Permit 'PI 41 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2022-00144
Date Issued: 12/8/2022
TIC A R r) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S112DD00900
Jurisdiction: Tigard
Site address: 15690 SW UPPER BOONES FERRY RD
Project: Tigard Towneplace Suites Hotel Subdivision: None Lot: None
Project Description: Install FDC and 25 FT of stubbed fire line as part of PHASE ONE for future PHASE TWO.
Contractor: INTERLAKEN INC Owner: BHGAH TIGARD LLC
PO BOX 2010 5895 JEAN RD STE 100
FAIRVIEW, OR 97024 LAKE OSWEGO, OR 97035
PHONE: 971-404-9244 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/08/2022 $156.00
12%State Surcharge-Building 12/08/2022 $18.72
Type of Use: COM Plan Review-Fire Life Safety-COM 12/08/2022 $62.40
Class of Work: NEW Type of Const: VB Info Process/Archiving-Lg$2.00(over 12/08/2022 $2.00
Occupancy Grp: R-2 Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: No Hazard:
Density: 0 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 $239.12
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
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 Of,952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: �� Permittee Signature: C "- �__i�. -
9
Call 503.639.4175 by 7:00,4.m.for the next available inspect on 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 FOR OFFICE USE ONLY
Received
City of Tigard natDate/By: I( aZ y Permit No.: TQS�4A ooI H
• 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 0 2 2022 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: .a, Other Permit:
1111^
T I G h tt D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: � }r } 7wi%: See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information&v,,,a,1 1 Ili ) i)- f. ►-
TYPE OF WORK REQUIRED DATA: 1-AND 2-FAMILY DWELLING
XNew 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 CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling Commercial/industrial
ElAccessory building ❑ Multi-family Number of bedrooms:
❑Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: Is�DnO G,"� vP( Ui+ES Vc �� New dwelling area: square feet
City/State/ZIP: T\C9 Pstz..7 C'2F.0 - Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:—TCWcctrt.A.c,c S.aswz.,4, I Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
�.1-..) SEQttb 1-A -%!',.c'' Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
�r Valuation: $
1r«'SC�� FOG. k `PAX 25 litk -A� c—eyc STta5 �,
S `FIlai r:c ID S(rC,E- \ FpQ �wT' J . C�ritt�Z-�V>rf Existing building area: square feet
l c* p � Z New building area: square feet
`) PROPERTY OWNER 0 TENANT Number of stories:
Name: "tickG Q,k..k, —\.0 p,V-A-- L,_c__ Type of construction:
Address: is,, `c �x., s--,-c `tj c Occupancy groups:
City/State/ZIP: 4:725,,,_$'CvO r c Z V e:73'' Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON NOTICE
Business name:..kr.s<-2t-1, Ce4yt,- Quz„,,nc,,{ ( t.,ki-A I-O cic W rL 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: -Z-L t k VA S--12-t- ^ jurisdiction in which work is being performed.If the
�Z A, G1'C _ applicant is exempt from licensing,the following reasons
City/State/ZIP:
t �- ��04 apply:
Phone:(SD3) 0V 4' _\\ 3, Fax::( )
E-mail: .pi,\cs,r'S Exi � Ia,+s crk eot,�i rLw'T aek ce3-cp&re • c t9 M_
CONTRACTOR BUILDING PERMIT FEES*
Business name: IyL�cE� (Please refer to fee schedule)
Permit fee:
Address: ^p-e,- 2,e=\O
City/State/ZIP: � ' `�pt State surcharge(12%of permit fee):
Q\iC ev -), C b - FLS plan review(40%of permit fee):
Phone:( 52,)Li'J 21‘..-- eiru D Fax:( ) (Due upon application submittal.)
CCB lic.: UJ C>k Total permit fees:
Amount received:
Authorized signature: ,�__
This permit application expires if a permit is not obtained
Date: k.C. \ within 180 days after it has been accepted as complete.
Print name:
't"t� �"� * Fee methodology set by Tri-County Building Industry
Service Board.
t:113uilding\Permits'FPS-PermitApp_031016.doe 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist RECEIVED
Page 2- Supplemental Information NnV 0 2 2022
Describe work to be done: C TY OF TIGARD
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration lr /W s�
New system Number of sprinkler heads: 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 (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler x a 3�3 mi l# ra'-+ hwe-now'X'srr s v +
Sprinkler Type ❑ Wct ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line El Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75 , . „ e wt r .
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
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: $
I:\Building\Permits\FPS_Pen JtApp_031016.dnc 2