Permit (83) IN ,. CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' .- COMMUNITY DEVELOPMENT Permit#: FPS2019-00108
Date Issued: 08/28/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 110
Project: Oregon State Board of Nursing Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Fire sprinkler permit:Adding(4)sprinklers. Affidavit submitted.
Contractor: EXPRESS FIRE SYSTEMS INC Owner: PARKLAND DEVELOPMENT
1913 41ST STREET 16083 SW UPPER BOONES FERRY RD,
WASHOUGAL,WA 98671 STE
TIGARD, OR 97224
PHONE: 360-953-8432
PHONE: 503-639-0108
FAX: 360-953-8394
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/28/2019 $91.44
12%State Surcharge-Building 08/28/2019 $10.97
Type of Use: COM Info Process/Archiving-Sm$0.50(up to 08/28/2019 $0.50
Class of Work: ALT Type of Const: 11x17)
Occupancy Grp: Height: ft Plan Review-Fire Life Safety-COM 08/28/2019 $36.58
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 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 $139.49
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,000.00
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 -I, other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started thin !c. says of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to allow the rules adop -d by t - Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00•o. ! You may obtain /cop 0 the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: vip
rmittee Si nature: /. 1 ' ";--C
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Call 503.639.4175 by 7:00 a.m.for the next available inspecti date.
This permit card shall be kept in a conspicuous place on the job site until completion of the proj=ct
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System FOR OFFICE LSI.()Nix
Cityof Tigard Date/ved
�j �J Permit No.: )(J
illi g _ Date/B :r° • (....-1
•- -
13125 SW Hall Blvd.,Tigard,OR 5�7 23, 'f t "" Plan Review
A Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: w - )1/q. 1 �`
T I( :1 H I} Inspection Line: 503.639.4175 4 r Date Ready/By: el See Page 2 for
Internet: www.tigard-or.gov 1 t Notified/Method: Mil Supplemental Information
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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
la Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
1 E .v work indicated on this application.
ID1-and 2-family dwelling El Commercial/industrial
Valuation: $
ElAccessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
. ot1011':-ANI*: Total number of floors:
Job site address: 16083 SW Upper Boones Ferry RD.,BLDG B.,STE.110 New dwelling area: square feet
City/State/ZIP: Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: BLDG B,STE 110 Project name: Fanno Creek Suite 1101(I/ry`r ,4v;; ; y e_. `�J Covered porch area: square feet
Cross street/directions to job site: "�s� /7"1-41-5' hitt 1 Deck area: square feet
Other structure area: square feet
Subdivision: I 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
�t work indicated on this application.
Add 4 new sprinklers Valuation: $'—("cc.),'=!
Existing building area: square feet
New building area: square feet
b ; Number of stories:
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Name: Parkland Development,LLC Type of construction:
Address: 16083 SW Upper Boones Ferry RD.,Suite 120 Occupancy groups:
City/State/ZIP: Tigard,OR 97224 Existing:
Phone:( 503 )639-0108 Fax:( ) New:
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Business name:Express Fire Systems,INC. All contractors and subcontractors are required to be
Contact name: Tiffany Bell licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 670 S.28TH ST. jurisdiction in which work is being performed.If the
City/State/ZIP: Washougal,WA 98671 applicant is exempt from licensing,the following reasons
apply:
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E-mail: Designoexpresstiresystems.com
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Business name:Express Fire Systems,INC.
Permit fee:
Address:670 S.28TH ST.
State surcharge(12%of permit fee):
City/State/ZIP:Washougal,WA 98671
FLS plan review(40%of permit fee):
Phone:( 360 )953-8432 Fax:( ) (Due upon application submittal.)
CCB lic.: 193272 Total permit fees: �9 3f',411
Amount received:
Authorized signature:
1
(,, �" This permit application expires if a permit is not obtained
Print name: ` ���1 ] / c� within 180 days after it has been accepted as complete.
/ ` ) 3/2/f / * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building Permits\FPS-PcrmitApp_031016.doe 440-4613T(11/02/COM/WEB)
Ci Ti
City of Tigard
F.. ` Permit No.: rP5 A)/`l._C/t)jt? 3-
13125 SW Hall Blvd.,Tigard,OR 97223
IN
■ Phone: 503.718.2439 Fax: 503.598.1960 G i i-7�j Date Received: i�i
Inspection Line: 503.639.4175
CIG Al'17 Internet: www.tigard-or.gov By: (6h) (4/- j,lee--2f
ii
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS Jam/
OR TENANT IMPROVEMENTS
(I to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Fanno Creek Suite 110 Occupancy: Light
Job Address: 16083 SW Upper Boones Ferry Rd. Type of Construction:
Suite: 110
Contractor: Express Fire Systems Phone: 360.953.8432
Number of Proposed or Altered Heads: 4
Type: Quick Response Hazard: Light Density: 0.1
1, Tiffany Bell Oregon Construction Contractors Board No. 193272
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.
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: betDate: 8/22/19
Print Name: Tiffany Bell
1:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1