Permit p CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IPA = COMMUNITY DEVELOPMENT Permit#: FPS2014-00128
f G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/04/2014
-T
Parcel: 2S 112 DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 200
Project: MANAGEMENT GROUP Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Modification of(4)fire sprinkler heads for TI
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES
9095 SW BURNHAM ATTN: N PIVEN
TIGARD, OR 97223 15350 SW SEQUOIA PKWY#300
PORTLAND,OR 97224
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/04/2014 $59.16
12%State Surcharge-Building 08/04/2014 $7.10
Type of Use: COM Plan Review-Fire Life Safety-COM 08/04/2014 $23.66
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $89.92
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $750.00
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 sta.-. within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rule ado* ed by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o•tain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permit tee Signature: � I .``CCalll 503.639.4175 by 7:00 a.m.for the next available inspection date. +�I /
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 Applicatio t
Fire Protection System iECEIVED
y FOR OFFICE USE ONLY
City of Tigard
Received t �/ _a6(��
tY g AUG 4 2014 Date/By. /e/ t� . . Permit
IIN
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.59 O fG RD Date/By Other Permit: u j) 2 j Z f _60 1
i I e; ,it n Inspection Line: 503.639.4175 �^ �ypn Date Ready/By: tuns, ® See Page 2 for
Internet: www.tigard-or.gov BUILDING[,e 1lIOV 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.
dwelling Valuation: S
❑ I-and 2-famil y g ®Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:15350 SW SEQUOIA PARKWAY New dwelling area: square feet
City/State/ZIP:PORLTAND,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:200 Project name:MANAGEMENT GROUP TI 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.
FIRE SPRINKLER ADD/RELOCATE FOR T.I. Valuation: $$750.00
Existing building area: 11279 square feet
New building area: 0 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: LIGHT
Phone:( ) Fax:( ) New: LIGHT
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Payne licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham Rd jurisdiction in which work is being performed.If the
City/StateJZ1P:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)684-2928 Fax::( )
E-mail:a.payne @wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:Wyatt Fire Protection 5�
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee): -2 .I 0
FLS plan review(40%of permit fee): �1
Phone:( ) Fax:( ) (Due upon application.) /,3- 44
CCB lic.:64077 Total permit fees: 9V.9;
Authorized signature: Amount received:
��{///fff This permit application expires if a permit is not obtained
Print name:Ashley Payne Date:8/1/14 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board
t^.Building Tnmits\FPS-PennitApp.doc Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
s
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ® 1-10 heads: No plan review required.
® Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 4
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group LIGHT
Density 0.10
Design Area 1000
K. Factor 5.6
Sprinkler Project Valuation: $ 750
B.) Type I - Hood Fire Suppression System
I Iood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Mann 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: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
C:\Users\Ashley\Desktop\Permit Applications\Tigard App.doc Rev 01/05/2012 2
City of Tigard Permit No.: k4 go/ — O /?-'
1111
• 13125 SW Hall Blvd.,Tigard,OR 97223 i�
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 7f/1/ l'f
�, Inspection Line: 503.639.4175 (
Internet: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: AA Ai"&Y le Occupancy: Lt
V
Job Address: 1S 5 (,tO1 �k...ki Type of Construction:
Suite: Z00
Contractor: W ex-1-4t— \ y\Q ,(j kc f 70x1 Phone: 56 Sq.-0-4t-
Number of Proposed or Altered Heads:
Type: ,C)(5? Hazard: torki-- Density: O l 0
I, Alp ►, , �. i _..�� Oregon Construction Contractors Board No. (.9 '4
L 077
certify the f.11 owin:/ s true an. .sonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
b) Positions of sprinkler heads relative to architectural features such as soffits, beams, partitions, walls, etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop (exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads (see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
In addition, I understand the following is required:
• Submit(3)copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• A copy I f this docu , with a copy of the sketch attached shall be available for all inspections.
Signature: 1� ( Date: 151`'t
Print Name: A-511k, 0,y !.Z 7,A€
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