Permit (53) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II ■' COMMUNITY DEVELOPMENT Permit#: FPS2018-00076
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/26/2018
I[ �I`�� g Parcel: 2S112DD01600
Jurisdiction:
Site address: 15495 SW SEQUOIA PKWY 150
Project: Acceleration Chiropractic Subdivision: PACIFIC CORPORATE CENTER Lot: 4
Project Description: Fire sprinkler:Add and relocate(19)sprinkler heads for TI.
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES
9095 SW BURNHAM ATTN: N PIVEN
TIGARD, OR 97223 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/26/2018 $102.20
12%State Surcharge-Building 07/26/2018 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 07/26/2018 $40.88
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 07/26/2018 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 07/26/2018 $9.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0.1 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 $166.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,138.00
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 1.800.332.2344.
Issued By: _ Permittee Signature:
hk
Call 503.639.4175 by 7:00 a.m.for the next available inspection d te.
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 . -
FOR OFFICE, USE ONLY
Received )
City of Tigard c Date/By: 7 A // Permit No.:F//k ,0/12�
III '� 13125 SW Hall Blvd.,Tigard,OR 97223 v L O i`3 Plan Review h.....3.
G� Other Perini) / v0[�//y �J(/g
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: /—/ `w`t/`'e e/ !y
t"t G A R D Inspection Line: 503.639.4175 ( Date Ready/By: 'oris: See Page 2 for
Internet: www.tigard-or.gov '. otified/MMthod: / iii / /X, Supplemental Information
/��j7J��J'�I�//r/ia/
TYI' ? `iitt, AT* 11;A ► 1
❑New construction ❑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
ATEGORY ONS �O work indicated on this application.
ID1-and 2-family dwelling ❑■ Commercial/industrial
Valuation: $
Number of bedrooms:
IDAccessory building ❑Multi-family
1:1 Master builder El Other:
Number of bathrooms:
SIT 'I OR TION. jii Total number of floors:
Job site address:15495 SW Sequoia Pkwy New dwelling area: square feet
City/State/ZIP:Portland, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:150 Project name:Acceleration TI Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQt D,_DATA:COI1 l RCTAL�I$E � : IBT
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
i sc-turrfo t o "WORD work indicated on this application.
Add/Relocate fire sprinkler heads for TI Valuation: $2138
Existing building area: square feet
New building area: 0 square feet
PROPERTY OWNER [3 TNAIA Number of stories:
Name: Type of construction:I I-B
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
Itis GO1T 1� 1tSbial -
i
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Nishihara licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham 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 J Fax: :( )503.684.9657
E-mail:a.nishihara@wyattfire.com
OR 10 T ��
Business name:Wyatt Fire Protection
Permit fee:
Address:9095 SW Burnham
State surcharge(12%of permit fee):
City/State/ZIP:Tigard, OR 97223 FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.) ,
CCB lie.:6407)7503.684.2928
4077 Total permit fees:
tiiAmount received:Authorized signature: V
L
This permit application expires if a permit is not obtained
Print name:Ashley Nishihara Date:6/29/2018 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PemitApp_031016.doc 440-4613T(1 l/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
ElNew system Number of sprinkler heads: 19 Number of alarm devices:
■❑ Addition or El 1-10 heads: Affidavit required and El 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑■ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Tyro Systems(co plet , ,, pplk ab e){.
A) Cc�i m r ial Spier'
Sprinkler Type SSP-QR ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line None ❑ Yes ❑ No
Hazard Group Light
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $2138
,.`I'yp ood Firs S app xaxtt. st trt��wne
Hood Project Valuation: $
C. 1 Mann Out Q. S„
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
illi
Square Footage: Permit Fee:
0 to 2,000 $198.75 ' P A< `
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.
Pim?r�,1t t io 'e�tt Pre f . �,,
� � � 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: $
W:\Permits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15495 SW SEQUOIA PKWY 150, TIGARD,
OR, 97224
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00076
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor