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Permit 14 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 11111 ' COMMUNITY DEVELOPMENT Permit#: FPS2014-00163 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2014 Parcel: 2S113AA00500 Jurisdiction: Tigard Site address: 16112 SW 72ND AVE B18 Project: Accosta Food Services Subdivision: ROSEWOOD ACRE TRACTS Lot: PT A&F Project Description: Fire sprinkler,add(1)head to electrical room Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES 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 10/09/2014 $56.47 12%State Surcharge-Building 10/09/2014 $6.78 Type of Use: COM Plan Review-Fire Life Safety-COM 10/09/2014 $22.59 Class of Work: ALT Type of Const: Occupancy Grp: Height: ft Stories: 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 $85.84 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $700.00 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 or direct••- ions • ` NC • calling 503.232.1987 or 1.800.332.2344. Issu d By: 9 /y Permittee Signat e: 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 Fire Protection System RECEQIED ".l 1.OR OFFICE l ONLY City of Tigard /o© A . Permit No.: vS ep —et" 47 i • 13125 SW Hall Blvd.,Tigard,OR 9721,,}„ Plan Review Phone: 503.718.2439 Fax: 503.598.1 T 9 2014 Date/B . Other Permit: It 1, Inspection Line: 503.639.4175 Date Ready/By: )uris: Iii See Page 2 for Internet: www.tigard-or.gov CITYpt r((„AH[) Notified/Method: Supplemental Information lint rAnalligalailiorpmpg TYPE OF WORK Q TIRED 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. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: S ❑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:16112 SW 72"d ST New dwelling area: square feet City/State/ZIP:TIGARD,OR Garage/carport area: square feet Suite/bldg./apt.no.: Project name:1 Covered porch area: square feet Cross street/directions to ob site: J C d'Sr-/- re)(J`73 i/l iA e f-5 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. ADD HEAD IN ELECTRICAL ROOM Valuation: $700 Existing building area: square feet New building area: 0 square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: I Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: LIGHT Phone:( ) Fax:( 1 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/State/ZIP: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* Business name:Wyatt Fire Protection (Please refer to fee scheJak) Address:9095 SW Burnham Rd Permit fee: �j q-7 City/State/ZIP:Tigard,OR 97223 State surcharge(12%of permit fee): [p• -7 g FLS plan review(40%of permit fee): Phone:(503)684-2928 Fax:(503)684-9657 (Due upon application.) 2- ,- CCB lic.:64077 Total permit fees: Authorized signature: 14 p Amount received: $5• ` This permit application expires if a permit is not obtained Print name:Ashley Payne Date:10/9/14 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. :\Building Permits\FPS-PetmitApp.doc Rev 01/05/2012 440-46137(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information 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. El Repair Number of sprinkler heads: 1 Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler ® \\et El Dry Additional Standpipes Information: Hazard Group LIGHT Density 0.10 • Design Area 1000 K. Factor 5.6 Sprinkler Project Valuation: $ 700 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: $ Plan review requires a completed application and three (3) sets of plans at submittal. Plan review fees are required at submittal. N:\Permit Applications\Tigard App.doc Rev 01/05/2012 2 City of Tigard RECE WED Permit No.: � ' >/z _ooko 3 II • 13125 SW Hall Blvd.,Tigard,OR 97223 a Phone: 503.718.2439 Fax: 503.598.►[f c 9 2014 Date Received: (0A l/% 1 1 G A It a Inspection Line: 503.639.4175r���Q�} �� Internet: www.tigard-or.gov CITY OF fl6Af1D By: LC '11 in mr,rwlont FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (1 to 10 SPRINKLER HEADS WITHOUT PLANS) Project Name: 16112 SW 72nd St Occupancy: Light Job Address: 16112 SW 72nd St Type of Construction: III-B Suite: Contractor: Wyatt Fire Protection Phone: 503-684-2928 Number of Proposed or Altered Heads: 2 Type: SSP Hazard: Light Density: 0.10 I, Ashley Payne, Wyatt Fire Protection Oregon Construction Contractors Board No. 64077 certify the following is true and reasonably 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 of this docu e t with a copy of the sketch attached shall be available for all inspections. Signature: ottry Date: 10/9/14 Print Name: Ashley Pa e 1:\BuildingTorms\FireSprinklerAffidavit_071514.docx Page 1 of 1 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 16112 SW 72ND AVE B18, TIGARD, OR, 97224 Commercial - Fire Protection System 999 Sprinkler final PASS - No C of O FPS2014-00163 Jeff Grove Violation Summary: Inspector Contractor