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Permit Er CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2006 -00558 COMMUNITY DEVELOPMENT DATE ISSUED: 11/29/2006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S110AA -00300 SITE ADDRESS: 14145 SW 105TH AVE ZONING: R -12 SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Fire suppression system. 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: 14 ft GARAGE: sf OCCU SEP. RATED: BSMT ?: N MEZZ ?: N REQD SETBACKS REQUIRED FLOOR LOAD: 50 psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING: VALUE: $ 2,200.00 . Owner: Contractor: PACIFIC HEALTH AND REHAB CASCADE FIRE SAFETY 14145 SW 105TH AVE PO BOX 244 TIGARD, OR 97224 VANCOUVER, WA 98666 Phone: 503 - 639 -1144 Contact #: PRI 360- 695 -9212 FAX 360- 695 -3286 FEES Reg #: LIC 74415 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 11/21/200E $72.10 [TAX] 8% State Surcha 11/21/200E $5.77 [FLS] FLS Pin Rv 11/21/200E $28.84 Total $106.71 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 obtain a copy oft e rules or dire ; uesti. u Pe rmittee Signature: j�� us to OUNC by calling 503.246.6699 or 1.800.332.2344. I i- fr G Is ued By: X �--- Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. V/02/2006 15:03 FAX 5035 8199601 ' / CITY OF TIGARD 0001 Fire Protection Sysite � 1J `a's , � Buildine Permit Application RECIVE I Ok clrhlc I. c tit: clNl,l 114 Ci of Tigard Received I d Permit 1V°-. j k,„4„ • 13125 SW Hall Blvd., Tigard, OR 97223 � )1' i i M 2 0 L�QO p� , pe j / Phone: 503.639.4171 Fax: 503.598-1960 ' Date/B . Other Pe ''L FIG I. <, Inspection Line: 503.639.4175 CITY OF TIGARD Data Rcady/Br• / /� Mir 13 See Page 2 for I nterneww.tigard- or.gov BUILDING DIVISION- t'ficd/M°fh:'' v " f Supplemental Information C w' C i �• �,,.- k . � ,., Pt• Hy. >oyy aal�e 5 r � Y ` i y w' '.�1� ^•`� ' ". � • <r �1'__ Mi �!"�° . '�• ��>•J�,�'�l['���1.7�; r • j ,'19',}t � > «i. . "' . • 'A �a a . Y III JSf° . P'�1h'�h: µ ` ''', ❑ New 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 '' tcoa YIo1r coN ue o I r r , *,' work indicated on this application. ❑ I- and 2- family dwelling ' Commercial/industrial . valuation: S e ❑ Accessory building ❑ Multi -family Number of bedrooms: — ❑ Master builder T 0 Other: Number of bathrooms: .1 ' ,r ''ip , •„,, ` " n rr ' Total number of floors: • Job site address: j 4 i y S S . Vd , ‘,3s-** NI New dwelling area: square feet Cit '-"r �a4-2) i •T • Garage /carport area: square feet Suite/bldg. /apt. no.: _ Project name: ..c? , t_ UMh e... ( ..z 1 t\tib _ Coveted porch area: square feet Cross street /dircctiona to job site: Deck area: square feet E06} Q CI ° 1 W ,ti 10 SA*‘ I bloc k -- kwI.: v. '7 - l 1 (11m--t- Other Structure area: square feet Subdivision: Lot no.: Permit fees arc 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 x` �;.,,� ` : �. r °' •; work indic on this a li ., . , '�' ', � ' ID� � '>1�0� �Ir'':•1tN0 &K ^ ��� 'd • indicated 0 application. • -∎* - � to Skct l) et4rain &S 4.- 14 gr c�t.n•t , \14 a e � ( fin:. e ea ��Z �- civ,4.. Valuation: $ � . �)© 'ci. Sr.1 ficccs.�� ShcAtIN, rc1�N •+sP\ kil _J� Sl �i Existing building area: square feet n`t.. cv S New building area: square feet Y :� ,.I i , , , ,,. �.,:.. V,. + «•'� '� .; wu_� � Number of stories: y. Name: c _, , ` \\•Q\-NAN eA l O ANwb Type of construction: S Address: \4\ 4 S 5 • cty . 1 � --- p e.- _ Occupancy groups: T City/State/ZIP: - ^`' ‘ , )q ,, 1 .-, Existing: Phone: (S (, 3 C1 - \ \ % 'A Fax: (5 ) (eat ....._,,at, ' New: r Y , �.FPC7ellaIin ' ° , tl F]y.�ca it ]e b . c V,.` rT + i Business name: c .� ., . �S<Ac r J:-_ ��t* .\ All contractors and subcontractors arc required to be Contact name: O‘h II-. c otv licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Addr ess: \ \,t7 VJ . %t " St t — p • • Q4X Qy L( jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/State/ZIP: V eNn Cuv.V tY v - G\ c o la (o )) _ l_ apply; Phone: (3t [ 6G)._. O1 ( a � 1 l Fax:: (i,(�) (fj - SQ5S 4 E Sc.cs- 't .- t '° ‘ �k,gy . sz - -- .' :... `:, a , _,, ;i'gCflI >. t c , y . � ::l� w., $L ° � r S" �y� '� ' ::t / . ,�. \ (^ , ,,i tc °�:y :; '47ti:.`. ,1 iOrafr'it i J Sty Business name. Permit fee: .. 7a, Address: \ \ V.j . $}' 9- i=s, • X aL\L` State surcharge (8% of permit fcc): .1', . City/State/ZIP: V q « . ° b (0 (e )� � c 1 FLS plan review (40 °/4 of permit fee): o ,`� ® Phone: (•31,.. 6Do -. ( ..\ a. ax: ( ∎ 0 �a S - .Q- � , _ (Duepon application) ea o • CC$ lie.: -- _ - ._ Total permit fees: l �6 .1i Authorized signature: 4 �_ Amount received: �Z This permit application expires if a permit is not obtained I \\�� _ J within 180 days after it has been accepted complete. Print name: �av (4-c%..,-4-, Date: rP V • Fee methodology set by Tri -County Building industry Smdce Board t:\Buildingl amnia FPSPemitApp.duc 03/23)06 440.[6137t11 /02/COM/WP,B) City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 November 22, 2006 • i �O QF P� TIGARD Cascade Fire Safety Dan Morgan 1100 W 8 St. PO Box 244 Vancouver, WA 98666 RE: FIRE SUPPRESSION SYSTEM Project Information Building Permit. BUP2006 -00558 Construction Type: 5 -B Tenant Name: Pacific Health & Rehab Occupancy Type: B Address: 14145 SW 105 Ave Occupant Load: NA The plan review was performed under the State of Oregon Structural Specialty Code (OSSC), Mechanical Specialty Code (OMSC) 2004 edition and 2004 Oregon Fire Code (OFC) amended by Tualatin Valley Fire & Rescue. The submitted plans are approved subject to the following. 1. The automatic fire suppression system shall be interconnected to the fuel or current supply for the cooking equipment and arranged to automatically shut off all equipment under the hood when the suppression system is activated. Shut off valves or switches shall be of a type that requires manual operation to reset OMSC 509.4 2. Each automatic fire suppression system shall have both automatic and manual actuation means. A manual actuation device shall be located at or near a means of egress from the cooking area, a minimum of 10 feet and a maximum of 20 feet from the kitchen exhaust system. The manual actuation device shall be located a minimum of 4 feet 6 inches and a maximum of 5 feet above the floor. The manual actuation shall require a maximum force of 40 pounds and a maximum movement of 14 inches to actuate the fire suppression system. Exception: Automatic sprinkler systems shall not be required to be equipped with manual actuation means. OSSC 904.11 3. Automatic sprinkler systems protecting commercial -type cooking equipment shall be supplied from a separate, readily accessible, indicating -type control valve that is identified. OSSC [F]904.11.4 4. Sprinklers used for the protection of fryers shall be listed for that application and installed