Permit CITY OF TIGARD ill FIRE PROTECTION SYSTEM PERMIT
' . COMMUNITY DEVELOPMENT Permit#: FPS2019 00136
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2019
Parcel: 1 S 134AA02100
Jurisdiction: Tigard
Site address: 10340 SW NIMBUS AVE NA
Project: Titan Supply Group Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: Relocate(9)sprinkler heads for new wall layout.
Contractor: FIRE ONE FIRE SYSTEMS INC Owner: DIETRICH, NANCY BISHOP
PO BOX 734 ROBINSON,JERRY CHRISTOPHER TRUST
OREGON CITY, OR 97045 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-557-9050 PHONE:
FAX: 503-557-9268
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/28/2019 $102.20
12%State Surcharge-Building 10/28/2019 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 10/28/2019 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 10/28/2019 $5.00
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard:
Density: .10 Design Area: 1500
K Factor: .56
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $160.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,500.00
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 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: ill" S F Permittee Signature:
/7;
Call 503.639.4175 by 7:00 a.m.for the next availableinspection 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.
Buildinz Permit Applications c-'-'t or 1% % r ,,
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Fire Protection System oCT 62019 „ IN "I II( 1 I N I 11
Received
City of Tigard l r Da /B fD I ,rte.
• 13125 SW Hall Blvd.,Tigard,OR 9722,11�` r 4+Iv.:%,, plan Review
• fflin
� •i rr 1 a Other Permit: `
Phone: 503.718.2439 Fax: 503 598. Date/B
I 1 i;4 P.t Inspection Line: 503.639.4175 ”' Date Ready/By: hums. 63 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK IUPTIREIIDATA:I-AND 2-FAMILY DWELLING
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Addition/alteration/replacement 0 Other: equipment,
the value(rounded to the nearest dollar)of all
Pi- equipment,materials,labor,overhead,and the profit for the
CATECo1ItY ov CQNSTRUC'1rIUN work indicated on this application.
Valuation: $
❑ 1-and 2-family dwellingommercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: t Q ' lt0 3.LA) (witi L S i,' ' New dwelling area: square feet
City/State/ZIP: /�-A 1 or,.�-r _-2 ',3 Garage/carport+ a: square feet
Suite/bldg./ .no✓ ) roject name: T 1 N Ski-17P L-'-1 Covered.• h area: square feet
Cross street/directionsJto job site: ;1-1 L.L 1(12L.VIC) / el wt, .. •F&. Dec. •A ea: square feet
/ + i er structure area: square feet
REQUIRED DATA:COMMERCIAL-USE C .1ST
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
DESCRIPTION O WORK work indicated on this application.
Valuation: $
Rr.1. t.:;C r Ct. fit Via)5 -ii)u-12. jar w `it70
\A.;i)--i-L. p-{i ti t.? Existing building area: square feet
J New building area: f5'0i.7 `square feet
0 PROPERTY OWNER 0-TENANT Number of stories: 1
Name: Tt•c'44_63 ,_5-0,. .?Ls-/ Type of construction: V 6
Address: t t7 3 9 U S': Lj i 11.1 R ik VV Occupancy groups:
15*
City/State/ZIP: Existing: I
Phone:( ) Fax:( ) New: Le (o 1
APPLICANt' CONTACT P NSE
Business name: p l e 12,02,t, - All contractors and subcontractors are required to be
Contact name: d ��-� --�� ( licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: L2‘ 90>1 1 3 4) jurisdiction in which work is being performed.If the
City/State/ZIP: Gvx• t�/` "3� -� C�
applicant is exempt from licensing,the following reasons
i apply:
Phone:( )55-7 Ct S-0 Fax::Y7 ): 5 7 —q---)..65-'
E-mail: ,( l
' !e.,-1L- t' ri r cru 6. , ,, ,p,.6....
./..
CONTRACTOR BUILDING PERMIT
(Pleaser"tofee le)
Business name: / Permit fee:
Address: : )1YY,. ! 0 0
Y State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lis.:
cg rHo Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: -- •. Date:��� � within 180 days after it has been accepted as complete.
l * Fee methodology set by Tri-County Building hrdustry
Service Board.
I:\Building\Permits\FPS-PermitApp 031016.doc 440-4613T(I1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
0 New system Number of sprinkler heads: Ct Number of alarm devices:
Addition or10 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
0 11+heads: Plan review required and 0 6+devices: Plan review required and
(3)sets of plans. (3)sets of plans.
Additional description of work:
T®. of S stem Com•lete A,B,C or'D as a. .licable :
Sprinkler Type V Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line . Yes 0 No
Hazard Group
Density 1 b
Design Area L2L7
K Factor ••5
Sprinkler Project Valuation: $ 2.5C7 2 7
B. Type I- Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone System) tg. . 1* t '
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600
$246.45 "it
3,601 to 7,200 $310.05
7,201 and greater $404.39 � :4-41t&
Sprinkler Project Square Footage: sq.ft.
Fire Protection Permit Fees
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: $
I:\Building\Permits\FPS_PemritApp_031016.doc 2
:-3 .
L
City of Tigard Permit No.::.YF� fn 5.to/9 .00/3
111 13125 SW Hall Blvd.,Tigard,OR 97223 OCT2
• Phone: 503.718.2439 Fax: 503.598.1960 U l 8 2019 Date Received: /0 24/f
Inspection Line: 503.639.4175 ..
r 1 D.v K D Internet www.tigard-or.gov �r r i Y Of' i G Ai ., By
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: T\T h SU L 1' L' Occupancy:
Job Address: 1,03 44,C) S u3)- I('M(3 S AV1-S- Type of Construction:
Suite: JW) 1 Sell E
Contractor: P.i P-E d ILL l:e Phone(51) q3 (--4={Li-c,
Number of Proposed or Altered Heads: 9
Type: Hazard: .1l T Density: d
I, N i L K Be)( 0—(-i 1 PT'1 Oregon Construction Contractors Board No. 9E3I t
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 u's doc me with a alit, of the sketch attached shall be available for all inspections.
Signatur Date: /0'0 1 e'
Print Name: I ! p -t
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