Report (11) . .UPZ0o3 -307
/5750 SW '?g'
Fire Marshal's Division Offices
L t j � D '
-' North Division South Division East Division
�� 14480 SW Jenkins Rd. 7401 SW Washo Court 624 7th Street
Tutalatin Valley Beaverton, OR 97005 Tualatin, OR 97062 Oregon City, OR 97045
(503) 356 -4700 (503) 612 -7000 (503) Fire & Rescue Fax (503) 644 -2214 Fax (503) 612 -7003 Fax (503) 657 -7913
FIRE FLOW and HYDRANT WORKSHEET
This worksheet is required to be submitted to and approved by the Authority Having Jurisdiction (AHJ)
before any permits for new building construction, building expansion, or fire hydrants will be issued by any
building department within the TVF&R District. Please complete, sign, and date the PREPARER
INFORMATION block. Then complete the GENERAL BUILDING INFORMATION block. Lastly, complete
either item A or B, and items C, D, E and F on page 2 titled CALCULATING REQUIRED FIRE FLOW.
Please clearly print all requested information. See the instruction book for help filling out the form or call one
of the above numbers.
PREPARER INFORMATION
Preparer: J AGK)1; 1 � 2-A1.IM1(JMR A GI,►T�S
Phone: 60 - ZZZ 9158 Fax: 503-222 - I li l/oD
Architec Engineer of Record: z4IK/M - Ae5OCkA4-7 - 05 JIM MILE. - le ,4IA
Phone: 503- Z22-el156 � Fax: 503'ZZZ-
Preparer Signature: /2 44.1. /tJ Date: 7"2f
GENERAL BUILDING INFORMATION
1. Project Name: fikARt CHOgal OP GQW - AP141PJ(51 kl7OJJ E3oiti)(/'JG.
2. Project Address: I ) '7 iW 413v A-V J
cit 716Al21) County: 14' 4-51BiIbfl)i1 zip: 97224
3, Construction Type(S) ❑ Type 1 Fire Resistive or Type II Fire Resistive I
❑ Type II One -hour or Type III One -hour
❑ Type IV Heavy Timber or Type V One -hour _ _ _ _
imil � 'E° t �a.t
❑ Type II Non -rated or Type III Non -rated t t t u L..:...
'( Type V Non -rated
4. Total Building Area: .Z40 i { 30 ' I {
Square Feet JUL
5. Total Fire Area: 3 '2.5 Square Feet CITY OF 1 I
6. Building Fire Flow: 1 500 Gallons per Minute (Table A- III -A -I)
7. Describe the Fire Area (If more than one fire area include an 8 1/2 X 11 or 11 X 17 drawing indicating th various fire areas)
Ot 2L I
F11 A OP 2 , 87.$ 5.P. J No AJ A 5 AILATIO U 3
8. Type of Occupancy or Use of Building: Deer TYPt
THIS LINE IS FOR FIRE DEPARTMENT USE ONLY FMZ I I
CALCULATING REQUIRED FIRE FLOW
A. Single Occupancy Hazard (If using item A, DO NOT use item B)
Al Building Fire Flow 1 GPM
Al Occupancy Factor 1-114-11" HA?AAP , 1
A3 (Multiply line Al by line A2) Required Fire Flow 1 GPM
B. Multiple Occupancy Hazard (If using item B, DO NOT use item A)
B1 ....Determine percent of each occupancy hazard in the fire area. •
(Occupancy Hazard Class) (Fire Area) (Total Fire Area) (Percent of Fire Area)
Light Hazard SF _ SF x 100 =
Ordinary Hazard Grp 1 SF _ SF x 100 =
Ordinary Hazard Grp 2 SF _ SF x 100 =
Extra Hazard GRP 1 SF _ SF x 100 = %
Extra Hazard GRP 2 SF _ SF x 100 =
Add all of the percentages in the last column, they must equal 100%
B2 ....Calculate Fire Flow
(Occupany Hazard Class) (Factor) (Fire Area) (Fire Flow) (Bldg Fire Flow)
Light Hazard 1.00 x % x GPM = GPM
Ordinary Hazard Grp 1 1.20 x % x GPM = GPM
Ordinary Hazard Grp 2 1.30 x % x GPM = GPM
Extra Hazard Grp 1 1.40 x % x GPM = GPM
Extra Hazard Grp 2 1.50 x % x GPM = GPM
B3 Required Fire Flow GPM
C. Calculate the minimum number of fire hydrants required
Required Fire Flow (A3) or (B3) 1 GPM + 1500 = I No. of Hydrants (Minimum 2 Req.)
