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Permit (213) if CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT ' COMMUNITY DEVELOPMENTPer mit#: FPS2016-00201 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/14/2016 Parcel: 1 S 136DD05300 Jurisdiction: Tigard Site address: 11850 SW 67TH AVE, STE#150 Project: American Family Insurance Subdivision: WEST PORTLAND HEIGHTS Lot: 9 Project Description: Fire sprinkler-Add/relocate(16)heads for TI Contractor: AFP SYSTEMS INC Owner: 19435 SW 129TH AVE PNWP LLC#2 TUALATIN, OR 97062 PNWP LLC 6600 SW 105TH AVE#175 BEAVERTON, OR 97008 PHONE: 503-692-9284 PHONE: FAX: 503-692-1186 FEES Description Date Amount Specifics: Permit Fee-COM 12/14/2016 $112.96 Type of Use: COM 12%State Surcharge-Building 12/14/2016 $13.56 Class of Work: ALT Type of Const: IIIB Plan Review-Fire Life Safety-COM 12/14/2016 $45.18 Info Process/Archiving-Lg$2.00(over 12/14/2016 Occupancy Grp: B Height: ft 11x17) $2.00 Stories: 1 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: 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 $173.70 Valuations: Sprinkler Valuation: Required Items and Reports(Conditions) $3,550.00 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: 53X4. 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 1 t r 'ts''.E, v�,,, FOR OFFICE USE ONLY Received - City of Tigard q / Permit No.: �� 1 �j Q I Date/ _ �� � �� ��—ao 13125 SW Hall Blvd.,Tigard,OR 97223.<,-;V ` Plan Review Phone: 503.718.2439 Fax: 503.598 19( 't Other Permit: // I .3 � � 1:"+ r 9 Date/B �h���� r-. ��lD T t G A R D Inspection Line: 503.639.4175 Gil (,.1 t ;,,,;-,/,,,,-,,...3,,,,r Date Rea,7 : t jr kris: ® See Page 2 for Internet: www.tigard-or.gov Ed, I Lo,,.,k d•. IA; Notified/Method: / j,al Supplemental Information L t 7/ f --L \ t �O : ; \ 1 a 11 3 IlE INO 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the t iv 111Mks ° work indicated on this application. Valuation: $ ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: ` O Total number of floors: 4, • JOBS f w `PION AI9 LOCATION may'. .. Y < Job site address:11850 SW 67th Ave. New dwelling area: square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: V150 I Project name:American Family TI Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet RE QUIP`ERjlrt''''''''•16'® CIAI? -USE CHECKLIST-4 IST Subdivision: 1 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 \ \ 1 PT'I©N OF WO 0',>•'''%4,,, work indicated on this application. e...-.,,,,, - �:� \..... :. moi ., ��,�; ,,.,,,e.-' ..: Add/relocate 16 sprinkler head drops to provide coverage for new floor plan. Valuation: $$3,550.00 Existing building area: square feet New building area: square feet pL?PlERT'.OWNERw. ✓ 0 "T'ENAN'T;, v Number of stories: 1 Name: Type of construction: III-B Address: Occupancy groups: City/State/ZIP: Existing: B Phone:( ) Fax:( ) New: no change ® APPLI AISfiT % 4' 1,, r CONTACT P tER, 5! l +'� A \ Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be 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 apply: Phone:( ) Fax::( ) E-mail:permits@afpsys.com CONIRACI#)teK\�' ,,,,,''.:',',4-,,,,„;. -4t.':•;::'\.,. B1IILD1NOP :,t; , *; Business name:AFP Systems Inc. x -• (Pleas ereferIo ek c Ftutok0,, , Permit fee: Address:19435 SW 129th Ave State surcharge(12%of permit fee): City/State/ZIP:Tualatin,OR 97062 0 FLS plan review(40%of permit fee): Phone:(503)692-9284 Fax:(503)692-1186 (Due upon application submittal.) CCB lie' r7 5 3 l Total permit fees: SAmount received: —CD Authorized signature: This permit application expires if a permit is not obtained Print name:Steve Frost Date:11/28/2016 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information -kf # .. /�`o: �s'�a { ? .,fir/n�,,+ \�b .: ....�� �N,.,, ��a. .'�. .. ..�; ��.5 �-am. 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: ❑ New system Number of sprinkler heads: 16 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 ® 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: �i .: - / //r \\�� a / /�` Fes\ j itr f ystem(Ca per �s pp ab e) . .. Cottimercial Sprier ; G '\ /ii/ i z;- €; ggfismgmolf it mmullimpui ® Wet ❑ Dry Additional Standpipes Information: Hazard Group LH Density 0.10 Design Area 1500 K. Factor 5.6 Sprinkler Project Valuation: $ 3,550.00 B.) Type I ;: , ;-iilghioopioggik5yotiwsnimaioAeoxagipooisonagpnEipEmrpgipepn Hood Project Valuation: $ zo` rpt%//rs ` % i \: Submittal shall Battery Calculations ❑ Yes include: Individual Component El Yes Cut Sheets Fire Alarm Project Valuation: $ � ;Re tdential Sprinkler an• cine Systenl<) ;; refsspgigtrisosngmmssmwiiiimggagolseiEont Square Footage: Permit Fee: gogn \ ogsmagkosugummimigmo 0 to 2,000 $198.75 \\KnAmegmossremft� 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05aMgk �' y 7,201 and greater $404.39 imiliktoNnomitkoN,geounneammimmmp:RgiumppKtaig4g Sprinkler Project Square Footage: sq. ft. S ,. „ Fire r"rotecticgrAennit Fees„ ' .m., Project valuation subtotal (see A,B & C above): $ 3,550.00 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: $ \\SERVER02\Data\Permits Steve\Tigard\american family TI-FPS_PemutApp.doc 2 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 11850 SW 67TH AVE STE 150, TIGARD, OR, 97223 Record Type: Commercial - Fire Protection System Inspection Type: 999 Sprinkler final Result: PASS- NoCofO Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: Record ID: FPS2016-00201 Inspector: Chip Barnett Contractor