in accordance with their listing. OSSC [F]904.11.4.1 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 y l 5. An approved K -type portable fire extinguisher shall be installed within 30 feet of the cooking equipment, as measured along an unobstructed path of travel. OFC 904.11.5 6. Extinguishing systems shall be serviced at least every six months. OFC 904.11.6.4 7. The automatic fire suppression system shall be acceptance - tested in accordance with OFC 904, and installation standard listed in section OMSC 509.3, and with the manufacturer's instructions. OMSC 509.5 8. The automatic fire suppression system shall be serviced at least every 6 months and after activation of the system. Inspection shall be by qualified individuals, and a certificate of inspection shall be forwarded to the fire code official upon completion. OFC 904.6.4 Premises Identification: Approved numbers or addresses shall be provided for all new buildings in such a position as to be plainly visible and legible from the street or road fronting the property. Approved Plans: 1 set of approved plans, bearing the City of Tigard approval stamp, shall be maintained on the jobsite. The plans shall be available to the Building Division inspectors throughout all phases of construction. 106.4.2 OSSC When submitting revised drawings or additional information, please attach a copy of the enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Respec /0,:e:::3.....)o Val Henzel, Senior Plans Examiner CITY OF TIGA►RD BUILDING DIVISION PERMIT #: BUP2Q0 &00558 - 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2912006 Phone: (503) 639 -4171 47 u � 1 Inspection Requests (24 Hrs.): (503) 639 -4175 1 A- A II INSPECTION WORKSHEET FOR DATE: 2/22€2007 TIME: 7:02AM PAGE: 51 SITE ADDRESS: . 14145 SW 105TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PACIFIC HEALTH & REHAB DESCRIPTION: Fire suppression system. Type I hood. OWNER: PACIFIC HEALTH AND REHAB, PHONE #: 5Q3- 0:91144 CONTRACTOR: CASCADE FIRE SAFETY PHONE #: 36Q- 0859212 Inspection Request Scheduled For: Date: 2''22/2007 Pour Time: Code # Inspection Description Confirm # - - - Message 999 Sprinkler final 043614-01 r N Corrections /Comments /Instructions: .� 360 - 7z- C6 /f3 - .L�`� ? 1773 0 7111_ id" -ASS n PARTIAL APPROVAL n CANCEL NO ACCESS • FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 6:/ / Date: 2 - - /Z- 1 1 6 7 Phone #: (503) 718- afri/ CIPCOF TIGARD . 4 , ■ BUILDING DIVISION PERMIT #: BUP2006-00558 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2912006 Phone: (503) 639-4171 ' iAA t1 470 ifillpti 111 Inspection Requests (24 Hrs.): (503) 639-4175 tn. INSPECTION WORKSHEET FOR DATE: •/2/2007 TIME: 7:00AM PAGE: 24 SITE ADDRESS: 14145 SW 105TH AVE CLASS OF WORK: • SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PACIFIC HEALTH & REHAB DESCRIPTION: Fire suppression system. Type I hood. • OWNER: PACIFIC HEALTH AND REHAB, PHONE #: 503-6391144 CONTRACTOR: CASCADE FIRE SAFETY PHONE #: 360-695-9212 Inspection Request Scheduled For: Date: 1/2/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 041672-01 360-695-9212 N Corrections/Comments/Instructions: , A lai - f:: I C — oi e or Litolk_ • [iv "VP ii Li_ S tiT4 ' mghli oh. etA-- SEWir OriP n PAS 0 PARTIAL APPROVAL 0 CANCEL NO ACCESS FAIL i ALL Fe R INSPECTION 0 ADDI IONPIL FEES ASSESSED i f Inspector: / Date: ( 1 0 Phone #: (503) 718-74.