Permit Building Permit Application R eAt` 'oh. 4-0 F ' s t o Z i. -o0 o
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received
Permit No.:
DateiB :
' 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
:071Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit:
i I G A R D Inspection Line: 503.639.4175 Date Ready'By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑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 ❑Q Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ❑■ Commercial/industrial Valuation: $
ElAccessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9600 SW Oak St, Suite 525 New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:525 Project name:Atrium West Suite 525 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Revision to existing fire sprinkler permit#FPS2022-00026 Valuation: $
Adding new pip and fire sprinkler heads 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:Levi Poling 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:I.poling@wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Wyatt Fire Protection Permit fee:
Address:9095 SW Burnham
City/State/ZIP:Tigard, OR 97223 State surcharge(12°/u of permit fee):
FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.)
CCB lic.:64077 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:Levi Poling Date:4/18/2022 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
t:Building`.Permits,FPS-PermitApp_031016.doc 440-4613TO 1/02/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:
❑ New system Number of sprinkler heads: 17 Number of alarm devices:
El 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 ❑■ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line E Yes ❑ No
Hazard Group light hazard
Density 0.1
Design Area 225 sq.ft.per head
K. Factor 5.6
Sprinkler Project Valuation: $4530
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:APermitss\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc 2
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to yourproject.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
IN Transmittal Letter
1 !i ;\[:t) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: GO') I DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
. n APR 2 0 2022.
FROM: _ 1_0 V I^ tl`'c,\is/1 9 CITY OF TIGARD
r� BUILDING DIVISION
COMPANY: " _)-(4q -±
PHONE: 5C.�_ (p Sy -- c\a By: 0
RE: C(re-0 SW Ock S\--) C3 \-2SP_SS
(Site Address) ` ' (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. (3 Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):REMARKS: C-,84ln3 N„,,,.) „-p,,,, ,r\Ok '1\\KLe-- V 1eaci3 .
FOR OFFICE USE ONLY
Route to Permit Tech Date:--)— ,,C,-- .,) Initials. �'j
Fees Due,Due ,1 Y Q No Fee Descri tion: Amount Due:
-S.— �{ FI�v\ 1'ev% 6,.�� $ c- �
$
$
$
Special
Instructions:
Reprint Permit (per PE • Yes No Done
p (P ) ❑ ❑
Applicant Notified: , Date: 41/02.(e )--) -- Initials:
I:\Building\Forms\TransmittalLetter-Revisions_06I 316.doc
RECEIVED ��
APR. t
0 zoz2 RD RECEIVED
APR 2 0 ?C�?z
� fl DIVISION BUILDING
NO - CITY OF TIGARD
BUILDING DIVISION
RECEIVED
APR 507027
CITY OF T;GARD
BUILDING DIVISION
III CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2022 00026
Date Issued: 3/17/2022
T I ;A R f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 525
Project: Atrium West Suite Subdivision: ASHBROOK FARM Lot: 5
Project Description: Adding and relocating fire sprinkler heads for TI
Contractor: WYATT FIRE PROTECTION INC. Owner: KING CAPITAL INVESTMENTS LLC
9095 SW BURNHAM ATTN KING, THOM
TIGARD, OR 97223 19250 NE PORTAL WAY
PORTLAND, OR 97230
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/16/2022 $123.72
12%State Surcharge-Building 03/16/2022 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 03/16/2022 $49.49
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 03/16/2022 $17.50
Occupancy Grp: B Height: 15 ft 11x17)
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 0.1 Design Area: 1500
K Factor: 05.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $205.56
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $4,530.00
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 i OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
. 4Issued By: .G%'��`'[ Permittee Signature: `
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 7
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 A ECEIV ED FOR OFFICE USE ONLY
City of Tigard FEB 9 2022 Receiv d 2\\SAZZ Pemut No. ����' �
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �� J
3
' 7., Other Permit:
• Phone: 503.718.2439 Fax: 503.598.196t(fY TIGARD Date/By:
Inspection Line:
ine: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
TIGARD Internet: www.tigard-or.gov L' UII [`uZING DIVISION ted/Method: // e7 116r Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑ Demolition Permit fees*are based on the value of the work performed.
El New construction Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
Valuation: $
❑ 1-and 2-family dwelling ❑■ Commercial/industrial
Number of bedrooms:
❑Accessory building ❑ Multi-family
❑Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9600 SW OAK ST New dwelling area: square feet
City/State/ZIP:TIGARD, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:SUITE 525 Project name:ATRIUM WEST SUITE 525 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: I 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
DESCRIPTION OF WORK work indicated on this application.
Adding and relocating fire sprinkler heads to accommodate tenant improvements
Valuation: $4530
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:Levi Poling 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
applicant is exempt from licensing,the following reasons
City/State/ZIP:Tigard, OR 97223 apply:
Phone:( )503.684.2928 Fax: :( )503.684.9657
E-mail:(.poling@wyattfire.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):
City/State/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 Total permit fees:
ie.v.7.\ Amount received:
Authorized signature: P •
This permit application expires if a permit is not obtained
Date:2/9/2022 within 180 days after it has been accepted as complete.
Print name:Levi Poling * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\PermitsTPS-PermitAPP_03 1016.doc 440-4613T(I I/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:
El New system Number of sprinkler heads: 7 Number of alarm devices:
El 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 El 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 ❑■ Wet ❑ Dr\
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes ❑ No
Hazard Group light hazard
Density 0.1
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: Sides (.-(5 30
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 (Stand Alone System)
Sprinklery )
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: $
VG':\Permits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc2