Permit (96) IL CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' COMMUNITY DEVELOPMENT
Permit#: FPS2017-00166
Date Issued: 10/26/2017
Tf(®a, fy"D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S133AD02200
Jurisdiction: Tigard
Site address: 12930 SW SCHOLLS FERRY RD
Project: Westgate Baptist Church Subdivision: None Lot: None
Project Description: Add(3)fire sprinkler heads underneath new shelf.
Contractor: WYATT FIRE PROTECTION INC. Owner: WESTGATE BAPTIST CHURCH
9095 SW BURNHAM 12930 SW SCHOLLS FERRY RD
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/26/2017 $59.16
12%State Surcharge-Building 10/26/2017 $7.10
Type of Use: COM Plan Review-Fire Life Safety-COM 10/26/2017 $23.66
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 10/26/2017 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: ORD1
Density: .15 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $90.42
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $750.00
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 e• C by calling 503.232.1987 or 1.800.332.2344.
Issued By: !_ Permittee Signature: -,
Call 503.639.4175 by 7:00 a.m.for the next available ins/ ion 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.
Building Permit Applicatio
RErvivED
Fire Protection System FOR OFFICE USE ONL\
Cityof Tigard ( r� �a ry Received ✓
g L !j[➢ ( Date/B : 0 �� /7 44' Permit No -.... 47::,,,,7.---(:) ,,,-67(/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' i Phone: 503.718.2439 Fax: 503.59 ARD Date/B : Other Permit:
TI G A R D Inspection Line: 503.639.4175 .�OF IIp Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov j; iq�j1�1 ��t� F ON Notified/Method: Supplemental Information
. 'F , TYPE OF W Iikl� t $y tt.4, T E UIRED DATA -AND 2FFAMILY DWELLING
❑New construction 0 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
-1, ` 't 4 ''14,r :; work indicated on this application.
a l TEGORY OF C,,,x4 TR CTIO z,,. _ _ 4,,y_ PP
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
Iva** t ?' ; Total number of floors:
JO SITE,I IFORMATION'AND OCATIO N
Job site address:12930 SW Scholls Ferry Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Westgate Baptist Shelf Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
'REQUIRED DATA:COM4RCIAIrUSE CHE(I{LIS
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
*Al? 7 y work indicated on this application.
,�yF < �t �DDB�SCRIPTION;OF, 4'ORI{ �•
Add fire sprinkler heads underneath new shelf Valuation: $750
Existing building area: square feet
New building area: square feet
❑PROPER C1 OWNER r ",1:1 TENAN _ ' ; Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
, " El APPLICANT =„0:3. 1u i4 CONTACT PERSON44 N TICS
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 St 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
F *
. ,, CONTRACTOR v BUILDING PER SIIT FEE *It; ',' ' "
(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 submittal.)
CCB lic.:64077 Total permit fees:
� � --—_____— Amount received: 940 i V.2-.-
Authorized signature:
This permit application expires if a permit is not obtained
l' Date:10/20/2017 within 180 days after it has been accepted as complete.
Print name:Max Colley
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp 031016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
ftitcribewtob done ' .51, ,-(
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 2 Number of alarm devices:
® Addition or ® 1-10 heads: Affidavit required and ❑ 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 ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
';414 Cystem(Complete B,C or D as apphe Ie). ,
Az a me ta1 Sp x '' F$,
w
j.
ankle
Sprinkler Type ® Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Ordinary I
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 750
. �t'Type I- Hood Fire Suppression Syst, .ft ` tT . :. „,,,,i,3,;,,,,,,,-„,- ;
Hood Project Valuation: $
.,
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
.1 til! i
. p i er,
D.) Residers 1 S
( tand Alone Sy-IC )
Square Footage: Permit Fee: 33 ”
0 to 2,000 $198.75
'332,001 to 3,600 $246.45 RR '
z
3,601 to 7,200 $310.05 �4 3 . 3 ,
7,201 and greater $404.39 ', i;; r: 4.3 ' ',:
Sprinkler Project Square Footage: sq. ft.
. 1 ., Fire Protection Permit Fees 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: $
W:\Max\1112 PERMIT APPLICATIONS\Tigard App.doc 2
City of Tigard Permit No.: /54).....(;20/7 — C 4
13125 SW Hall Blvd.,Tigard,OR 97223
:11111 I Phone: 503.718.2439 Fax: 503.598.1960 Date Received: /�/ //7
T I G A R D Inspection Line: 503.639.4175
Internet: www.tigard-or.gov By: /017
FIRE SPRINKLER AFFIDAVIT FOR ALTERATION ECEIVEDA
OR TENANT IMPROVEMENTS 0 C h 2 6 2017
(1 to 10 SPRINKLER HEADS WITHOUT PLANS) CITY®F T
IGARD
BUILDING DIVISION
Project Name: Westgate Baptist Shelf Occupancy: Ordinary 1
Job Address: 12930 SW Scholls Ferry Rd Type of Construction:
Suite:
Contractor: Wyatt Fire Protection Phone: 503-684-2928
Number of Proposed or Altered Heads: 3
Type: SSP Hazard: Ordinary 1 Density: 0.15
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 sprinlder 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 sprinlder 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: 10/20/2017
Print Name: Max Colley
1:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12930 SW SCHOLLS FERRY RD, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00166
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor