Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 I COMMUNITY DEVELOPMENT Permit #: FPS2011 00031
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2011
Parcel: 2S113AC00101
Jurisdiction: Tigard
Site address: 16655 SW 72ND AVE 300
Project: Food Sales West Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Fire supression system for for type 1 hood.
Contractor: GUARDIAN FIRE PROTECTION Owner: PACIFIC REALTY ASSOCIATES
1012 SW A ST 15350 SW SEQUOIA PKWY #300
CORVALLIS, OR 97333 PORTLAND, OR 97224
PHONE: 541 - 752 -2258 PHONE: 503 - 624 -6300
FAX: 541 - 752 -4259
FEES
•
Description Date Amount
Specifics: Permit Fee - COM 03/18/2011 $102.20
12% State Surcharge - Building 03/18/2011 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 03/18/2011 $40.88
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Sm Sheet (up to 03/18/2011 $1.50
Occupancy Grp: B Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: 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 $156.84
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,200.00
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 ' ork is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you o follow t rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 .090. You mqy obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.3
Issued By: 1 - Permittee Signature:
ce, — --
l
Call 503.6b 7:00 a.m. for the next available inspection da
This permit card shall be • . 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 OFFICE SE ONE)
City of Tigard ,1>eh «�, . Received
1 11 ei
Date/By: 3 I / l( Permit No.: } �
3 / _ .. 5 I
• 13125 SW Hall Blvd., Tigard, Plan Review n�
Phone: 503.718.2439 Fax: . \\ Date/By: 3 he ff C�+� Other Permit: Peril -f Xr)�
T I Ci A K D Inspection Line: 503.639.4175 �` Dat Ready/By: .� . aria: Fite: Page 2 for
Internet: www.tigard or.gov * i.fa � ,,� Notified/Method: � I/� Supplemental Information
l
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
ddition/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 ,' ommercial/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: j W 5 9 S, K/, / 7).4 ,c9 e New dwelling area: square feet
City/State/ZIP: ( 9 , C9/6 s ' a� tt Garage/carport area: square feet
'
Suite/bldg. /apt. no.: � Project name: A 4s co 4- 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: 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.
/
- iel4 .� A/ F <4,-6.-- `, 4y60:71" 4y60:71" � Valuation: $ ,7--,?(V
� Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: ,ter All contractors and subcontractors are required to be
Contact name: C� A'J licensed with the Oregon Construction Contractors Board
� under ORS 701 and may be required to be lcensed in the
Address: ----e'9.-6-* w' jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State /ZIP: apply:
Phone: ( ) Fax:: ( )
E -mail:
//�� CONTRACTOR BUILDING PERMIT FEES*
Business name: ( � 1f R.✓ 6. p �. '
(Please refer t o fee schedule
tt77 Permit fee:
Address: <O (z S W , r
State surcharge (12% of permit fee):
City /State /ZIP: G9,( C/terilru 62 R 9 1/47 55 FLS plan review (40% ofpermit fee):
Phone: ( g4q) 75 u,....72..2. Fax: (5z,1 ) 7'5 - 59' (Due upon application.)
CCB lie.: Are s5 N5- 61 a / y Total permit fees:
Authorized signature: (2. Amount received:
Q (�,v� y This permit application expires if a permit is not obtained
Print name: s.4 . 4 ., pee ✓ U s ,,v I D within 180 days after it has been accepted as complete.
*
9 Fee methodology set by Tri-County Building Industry
Service Board
I:\ Building \Permits\FPS- PermitApp.doc 02/01/2011 440- 4613T(I1 /02JCOM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
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
El 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: I $ZO(70 c ;✓
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
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: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
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