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CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
114
COMMUNITY DEVELOPMENT Permit#: FPS2022-00040
T I C.;A ft T.) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/17/2022
Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16535 SW 72ND AVE
Project: Allstructure Engineering Subdivision: None Lot: None
Project Description: Fire sprinkler permit-add&relocate(21)sprinkler heads for TI.
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES LP
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 03/16/2022 $112.96
12%State Surcharge-Building 03/16/2022 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 03/16/2022 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 03/16/2022 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories:
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 $177.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,834.00
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 0 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Permittee Signature:
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 RECEIVE . ij
Fire Protection System �1 FOR t)hfl( I LSE OM l
City of Tigard FEB 2 4 2022 Received ea DZ ZG�2 r Penult No.FP 2�Z'(O4
114 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960�l I Y OF TIGARD Date/By: a" /1/43. a1pl. Other Permit:
116,11M Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: i See Page 2 for
Internet: www.tigard-or.gov tified 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms:
❑Accessory building ❑Multi-family
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:16535 SW 72nd Ave New dwelling area: square feet
City/State/ZIP:Tigard OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: /4-fipcat G /t✓ J , J2'Z.i L _ Deck area: square feet
�- Y 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.
Add and relocate fire sprinkler heads for TI. Valuation: $3834
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT 0 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@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 Iic.:64077
Total permit fees:
Amount received:
Authorized signature:44;f1,
G
This permit application expires if a permit is not obtained
Print name:Ronin Campbell Date:2/24/22 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1.\BuildingPermits\FPS-PermitApp_031016.doc 440-4613T(I 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: 21 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 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 ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line j Yes El No
Hazard Group light hazard
Density 0.1
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $3834
B.) Type I- Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component El 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
rl
i Sprinkler Project Square Footage: sq. ft.
1
Fire Protection Permit Fees
l Project valuation subtotal(see A,B&C above): $
4 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
W:\Permits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc2
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Facilities Permit
Sprinkler/Underground Permit Submittal Requirements
Scope: Fire permits for work associated with a Facility Permit Project. Fees will be billed monthly.
1. Permit Application, including related facilities project permit number.
2. Two sets of plans. Plans need to be of a quality clear enough to microfilm. Name of project,job
address, and the engineers/architect's name designing the system must be on all sheets.
3. Specification sheets of all equipment in the system.
4. Hydraulically-designed fire sprinkler systems—
• Portland Water Bureau flow test sheets. All systems must be designed using 80% of the
normal maximum static pressure.
• Hydraulic calculations necessary to verify design details.
5. Underground systems—
• All necessary features relating to the scope of the permit application, including fire
department connection, back flow prevention, thrust restraints, etc.
6. Any relevant appeal information.
Note: To install sprinkler systems and underground sprinkler water supply piping, the installer is required to
have
a Certificate of Fitness issued by Portland Fire &Rescue.
For questions,please call 503-823-3712.
{
Submit plans to: Facilities Program
Bureau of Development Services
1900 SW 4th Ave—5th Floor
Portland, OR 97201
PF&R #300.24FA Rev.03/13 ej Facility Sprinkler System Permit Application Page 2 of 2