Permit (128) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
.111,_ .
. COMMUNITY DEVELOPMENT Permit#: FPS2017-00134
T[ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2017
Parcel: 1 S 1260000300
Jurisdiction: Tigard 1
Site address: 9402 SW WASHINGTON SQUARE RD P01
Project: Dick's Sporting Goods Subdivision: None Lot: None
Project Description: Fire sprinklers-demolition of(3)sprinkler heads.
Contractor: FIRE EXTINGUISHER SERVICE CTR Owner: PPR WASHINGTON SQUARE LLC
3460 SW 209TH AVE PO BOX 847
BEAVERTON, OR 97005 CARLSBAD, CA 92018
PHONE: 503-643-3309 PHONE:
FAX: 503-356-1736 r
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/23/2017 $51.09
12%State Surcharge-Building 08/23/2017 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 08/23/2017 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 08/23/2017 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard:
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 Gales Provided: Cut Sheets Required:
Total $78.16
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 s .rted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folly% the rule. 'opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You '.,y ,,. :'' a copy af the rules
or direct questions to OUNC by calling 50 .232.1987 or 1.800.332.2344.
�� Al_,/ 4
Issued By: .2�1/'t /) 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.
11 - City of Tigard Permit No.: FP-SAY 7-00 134
4 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: j, 3/i 7
InspectionLine: 503.639.4175 a` P4e91/ Lff-
T1GARD Interne: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS RECEIVED
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
AUG 2 3 2017
CITY OF: TI ARD
BUILDING DIVISION
Project Name: N\�.>,C S Pc.-Az-,c%N i.y- r 5 Occupancy:
Job Address: q 4 )2- S--) LU P I,, 6;., e..b Type of Construction: (_'INA-c=(jQ& )
Suite:
Contractor: ,31;. C x T%N 6 u( i.k crit_ (til_%_)%t-.i_ e ;0-Phone: 52i"3 Cs 4 - 3 301
Number of Proposed or Altered Heads:
Type: 7i-_:-- -,V, Hazard: Density:
I, N 4 C-I-2 p tirTvAckL Oregon Construction Contractors Board No. (•a 11 $4
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)c ies of a etch showing the area of work within the building's structure.
• Building fi protecti i ii j stem p• mit.
• A copy of is i i tum 4ith a i ,y of the sketch attached shall be available for all inspections.
Signature: / ��� Date: J - Ze") - \1
Print Name: St:F A O C71-7--P'4-'{1`c-iL
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1
ilding Permit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received 2'
1,1 . 13125 SW Hall Blvd.,Tigard,OR 97 1\1m.. PDate/Blan Review: �� �`� Permit No.: `FP mor
Phone: 503.718.2439 Fax: 503.598. 9 "�� Plan ����^t/
Date/B Other Permit:
Inspection Line: 503.639.4175 Date Ready/By:
lulls: See Page forTIGARDInternet: www.tigard-or.gov Notified/Method: Supplemental Information rmationHVr32.°�
. , i = amu; , A ,r O %-, T, - k_y *A s .
0 New construction on 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 Otherequipment,materials,labor,overhead,and the profit for the
F LIwork indicated on this application.A O CO
❑ 1-and 2-family dwelling '9'.+Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
: I O � I Total number of floors:Z j ao ` " wP_ ar , , , � vi r �
Job site address: Ci 461, 5 t� to pc5tAl N G4..i. S 4Qb New dwelling area: square feet
City/State/ZIP: ---71(r kIZA) Ott Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: �n,.