D. Reduction of fire flow (check one box only and then complete the calculation in Section E)
D1 ❑ Multiply either line A3 OR line B3 by 75% for a full fire alarm
D2 32C Multiply either line A3 OR line B3 by 50% for automatic sprinklers 1 6b0 x 50 ° 4 =750
D3 ❑ Multiply either line A3 OR line B3 by 25% for central station supervised sprinkler protection
E. Required fire flow
Fire Flow ) 5 00 GPM x Reduction S 0 % = Total Req. Fire Flow 756 GPM*
(Line A3 or B3) (Line 01, D2, or D3)
Minimum 1500 - Maximum 3000 GPM
F. Available Fire Flow to the Building Test Results: GPM
Please attach documentation of the flow test that was made. It shall include date, time, location of static/residual and
flow hydrants, and the tester's name, phone number and address.
Fire Marshal's Offices
'S North Division South Division East Division
` x f a° ? 14480 SW Jenkins Rd. 7401 SW Washo Court 624 7th Street
Beaverton, OR 97005 Tualatin, OR 97062 Oregon City, OR 97045
Tualatin Valley (503) 356 -4799 (503) 612 -7000 (503) 657 -1365
Fire & Rescue Fax (503) 644 -2241 Fax (503) 612 -7003 Fax (503) 657 -7913
Page l oft Building Survey Report
FMZ : (to be filled out by TVF &R) Code Edition:
Name of Facility:_11g_CA1 L12P___ &_QP
Name of Building: _Ai2 M1.I 15_t A1'laki __I30ILl21Nb
Address: 15 rtf_ veAU2
Owner: 11L _f 111 L __O __ Z42 Telephone No. (503 ) 3' goo()
Architect: ILAI N(((om _/t c(A n_ Telephone No. ( 563) 2Z2-'cLL55
JIM 111..I J/1 k I 1QDOT
Architect Address: _ _ __ _
3 �{0 Iv, nl sore 201 PazTLAITO OK__
„ PTMIUN.
`1VI3'
1. Occupancy Type Use /7M /. Capacity 1{
2. Construction Type VtJ Year Built ff
3. Area (Sq. Ft.) z 875 Total Z g 75 Largest Floor 2875 Basement —
4. Stories No. Height 17/ A-f 04 lA, Y WN
5 a. Exterior Wall Construction /3g.1( ov42. wav /( nlY wAu
b. Opening Protection ( 1J
6. Interior Wall Construction IN p OP M' PJ( 7. Floor Construction . W D �►VI
8. Roof Construction to-rat, ,DoP dPt k.42V - M-
9. Attic Draft Stops No.
IOa. Occ. Sep. Wall Construction — No.
b. Opening Protection I f1R
1 Ia. Area Sep. Wall Construction -- No.
b. Opening Protection
12a. Smoke Barrier Wall Construction _- No.
b. Opening Protection --
13a. Corridor Wall Construction i H
b. Opening Protection — -
14a. Corridor Ceiling Construction
b. Opening Protection
•
15a. Shafts No. IType
b. Opening Protection
•
•
Building Survey Report
FMZ • (to be filled out by TVF&R)
Name of Facility: __ 41944//vtom___eliju)/Ajb.
"." i"' L
16a. Stair Enclosure No. "rIAIK5
b. Opening Protection
17. Stairs No.
18. Ramps x /14 KAMP5 ex ag...ci
19. Interior Finish Class J ifie Room Corridor Exit Enclosure
20. Exits 3 No. Total Width 2
21. Exit Hardware Type PM! eau:
22a. Exit Signs/Illumination
b. Emergency Lighting le*2
23. Auto Sprinkler Coverage ‘fs
24. Standpipe Class/Locations /4 51a of PC(511A)i%' et-p. 14111-4- Nrm
25. Fire Alarm Type/Coverage
26. Heating, Ventilation & Air Conditioning y Type Fuel
27. Electrical Installation ri4 -Petif rNf-iltolvt 1/Peizery
28. Stage/Platform
29. Hazardous Area
30. Other
Comments:
734 lOrf,i) lif-XiiVie (4)1U t30 rtta-
Alternate Materials & Methods
•
ss:TYF&IVUse:Qnly
Inspected B :Date 4 No Attachments •
Reviewed ......_..
By - . , Date
•
. .
ss-PP . - •
s .-- • . . . .
: . • s „ .
' • s
•