Permit illCITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 ` COMMUNITY DEVELOPMENT Permit#: FPS2016-00157
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/13/2016
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 140
Project: US Investors International Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Fire sprinklers-Add/relocate(5)sprinkler heads for TI
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: 503-624-6300
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/13/2016
$61.85
12%State Surcharge-Building 09/13/2016 $7.42
Type of Use: COM Plan Review-Fire Life Safety-COM 09/13/2016 $24.74
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 09/13/2016
Occupancy Grp: Height: ft 11x17) $0.50
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $94.51
Valuations:
Required Items and Reports(Conditions)
Sprinkler Valuation: $811.00
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 N•' . ion .-nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir- questions to UN a 'ng 503.232.1987 or 1.800.332.2344.
Iss ed By: j1k / Permittee 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 co .Ietion of the pr.__-.%
Approved plans are required on the job site at the time of each inspection.
Building Permit Application'' rc ', .'
Fire Protection System FOR OFFICE USE ONLY
City of Tigard cDaRete/Beive.d
INFmom II 11111 . PermitNo.:g0580/6--e6/57
13125 SW Ha11 Blvd,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit. Q l�...-e6 9
T 1 G A R D Inspection Line: 503.639.4175 f Date Ready/By: Juns: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
:04.:;.'i. x ` _ ° '.M t k D Ar e F P. D LL11YGor
.. ;
❑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
O work indicated on this application.
rr .n � TIt �Y PP
El1-and 2-familY Valuation: $
dwelling ®Commercial/industrial
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
11,1 JO S t i *i0x
O ,I I. ' , ,' Total number of floors:
Job site address:12909 SW 68TH PKWY New dwelling area: square feet
City/State/ZIP:PORTLAND,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:140 Project name:US INVESTORS INTL Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQ IIRE t tAei4i,"C O MERG a,C C S
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
SD 1TION work indicated on this application.
Add and relocate fire sprinkler heads as required for TI Valuation: $$811.00
Existing building area: square feet
New building area: 0 square feet
PROD ER
� '� �:" ��'; . o❑MSI' Number of stories:
Name: Type of construction:
Address:
Occupancy groups:
City/State/ZIP: Existing: LIGHT
Phone:( ) F
New: „
APPI;C T .;
fr V_ CONTACT 'ER O) ' •. , ,*1- - -' t- '
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be Y
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
} -.,„4.': CONTRiCJOR ''x M . k D G PERMITF S
Business name:Wyatt Fire Protection ' �. « tele iefer o Je ed,�
Address:
Permit fee:
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: Amount received: 11'51
This permit application expires if a permit is not obtained
Print name:Max Colley h
Date:9/13/16 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pecmits\FPS-PermitApp.doc Rev 01/05/2012 440.4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
fes ri }. r a,t bi dole .� . r.
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: 5
Additional description of work:
y f ''s ;�'� .' . si �C`5t' • a Row +, ±
a . .:.} °� e t4 ..
e �, ` ® Wet �❑` Dry '
Additional Standpipes 0
Information: Hazard Group LIGHT
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 811
�= ; 1? ess'o5 :*,fit, ' r
Hood Project Valuation: $
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
Asn ,
D. Rosi en�al 4er(Sta ones Sys 4'
,.- 00, ,,,, ,.‘ 0 ,ti.. 0
Square Footage: Permit Fee: :::46' iii74,„tit,
0 to 2,000 $198.75
2,001 to 3,600 $246.45i
ii
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Yi re Potecn"�`` 'etms: „. .
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:\Max\1112 PERMIT APPLICATIONS\Tigard App.doc Rev 01/05/2012 2
- City of Tigard Permit No.: /r 5 i(p— '5 7
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: Cf /3//�
T I G A R D Inspection Line: 503.639.4175
Internet: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
Cti u` 1,i9h,
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: US INVESTORS INTL Occupancy: LIGHT
Job Address: 12909 SW 68TH PKWY#140 Type of Construction:
Suite:
Contractor: Wyatt Fire Protection Phone: 503-684-2928
Number of Proposed or Altered Heads: 5
Type: SSP Hazard: LIGHT Density: 0.10
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: Date: 9/13/16
Print Name: M. Colley
I:\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
12909 SW 68TH PKWY 140, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2016-00157
Chip Barnett
Violation Summary:
Inspector Contractor