Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111111' COMMUNITY DEVELOPMENT Permit#: FPS2016-00199
Date Issued: 11/28/2016
T I c..A Iz.i7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DC00500
Jurisdiction: Tigard
Site address: 15883 SW 72ND AVE
Project: Spec Space Subdivision: FANNO CREEK ACRE TRACTS Lot: 40
Project Description: Fire sprinklers-Add and relocate(2)fire 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 11/28/2016 $69.92
12%State Surcharge-Building 11/28/2016 $8.39
Type of Use: COM Plan Review-Fire Life Safety-COM 11/28/2016 $27.97
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 11/28/2016 $0.50
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 $106.78
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,200.00
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 Notifcati.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 dire questions . •UNC • - . g 503.232.1987 or 1.800.332.2344.
Issu d By: ik., / , Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection .. 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.
City of Tigard Pennit No.: �PS�b!(Q —DO/99
13125 SW Hall Blvd,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: /VP.gf t!�
T I n Et n
Inspection Line: 503.639.4175 CD' �u�
Internet: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERAT „ X11
OR TENANT IMPROVEMENTS OC T 1 9 2016
(1 to 10 SPRINKLER HEADS WITHOUT PLANS) µ" - OF ,1..s'R z,t j
Project Name: 15883 SW 72ND SPEC SPACE Occupancy: LIGHT
Job Address: 15883 SW 72ND AVE Type of Construction:
Suite:
Contractor: Wyatt Fire Protection Phone: 503-684-2928
Number of Proposed or Altered Heads: 2
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: 11/23/16
Print Name: Max Colley
I:1Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1
Building Permit Application
Fire Protection System E ,F 0 FOR OFFICE I;SE ONLI`
City of Tigard Da ;Bed llEfiZIMMPermit No.: ��j(91C/112—er.) °
q 13125 SW Hall Blvd.,Tigard,OR 97223 T 1 9 2016 Plan Review / /� 2
Phone: 503.718.2439 Fax: 503.598.1960 L' Date/B : Other Permit: �(p�b J a
-
TIG R D Inspection Line: 503.639.4175 r l + Date Ready/By: Juris: ® See Page 2 for
CITY , fr��
Internet: www.tigard-or.gov `_3ut 6 a ,i,n,P 1 Notified/Method: Supplemental Information
BUtLDli I,> „r
I ,. x ,,,,,;(1.:TYPE;OFA ` ,I , REQUIRED 1:04 :11 AN —0
D ,,tNIII. D iVE 1G
❑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 0 Other: equipment,materials,labor,overhead,and the profit for the
�< ,,,4 x work indicated on this application.
1. , NCATE `.,o-. ° C07,VSTRUCTIO ,I ,;•,,
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
, r: rt" JOB•SITE INFO' TIONAND CATION zoo ,,p < Total number of floors:
Job site address:15883 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:1388 SPEC SPC Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQ f I D 4DAT.- 41 MERC 'USE CKL14ST 1
'
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
tI ;SCRIPTI a OORK a t work indicated on this application.
Add and relocate fire sprinkler heads as required for TI Valuation: $$1,200.00
Existing building area: square feet
New building area: 0 square feet
❑ PROPERTY OWNERt e A'` 0 TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: LIGHT
Phone:( ) Fax:( ) New: tl
= # `APPLIC, ilit CONTA RSON ,,,,r-. CE :� =
)-
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
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
CO CTOR IA *
r. . , r, 4. . - ,• - 1,,,:$ :„ A-,. .,,, F BUILDING PE IT:r FEES...
,,
Business name:Wyatt Fire Protection
Ptease refer toe sr scheduler
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.) i
CCB lic.:64077 Total permit fees:
Amount received: !d(9. 78
Authorized signature: /�
This permit application expires if a permit is not obtained
Print name:Max Colley -'--- Date:11/23/16 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
It)esribe woro be-done: k ' 7
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: 2
Additional description of work:
acid'ofS ste ni lete ,B or'D as a licable :, i
Conme is prinkl t `
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group LIGHT
Density 0.10
Design Area 1500
K.Factor 5.6
Sprinkler Project Valuation: $ 1200
4 TypeI 11Iooc Fire So essi. n System''- fi r p, £; ' w
Hood Project Valuation: $
Ci Ft -Alarm ., g = 2- :
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
' Fire Alarm Project Valuation: $
D:`) Residential Sprinkler(S nd Alone System) # „,4-
Square
,
Square Footage: Permit Fee: *”
Oto2000 $198.75 ;'
2,001 to 3,600 $246.45 4'4777 .77
3,601 to 7,200 y
$310.05
7,201 and greater $404.39474.4.4.747_71
,�
Sprinkler Project Square Footage: sq. ft.
'. :, r Fire Protection e*1t-Fees ;,....!:4-V,..,- ; ,
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
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15883 SW 72ND AVE, TIGARD, OR, 97224
Record Type:
Commercial - Fire Protection System
Inspection Type:
999 Sprinkler final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
FPS2016-00199
Inspector:
Chip Barnett
Contractor