (,00 s e wolf,i 7'I M(r' ply a jurisdiction in which work is being performed.If the
City/State/ZIP: eve) applicant is exempt from licensing,the following reasons
VA-W coutrait (16'6G/ apply:
Phone:(3c,�,)�13 i fG Fax: :( )
E-mail:S &bo a S Ft((-j 5 r--ST(_Srt.}`j 4DJ f, Ga/ t ��}}t�rx{{{{{{err�rr �T/Y b y�,�-��+�Y
VY efdk..n ... '::_l. -v- t = i.itj, 17. .. y A ALs Y r1flVoltgro h�$*
Business name: �t 5751 S mar (PlrrFg.referinh seGf<e:
Permit fee:
Address: G i 5Lx YnAdttTlrt.,u J1V4C v
y Coca VC th'u" Cr G G 1 State surcharge(12/c of permit fee):
City/State/ZIP:Vivo ) FLS plan review(40%of pennit fee):
Phone:( ) _ Fax:( ) (Due upon applica/ion submittal)
CCB lie.: 4 9 7 3 2__ Total permit fees:
Amount received:
Authorized signatur .
r„ip- This permit application expires if a permit Is not obtained
S f3"t p-pili S01/41/ Date:3-• O•ZOO within 180 days after it has been accepted as complete.
Print name;
* Fee methodology set by Tri-Gouty Building Industry
Service Board.
t:\auildingt'ermits\FPS-Perme App 031016.dor 4404612T(tl/02/COMAVaa)
M
r _
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: O Number of alarm devices: MA
11144 Addition or 1132 1-10 heads: Affidavit required and El 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: PIan 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 appIicable •
A.) Commerciail Sprinkler
Sprinkler Type 21 Wet ❑ Dry
Additional Standpipes - tsa/A
Information: Sprinkler Supply Line ❑ Yes IN No
Hazard Group
Density
Design Area 52w
K.Factor • S' G.
Sprinkler Project Valuation: $ 2.//0°
B.) Type I - Hood Fire,S ppression.System
Hood Project Valuation: $•
N/f}
O Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 0 s/v
•
IY) Residenttal Spnialclet(Stand Alone System
Square Footage: Permit Fee:
0 to 2,000 $198.75 j
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: tat sq. ft.
Fire Protection Permit l egs; ,, ,
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_PcnnitApp_031016.dvc 2
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- !VAJ!E!NN! -m 100 d - RECEIVED
II!I-: MAR 3 0 2020
CITY OF TIGARD
OFF'
-FIGE 101 BUILDING DIVISION
—M4cii .
1(2 L — A • 1 1/2
Ilia f
QI'FICE COPY
SPRINKLER PLAN
SCALE: 3/32"=1'-0"