Permit (115) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
14,
■ . COMMUNITY DEVELOPMENT Permit#: FPS2018-00127
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2018
TIGARD g Parcel: 2S113AD01800
Jurisdiction: Tigard
Site address: 16770 SW 72ND AVE B14
Project: Cedars Foods Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS 5-1
Project Description: Adding(8)new sprinkler heads in cooler. (Ordinary Hazard 1).
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 Fee-COM 10/03/2018 $102.20
12%State Surcharge-Building 10/03/2018 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 10/03/2018 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 10/03/2018 $1.00
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Dry
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 $156.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,925.00
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 OUNC by calling 503.2 .1987 or 1.800.332.2344.
Issued By: Permittee Signature:AAKAAA/ �, `
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.
Building Permit Application
Fire Protection System fiEGEIV;
FOR OFFICE USE ONLY
City of Tigard Received
ate g / 2 ,I Pew ) �10�7
• 13125 SW Hall Blvd.,Tigard,OR 97223 S E P 1 S 2 C 1 Ulan Review L ��
_ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �
Date �1
Ofr Other tt:eXjTeS
iF?
Inspection Line: 03.634175 Bl See Page 2 forTtGAR ) �' � I � �� teetho � /LInternet: www.tigard-or.gov Supplemental Information
BUILDNG
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❑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
work indicated on this application.
,,* Ct11r ESR � .' 2 €( (1I ,,
Valuation: $
1=11-and 2-family dwelling ❑■ Commercial/industrial
❑Accessory building El Multi-family Number of bedrooms:
0 Master builder 0 Other Number of bathrooms:
JOB ITE I O I€O Yom) AIIOI*1 x Total number of floors:
Job site address:16770 SW 72nd Ave New dwelling area: square feet
City/State/ZIP:Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Cedars Mediterranean Cooler Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED .TAoMER is C, tI~ST ,
Subdivision: 1 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
} Wdiri ” work indicated on this application.
Add 8 new heads in cooler(Ordinary Hazard 1) Valuation: $2925
Existing building area: square feet
New building area: 0 square feet
El P-i)▪) OW € I, tT ' Number of stories:1
. : ,$ , „ ❑
Name: Type of construction:III-B
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax ( ) New:
yI��+s N ON `
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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 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 I Fax: :( )503.684.9657
E-mail:a.nishihara@wyattfire.corrl
iiiiika
z ,..�...h t„ , m▪ .,,:#,;:,it ,...O, ;:ijoi ... ,- �r „,.,,,, ,. �$.., ,,. ff s ai ' t i 1. t t ' c.",
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Business name:Wyatt Fire Protection Permit fee:
Address:9095 SW Burnham
State surcharge(12%of permit fee):
City/State/ZIP:Tigard,OR 97223 FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.)
CCB lic.:64077 Total permit fees:
I
f ;7 if
Amount received:
Authorized signature: ( 1� t 7 ,
��fL '✓ ' This permit application expires if a permit is not obtained
Print name:Ashley NishiharaDate:9/14/2018 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pemsits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
I=1New system Number of sprinkler heads: 8 Number of alarm devices:
❑■ Addition or ■❑ 1-10 heads: Affidavit required and El 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 El 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:Heads in cooler don't qualify for affidavit due to Ordinary Haz. Occupancy
Sprinkler Type Dry head,wet system ❑ Wet ■❑ Dry
Additional Standpipes 0
Information: Sprinkler Supply Line El Yes ❑ No
Hazard Group Ordinary Hazard Grp 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $2925
Hood Project Valuation: $
IIVOSIMIIUOOOIRIPSVRCPIPMAIONPMNSOIISIIIIIINISNOIIOMIUIIUOTVVIIWMINONTZNIINNN
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Submittal shall Battery Calculations El Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
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Square Footage: Permit Fee: -AIOIIIIVZIIVIVMAZSITOARIVKTMIINPPXV
m f
0 to 2,000 $198.75 -oW �
2,001 to 3,600 $246.45 }
3,601 to 7,200 $310.05 atagilititinallignininnienatiMMIS
7,201 and I eater $404.39
Sprinkler Project Square Footage: sq.ft.
indllnnnttrVUISVMIP.aigLtf:'r.aiaagten,DNrIMZgSVSEINUMIESIM
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16770 SW 72ND AVE B14, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00127
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor