Loading...
Permit (47) INCITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT . ` COMMUNITY DEVELOPMENT Permit#: FPS2016-00178 Ti GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2016 Parcel: 2S113AB00101 Jurisdiction: Tigard Site address: 16101 SW 72ND AVE 200 Project: Perlo Subdivision: None Lot: None Project Description: Fire sprinkler modification of(1)head for stair and lobby TI Contractor: CROSSFIRE SPRINKLER CO Owner: PACIFIC REALTY ASSOCIATES LP 17400 SE 82ND DR ATTN: N PIVEN CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-210-5506 PHONE: FAX: 503-210-5538 FEES Description Date Amount Specifics: Permit Fee-COM 10/13/2016 $51.09 12%State Surcharge-Building 10/13/2016 $6.13 Type of Use: COM Plan Review-Fire Life Safety-COM 10/13/2016 $20.44 Class of Work: ALT Type of Const: Occupancy Grp: Height: ft 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 $77.66 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $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 s ion OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Air . Ceerer--4//4-4-4(1/ ,ii/d97- Call 503.639.4175 by 7:00 a.m.for the next available inspe• on :ate. 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 Applica__t__ion Fire Protection System N�����- i�"' FOR Of�['ICF USE ON1,1' City of Tigard i'8+ i:1 ! ;;�t Received .114 g 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : 1' Q^.+ I D /J �� Permit No.: /✓i O/ep-Qo/7g Phone: 503.718.2439 Fax: 503.598. 9 Plan Review T!G A R D Inspection Line: 503.639.4175 In, I `o "if,f Date/B : Other Permit: Internet: wwne:5 3.63 .41 r Date Ready/By: gov y ,1,,r,ii, 0.,,-1 t Notified/Method: ® !a See Page 2 for a-)c k i it k & (.1 1,-,1.,,) Supplemental Information TYIP' Vil N , DIVISION ❑New construction REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 Demolition Permit fees*are based on the value of the work performed. Addition/alteration/replacement 0 Indicate the value(rounded to the nearest dollar)of all CECOther: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling Commercial/industrial Valuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND ` LOCATION Total number of floors: Job site address: G Z New dwelling area: square feet City/State/ZIP: fr7644tiet OOg- 2.2-- Suite/bldg./apt.no.: Garage/carport area: square feet Project name: ott,„0r/ea,... Cross street/directions to job site: ��_ Covered porch area: square feet -. 11111111111111111111111111111111111111111111... Deck area: square feet Other structure area: square feet Subdivision: REQUIRED DATA:COMMERCIAL,,,USE CHECKLIST Lot no.: Tax map/parcel no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all DESCRIPTION OP WORT{ equipment,materials,labor,overhead,and the profit for the work indicated on this a..lication. Ad. * A '/ ` t6"t d Valuation: $ C IIIIMIIIIIIIIIIIImimiuniiiExisting building area: New building area: 0 ® TENANT square feet PROPERTY OWNER square feet Name: �, „, Number of stories: 4, ,1 vL-rioev D ,..54,..- Type of construction: Address: ! 2yi� ,• ,Sv ,- �v City/State/ZIP: r ; L, Of( Occupancy groups: ('�4 GZ 2 i zv Phone: , Egiiimmimmi 1111:21111111111111111111111111111 tat APPLICANT. 0 CONTACT PERSON �^ NOTICE Contact name: O Lr 9.,../ All contractors and subcontractors are required to be �. licensed with the Oregon Construction Contractors Board Address: G O ��� under ORS 701 and may be required to be licensed in the Add .If the ress: ZIP: "0 G/�'�l0 24,4, 4,4 �e v ' 2.vi7 jurisdiction in which work is being Phone: y ZZ-y applicant is exempt from licensing,the following reasons a 2 a apply: ..11111 111111111111.11111111111.1 E-mail: c&21,, CONTRACTOR BUILDING PERMIT FEES*Business name: C Lw Ss t 1 6- o" 444, ,,kCO (Please re er to ee schedule Address: e2014/0 Permit fee: IIIIIIIII City/State/ZIP: .4�� ©!4. 4 7015 State surcharge(12%of permit fee): IIIIIMIIII Phone:(3(2 4O i d FLS plan review(40%of permit fee): CCB lic.: '1 i/ Due uson a..lication submittal. Authorized signature: `C Total permit fees: MUM ,......,& Amount received: IIIIIIIIIII This permit application expires if a permit is not obtained Print name: 5T�l�/t�,�/8"�-(��/L Date: tq j. xe within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry I:\Building\Permits\FPS-PennitApp_031016.doc 440-4613T(1002/COMiwEB) Service Board. City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information _____.......•.i•••••nllll1llIllI1IllllIIl.IlIII111lll..i•••m•llll.11Ill1llIlIlIIIII1II.I...I........m.-----•ii•miim•m•ii• Describe work to be done: Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: 1.) Type of Work. 2.) 0 New system Number of sprinkler heads: Number of alarm devices: 1-5 devices:. Affidavit required and [:1 Addition or 0 1-10 heads: Affidavit required and 0 (3)copies of sketch showing area Alteration (3) copies of sketch showing area of work within building structure to existing of work within building structure system + devices: Plan review required and 0 11+heads: Plan review required and ❑ 6+sets of plans. (3) sets of plans. Additional description of work: -- Tile of S stem Com•lete A,B,C or D as a• •lic able A.) Commercial Sprinkler iiiiiiiiiiiiiiiiii1111111Wet ❑ D Additional Stand.i.es ❑ Yes ❑ No Information: Hazard Grou. Densi IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Desi: Area IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII K.Factor IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1311111111111111111111111111 S•rinkler Pro'ect Valuation: B. T j►eI- Hood Fire Su a i ression S stem Hood Pro'ect Valuation: C.) Fire Alarm ❑ Yes Submittal shall Batte Calculations include: Individual Component 0 Yes Cut Sheets rimminiiiiii Fire Alarm Pro'ect Valuation: D.) Residential Sprinkler(Stand Alone System) nigffiffilizmm S•uare Footate: $198.75 0 to 2,000 $246.45 2,001 to 3,600 $310.05 3,601 to 7,200 $404.39 7,201 and : eater sq.ft. Sprinkler Project Square Footage: Fire Protection Permit Fees Pro'ect valuation subtotal see A,B &C above : 01111111111111111111 Permit fee based on .ro*ect valuation see fee schedule : Permit fee based on s•uare footate see D above : State Surcharte 12% of .ermit fee : FLS Plan Review 40% of .ermit fee : TOTAL: I.\Building\Permits\FPS_PermitApp_031016.doc 2 City of Tigard /4S 13125 SW Hall Blvd.,Tigard,OR 97223 Permit No.: l _ 0 l7 m Phone: 503.718.2439 Fax: 503.598.1960 C3�v '� Inspection Line: 503.63Date Received: 1p t Tits:ARD , 9.4175 , Internet: www.tigard-or.gov $ a r i g k j:4-`J p FIRE SPRINKLER AFFIDAVIT ALTERATIONS OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: �i LO J4 772 ? ,,/ 57)6t1g5 Occupancy: 13 Job Address: 4100£74/ F Z4,0 �OO Type of Construction: / G� Suite: Contractor: C, # =/IZ(, S / (A43gG 45 Phone: 603 Z/ Number of Proposed or Altered Heads: i Type: Hazard: Density: certify the following is true and reasonably defines gthe scope of work foron Construction Contractors Board No. 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 current with a copy of the sketch attached shall be available for all inspections. Signature: Date: d f 3 lG Print Name: S 70A(r4/ G.� I:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1