Permit (84) n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00015
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/03/2016
Parcel: 2S 113AA00100
Jurisdiction: Tigard
Site address: 16342 SW 72ND AVE
Project: Bridgeport Distribution Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS A,B
Project Description: Adding(1)sprinkler head to new bathroom. 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 02/03/2016 $51.09
12%State Surcharge-Building 02/03/2016 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 02/03/2016 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 02/03/2016 $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 $78.16
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $425.00
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.
Issued By: a Signature:
Call 503.63 .4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on thejob 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
eceived
City of Tigard PennitNo.:
13125 SW Hall Blvd.,Tigard,OR 97223 RECEIVE e/By. '0QA//1(g01
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By. Other Penn /Oit,Pa)I&
r
Inspection Line: 503.639.4175 20116 Date Ready/By: Juris: 0-See Page 2 for
Internet: www.tigard-or.gov Notified/Method. Supplemental Information
Y t jF TIGA 7t,0
ATA.'
IRR D
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----------- A
0 New construction El 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 ION work indicated on this application.
Valuation: $
El I-and 2-family dwelling Z Commercial/industrial
El Accessory building El Multi-family Number of bedrooms:
El Master builder El Other: Number of bathrooms:
" JOB SITE Total number of floors:
669-ANi) LOCATION
Nt
s.
FORM&
Job site address:16342 SW 72nd St New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:4 Project name:Bridgeport Distribution 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTIONOF WORK work indicated on this application.
Add one fire sprinkler to new bathroom Valuation: $425
Existing building area: square feet
New building area: square feet
❑ PROPERTY,0" Ef ikNAN T Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: Light
Phone: Fax: New: to
ED CONTACT PERSON NOTICE
CANT
APPL
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Max Colley 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:aLcolley@wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Pkew refer two feme ached
uk
Permit fee:
Address:see above
State surcharge(12%of permit fee):
City/State/ZIP; FLS plan review(40%of permit fee):
Phone:( I Fax: (Due upon application.)
CCB lic.:64077 Total permit fees:
Authorized signature: Amount received:
This*permit application expires if a permit is not obtained
Print name:Max Colley te:2/3/2016 within 180 days after it has been accepted as complete.
Fee methodology set by Tri-County Building Industry
Service Board
I:\Building\Pctmits\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Descnbe_: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: 1
Additional description of work:
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group light
Density 0.1
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 425
B. '.T e I Hood Fire Suppression S` stem
Hood Project Valuation: $
C.) Fire'Alarm
Submittal shallBatte Calculations El Yes
include: Individual Component El 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 $310.05x,
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:\Max\Permit Applications\Tigard App.doc Rcv 01/05/2012 2
City of Tigard ��� �� ermit No.:
13125 SW Hall Blvd,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 ate Received: 2/30&
Inspection Line: 503.63.gov FEB 3 1 B
Internet: www.tigard-or.gov 2 0,6 Y
CITY ,q
FIRE SPRINKB,t�.lIW FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(I to 10 SPRINKLER HEADS WITHO UT PLANS)
Project Name: Bridgeport Distribution Occupancy:
Job Address: 16342 SW 72nd Ave Type of Construction:
Suite: Bldg 4
Contractor: Wyatt Fire Protection Phone: 503-684-2928
Number of Proposed or Altered Heads: 1
Type: SSP Hazard: Light Density: 0.1
I, Max Colley, 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 document with a copy of the sketch attached shall be available for all inspections.
Signature: Gz Date: 2/3/2016
Print Name: Max Col ey
1:\Building\Forms\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
16342 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2016-00015
Chip Barnett
Violation Summary:
Inspector Contractor