Permit (177) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00011
Date Issued: 01/25/2016
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 112 DC00701
Jurisdiction: Tigard
Site address: 15957 SW 72ND AVE
Project: TAP Plastics Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: Fire sprinklers-Alteration of(9)sprinkler heads.
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:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Feer COM 01/25/2016 $72.61
12%State Surcharge-Building 01/25/2016 $8.71
Type of Use: COM Plan Review-Fire Life Safety-COM 01/25/2016 $29.04
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 01/25/2016 $6.00
Occupancy Grp: Height: ft 11x17)
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 $116.36
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,279.00
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 No n 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 di t questions t0 UNC calling 503.232.1987 or 1.800.332.2344.
Is ued By: Permittee Signature:
l
Call 503.639.4175 by 7:00 a.m.for the next available inspection dat
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.
Buildim Permit Amlication
Fire Protection System
City of TigardReceivedDate/By. Permit No.:
G
2AN
13125 SW Hall Blvd.,Tigard,OR Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By. Other Permit:
Inspection Line: 503.639.4175 x c x t Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method Supplemental Information
'T
El New construction El 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 El Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
POK
Wwll W Valuation: $
El I-and 2-family dwelling Commercial/industrial
El Accessory building El Multi-family Number of bedrooms:
El Master builder El other: Number of bathrooms:
Total number of floors:
Job site address:15957 SW 72nd Ave New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:TAP Plastic, Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
I IR,'
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
work indicated on this application.
Fire sprinklers add/relocate for retail TI Valuation: $1279
Existing building area: square feet
New building area: 0 square feet
R
❑4JPROPJF
&T Number of stories: 1
R"
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: Ordinary I
Phone: Fax: New:
ax NO �CE
FG
0,010%
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 Rd jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:Tigard,OR 97223 apply:
Phone:(503)684-2928 Fax:
E-mail:a.payne@wyattfire.com
77 S*
'4"Wale
Business name:Wyatt Fire Protection Ye e
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( I Fax: (Due upon application.)
CCB lic.:64077 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:Ashley Nishihara Date:25 Jan 2016 within 180 days after it has been accepted as complete.
Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(I 1/02/COMAVEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 -Supplemental Information
ft
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: 9
Additional description of work:
A)A�F� y-
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Ordinary 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 1279
Fir reiiW' "stem
Hood Project Valuation: $
� � IFF
C ,
,u
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
esi tialS a and�Alone ysteiin) t +` � At'
S uare 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.
Project valuation subtotal (see A,B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based onsquare 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.
C:\Users\Ashley\Desktop\PennitApplications\TigardApp.doc Rev 01/05/2012 2
City of Tigard Permit No.: ;
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received:
Inspection Line: 503.639.4175
Internet: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERAT
OR TENANT IMPROVEMENTS
(I to 10 SPRINKLER HEADS WITHOUT PLANS)
Rn 7
Project Name: TAP Plastics Occupancy: Ordinary I
Job Address: 15957 SW 72'Ave Type of Construction: IIIB
Suite:
Contractor: Wyatt Fire Protection Phone: 503-684-2928
Number of Proposed or Altered Heads: 9
Type: SSP Hazard: Ordinary I Density: 0.15
1, Ashley Nishihara,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.
fl 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.
41y,
Signature: /- w� 0!�A� Date: .1/25/2016
V
Print Name: Ashley Nishihara
1:\Building\FormsTireSprinklerAffidavit-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
15957 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2016-00011
Jeff Grove
Violation Summary:
Inspector Contractor