�tC.1C 5 SQ�1/J1r 6e4.1,5 Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
• -�� A l E 1 m �,� e r r.= t'4 t I.4T�`
Subdivision: . ...1"4�� , ,
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
t g equipment,materials,labor,overhead,and the profit for the
��,f� �_ _ �r� � , �, �, � � � � � �� ;w � � ',��„ work indicated on this application.
r
�, � st-�itt,t"L j Valuation: $ ��t,j�-
Existing building area: square feet
New building area: square feet
.' 4, _V ,, a ,,•4 r U v� . + Number of stories:
Name:
Address: Type of construction:
Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax ( )
xNewlifilftr*"**7.'0 y - fNTACT PERS
Business name: ,.�''�'t �7t'�R- C.0 '>� � ".,�����a,�` "`_§i���:�,,���:�,, ,��r � ��t �-c �t‘1,3 `'t's iAt� `I° All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
u-> c,'Ia under ORS 701 and may be required to be licensed in the
Address: 3 4(2G
jurisdiction in which work is being performed.If the
City/State/ZIP: ,EA J��fG� .�2 applicant is exempt from licensing,the following reasons
apply:
Phone:
(�3 ) 6(43. 3;et I Fax::( )
E-mail:
44 7 *21Wimoi; 1
b ice e F@R� !
Business name: r� r 5 t'vC ,t , 'fie if -'ek ."��J y
r e'b.
Address: - Permit fee:
City/State/ZIP: State surcharge(12%of permit fee):
Phone:( ) I x:( FLS plan review(40%of permit fee):
(Due upon application submittal.)
CCB lic.: 6,1„3.3-f, / r
//AV/ 7 Total permit fees:
f7�ltl'
Authorized signature: �r ` ao , ' Amount received:
This permit application expires if a permit is not obtained
Print name: = �1`--k*tLP Pei AA.(wDate: c • 1.7) I.ill 1 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
IABuildingWermitsTPS-PermitApp_031016.doc Service Board.
440-4613T(1 1/02/COM/WEB)
l
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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a » _� Y4 I. s-, a=� '4'x. 4 .�F „�,' ---11a,,..-404:7:-�%,q'•_? - _ tl.f. . ._; �� a
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: _ Number of alarm devices:
1 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:
,� � rb
i t lc 'x °' ?6 �'i ,® ,� i it 9��'; -h NG '�- ai A ,1: -„r Cn .
'AVp 1�:f � # � u,-�, a �'' , � -,� 'r'� ,� ��-' � '.� x � e i a ;�A y,:.
' i / D Y 1< D - , `moi " �- divot ' - "; .xi .10.1-4.4v-4'"-',---'
1 i �t ' 1 ' '�
J s, !.a =i il'ig...71 T.- }: . ate.. _041 r 4442.1';_,%;4'
_. £^ ' .r- %�l�,4,f.,,',-''--4,." �" ,` rr` "-'i x, ,- _
Sprinkler Type Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor S(w
y'} Sprinkler Project Valuation: I $ 5a)'
e .� ® �-. .,> s�.�"=�a T.�v uF ""+'li � ¢' "�� �r=,#y mI k,:r ¶� .i ''� ,-- -, '— a i=m4 ,,,, i "'-`.. ,*
Hood Project Valuation: $
;. r - � er�� � a � p � � � ,! � ' � a �4 �l � "fi -� a
R
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
`�"-- ,�iL�`S. � ' Yk nI'fr= , " 5 1 �H '� - � 'Lf ,4 ^Ir_` - w } -
`N4-1
rk ' ' n - � k �
s�4 -1-6-,a;-'
-k tk-t t� � 4 �, ia + � F '-'41t440- �- x P® ® ® '41 ,4, t 'A . a �, -"-m_44-'
Square Footage: Permit Fee:
f.
0 to 2,000 $198.75 . a T'
2,001 to 3,600 $246.45 r , r
3,601 to 7,200 $310.05 , i
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
.. .n Ii, ` _ ��1E& -:aft:a(tii?ii -- a j ,Project ubtotal (see A,B &C above): $
tf-iPermit 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: $
2
C:\Users\Tracy\Downloads\FPS_PermitApp(1).doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9402 SW WASHINGTON SQUARE RD P01 ,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00134
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor