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Permit (42) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT fi COMMUNITY DEVELOPMENT Permit#: FPS2017-00148 Date Issued: 09/28/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 28/201 1400 Jurisdiction: Tigard Site address: 7358 SW DURHAM RD Project: Coram Subdivision: None Lot: None Project Description: Add(6)pendent sprinkler heads into temporary clean room,and relocate(3)upright sprinkler heads. Contractor: METRO SAFETY&FIRE INC Owner: PACIFIC REALTY ASSOCIATES LP PO BOX 33650 ATTN: N PIVEN PORTLAND, OR 97292 15350 SW SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-231-2999 PHONE: FAX: 503-256-4691 FEES Description Date Amount Specifics: Permit Fee-COM 09/28/2017 $112.96 12%State Surcharge-Building 09/28/2017 $13.56 Type of Use: COM Plan Review-Fire Life Safety-COM 09/28/2017 $45.18 Class of Work: ALT Type of Const: IIIB Info Process/Archiving-Sm$0.50(up to 09/28/2017 $5.50 Occupancy Grp: B Height: ft 11x17) Stories: 1 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Hazard: LT Density: .10 Design Area: 3000 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 $177.20 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $3,094.00 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 stt{o///O/�UNC by calling 503.232.1987 or 1.800.332.2344. I_ Issued By: .�' ( /W/-47 Permittee Signature: Lie "`��y(((` 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 FOR OFFICE USE ONLY s �� City of Tigard Received I' — •:f 9 Permit No.: J 7�7—CO - 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2 8 2017 Plan Review �� /�����/ Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Peri f Inspection Line: 503.639.4175 v� Y lr l : c Date Ready/By: Juris: See Page 2 for TIGARD Internet: www.tigard-or.gov R Tsle L 1 q _ 01'�+p p'°tp,„: Notified/Method: Supplemental Information ❑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 r `r work indicated on this application. F / \ \\ �� R�' Valuation: ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: old k e\A`tCA,T1©N % Total number of floors: Job site address:7358 SW Durham Rd New dwelling area: square feet City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Coram CVS/Specialty Covered porch area: square feet Cross street/directions to job site:SW Upper Boones Ferry Rd. Deck area: square feet Other structure area: square feet Subdivision: 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 ii �prl fl � \ laiM work indicated on this application. We will be adding 6 Pendent sprinkler heads into a new temporary clean room. Valuation: $$3,094.00 We will also relocate 3 upright heads due to a new full height wall being Existing building area: 20000 square feet installed around the clean room. New building area: 360 square feet ;. - w\:ii TENANT% aa Number of stories: 1 Name:CVS/Specialty Type of construction: Remodel Address:7358 SW Durham Rd Occupancy groups: //f 6 City/State/ZIP:Portland,OR 97224 Existing: Light Phone:(503)684-3046 Fax:(503)684-8384 New: Light ►1 1A \ ` ONTAT Plow �� \u\ Business name:Metro Safety and fire All contractors and subcontractors are required to be Contact name:Derek Langel licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address:14321 SE Stark St. jurisdiction in which work is being performed.If the City/State/ZIP:Portland,OR 97233 applicant is exempt from licensing,the following reasons apply: y: Phone:(503)231-2999 Fax: :(503)256-4691 E-mail:Derek@metrosafetyandfire.com yV 7 //f I IN+ P Ielm Business name:Metro Safety and Fire Permit fee: Address:14321 SE Stark St. State surcharge(12%of permit fee): City/State/ZIP:Portland,OR 97233 FLS plan review(40%of permit fee): Phone:(503)231-2999 . Fax:(503)256-4691 (Due upon application submittal.) CCB lie.:63651 Total permit fees: Amount received: Authorized signature: This permit application expires if a permit is not obtained Print name:Derek Lan el Date:9/28/2017 within 180 days after it has been accepted as complete. g * Fee methodology set by Tri-County Building Industry Service Board. I:ABuilding\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information s, 1.) Type of Work 2.) Addition/alteration only •to sprinklerAddition/alteration only alarm devices: heads: 3.) ❑ New system Number of sprinkler heads: 9 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 ❑ 6+devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work 1 1 fi' '� � 2,� o, � a! ,,, - bl j ilnP y -,-.41180F:-:Ego / x y 4' cial i r kler y/ / �i� ��// `\\ a /` .. ...., ......... ,. '. r \\\lam i� .....//"• ,l - � . �-s s Sprinkler Type ® Wet ❑ Dry Additional Standpipes Information: Sprinkler Supply Line ® Yes ❑ No Hazard Group Light Density .10 Design Area 3000ft2 K.Factor 5.6 S Sprinkler P rojecValuation \ $ 3094. 0 ' st valuation: - res1xo HoodpPB Project \`\\ \ „,,:'.'4-,4!,•,.]0 ,.\\\\\ '^cam % \ y Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: I $ „• , , y ;\ rr Square Footage: Permit Fee: ./ %,. 0to2000 $246.45 y $198.75 ` \r ” y r 2,001 to 3,600 3 601 to 7,200 $310.05 ' G y' ; .-� --44 7,201 and greater $404.39 Sprinkler Project Square Footage: sq. ft. 3 e "i , t �Ftte Eroteettl) Permit r it Project valuation subtotal(see A,B &C above): $ Permit fee based on project valuation(see fee schedule): :petfeebasedonsquarefootage (seeDaoove : ) State Surcharge (12% of permit fee): :FLsplanReview(40/ ofpe fee): TOTAL: $ 2 Q\Users\AutosprinkMETROFIRE\Deslctop\CVS Permit.doc RECD t City of TigardPermit No.: " /S', , /7—00/j� 114 . 13125 SW Hall Blvd.,Tigard,OR 97223 S P P 2 8 2 017 g Phone: 503.718.2439 Fax: 503.598._,960 Date Received: ���r2,��7' Inspection Line: 503.639.4175 ; g y ,�t' TtrAILD Internet: www.ti and-or. ov ?s J 1 t '!� 35.� t''I '� sN B g g �."t I �t � aV By: FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: Coram CVS/Specialty Occupancy: Clean room Job Address: 7358 SW Durham Rd Portland, OR 97233 Type of Construction: Remodel Suite: Contractor: Metro Safety and Fire Phone: (503) 231-2999 Number of Proposed or Altered Heads: 9 Type: Office Hazard: Light Density: •10 I Derek Langel Oregon Construction Contractors Board No. 63651 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: c ').J1 Date: 9/28/2017 LangelDerek Print Name: I:\Building\Fonns\FireSprinklerAffidavit_071514.docx Page 1 of 1