Permit (118) 1111 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I COMMUNITY DEVELOPMENT Permit#: FPS2019-00107
TiG A R.L3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2019
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 100
Project: Pacific Star Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: Fire sprinkler permit:Adding and relocating(14)sprinkler heads for TI.
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES LP
9095 SW BURNHAM ATTN: N PIVEN
TIGARD, OR 97223 15350 SW 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 09/12/2019 $102.20
12%State Surcharge-Building 09/12/2019 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 09/12/2019 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 09/12/2019 $12.50
Occupancy Grp: B Height: ft 11x17)
Stories:
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 Gales Provided: Cut Sheets Required:
Total $167.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,170.00
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 •y calli : 503. 32.1987 or 1 00.332.2344.
Issued By: Permittee Signature: 11 j1�y p
1 � c
Call 503.639.4175 by 7:00 a.m.for the next available inspection d e.
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 i FOR OFFICE USE oNLv
City of Tigard t- e Received
III '� 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 01.'��f,, .._: -r7- Permit No.: T�
! 2 2 ) Plan Review ` '1 J � `'�'l��'
Phone: 503.718.2439 Fax: 503.598.1960 [ 1 DateBy:
10. )9 Other Permit: +n �,el_�yr7,
T[G 1 R D
Inspection Line: 503.639.4175 i r g, Date Read/B e LiCJtTC
Internet: www.tigard-or.gov y y' / / -,. I°"s I See Page 2 for
3 r i ?ified Meth.•i� `l
3I i .� Supplementallnformation
: -
,f,',..
TYPE OF WORK # ^; REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Q Addition/alteration/replacement Indicate the value(rounded to the nearest dollar)of all
❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF-CONSTRUCTION work indicated on this application.
E 1-and 2-family dwelling ❑■ Commercial/industrial Valuation: g
Number of bedrooms:
E Accessory building
❑Multi-family
0 Master builder
0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:15055 SW Sequoia Pakwy New dwelling area: square feet
City/State/ZIP:Portland, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:100 Project name:PacStar Office Alteration
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 for TI Valuation: $2170
Existing building area: square feet
New building area: 0 square feet
0 PROPERTY OWNER I 0 TENANT Number of stories:
Name:
Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( )
New:
® APPLICANT 0 CONTACT PERSON
Business name:Wyatt Fire Protection NOTICE
All contractors and subcontractors are required to be
Contact name:Ronin Campbell licensed with the Oregon Construction Contractors Board
Address:9095 SW Burnham under ORS 701 and maybe required to be licensed in the
jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard, OR 97223 applicant is exempt from licensing,the following reasons
Phone:( )503.684.2928 I Fax::( )503.684.9657 apply:
E-mail:r.campbell@wyattfire.com
CONTRACTOR
BUILDING FERMIT FEES*
Business name:Wyatt Fire Protection
(Please refer to fee sriwdule)
Address:9095 SW Burnham Permit fee:
City/State/ZIP:Tigard, OR 97223 State surcharge(12%of permit fee):
Phone:( )503.684.2928 I Fax: FLS plan review(40%of permit fee):
( )503.684.9657 (Due upon application submittal.)
CCB lic.:64077 Total permit fees:
Authorized signature: fc.:7/1:(\ C/�/ Amount received:
This permit application expires if a permit is not obtained
Print name:Ronin Campbell I Date: K/2�/1 etwithin 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
I:/Building\Permits/FPS-PermitApp_031o16.doc Service Board.
440-46 i 3T(t 1/02/COM/wEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads:
14 Number of alarm devices:
Q Addition or1-5 devices: Affidavit required and
❑ 1-10 heads: Affidavit required and ❑ (3) copies of sketch showing area
Alteration (3) copies of sketch showing area
to existing
of work within building structure of work within building structure
system6+ devices: Plan review required and
0 11+ heads: Plan review required and ❑
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B,C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type 0 Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Light
.10
Density 1500
Design Area
K. Factor 5.6
Sprinkler Project Valuation: I $2170
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: I $
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: $
W:APermits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc 2