Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• COMMUNITY DEVELOPMENT Permit#: FPS2015-00203
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/19/2016Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 290
Project: Spec Space Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,P1
Project Description: TI for future tenant:Adding offices.
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 12/30/2015 $75.30
12%State Surcharge-Building 12/30/2015 $9.04
Type of Use: COM Plan Review-Fire Life Safety-COM 12/30/2015 $30.12
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 12/30/2015 $2.00
Occupancy Grp: B Height: It 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 12/30/2015 $5.50
11x17)
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 $121.96
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation. $1,320.00
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 questions to OUNC
by calling 503.232.1987 or 1.800.3.32.2344.
Issued By:
Permittee Signature:
___ IIIXXX Call 503.639.4175 by 7:00 a.m.for the next available inspection
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on thejob site at the time of each inspection.
Building Permit Application
Fire Protection System
City of Tigard' Pe mit No.:
• 13125 SW Hall Blvd,Tigard,OR 97223
e Phone: 503.718.2439 Fax: 503.598.1960 ,3 p ti0�5 Da1dB 7 Other Pemlit: 6AAG101s '
Inspection Line: 503.639.4175 DE�, ate R y: 1 Suds: See Page 2 for
Internet: www.tigard-or.gov #k� otified01ethod: f• �(� _ SupplementW Information
'-` REQUIItED ATA:1-AND 2-FAMILY DWELLING
+. TYPE OF WORK:;,
❑New construction ❑Dem on Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
® Addition/alterationJreplacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work to
on this is,
❑ I-and 2-family dwellingValuation: $
®Commercial/industrial
❑ Accessory building ❑Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SBE'.INFORMATION AND LOCATION - Total number of floors:
Job site address:12909 SW 68'h PKWY New dwelling area: square feet
City/Slate/ZEP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldgd/ pt.no.:290 Project name:PPC 082-290 Spec Space Covered porch area: square feet
street/dnections to job site:
Cross 1 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.
Replace(26)underspace heads with standard coverage,plug(11)and add(11) Valuation: $1320
heads as required for TI Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑.TENANT - Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/Slate/ZEP: Existing: Light
Phone:( ) Fax:( ) New: o
®APPLICANT ® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Nishiharn 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@wya tfire.com
CONTRACTOR BUILDING PERMIT FEES'
Business name:Wyatt Fire Protection Pkaar merro mwWak
Permit fee: r
Address:same as above
State surcharge(12%of permit fee):
City/State/ZIP: o
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) Due upon a lication.
CCB lic.:64077 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:Ashley N sh ata Date:12/29/2015 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry
Service Board
I,Bulldivg PmviuPPS-PennitA pdoc Re,01/052012 4MA613T(I IM COM WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describework➢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: 48
Additional description of work:
T' a of Sji m(C5tA lefeVgB (Xoe D'ae':
A Commer $pnn�cl
#Mnmwn, n o ,�i}w't `i�4,...'�},{b•✓('S, �`sh.�` a5 $`1�.a.r;3.'�i>�s'='„3t P w J,
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Light
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 1320
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 onsquare 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.
w:VNla,VN.,t ApplicationsATigard App.doc Rm,01/05/2012 9
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
12909 SW 68TH PKWY 290, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
February 16, 2016 at 1:54:34
PM
FPS2015-00203
Chip Barnett
Violation Summary:
Inspector Contractor