Permit 14 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2022-00074
Date Issued: 6/30/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AD12300
Jurisdiction: Tigard
Site address: 10873 SW ANNAND HILL CT
Project: Annand Hill,Lot 2 Subdivision: ANNAND HILL CT PARTITION Lot: 2
Project Description: Fire Sprinkler permit:New residential sprinkler system.
Contractor: WYATT FIRE PROTECTION INC. Owner: BLUE PALOUSE PROPERTIES LLC
9095 SW BURNHAM 333 S STATE ST STE V452
TIGARD, OR 97223 LAKE OSWEGO, OR 97034
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Building Permit-COM 06/30/2022 $198.75
12%State Surcharge-Building 06/30/2022 $23.85
Type of Use: MF
Class of Work: NEW Type of Const: VB
Occupancy Grp: R-2 Height: 25 ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: 0.05 Design Area: 250
K Factor: 4.9
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $222.60
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,376.00
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
Issued By: t Permittee Signature: ittlq' I ( C
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.
r Building Permit Application R EC E IVE?
Fire Protection System APR 2 8 2022 FOR OFFICE USE ONLY
Cl of Tigard Received /^ VI- ,
g CITY OF TIGARD Date/By: ���y ,',\ Permit No.: SaG,1a vh l-)
III
-- 'i 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 't lJ I
Phone: 503.718.2439 Fax: 503.598.1960 BUILDING DIVISIODate/By: G'a a2""f i OtherPermit: � ���9Q�j-'
f I C A R n Inspection Line: 03.63�.4175 Date Ready/By: �� � mr s: See age 2 for f-��"f'�
Internet: www.ti and-or. ov 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
.
Valuation:
❑ 1-and 2-family dwelling ❑Commercial/industrial $ 2 37 C
❑Accessory building 0Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
11 JOB SITE INFORMATION AND LOCATION Total number of floors:
n Job site address: (v 8 F 3 SW Annand Hill Ct New dwelling area: square feet
City/State/ZIP:Tigard OR 97224 Garage/carport area: square feet
o ssbldg./apt.no.:Cr Project name:Annand Hill Triplexes 2 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
i.
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.
Install complete residential fire sprinkler systems for triplex. Valuation: $
Existing building area: square feet
r
,.) 1.j, S 1'7- ' New building area: square feet
❑ PROPERTY WNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
CI 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 maybe 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*
Business name:Wyatt Fire Protection
(Please refer to fee schedule)
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 lic.:64077 Total permit fees:
Authorized signature: 14"1 n 4� Amount received: )d�-'COO
/ • V t This permit application expires if a permit is not obtained
Date:4/28/2022 within 180 days after it has been accepted as complete.Print name:Ronin Campbell
* Fee methodology set by Tri-County Building Industry
Service Board.
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W .
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: 29 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
Ei 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 ■❑ Yes ❑ No
Hazard Group 13D
Density 0.05
Design Area 2 heads
K. Factor 4.9
Sprinkler Project Valuation: $7130
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)
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: $
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