Permit (6) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 COMMUNITY DEVELOPMENT Permit#: FPS2018-00056
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/07/2018
t c_;,�It t r 9 Parcel: 1S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 380
Project: PrimePay TI Subdivision: ASHBROOK FARM Lot: 5
Project Description: Fire sprinklers:Relocating(1)and removing(1)sprinkler head for TI.
Contractor: PATRIOT FIRE PROTECTION INC Owner: PLAZA WEST OWNER LLC
4708 NE MINNEHAHA ST BY CHIEF FINANCIAL OFFICER
VANCOUVER,WA 98661 680 FIFTH AVE 20TH FL
NEW YORK, NY 10019
PHONE: 360-699-4403 PHONE:
FAX: 360-699-4485
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/07/2018 $53.78
12%State Surcharge-Building 06/07/2018 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 06/07/2018 $21.51
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 06/07/2018 $0.50
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 010 Design Area: 0
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 $82.24
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $600.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' " —— Permittee Signature: A14
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection Systemj V E FOR OrFICI FSI,()NIA
City of Tigard DateReceived Aripmarag//� Permit No.: 19s • `'i
I " 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 0 4 2018 Plan Review .» 3,
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit fe7
J_I C A R tD Inspection Line: 503.639.4175 Y 1 CI-1 O F T I(BARD Date Ready/By: Juris: IZI See Page 2 for
Internet: www.tigard-or.gov 41 1 T t i ce , Notified/Method: I AM Supplemental Information
BUILDI
G DIVISIO,
, -- - _ ,xe rh' 9 ! Rdia--- 9 9 -
W,m,,i, ,. I moi,UW i a,. N dka err I' @ _ xi p 3 I
❑New construction ❑Demolitionbased' ' ' "' '
®Addition/alteration/replacement ❑Other: ;,, , - :, : , : ,., ,
Xi1i�
d x.'e'VIM' � a")�,.9 � r i ',4,,,1,6,;,i,,,10,7',$fl`�0��'ii„ f`,jp t» sa1MAAafi-Tz
Valuation: S
❑ 1-and 2-family dwelling 29 Commercial/industrial
Number of .
❑Accessory building ❑Multi-family bedroom'
❑Master builder ❑Other: Number' bathrooms:
Job site address: 9600 SW Oak StreetNew are.. quare feet
City/State/ZIP: Tigard, OR 97223 ,i area: ,
Suite/bldg./apt.no.: 380 Project name: Prime Pay , - •, area: square f.z
ther
Cross street/directions to job site: SW 95th Ave �- area: ,
•
Subdivision: 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
p `l11 ' *fi i l? 1oN OTIOR 45� (1 ' TF - 1 work indicated on this application.
relocate (1) & delete (1) sprinkler Valuation: $ 600
to accommodate remodel Existing building area: same square feet
New building area: same square feet
a 1® p IP;
Number of stories:
Name: Prime Pay Type of construction: 2B
Address: 9600 SW Oak Street, suite 380 Occupancy groups:
City/State/ZIP: Tigard, OR 97223 Existing:
B
g:
Phone:(503 ) 499 0073 Fax:( ) B
New:
IN ' lir
(1 fli�i� - F”-���,70116.i' �i -�°q .r�.
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d4 " . : ,. . r ,ri �r , 10 ii ti„ y t;�', gigi1P r e,,.n r�,0,-T „, '�' t Gam.° ...W. °�:; ... , i i".
Business name. Patriot Fire Protection, Inc All contractors and subcontractors are required to be
Contact name: Ted Baker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4708 NE Minnehaha Street jurisdiction in which work is being performed.If the
City/State/ZIP: Vancouver, WA 98661 applicant is exempt from licensing,the following reasons
apply:
Phone:(360) 699 4403 Fax: :(360 ) 699 4485
ted.
baker@patriotfire.com
E-mail:
YWii-i; ,, 1, 101 11)i��0 ,1, ,.,, OiM110�� ,P4i 001 . 111CiA' „ i id sYlleseT 1: ,o d !r,-,-,1,-,:iii :a
Business name: same as above
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lie.: 70822 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: Ted Baker Date: 6-4-1 8 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
® �'� Df i ''''''',1
h _ -2114'11*;'''''"
am +ei.� - ",`6 u n , ^��� ' 2b
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:
0 Addition or �] 1-10 heads: Affidavit required and 0 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:
A4:1411;4,404,,a� ne1} fin .. .,.--,..-,44,441'''-''. aLe! ` �; �- , '
® Wet 0 Dry
Additional Standpipes no
Information: Hazard Group light
Density .10 (existing)
Design Area N/A
K. Factor 5.6
( Sprinkler Project Valuation: I $ �• G(,b
B). �i yid Fire 521 '''',AS,'-14' ° t _ �7, i�, ,t, ..-.,1,,,„„„,�F'
Hood Project Valuation: $
S ... .411 1 A o.3� ti
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Val77;io;14.41 $4,1.,--'''''
Square Footage: Permit Fee: I
Oto 2000
� � 'reg F ;� I
$198.75 � � m� gal
2,001 to 3,600 $246.45 "� 41'
3,601 to 7,200 $310.05 -4411640%,'-'''',7--;- �- .
7,201 and greater $404.39 ;i1 11 �I�
Sprinkler Project Square Footage: I sq. ft.
qr
—, ei
» ail
Project valuation subtotal(see A,B&C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see Ds
above): $
State Surcharge (12% of permit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
.doc 2
\\patriotfire.local\dfs\VAN Profiles\ted.baker\Downloads\FPS_PermitApp
City of Tigard RECEIVED Permit No.: F/°SZ Ufa-0/00C10'
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.19601 N 0 4 Z018 Date Received: 61-///r
Inspection Line: 503.639.4175
"I I UAR D Internet: www.tigard-or.gov
CITY Off. 'FIGARO By: JTA/r t/tYL�W��t'
fooNG orvislo
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Prime Pay Occupancy:
Job Address: 9600 SW Oak Street, Tigard 97223 Type of Construction: 2-B
Suite: 3 8 0
Contractor: Patriot Fire Protection, Inc Phone: 360 699 4403
Number of Proposed or Altered Heads: 2
Type: SSP Hazard: light Density:. 10
Ted Baker 70822
I, Oregon Construction Contractors Board No.
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: / 6-4-18 Date:
Print Name: Ted Baker
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1