Permit (145) CITY OF TIGARDFIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2018-00152
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/24/2018
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9520 SW WASHINGTON SQUARE RD H06
Project: L'Occitane Subdivision: None Lot: None
Project Description: Fire sprinkler permit:Altering(3)sprinkler heads for TI. Affidavit submitted.
Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE LLC
9095 SW BURNHAM PO BOX 847
TIGARD, OR 97223 CARLSBAD, CA 92018
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/24/2018 $51.09
12%State Surcharge-Building 10/24/2018 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 10/24/2018 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 10/24/2018 $0.50
Occupancy Grp: Height: ft 11x17)
Stories: Permit Fee-COM 10/24/2018 $51.11
12%State Surcharge-Building 10/24/2018 $6.13
Plan Review-Fire Life Safety-COM 10/24/2018 $20.44
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
Density: .2 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 $155.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,110.00
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 503.232.1987 or 1.800.332.2344.
r
Issued By; Permittee Signature: l�y--7-
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 Application
A lication
Fire Protection SystemFOR OFFICE USE ONLY
City of Tigard
Date/B
Received fes,, �
fill lt/� Permit No.: _/ l
Iii
" 13125 SW Hall Blvd.,Tigard,OR 97223 r e 1\ Plan Review
C
■ Phone: 503.718.2439 Fax: 503.598.1960 �� ' Date/B : Other Permit: • I. q
T 1( ARI) Inspection Line: 503.639.4175 S fit`"t44t Date Ready/By: IIEMEi See Page 2 for
Internet: www.tigard-or.gov V A t ..Notified/Method: Supplemental Information
CAIN
:" TYP OF+ {a < REQUIRED DATA` AND FAMILY WE
❑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
CATEGORY OF CON .0 TION work indicated on this application.
❑ 1-and 2-family dwelling ❑■Commercial/industrial Valuation: $
D Accessory building ElMulti-familyNumber of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
MTotal number of floors:
i
;t�Iilf 1E?Ull�tA1l'l�C) '�LfJCA:i`I171V .. . ..
Job site address. SW Washington Sq Rd Space#6H New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:L'Occitane Washington Square Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED IDATA COMMERCiAr/I3S CHECKLIST
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
, ��TIO . 'WORK work indicated on this application.
Demo/Raise 3 heads for TI in Commercial Space to maintain NFPA 13 Valuation: $2110
coverage Existing building area: square feet
New building area: 0 square feet
'R3PRIk R ❑ T Z Number of stories:1C _
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
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 Fax::( )503.684.9657
E-mail:a.nishihara@wyattfire.com
C +ORBUILDINGYER E.. * `'
«r..... . , .Kfto. ertof sci dine i:. ...... ..
Business name:Wyatt Fire Protection
Permit fee:
Address:9095 SW Burnham
City/State/ZIP:Tigard, OR 97223 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.) r
CCB lie.:64077 / ' Total permit fees: '.2 '''...,HO
ll
1..fi/xj...„ImitAstA.,a' Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Ashley Nishihara Date:10/24/2018 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-Pe mitApp_031016.doc 440-46131(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
PageSupplemental
p} 2- jyInformation
ynf
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 3 Number of alarm devices:
❑■ Addition or D 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:Not Light Hazard. Does not qualify for Affidavit
T f.S s m (Cgmj ete` 1,B;,C ar. as appli able):,,,
14) Co inetcMl p: Ole
Sprinkler Type ❑ Wet ❑., Dry„ „ ,
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
$,,,` '
.,..ikI 0d� e uppresian iate•Ak„,,....ng+. t.,,windo,,Aitsmsoa_ , „ .,,.,, m+;
Hood Project Valuation: $
Submittal shall Battery Calculations ❑ Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
l +`#v U !+A v {" Y +. �.. 0. ,....
d iTer4a5nu in ri� Q.�t�3s 4P�tat .T+7i�ir�l�
mi
Square Footage: Permit Fee: r o r q )i T- a :� t 'i
0 to 2,000 $198.75 0600090.6ttOWSWOROANWAROPiatinfigi`
■ 2,001 to 3,600 $246.45
3,601 to 7,200 $310.05 vOMPROWiimen
7,201 and greater39
404P e.
$ . . _: , >, .':,,,, -4 -gay° *_
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 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
11111 City of Tigard Permit No.: P i/f.- 00i 5-63
13125 SW Hall Blvd.,Tigard,OR 97223
M Phone: 503.718.2439 Fax: 503.598.1960 Date Received: Avokiiii r
TIGARD Inspection Line: 503.639.4175 �-y�-�
Internet: www.tigard-or.gov By: Q -, ,ti JGGr�
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: L' ® C/('i\ \-Gu .IL@./ �� . Occupancy: V
Job Address: 9 S L (,l cl,sWAty 1p Type of Construction: ---k in .,5tr.1•.--‘,t—r-__S
Suite: irk- e
Contractor: c 0.) Porc_Phone: 503 . t,‘' (d84_ 2.128
Number of Proposed or Altered Heads:
Type: Hazard: Z C 2%n Density:0- 1.0
I, cokkW C.64JL-- Oregon Construction Contractors Board No.
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: 4 ejk131Q Date: ` / 4 je
Print Name: 5o_e'..Xi
I:\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:
9520 SW WASHINGTON SQUARE RD H06, November 21 , 2018 at
TIGARD, OR, 97223 9:42:57 AM
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00152
Inspection Type: Inspector:
999 Sprinkler final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor