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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT .1111 11 COMMUNITY DEVELOPMENT Permit#: FPS2021-00005 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/9/2021 T I G A R f� g Parcel: 2S101AD03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY Project: Pacific Parkway Common Area Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25, PT Project Description: Relocate heads for TI Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES 9095 SW BURNHAM ATTN: N PIVEN TIGARD, OR 97223 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-684-2928 PHONE: FAX: 503-684-9657 FEES Description Date Amount Specifics: Permit Fee-COM 02/08/2021 $209.80 12%State Surcharge-Building 02/08/2021 $25.18 Type of Use: COM Plan Review-Fire Life Safety-COM 02/08/2021 $83.92 Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 02/08/2021 $2.00 Occupancy Grp: B Height: ft 11x17) Stories: Info Process/Archiving-Sm$0.50(up to 02/08/2021 $12.50 11x17) Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: LT Density: 0.1 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 $333.40 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $12,296.00 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: \\d Permittee Signature: L 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 �q "tj_ -� Fire Protection System FOR OFFICE USE ONI.1 rl City of Tigard Receive d 1Z',Z\ Permit No.:V?S2C2%-O 5 13125 SW Hall Blvd.,Tigard,OR 97223 Da g Plann R Reveview Phone: 503.718.2439 Fax: 503.598.14960 «. '>...• Datc/By: l Other Permit: 1 r ,R I) Inspection Line: 503.639.4175 Date Ready/ y: T /, s tu : See Page 2 for Internet: www.tigard-or.gov otified/Met d#w / . of Supplemental Information TYPE OF WORry Q" I it„iriAJ REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑Deiitol( DIVISION Permit fees*are based on the value of the work performed. - Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ El 1-and 2-family dwelling Commercial/industrial ElAccessory building El Multi-familyNumber of bedrooms: ElMaster builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:12909 SW 68th Parkway New dwelling area: square feet City/State/ZIP:Tigard OR 97233 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Pacific Parkway Common Area Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST 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 OF WORK work indicated on this application. Relocate Heads for TI Valuation: $12296 Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: © APPLICANT ❑ CONTACT PERSON NOTICE Business name:Wyatt Fire Protection All contractors and subcontractors are required to be Contact name:Ronin Campbell licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address:9095 SW Burnham jurisdiction in which work is being performed.If the City/State/ZIP:Tigard, OR 97223 applicant is exempt from licensing,the following reasons apply: Phone:( )503.684.2928 Fax: :( )503.684.9657 E-mail:r.campbell@gmail.com CONTRACTOR BUILDING PERMIT FEES* (Please refer to fee schedule Business name:Wyatt Fire Protection Permit fee: Address:9095 SW Burnham State surcharge(12%of permit fee): CitylState/ZIP:Tigard, OR 97223 FLS plan review(40%of permit fee): Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal) CCB lie.:64077 a, /!/J+? /,lu Total permit fees: Authorized signature: �jq(1l r l G Amount received: VV'' This permit application expires if a permit is not obtained Print name:Ronin Campbell Date:1/18/2021 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. r\BuildingUPermitsTPS-PermitApp_031016.doc 440-4613T(1 l/02/COM IWEB) 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: ❑ New system Number of sprinkler heads: ('( 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: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler Sprinkler Type 1Wet ❑ Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes El No Hazard Group :SA Density 1. Design Area IS OD K. Factor s- G Sprinkler Project Valuation: $ 12.744 B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone 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 and greater $404.39 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: $ W:\Permits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc 2