Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENTIN
Permit#: FPS2019 00148
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/11/2019
Parcel: 2S113AD01800
Jurisdiction: Tigard
Site address: 16736 SW 72ND AVE B16
Project: Tonya Vonderaye Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS 5-1,
Project Description: Fire sprinkler permit: Relocating(2)sprinkler heads for TI. Affidavit submitted.
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 12/11/2019 $59.16
12%State Surcharge-Building 12/11/2019 $7.10
Type of Use: COM Plan Review-Fire Life Safety-COM 12/11/2019 $23.66
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/11/2019 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 0
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: $792.00
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.
Issued By: g7—r--;"......7 / 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.
s - .411
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
\ Ir Received ) t
iliCity of Tigard (�E w E DateB 9-EA Permit No.: f"7a , ♦L f•-•440 i
r 13125 SW Hall Blvd.,Tigard,OR 97E Plan Review
• : Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: "/,� - I•„t. A
TIGARD Inspection Line: 503.639.4175 DEC 112019 Date Ready/By: ions: EI See Page 2 for
Internet: www.tigard-or.gov Notified/Method: --j Supplemental Information
C'TY,QF TIGARD
w -,, * ;�0 RKY' REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTIONiii work indicated on this application.
Valuation: $
El1-and 2-family dwelling ❑■ Commercial/industrial
ElAccessory building ❑Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:16736 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:Vonderaye Interiours TI/ a 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: I 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
DESCRIPTION OF WORK work indicated on this application.
Relocate 2 heads to bring sprinkler coverage back to code Valuation: $792
Existing building area: 874 square feet
New building area: 0 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:1
Name: Type of construction:
Address: Occupancy groups:Light Hazard
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name: 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:
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection fP[ease refer to fee schedule)_
Permit fee:
Address:9095 SW Burnham
State surcharge(12%of permit fee): 1
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 lie.:64077 Total permit fees: L.p10_d'1
�µ a Amount received:
Authorized signature: t.---....---- ,, - ` j
C!" This permit application expires if a permit is not obtained
Print name:Tam Holland Date:12/11/19 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\PermitsWPS-PermitApp_031016.doc 440-4613T(1 1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done:
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:
Type of System Com lete A $ C or D as a ltcable
A.) Comm� " 'i; ,F, y •',; .
Sprinkler Type • Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line • Yes ❑ No
Hazard Group light hazard
Density 0.10
Design Area
K. Factor 5.6
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
Submittal all Battery Calculations '❑ Yes
include: Individual Component ❑ Yes
sh
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stanist!li-:,";;37,7":,w1L'4,7::
d � . � - y� -LL.�3 -
Square Footage: Permit Fee: c w y
0 to 2,000 $198.75 ` y
2,001 to 3,600 $246.45 .
3,601 to 7,200 $310.05 -
7,201 and greater $404.39
sq.
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
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:APermits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc2
City of Tigard Permit No.: F5;7f. 'f
r 13125 SW Hall Blvd.,Tigard,OR 9722 a E E I Y`�'E® I
s F� Phone: 503.718.2439 Fax: 503.598.1'. Date Received: /d- f/ f
TI GAR C3 Inspection Line: 503.639.4175
Internet: www.tigard-or.gov DEC 1 12019 By:
FIRE SPRIN. I �� ; ;1 t r4',VIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Vonderaye Interiors TI Occupancy:
Job Address: 16736 SW 72nd Ave Type of Construction:
Suite:
Contractor: Wyatt Fire Protection Phone: 503-684-9657
Number of Proposed or Altered Heads: 2
Type: SSP-QR Hazard: Light Density: 0.1
I, 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 o the sketch attached shall be available for all inspections.
�
Signature: Com/ - Date: 12/10/19
Print Name: Tam Holland
I:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1