Permit (73) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 COMMUNITY DEVELOPMENT
Permit#: FPS2017-00145
Date Issued: 09/25/2017
T[GA .D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S102AD03051
Jurisdiction: Tigard
Site address: 12760 SW ASH AVE
Project: Studio 7 Subdivision: BURNHAM TRACT Lot: 5
Project Description: Fire sprinkler permit:Adding(3)sprinkler heads for TI. Affidavit submitted.
Contractor: SPRINKIT FIRE PROTECTION INC Owner: PREMIUM PROPERTY-TIGARD LLC
PO BOX 2227 BY CAPSTONE PARTNERS LLC
OREGON CITY, OR 97045 1015 NW 11TH AVE
STE 243
PORTLAND, OR 97209
PHONE: 503-272-6650 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/25/2017 $56.47
12%State Surcharge-Building 09/25/2017 $6.78
Type of Use: COM Plan Review-Fire Life Safety-COM 09/25/2017 $22.59
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 09/25/2017 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD2
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 $86.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $642.00
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. ou ma o tain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 50 .• 9.4175 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 IOR OFF l sr,ONLY
Received Permit No.: f T
City of Tigard ?,,1. Date/ : �. ,� t"
13125 SW Hall Blvd.,Tigard,OR 97t Plan Review Other Permit:
9 s' DateB':
Phone: 503 inn: 439 Fax: 503.598.^•`I' t "` ® 63 See Page 2 for
Inspection Line: 503.639.4175 Date Ready/By: �,'i�
-LIG=1};C1 p Notified Method: Supplemental Information
Internet: www.tigard-or.gov S�.P 2 5 ?0 j
Tl* ole .' `l t ,,= o- T �ilr �o
Permit fees*are based on the value of the work performed.
❑New construction I4)n I�I a+1 f
l 1� q , _ t Indicate the value(rounded to the nearest dollar)of all
LI Addition/alteration/replacement Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
A' G(3t2V O ONS RUC`'1CON1
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi-family
Number of bathrooms:
❑Master builder
0 Other:
Total number of floors:
4$1 IT rNfOgtAN€IGN ANA
New dwelling area: square feet
Job site address: 12760 SW Ash Ave
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: Studio 7 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
)t)<11IiRE IPA`l A tl'I:�#..f li ms i 1Ch 1 T
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
� "TIo a wo work indicated on this application.
... Valuation: $ 642.00
Adcfire sprinklers for TI
Existing building area: square feet
New building area: square feet
''*'T)tA T Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
-C , PucA0C COTAT nli ....
� iill
Business name: Same as below All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: apply:
Phone:( ) Fax::( )
E-mail:
'1ti1N' ' A J<f'R 11 mmittg:lg;
Business name: Sprinklt Fire Protection Inc. Permit fee:
Address: PO Box 2227 State surcharge(12%of permit fee):
City/State/ZIP: Oregon City, OR 97045 FLS plan review(40%of permit fee):
Phone:( 503)272-6650 I Fax:( ) (Due upon application submittal.)
Total permit fees: �
CCB]ic.: 211320 ?l �.�3��
i5�t
Amount received:
Authorized signature: /4...euAes. '12 ti��/L This permit application expires if a permit is not obtained
Date: 9-25-17 I within 180 days after it has been accepted as complete.
Print name: Travis Schweitzer * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitAPp_031016.doc 440-4613T(11/02/COM/WEB)
, City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads:"7 Number of alarm devices: N/A
❑x 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:
T cif gt ( � ket> as ��c� � w
8 t
Sprinkler Type [] Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Ordinary 2
Density 10
Design Area
K. Factor
Sprinkler Project Valuation: $ 642.00
`y 4:"fto irekS ppre i S r to
Hood Project Valuation: $
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
{
) Re id ttial Sp der t; AJone 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 andgneater $404.39 „ ,„ k,
w:..a
Sprinkler Project Square Footage: sq. ft.
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\SprinkIt Fire\Downloads\FPS_PerrnitApp.doc 2
City of Tigard Permit No.: 2O1 "7-6;l'i
13125 SW Hall Blvd.,Tigard,OR 97223
C Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 17/2-510 i / "
Inspection Line: 503.639.4175
Ti G A R D Internet: www.tigard-or.gov By: efaAljtew /0,77,4114-,
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: 5TL :v 7 Occupancy: re-f-,7il
Job Address: �2 5L1 F! �� r�� Type of Construction: L.,)cc. —
Suite:
Contractor: 5PP,`n.V.;fi PI f R08-ecA:v ,A Phone: Q7i_3Y‹) --alTe
Number of Proposed or Altered Heads: 3
Type: (A+- Hazard: Cr-EA) '`� - Density:
I,r(2 J.'' Q 1 2"�`2 Oregon Construction Contractors Board No. 2 i 1 37 v
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 t}is�document with a copy of the sketch attached shall be available for all inspections.
(��/5 .Jr� 2,5----/7
Signature: Date:
Print Name: 77),,to.,. c t,_ +r l
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