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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT '� Permit#: FPS2016-00108 F ''' COMMUNITY DEVELOPMENT Date Issued: 06/23/2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102DA00401 Jurisdiction: Tigard Site address: 13125 SW HALL BLVD None Lot: None Project: Tigard Police Department Subdivision: Project Description: Adding(1)sprinkler head and relocating(1)sprinkler head for TI. Affidavit Submitted. Contractor: CROWN FIRE SYSTEMS INC Owner: TIGARD, CITY OF 7402 SE JOHNSON CREEK BLVD 13125 SW HALL PORTLAND,OR 97206 TIGARD, OR 97223 PHONE: PHONE: 503-777-5030 FAX: FEES Description Date Amount Specifics: Permit Fee-COM 06/23/2016 $56.47 12%State Surcharge-Building 06/23/2016 $6.78 Type of Use: COM Plan Review-Fire Life Safety-COM 06/23/2016 $22.59 Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 06/23/2016 $0.50 Occupancy Grp: Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: No Sprinkler Type: Wet Standpipe Required: Hazard: LT Density: 0 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 $86.34 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 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 :I• .4. Permittee Signat. e: -7 Issued By: — ,,..s ...,........ea...i____ Call 503 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 is Fire Protection System "`t''' FOR ohFlcl, usr:oNLv Received ti�� Permit N°.: MI 19 rAW . —�� 7i. City of TigardIZ Date/B : 1� g 13125 SW Hall Blvd.,Tigard,OR 97223 �\)�a Plan Review Other Permit: /��� y. Phone: 503.718.2439 Fax: 503.598.1960 8 ,;; date/B y y_ ® See Page 2 or Inspection Line: 503.639.4175 ,, x i)�ead /B 10 See Page 2 Information I 1 l;A R I� c•-...,..' t ted/Method: it Internet: www.tigard-or.gov I_, i a+ I(14-' , REI)DAi.TA.�-I=AND 24AtMLY DWELLING :s k �, TYPE OF WOTtK� f���[Ii ... , Permit fees*are based on the value of the work performed. ❑N onstruction ❑Demolition Indicate the value(rounded to the nearest dollar)of all Addttion/alteration/replacement ❑Other equipment,materials,labor,overhead,and the profit for the work indicated on this application. „: : ,i ,.-,, ,C t oN cT , ,, o. .n... .x Valuation: $ �� Commercial/industrial ❑ 1-and 2-family dwelling Number of bedrooms: ❑Accessory building 0 Multi-family Number of bathrooms: ❑Master builder ❑Other: Total number of floors: JOB'SITE JNFORMATION AND' LOCATION-/. sq uare feet New dwelling area: Job site address: 1312 S SGS"- HALL L .'�v17� '7"--/ �r City/State/ZIP: / / Z.-A-72 v 6 % 72 2- Garage/carport area: square feet Suite/bldg./apt.no.: I Project name:����� �G/C Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet It l[�,II RED DATA C mmolcImAisE CHECKLIST.'" Lot no.: Permit fees*are based on the value of the work performed. Subdivision: Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the 3fESC3ti�''C'ION�0F �vOx� " work indicated on this application. ', Valuation: 746/ 0)� ��LD ��7 �lz av �W G✓f14 L $ Existing building area: square feet New building area: square feet PROPERTYOWNER n" ❑ TENANT ,. .; Number of stories: Type of construction: ttJ p-O J-b-. FJ Name: Address: Occupancy groups: 41 6_,..1-7-- /7/„."...7_,4_,),_)>,. City/State/ZIP: Existing: Phone:( ) Fax ( ) :f f CONS AO7 " S f, : OThLE PLICr4NT ,- ... Business name: �1�/1) r/, 1E SYs7 s All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board • Contact name: � r✓ Q'���1��/1'� under ORS 701 and may be required to be licensed in the Address: 7i711 2 _SF -7--„, A,S o e"`�t L ✓7>, jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP: r f L�j✓ P 0/2---- apply: Phone:(S03) g---e7/9:.._ g-1 a Fax: :(�+,Yl) y^ Email 'f cgdp-)ru > b ff ES/C' -s. rCQ2 . rye ! "v,ON L �= 0". . `fix.. `- 01�.r; G 1[, F ''''t' V ' „ �,,� ' „4, s .;: �� �t ._ .� ,.:� ;;0.0.,,, .... . .. � * .rx`xT .., : '��!'O�er, � u#B)�' "t. v=: .�' ..� Business name: _cA� i.; /001/%3 Permit fee: Address: State surcharge(12%of permit fee): City/State/ZIP: FLS plan review(40%of permit fee): Phone:( ) . /'_ Fax:( ) (Due upon application submittal.) Total permit fees: P Com•T CCB lic.: Amount received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:?yfl�lJ phi�/�? ff/J Date:�r-2 3(.6 * Fee methodology set by Tri-County Building Industry Service Board. i:\Building\Permits\FPS-Permit App031016.doc 440-4613T(IT 02,con WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information Descr a'work to- e ur; 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: ❑ New system Number of sprinkler heads: 2_ Number of alarm devices: ..-54,2 Addition or 01-10 heads: Affidavit required and / lteration ❑ 1-5 devices: Affidavit required and (3) copies of sketch showing area (3) copies of sketch showing area to existing of work within buildingstructure 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 ©f S st•m (Complete tA,B,C or as appl cal i e : A) Com►rerotalSprirer Sprinkler Type Wet ❑, Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group /C-/1 Density Design Area K. Factor 5, Sprinkler Project Valuation: I $ B:,), Type I, flood Fite Suppression System . Fr t v Hood Project Valuation: I $ ... .. f' '' " Submittal shall Battery Calculations � " include: ❑ Yes Individual Component ❑ Yes Cut Sheets Fire Alarm Proj eam,ct Valuation: : I $ t.-",..-4.'..„,..4 ''-',. .. "z e p'', ,, . � " ti ,,, § :':) pa'd'e y wn ISprinkler(Stand Alone'System). zz , Square Footage: Permit Fee: 0 to 2,000 $198.751 2,001 to 3,600 $246.45 _ ; , � 3,601 to 7,200 $310.05 4A a� i 'Y. * 7,201 and greater $404.39 Sprinkler Project Square Footage: I sq ft. ::.. v . 6'` :Fie Pro i_i t e:,4:',-..„,:*;,.' 1 7 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:A Building\Permits\I'PS_Permit.1pp_031016.doe 2 F City of Tigard t, PermitNo.: Xt.. J,, /t' -Veda IN13125 SW Hall Blvd.,Tigazd,OR 972 3 z • Phone: 503.718.2439 Fax: 503.598.1960 v `�°1'` Date Received: Inspection Line: 503.639.4175 J\wP By: c lis ,\I � ', f ii Internet: www.tigazd-ortr x ,- FIRE SPRIN _I `AFFIDAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: 77 'P ?oz.. �l% T. Occupancy: (,f/ /G Job Address: -/3/OS St.,-) 14i444 �4i/ Type of Construction: Suite: Contractor: 6OtA)/v . -->R 5 V i F S Phone: S3 77 SO? Number of Proposed or Altered Heads: 2.. Type: 59-a)D• 21-5, Hazard: L/ a--/-4 T Density: , & /4- I, c�wl /�,2/f1A .AJ Oregon Construction Contractors Board No. /C ,.- if 20 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: IIIIIIIMINNINW Date: ‘ -75--lig Print Name: v ") OF7, 7Z N--1'4n� Page 1 of 1 I:\Building\Forms\FireSprinklerAffidavit 071514.docx z w, fA:' 155 111.1 c.4gid'; L 6 e R. ca s A 'V �QI�� mod r-z26 v 4 0/8 g0$ -i k a /1/4.;/. /. vZLb °z!Q <cc.r-knsa:0� a/iv 7 2OhL SP)/-W'/i5' 1 '1Q32 'CL77 -774/7/ 0.5' 5z )E/