Permit (52) :1ry CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 2 -' COMMUNITY DEVELOPMENT Permit#: FPS2016-00037
TWGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2016
Parcel: 1 S 134AA01900
Jurisdiction: Tigard
Site address: 10115 SW NIMBUS AVE 200
Project: I Love Kick Boxing Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Fire sprinklers-modification of(34)sprinkler heads.
Contractor: WYATT FIRE PROTECTION INC. Owner: ROBINSON, CONSTANCE A
9095 SW BURNHAM BY KILLIAN PACIFIC LLC
TIGARD, OR 97223 500 EAST BROADWAY, STE 110
VANCOUVER,WA 98660
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/23/2016 $112.96
12%State Surcharge-Building 03/23/2016 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 03/23/2016 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 03/23/2016 $7.50
Occupancy Grp: B Height: ft 11x17)
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: ORD1
Density: .15 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 $179.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,681.00
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 :t:.-.-..-- .
Issued By: mittee Signature:
i„&rteee..\____ gililliftPP' ...--.---- -""--- -.7:7-.
4101110
Call .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 RECEIVE!) FOR OFFI( F: l Sl?O\I.1
City of Tigard Received n � nDate/B . w o2 9/4. mit"./ Permit No.: g O,(—00637
jig u 13125 SW Hall Blvd,Tigard,OR 9722 g 2 9 2016 Plan Rev -W !�1
Phone: 503.718.2439 Fax: 503.598.1 Date/B . .igh, Mg Other Permit:434.4/AVee—ettncill
Inspection Line: 503.639.4175 Date Read tom: ® See Page 2 for
Gn
1IRD r
Internet: www.tigard-or.gov t.%1r VUi It(ittU Notified/Metho,: ItP yjArI Supplemental Information
v ✓ -
u
aI ,, TYPE . ORK # , '.14;;;-41, REQUIRED DATA 1 AND.2 F,AMPI 6::, ELEI ,G',1,,:
0 New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
dwellingValuation: $
0 1-and 2-family ®Commercial/industrial
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
'JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10115 SW Nimbus Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:200 Project name:I Love Kickboxing 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: I 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 and relocate fire sprinkler heads as required for TI Valuation: $$3,681.00
Existing building area: square feet
New building area: 0 square feet
0 PROPERTY OWNER 0 TENANT Number of stories: 1
Name: Type of construction: V-B
Address: Occupancy groups:
City/State/ZIP: Existing: Ordinary 1
Phone:( ) Fax:( ) New: r'
® APPLICANT ® CONTACT PERSON NOTICE
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 I Fax::( )
E-mail: m.colley@wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Please refer tofee schedule)
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) I Fax:( ) (Due upon application.)
CCB lic.:64077 Total permit fees:
Authorized signature: Amount received: .......69--'This permit application expires if a permit is not obtained
Print name:Max Colle Date:2/25/16 within 180 days after it has been accepted as complete.
- * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PennitApp.doe Rev 01/05/2012 440.4613T(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:
Z Addition El 1-10 heads: No plan review required.
❑ Alteration ® 11+ heads: Plan review required.
El Repair
Number of sprinkler heads: 34
Additional description of work:
Type of System" Com lete ;B,C or D as applicable):
•
A
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Ordinary 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 3681
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.
W:AMax\1112 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
10115 SW NIMBUS AVE 200, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2016-00037
Chip Barnett
Violation Summary:
Inspector Contractor