Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
`� I COMMUNITY DEVELOPMENT Permit#: FPS2020-00042
Date Issued: 04/30/2020
T1L;ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16620 SW 85TH AVE
Project: Clean Water Services Subdivision: None Lot: None
Project Description: Solids Building-(8)new pendant sprinklers.
Contractor: BASIC FIRE PROTECTION INC Owner: CLEAN WATER SERVICES
8135 NE MARTIN LUTHER KING BLV 2550 SW HILLSBORO HWY
PORTLAND, OR 97211 HILLSBORO, OR 97123
PHONE: 503-285-1855 PHONE:
FAX: 503-285-0713
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/23/2020 $123.72
12%State Surcharge-Building 03/23/2020 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 03/23/2020 $49.49
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 03/23/2020 $2.00
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $190.06
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $4,977.48
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 952-001-0010through 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: C` ! /� 1:/�,y6/ � 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'
City of Tigard
RECEIVED Received
Date• 13125 SW Hall Blvd.,Tigard,OR 9722L n pp 9 q Plan : ;�, s
I Phone: 503.718.2439 Fax: 503.598.19 f3 1 202a Plan Review
Date/B : Other Permit:
T 1 C;A R D Inspection Line: 503.639.4175 Date Ready/13y: 1 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
Rt)ILDINIG DIVISION ��L����1f
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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
CATEGORY OF CONSTRUCTION work indicated on this application.
El1-and 2-family dwelling ElCommercial/industrial Valuation: $
0 Accessory building El Multi-familyNumber of bedrooms:
0 Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site addressjl 550—&> Ave /(y6/�0 St...a -4.- New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Clean Water Services —5 I 1-As Qi„I'U it.„7 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.
Tax map/parcel no.: 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.
Install'Rooster Tail'from existing upright sprinkler locations in order to Valuation: $$4,977.48
install new drop pendent sprinklers to provide coverage below existing drop Existing building area: square feet
ceiling within area of work. New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Clean Water Services Durham Facility Type of construction:
Address:1060 SW 85ta Ave Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:(503)547-8150 Fax:( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Basic Fire Protection All contractors and subcontractors are required to be
Contact name:James Simmerman licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:8135 NE MLK Jr.Blvd jurisdiction in which work is being performed.If the
City/State/ZIP:Portland OR 97211 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)285-1855 Fax: :( )
E-mail:jamessimmermangebasicfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Basic Fire Protection (Please refer Sofro uhsduie1
Permit fee:
Address:8135 NE MLK Jr.Blvd
City/State/ZIP:Portland,OR 97224 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)285-1855 Fax:( ) (Due upon application submittal.)
CCB lic.:48641 Total permit fees: /10, O(/.
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name:James S mmerman Date:3/18/20 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pnmits'FPS-PermitApp_031016.doc 440-4613T(11/02/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:
El New system Number of sprinkler heads:/71 per rsvfi Number of alarm devices:
El 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:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ® Wct ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Light
Density .10
Design Area
K. Factor
Sprinkler Project Valuation: $ 4,977.78
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: $
C:\Users\Chase\DWG\20-42851 CLEAN WATER SERVICES DURHAM\Submittals1AH.J\FPS_PemutApp.doc
City of Tigard .ECEIVED Permit No.: F",5 -Ott>ti c
.III — • 13125 SW Hall Blvd.,Tigard,OR 972E31•
Phone: 503.7182439 Fax: 503.598.1960 9 r� Date Received: 3�17/�
Inspection Line: 503.639.4175 MAR 1 ZOZO ��
i l :1 kt I) Internet: www.tigardor.gov By: / V 4+ T yam,'
CITY OF TIGARD ,
1
FIRE SPRINR-EGAf �AVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project NaTee:-6 _Clean Water Services (Durham) Occupancy: Light
Job Address6d� SW 85th Ave, Tigard 97224 Type of Construction: A-1
Suite:
Contractor: Basic Fire Protection Phone: 503-285-1855
Number of Proposed or Altered Heads: 8
Type: WET Hazard: Light Density: •10
1 Basic Fire Protection Oregon Construction Contractors Board No. 48641
certify the following is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and annoyers 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 docume with a copy of the sketch attached shall be available for all inspections.
Signature: / Date: 3/16/20
Print Name: ames Simmerman
1:\BuiMmg\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1
BASIC LETTER OF TRANSMITTAL
� . FIRE
w PROTECTION INC.
8135 NE MLK JR. BLVD. RECEIVE[°ATE 03/18/20 '°'N°.20-42851
PORTLAND, OREGON 97211 ATIEMION
PHONE 285-1855 FAX 285-0713 MAR 1 9 202`n Permits
REGARDING:
CITY OF TIGARD Clean Water Services Durham
CITY OF TIGARD BUILDING DIVISION
13125 SW HALL BLVD
TIGARD, OREGON 97223
WE ARE SENDING YOU
0 Shop drawings ❑ Prints ❑ Plans ❑ Samples I I Specifications
El Copy of letter ❑ Change order 0 Hydraulic calculations Q Submittal Data
COPIES DATE NO. DESCRIPTION
3 03/18/20 1 Fire Sprinkler Plan
03/18/20 + Fire SprinklerData- /q/n- u„l„�A .?///Y/td /3-T
1 03/18/20 Permit Application 66
1 03/18/20 Fire Sprinkler Affidavit Form
THESE ARE TRANSMITTED as checked below:
p For approval El Approved as submitted El Resubmit copies for approval
El For your use ❑ Approved as noted ❑ Return corrected submittal data
❑ As requested ❑ Returned for corrections ❑ Return corrected prints of each
❑ For review and comment El For Architect's/Engineer's Approval
❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
IF YOU HAVE ANY QUESTIONS OR NEED FURTHER INFORMATION
FEEL FREE TO CALL ME AT 503-285-1855
COPY TO: FILE
James Simmerman
SIGNED: