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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT Iii i . ,.e COMMUNITY DEVELOPMENT Permit #: FPS2011 -00109 Date Issued: 09/21/2011 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 2S110DCO2200 Jurisdiction: Tigard Site address: 15570 SW PACIFIC HWY Project: Safeway Subdivision: 1997 -016 PARTITION PLAT Lot: 2 Project Description: Relocate (1) horn strobe for TI. Contractor: STONER ELECTRIC Owner: TRC MM LLC 1904 SE OCHOCO 5973 AVENIDA ENCINAS STE 300 MILWAUKIE, OR 97222 CARLSBAD, CA 92008 PHONE 503 - 462 -6500 PHONE FAX 503 - 659 -4968 FEES Description Date Amount Specifics: Permit Fee - COM 09/13/2011 $56.47 12% State Surcharge - Building 09/13/2011 $6 78 Type of Use: COM Plan Review - Fire Life Safety - COM 09/13/2011 $22 59 Class of Work: ALT Type of Const: VB Info Process /Archiving - Sm Sheet (up to 09/13/2011 $1 00 Occupancy Grp: M Height: ft 11x17) Stories: 1 Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Standpipe Required Hazard Density. 0 Design Area. 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Yes Alarm Type Automatic Pull Station Required: Yes Smoke Detectors Req Battery Calcs Provided• No Cut Sheets Required No Total $86.84 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation $0.00 Residential Square Footage: 0 Fire Alarm Valuation $675.00 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 or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. i Issued By: ` Permittee Signature: -Z9 v ; 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. Buildin Perm A licati CEIVED a 5 ' Fire Protection System a • " FOR O s • City of Tigard SEP 1 3 2011 Date Bey 9 / 3 /, I Permit No P P41 / — QOlD9 • , ' - ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Kecre4,3 Phone: 503.718.2439 Fax: 503. o0F TIGARD Date/By e tbi l t other Pem it P� / - ' / 39 Tl GAKD Inspection Line• 503.639.4175 BUILDING DIVISION Dae Reads t 2 hum H See Page 2 for - Internet: www tigard -or gov Notified I \ ' . Supplemental Information L.v TYPE 'OF ' WORK " - REQUIRED DATA: 'i- 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 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 ❑ Accessory building ❑ Multi- family Number of bedrooms: CI Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address' /557 p 5 W Ps i , New dwelling area: square feet City/State/ZIP: - 1 - '7 liar I / ule �' LZ9 Garage/carport area: square feet Suite/bldg_ /apt_ no.: Project name: < E/ 4, 9 7g Covered porch area square feet Cross street/directions to job site: / Deck area: square feet Other sixucture area: square feet REQUIRED DATA: COMMERCZAL -USE CHECKLIST_ Subdivision I 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 work indicated on this application. DESCRIPTION OF «iORIC PP Valuation: $ 6 S o• b ! ( a -JO Existing building area: square feet ���((( Gait /(� eA , 7 New building area: square feet y PROPERTY OWNER . ❑ TEN ANT = Number of stories: Name: 5 6.. - Q.uJA/ j y L. Type of construction: Address: f 6 3 0,3 se Ev cut K CA • Occupancy groups: City/State /ZIP: C[ o-e le GtS ®R 97 0/ 5 Existing: Phone: S 4,57.. 8s [ 0 Fax: ( ) New: ❑' - ,iPPLIC'ANT' ' ❑ CONTACT' PERSON- - - , NOTICE , Business name: 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: jurisdiction in which work is being performed. If the City /State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) 1 Fax.. ( ) E -mail: . - CONTRACTOR ., ' , , 1 . BUILDING PERMIT FEES* . t (Ptea.le refr re fer schedule) - Business name: 5 *,,,, fi f� _i" )4f _ e _ 1z„,„..4,. Permit fee. Address: / / O 7 , 6 0 e-V S I State surcharge (12% of permit fee): City/State/Z1P: /14 /1 ',OE 9 7 �� / ° f '� I,V / T/ FLS plan review (40"t, of permit fee): Phone: ( 50 41, 3 ./ g Fax: (S 5 6S' 7 , 7 b$ (Dixe li ne opplicutin:a. I "l'T CCB lic.: v 2 ....3 7 Total permit fees: Authorized signature: 4 6e 1 / ' ,�- Am This J�-1 This permit application expiripir es if a permit is not obtained Print name: Up L � t.., (lJ 'Date: * i within 183 days after it has been accepted as complete. Fee methodology set by Tri- County Building Industry Service Berard. I\ auxld 'ing\Permxts \ FPS-PermoAppdos ©2/01/11 , 440- 4d1 l/02/COM/ -WEB) 4 City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe - work to `bee done'. - - ° , _ ; .. 1.) ❑ New 2.) i to lineation to sprinkler heads only: El Addition ❑ 1 -10 heads. No plan review required El Alteration ❑ 11+ heads Plan review required. ❑ Repair Number of sprinkler heads Additiu>nal description (if work. Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler El Wet ❑ L)ry Additional Standpipes Information: FIazard Croup Density Design Area h Factor Sprinkler Project Valuation: $ 5-) Type I - Hood Fire Suppression System.` - . Hood Project Valuation $ C.) Fire Alarm . . Submittal shall Battery Calculations El Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ • D.) ResidentialSprinkler (Stan Alone System)°_, - . Square Footage. Permit Fee 0 to 2,1)(0 $198 75 2,0(11 to 3,0)0 $246.43 . 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 2 sets of plans at submittal. Plan review fees are required at submittal. http : / /www.ngard- or.gav /city_hall/ departments /cd /docs /FPS- PermitApp.doc 02 /01 /tt --- • / JANI I US ROOM ,.. ---- 1 : I (E) a / PHARMAC) / , ; 1 122 I I IL ' STORAGE / (NI —I— .,. ..er Otl 7 —_— i 1 I 170 I PHARMACY gl CONSULTING IV CURB - 1 FREEZER Lro .., I- H CZY BOX tc4 1 ..•W! oVr. :.i II „it..., BOX I 115 I I.' ... ,r [ 124 I 1 i, I N) UNISEX (r4) COMER seP \ NI scts t. il l i f e c) ''' \-, r tORN RESTROOM 1- \ i 1 142 I Ni ,, — I l.3 x - (10 - com ( RAcx / I a“ 6.7 N's- p i X. - I - -v t : (N . 1141'. ) 1, ;,,.., ____ U , HALL AY c., L — 4 - -I — ' Will Vir .. 1.1 i : , •-•••••••; ! I ..... ....„ ; • •, .: ; ; \ • '...------: i .. i .. YiDAMA I i i I ; ; . WORK AREA I i i i -77- — 1 LT] I . 7 ' ' 11111111111111111 > .: .1 I i RELOCATE PIXTUICS_/_MIkLIVRJC AS t•EGESSARY - , ..M.. ALL MILLYIORK FINISI-ES i ') POOR 10 - "• • TOR -- - - (M) a Ith% PHAHmACY WAITING I 120 I TZI ....... - . ( F' '---■ R NINDOYI li 35 Sq. Ft 1 z.,// 0 r : ft 11111. Ill OC' . , , ...., „ ,,,,, - . . ... ,.., „ „ ,,,,,,,,,,, Y ..,. 1•••••11111/3■ • s•r ... - - .— -- -"1111111 U T14175 aW" ( il b v ,.. Ye l,,r 9 e.. 0 T. 1 - 3 i ... =,------- -- itii • •• ' ) S (Froat,ia __J-- • .4. c!;:' • -_--1 _ ..., ......... • •11 *- . el: ,,,,_., _ # zs _., • • • • , ! ..,,, . I% CI * , ■ 1 . .. . ' . . • i lir..: (§ P v i L. 2 F • \ 41..... 7 . I i i i i ■ °all ' Ike II N 6 74 %.1 0* ..., r) K ilu• Itt. - _ till 0 4:ili! 1 0 ..,..... ,., • ,...c, —. r■-s r.., re . . . • I II • BSAA ARCHITECTS 1 PLANNING SAFEWAY INC. ZONING' 13125 9W HAL c/o JAMES M. PARK 16300 SE. EVELYN STREET TIGARD, OR 5200 S.W. MEADOWS ROAD, SUITE BI30 CLACKAMAS. OR 91015 PHONE: 50: LAKE OSWEGO OR 91035 PHONE• (503) 651.8510 ATTN: BRAE PHONE: (503)610 -0234 FAX: (503)651 -8636 FAX: (503) 610.0235 BUILDING CITY OF TIG SAFEWAY INSPECTION: 13125 sw 14A1 CONSTRUCTION TIGARD, OR I I I I I I I I I I I I STRUCTURAL MANAGER: qT°N MR L ENGINEER: SAFEWAY INC 1 , c_to M I I I I II I. II I I II I III I II I I I • I I I �� M� �.�1 ■ A O ASSOCIATED CONSULTANTS, INC. c/o BRIAN NORTH 1_`� - I I II — i i I I I _ I� a O NOUC GANEH 630 S EVELYN STREET TIGARD GIT _ I 1340 SW BERTHA BLVD. SUITE 200 CLACKAMAS, OR 91015 13125 SW FIAT I _ -_ — - PORTLAND, OREGON GON 91219 (5 PHONE: ( b 51 -446% 65.6486 FAX: 150313) 6 TIGARD, OR I PHONE. (5031384.0460 PHONE. l52 i l F I .. __ - FAX (503)384 -0459 MUM ■ I I _, a a .Jt rt I I I 1 Lii� i'I llip p FIRE . 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