Permit CITY TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT DATE SSUED: 77/ 2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114AA-00200
SITE ADDRESS: 16285 SW 85TH AVE 103 ZONING: I -P
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT: JURISDICTION: TIG
PROJECT: CHEZ GOURMET
Project Description: Fire suppression for Type I hood.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: Fl TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,850.00
Owner: Contractor:
BIRKEMEIER, BRENT T /JANET D TRS UNIVERSAL FIRE EQUIPMENT
BY THE BIRKEMEIER FAMILY TRUST 8049 SW CIRRUS DR
10573 SW NAEVE ST BEAVERTON, OR 97008
TIGARD, OR 97224
Contact #: PRI 503 641 - 8702
Phone: FAX 503 - 643 -1472
Reg #: LIC 86723
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/13/2007 $62.50
[TAX] 8% State Surcha 7/13/2007 $5.00
[FLS] FLS Pln Rv 7/13/2007 $25.00
Total $92.50
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 than 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 -0100. You may . ain a copy
of thes- -. -s • -ct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Is ued By: I 0 file I.-al Permittee Signature: I _
Call 503.639.4175 by 7:00 a.m. for an insp • that b mess day.
This permit card shall be kept in a conspicuous place on the job site un i completion of the project.
Approved plans are required on the job site at the time of each inspection.
li Building Permit Application
Fire Protection System - FOR OFFICE USE ONLY
City of Tigard Date/By: ? �� 4 7 I' Permit No.: o l 7 y )367
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R U Inspection Line: 503.639 Date Ready /By: ! JW! ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: I i Ur Supplemental Information
TYPE OF WORK 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
g . Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
( CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling X Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / Z�j S 5 sat,) T3- T A ve, 4193 New dwelling area: square feet
City/State /ZIP: / P, y7 rt� p - o p -/ 7 2 23 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name:.' A e a 6 ' 0 4 rt'r'y ..4- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
D tz r ` -71- J,- -`f 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.
Valuation: $ 1 9"5b of
4..fri s- 1-- ‘25 -,-, ci.zP /$ ro C 4 ee-N
PL / 3 e,-v P--Q5 /_ -1 c--)A-0.._ Existing building area square feet
S / °) IC cY+� n g 6 ,P1---%._ . New building area: square feet
w ✓ P
PROPERTY OWNER ,TENANT Number of stories:
Name: , 4 rr e ems S e •-'‘ Type of construction:
Address: J (� 2 d S gc- Ave . Sce !k /0 � Occupancy groups:
City /State /Z1P:7 7 O Ifs 77 2 23 Existing:
Phone: ( ) Fax: ( ) New:
A APPLICANT A CONTACT PERSON NOTICE
Business name: GLh I d 5 i _ L % „ fi c . All contractors and subcontractors are required to be
Contact name: 6— tL � licensed with the Oregon Construction Contractors Board
`� under ORS 701 and may be required to be licensed in the
Address: 4' Q 41 , C /"Cf � S V c; jurisdiction in which work is being performed. If the
�� 70-0 applicant is exempt from licensing, the following reasons
City /State /ZIP:
)� _I � 0 l� ! 7� apply:
Phone: ( , O 3 6 c G! — 7 7 Fax:: b ,c Y 3 - / Y 7 Z
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name d 1V e r -, ( fl r �1 n ee 4- (Please refer Permit
c �,/ /� / Permit fee:
Address: AQ Gcl 5.,4? ` •NY�ts C
State surcharge (8% of permit fee):
City /State /ZIP: 73 e- tU e.r—S'01 Q _ 9 7 c. FLS plan review (40% of permit fee):
Phone: (� 6 (/ (, - Z Fax: 16 ,3 0 ce .� .4 t 77 (Due upon application.)
CCB lie.:
8'67 2 3 Total permit fees:
Amount received: �� 7
Authorized signature:
This permit application expires if a permit is not obtained
Print name; _ . Date: '7 �`� within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1:\Building\Permits \FPS- PermitApp_doc 03/23/06 440 -4613T(11 /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be do ne:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: 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 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
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 (8% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
I: \ Building \ Permits \FPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00367
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1312007
Phone: (503) 639 -4171 4u i�' (
Inspection Requests (24 Hrs.): (503) 639 -4175 AI!.
INSPECTION WORKSHEET FOR DATE: 8/1 /2007 TI : 7 :03AM PAGE: 59
SITE ADDRESS: 16285 SW 85TH AVE 103 CLASS OF WORK:
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: CHEZ GOURMET
DESCRIPTION: iiM11111 for Type I hood.
OWNER: BIRKEMEIER, BRENT T /JANET D TRS, PHONE #:
CONTRACTOR: UNIVERSAL FIRE EQUIPMENT PHONE #: 503 - 8702
Inspection Request Scheduled For: Date: 8/1/2007 Pour Time:
Code Insp esc_ription Confirm # Contact # Message
X96 Misc. e i �[W [ 55 L-0.1," L-0.1," ` Dins is C 053129-01 503-641-8702 N
46 n
r
Corrections/Comments/Instructions: /)
4 4, 1 "U) 19 `) - 00 5 (I F. 1 A j / 1 , a
..------ M -C- --- CO - 0 6 ( C iC, e ._.:c s _____( o\ye.Qr)
, ctAA,
tric--
rte'
&A - 4k 5 I _
A L_
elliFiliiip.
A
�k
o f OA
/ ,
7
4 411
PASS ❑ PARTIAL APPROVAL [CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: k%47 (j C Date: Fl k /C ) Phone #: (503) 718- 2-1/41z /