Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00101
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/14/2016
Parcel: 2S113AA00700
Jurisdiction: Tigard
Site address: 16416 SW 72ND AVE B5
Project: Stauffer Cisco Supply Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: (11)sprinkler heads for TI.
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY TRUST
9095 SW BURNHAM ATTN: N PIVEN
TIGARD, OR 97223 15350 SE 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 07/14/2016 $61.85
12%State Surcharge-Building 07/14/2016 $7.42
Type of Use: COM Plan Review-Fire Life Safety-COM 07/14/2016 $24.74
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 07/14/2016 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 07/14/2016 $10.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
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 $106.01
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $900.00
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 1.80' -. - •
Issued By: ' 'ermittee Signature:
Call by a.m.for the next available inspection •....2.0/0111111111111111111111111111111111.11111"."—
This
eThis permit card shall be kept in a conspicuous place on the job site until co p etion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System \\IFOR OFFICE USE ONLY
City of Tigard Received III
Date/B . l Permit No.: yt _'
III III13125 SW Hall Blvd,Tigard,OR 972 3 Q 2016 ' "" — _
D Plan Rev' • Oj,
Phone: 503.718.2439 Fax: 503.598.1960 ..0oitDaze/By: 0t-, Yiwa Other Permitift : ' /' • - -
T 1 G n R D Inspection Line: 503.639.4175 eyG `,�}� � -Date Ready/B : See Page 2 or ,
Internet: www.tigard-or.gov
0-1\11
``� vw,�®,\Is,� Notified/Method: N Supplemental Information
;,OF . 1�� � ,40,4'1.w.''' UIR fi t ►AT -F ' Y *L
❑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
' EGO :OFACONSTRUCTIONwork indicated on this application.
❑ 1-and 2-family dwelling /1 Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
B SITE IN S4LAT T R Total number of floors:
Job site address:16416 SW 72nd Ave(PTR,#lobp114) New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:Bldg5 Project name:Stauffer-Cisco Demising Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
RE 6R0 ATA.," M C S HE(I ST14: 4
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•O O 4, work indicated on this application.
Add and relocate fire sprinkler heads as required for new demising wall Valuation: $$900.00
Existing building area: square feet
New building area: 0 square feet
j PRER 0 rER • • AN ' Number of stories: 1
Name: Type of construction:
Address:
Occupancy groups:
411 P Y
City/State/ZIP: Existing: Light Hazard
Phone:( ) Fax:( )
— New: "
?NN „
s ® PL ANT � TACT PERSO - NO IC ?„ _
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:m.colley@wyattfire.com
• CON CTOR ` � n �1wBUILDING PERMIT FEES*. A. ;
Business name:Wyatt Fire Protection (Pleaserejertofeeschedulej
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:
Authorized signature 1 Amount received:
This permit application expires if a permit is not obtained
Print name:Max Colley Date:6/8/2016 within 180 days after it has been accepted as complete.
— * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pemrits\FPS-PemritApp.doc Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
c ; �r" o be done.
1.) I=1
New 2.) Modification to sprinkler heads only:
® Addition I=11-10 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 11
Additional description of work:
3 o s e �'omple , .�( o D s ce '
Nt.
0 e a p kl r
® Wets 0 Dry
Additional Standpipes 0
Information: Hazard Group Light
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 900
B.) I' o dd. ire Super, ssi
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
16416 SW 72ND AVE B5, TIGARD, OR, 97224
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2016-00101
Jeff Grove
Violation Summary:
Inspector Contractor