Permit ;, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
. , ° :-: COMMUNITY DEVELOPMENT Permit#: FPS2015-00150
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/05/2015
TIGARD Parcel: 2S 112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 150
Project: Vanderveer Center Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Adding and relocating(3)sprinkler heads. Affidavit submitted.
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: 503-624-6300
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/05/2015 $80.68
12%State Surcharge-Building 10/05/2015 $9.68
Type of Use: COM Plan Review-Fire Life Safety-COM 10/05/2015 $32.27
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 10/05/2015 $2.00
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Reg:
Battery Calcs Provided: Cut Sheets Required:
Total S124.63
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,552.00
Residential Square Footage: 0
Fire Alarm Valuation: S0.00
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Si nature: h / /� ii
y L«� 9 al `
Ca 9.4175 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 completi. of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System Ct °) FOR OFFICE USE ONLY
Received �j
City SW Tigard ^ Date/H . I iY� Penult No.: �l5�rJL�UI LI
° 13125 SW Hall Blvd.,Tigard,OR 97223 btt Plan Review
d ac? Q Other Permn:
Phone: 5n Line:.5 39 Fax: 503.598.1960 C G, J Dale/By. ,�� • y` -r
TIGARD Inspection Line: 503.639.4175 JG ���0 Date Ready/By: See Paget for
Internet: www.tigard-or.gov ����f\�s��`���,O;�Noti led7d ethod: — Supplemental Information
TYPE OF 11/21011011-v`�� 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.
❑ I-and 2-family dwelling Valuation: $
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:6650 SW Redwood Lane#151) New dwelling area: square feel
City/Slate/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: 150 Project name:Vanderveer 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.
Add&relocate fire sprinkler heads as required for tenant improvement Valuation: $$1,552.00
Existing building area: square feet
New building area: 0 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Nishihara 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.nishihara @wvatlfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: Wyatt Fire Protection (Please refer lo fee schedule
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lie.:64077 /7 Total permit fees: I�,/dy. 63
•
Authorized signature: Sk9. I) / ,-1 „�, „ 4,v Amount received: lr
✓✓✓��\ /JI tl-"Y/v"I�wr^` This permit application expires if a perndt is not obtained
Print name:Ashley Nishihara Date:9/29/15 within 180 days after it has been accepted as complete.
- * Fee methodology set by Tri-County Building Industry
Service Board.
h\BUilding\Pmeits\FPS-PennitAppdec Rev DI/05/2012 44DJ61?'q I Ii02,COM/WEB)
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City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
Z Addition ® 1-10 heads: No plan review required.
E Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 3
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes
Information: I-Iazard Group
Density 0 IO
Design Area l St
K. Factor
Sprinkler Project Valuation: $ 1552.00
B.) Type I- Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alaim
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.
C:AUsersAACwrau Fire A Documents VTigard App.doc Rev 01/05/2012 2
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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
6650 SW REDWOOD LN 150, TIGARD, OR,
97224
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2015-00150
Chip Barnett
Violation Summary:
Inspector Contractor