Permit (5) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00134
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2019
Parcel: 2S112DD00200
Jurisdiction: Tigard
Site address: 15862 SW 72ND AVE 150
Project: Wood Enviornmental Subdivision: None Lot: None
Project Description: Fire sprinkler. Adding (57)sprinkler heads for TI.
Contractor: WYATT FIRE PROTECTION INC. Owner: PACIFIC REALTY ASSOCIATES LP
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 10/24/2019 $156.00
12%State Surcharge-Building 10/24/2019 $18.72
Type of Use: COM Plan Review-Fire Life Safety-COM 10/24/2019 $62.40
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 10/24/2019 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 10/24/2019 $10.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No 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 $249.62
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $7,390.00
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 952-001-009 . You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.:;;.--^. . 4.
Issued By: ..`ttee Signature:
Call 503.639.4175 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.
7
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Building Permit Application
Fire Protection System FOR OFFICE USE ONL1 /�J (�
City of TigardRECapy ReceivDate/Bed to ci !l .W. .41 /v&/3 /
illiiV 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rev: QC �,�f t�,� f/Gj �-.��J
3 Phone: 503.718.2439 Fax: 503.598.�6br 2019
DateBy: Q' 4 - )4 i-)) '' -V l I (/ 6` ( -Ua _
[[CARD Inspection Line: 503.639.4175 D Ready/By: uric See Page 2 for
Internet: www.tigard-or.gov CIT ad' v � Supplemental Information
riD
T 0 *= ` "t / fiedfM.
. -t REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ❑■ Commercial/industrial Valuation: $
❑Accessory building ElMulti-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
1 � JOB SITE INFORMAT//IOl�I AND LOCATION Total number of floors:
Job site address: ___ V
✓ ✓ 4-2/ AVQ New dwelling area: square feet
City/State/ZIP: if Q( b' 271-f Garage/carport area: square feet
Suite/bldg./apt.no.: name: 1 �"�' �
Project ��Q� �Vl Y�,gvrr,�•itl' 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: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK ff-- work indicated on this application.
/.''lvl(It I .1''•(/ sjir ( 5 �✓r T/L Valuation: $7390
Existing building area: 0 square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
IN APPLICANT ❑ CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ronin Campbell 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 Fax: :( )503.684.9657
E-mail:r.campbell@wayttfire.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Wyatt Fire Protection
Permit fee:
Address:9095 SW Burnham
City/State/ZIP:Tigard, OR 97223 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.)
CCB lie.:64077 Total permit fees:
Amount received:
Authorized signature: ! /
1 ✓ This permit application expires if a permit is not obtained
Print name:Ronin Campbell Date: (o/' Zhetwithin 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/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: 57 Number of alarm devices:
❑ Addition or ❑ 1-10 heads: Affidavit required and 0 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 0 6+ devices: 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 :"*.**"4-i: r
Sprinkler Type ❑■ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Light
Density 0.1
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $7390
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)9,
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:\Permits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc2