Permit !" .} CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT Ri
'` COMMUNITY DEVELOPMENT Permit#: FPS2015 00165
s 'tin f° Date Issued: 10/15/2015
f 1CrAR 13125 SW Hall Blvd,Tigard OR 97223 503 718 2439
__;, i .Iya Parcel: 2S113AA00400
Jurisdiction: Tigard
Site address: 16240 SW 72ND AVE B2
Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: C
Project Description: Fire(8)sprinkler heads in new office area Affidavit Submitted
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 10/15/2015 $64 54
12%State Surcharge-Building 10/15/2015 $7 74
Type of Use: COM Plan Review-Fire Life Safety-COM 10/15/2015 $25 82
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0 50(up to 10/15/2015 $0 50
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 Req
Battery Calcs Provided Cut Sheets Required
Total $98 60
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation $964 00
Residential Square Footage 0
Fire Alarm Valuation
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: •• mittee Signature. ..
Call 503.639.4175 by 7:00 a.m.for the next available inspection d.
This permit card shall be kept in a conspicuous place on the job site until completion of the • • • .
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY .
City of Tigard Received
`.1 g `��� Date/B . 1 r ® G7 Permit No• wish
a 13125 SW Hall Blvd.,Tigard, ``r*(t Plan Review
II • Phone: 503.718.2439 Fax: 50z.1,6111t.i Date/By:
Other Pennit: L . a s , I
TIGARD Inspection Line: 503.639.4175 . ` \S Date Ready/By .�1See Paget for
Internet: www.tigard-or.gov OC,?1 1 D Notified Method. �; Supplemental Information
O G D \\O4 REQUIRED DATA:1-AND 2-FAMILY DWELLING
TYPE O �O�Q'jR,�t
❑New construction BDemolition 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 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:16240 SW 72"d Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: lobp108-16240 SPEC 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 DROPS INTO NEW OFFICE AREA. Valuation: $$964.00
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
t
Phone:( ) 1 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.payne @wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Please refer ro 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 lic.:64077 /� ' Total permit fees= r, ( o
Authorized signature: �r /i���AVAIV�- Amount received:
V This permit application expires if a permit is not obtained
Print name:Ashley Nishihara Date:10/15/2015 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1\Bwldmg\Permas\FPS-PenmtApp doc Rev 01/052012 440-46 t 3T(t 1/02/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 El 11+ heads:' Plan review required.
❑ Repair
Number of sprinkler heads: 8
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Z Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Light
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 964
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.
C:\Users\Ashley\Desktop\Permit Applications\Tigard App.doc Rev 01/05/2012 2
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
16240 SW 72ND AVE B2, TIGARD, OR, 97224
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2015-00165
Jeff Grove
Violation Summary:
Inspector Contractor