Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
■ _ COMMUNITY DEVELOPMENT Permit#: FPS2017-00023
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/06/2017
T r c ;+ li T3 13125 Parcel: 1S135BC00700
Jurisdiction: Tigard
Site address: 10795 SW CASCADE AVE
Project: Arcadia Design Subdivision: None Lot: None
Project Description: Fire sprinklers-Adding(1)sprinkler head
Contractor: WYATT FIRE PROTECTION INC. Owner: CASCADE FUTSAL LLC
9095 SW BURNHAM 5010 NE OREGON ST
TIGARD, OR 97223 PORTLAND, OR 97213
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/06/2017 $53.78
12%State Surcharge-Building 03/06/2017 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 03/06/2017 $21.51
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 03/06/2017 $9.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard: LT
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 $91.24
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $525.00
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 que s o UNC by calling 503.232.1987 or 1.800.332.2344.
Issued B / Permittee 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.
City of Tigard Permit No.: A03 v 7-cOQ?3
13125 SW Hall Blvd.,Tigard,u12.
■ Phone: 503.718.2439 Fax: 503.598.1960 Date Received: c3/40// 7
Inspection Line: 503.639.4175 P•I' ;d a ,'O
TIGARD p w ' Alf
Internet: www.tigard-or.gov By: G
FIRE SPIUNkLER AFPtAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Arcadia Design Add Head Occupancy: Light
Job Address: 10795 SW Cascade Ave Type of Construction:
Suite:
Contractor: Wyatt Fire Protection Phone: 503-684-2928
Number of Proposed or Altered Heads: 1
Type: >$15(,0 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: 3/3/17
Print Name: Max Colley
I:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1
Building Permit Application
Fire Protection System FOH OFFICE 1 SE ON LI
71
Received
City of Tigard
.4 13125 SW Hall Blvd.,Tigard,OR 94-2 '''' " ;
Date/B
I Phone: 503.718.2439 Fax: 503.598.1960
il % -- , IMIIFMA.M1
: MI
Plan Review
Date/B : Of ,- Permit No.: Ai , •,7-0642-3
Other Permit: 64-L-12470 /0-450-7:
TIGARD Inspection Line: 503.639.4175 I SS l,i: Date Ready/By: Reis 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
I :' 1
Typk0R.k4thilitrqtai i--)i\fl°5 V Wil.,16: '''` ''/4-QUlltiD:PATAi l'"AND 2-FAMMY D*E- LLING
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
lEi Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION ,,!,4.: 1,,, 74.1I,',.--"' work indicated on this application.
Valuation: $
0 1-and 2-family dwelling CE]Commercial/industrial
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10795 SW Cascade Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Arcadia Design Add Head 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 work indicated on this application.
Valuation: $$525.00
Add(1)Head in riser room
Existing building area: square feet
New building area: 0 square feet
El PROPERIV6Eit 4,:fae 0 TENANT ''''''' I: ' Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: light
Phone:( ) Fax:( )
-New - - -" —
- ..
APPLICANT, ,',i:,. . r'' l':-' ' El CONTACT PERSON,
NOTICE
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
applicant is exempt from licensing,the following reasons
City/State/ZIP:Tigard,OR 97223
apply:
Phone:(503)684-2928 Fax::( )
E-mail:m.colley@wyattfire.com
CONTRACTOR ,,,,--- 4 - ' ''' BUILDING PERMIT FEES*
(Please refer to fee schedule) -
Business name:Wyatt Fire Protection
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lie.:64077 Total permit fees: L
00
Authorized signature: P.--
„ .."*.'"°. Amount received: 14 e7/,'3*-Y
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Max Colley Date:3/3/17
* Fee methodology set by Tri-County Building Industry
Service Board.
FBuildingTermitsTPS-PermitApp.doc Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
bribe work to ice:done:+
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: 1
Additional description of work:
TP ., S stem (Complete A,B,.0trD u
A.) ComrYiercial Sprinklers ~. ,
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group light
Density 0.10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 525
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: 4.444, 4.Mm44
$
&14) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D. Residential Sp rinkler(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 4,zi� � r.;�.
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10795 SW CASCADE AVE, TIGARD, OR, 97223 March 8, 2017 at 1 :19:45 PM
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00023
Inspection Type: Inspector:
999 Sprinkler final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor