Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
t COMMUNITY DEVELOPMENT Permit#: FPS2021-00129
Date Issued: 11/3/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CC01100
Jurisdiction: Tigard
Site address: 13680 SW PACIFIC HWY
Project: Tigard-Orenomah Lodge Subdivision: None Lot: None
Project Description: Installation of suppression system in kitchen hood.
Contractor: PYE BARKER FIRE&SAFETY LLC Owner: TIGARD-ORENOMAH LODGE#207 OF AF&AM
18260 SW 100TH CT PO BOX 230184
TUALATIN, OR 97062 TIGARD, OR 97281
PHONE: 503-691-9000 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/02/2021 $112.96
12%State Surcharge-Building 11/02/2021 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 11/02/2021 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 11/02/2021 $62.50
Occupancy Grp: A-3 Height: ft 11x17)
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type.
Pull Station Required: Smoke Detectors Reg:
Battery Calcs Provided: Cut Sheets Required:
Total $234.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,250.00
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
Issued By: He L Va.vi.-De Wege, Permittee Signature:
OwApr-Lit-0,6-01A-
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 RECEIVED
J
�/ ED
City of Tigard OCT 21 2021 aewB /D 2l 20Z/ G/'SZ1J.Z1-I0/29
Permit No
1413125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.19 Date By: 1 _a Other Permit:
Inspection Line: 503.639.4175 '"�TY )� i llaa�tll�t�' Date Ready,B Juris: 2
f IC,11'1� p BUILDING DIVISION N •' ed`Meth3 11 ®SIemental Information
Internet: or
www.tigard-or.gov �/`GL` //` 1 l PP
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NtNew construction ❑Demolition Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑.\uditionalteration/replacement Cl Other: equipment,materials,labor,overhead,and the profit for the
CA4u et'1t' ti,1 a i i work indicated on this application.
.• Valuation: $
0 I-and 2-family dwelling 5 Commercial/industrial
❑ Number of bedrooms:
Accessory.building ❑Multi-family
0 Master builder 0 Other: Number of bathrooms:
rt t t ,t'+.a :. Total number of floors:
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Job site address: 'aA.0tip cw .10,1,t L N.Cq\')1'Ua-k New dwelling area: square feet
City/State/ZIP: -1 qa i1 A , of. 01.1'?-)-� 1 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Tigard ()'e 1L � T)}�,,e Covered porch area: square feet
Cross street/directions to job site: i r t U19+ , Deck area: square feet
Other structure area: square feet
4r1t.i.3 € 3iilriit332,,,b,:o r g,l.nt,,,,,41,,rq sri.ii.4Pitii1M14i l:
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
r fi%
equipment,materials,labor,overhead,and the profit for the
)'Anrr,x)fi 1i, `171 > y '11'1. .rirr work indicated on this application.
tis,,. mfr„>c6 a.ara lass x o-#. .. «Z H�e�-#F _
1.-�r�51 ttGt1l7 4`1 CA f'lv'e sU,c vvcS1( 11 ` y�e.r 114( Valuation: $ �JU
v cv r v hOOU Existing building area: square feet
New building area: square feet
4,k; Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) I. { New:g }y t till
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Business name:ptie, (�tt u f 1re -{• sateiii All contractors and subcontractors are required to be
Contact name: 1q p 3f �� �j��ln �� licensed with the Oregon Construction Contractors Board
v� t� i Y under ORS 701 and may be required to be licensed in the
Address: 0 Sp I01)kh LA jurisdiction in which work is being performed.If the
City/State/ZIP:IVAt�,ti y\ Gf,. gi to applicant is exempt from licensing,the following reasons
apply:
Phone:(`'h'3 ) (Q`"i(,` -CI f�V ) Fax::( )
E-mail r • + , S t
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Business name:p�t {Y i.1 L i A f Permit fee:
Address: I(v�L,J ,7*l IUt&4V") C.L ----
City/State/ZIP:�1 kh OL-h kZ nK G-tou, }5• State surcharge(I 2%of permit fee):
FLS plan review(40)/0 of permit fee):
Phone:(c3c ) (QC1 L1 Fax:( ) (Due upon application submittal.)
CCA lie.: 7n Total permit fees:
Authorized signature:'( A � t'i Amount received:
X [[[www���-��_ +` i This permit application expires if a permit is not obtained
Print name: -' ?U Date: io IhG 1 �3--1
' within Iti(1 days after it has been accepted as complete.
Fee methodology set by Tri-County Building industry
Service Board.
1.,BwWing`Yermas;FPS-PemutApp_071010 dnr 440-4613T(t I/02/COM'WEB)