Permit •
CI Y OF TIGARD BUILDING PERMIT
Q _
; . PERMIT #: BUP2008 -00012
COMrIviUNITY DEVELOPMENT DATE ISSUED: 2/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 DB -00100
SITE ADDRESS: 07320 SW HUNZIKER RD 106 ZONING: C -P
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WOODEN SHOE DELI
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: 3N sf N: S: E: W:
OCCUPANCY GRP: A2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 50 BASEMENT: sf AREA SEP. RATED:
STOR: 3 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,100.00
Owner: Contractor:
ROBINSON DEVELOPMENT GUARDIAN FIRE PROTECTION
21360 NE AMBERWOOD DR. 1012 SW A ST
HILLSBORO, OR 97124 CORVALLIS, OR 97333
Phone: 503-645-8531 Contact #: PRI 541 - 752 - 2258
FAX 541 - 752 -4259
Reg #: LIC 100355
FEES
Description Date Amount
REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/14/2008 $69.65
[FLS] FLS Pin Rv 1/14/2008 $27.86
[TAX] 12% State Surch 1/14/2008 $8.36
Total $105.87
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
of these rules or direct questions to OUNC by callin 503.246.6699 or 1.800.332.2344.
Issued By: �- • - rmittee Signature: ' .— / /lam 1
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.
/,Building Permi p.plication
Fire Protection 6..; "stem -
,,
/Bu FOR OFFICE USE ONLY
City of Tigard ��N 4 'Z008 Date/B / 11,/ IC
I
Permit No.: (( U o exe/
City g P
° 13125 SW Hall Blvd., Tigard, OR 97223 n Plan Review �
Phone: 503.639.4171 Fax: 503.598.19 T or. ffGARD i e/B : �.J�� �� Other Permit:
TI GARD Inspection Line: 503.639 i eke ��� i ewON Date Ready :yd ` � u J / '_�. p
0 See Page 2 for
Internet: www.tigard or.gov BU'! ®61v� Notified/Method: 1 n_ '/ / Supplemental Information
A 'P l Pcrad44 '
. • 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 (romded to the nearest dollar) of all
0 Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION • work indicated on this application.
❑ l- and 2- family dwelling Commercial /industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION A ND LOCATION Total number of floors:
Job site address: 7 . y/ / /� k, ,e New dwelling area: square feet
City /State /ZIP: ! 9 4 Garage /carport area: square feet
Suite/bldg. /apt. no.: / Project name: ._ - . `` Covered porch area square feet
Cross street/directions to job site: G000b - t)Fo Deck area: • square feet
Other structure area: square feet
,REQUIREDDATA: COMMERQIAL .CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rotnded 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. G
a
if / / r- I Valuation: $
Existing building area r � W square feet
New building area: square feet
• I n PROPERTY OWNER . . ❑ TENANT Number of stories:
Name: r^ / 5n k) g. /(../1
� k) p� Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
❑ APPLICANT ❑ 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: ( ) Fax:: ( )
E -mail:
CONTRACTOR BUILDING.PERMIT: FEES*
/ I (Ptedse refer*, fee schedule)
Business name: C_at� /ate �. / e r /`7 ,.� —
YV
Address: /v 0- -- 4 S Permit fee:
State surcharge (12% of permit fee):
City/State/ZIP: �,�i /�
y C9,( c'4. ' I O �7..» FLS plan review (40% ofpermit fee):
Phone: (911 ) 7c .. ,..2... s7 - Fax: (gi �) 7e._ 9 , c 9 (Due upon application.)
CCB lie.: �OQ . r Amount received: Total permit fees:
/ O 5 Authorized signature: , g .
�•G� --� This permit application expires if a permit is not obtained
Print name:' — tom
yea y Cr� Date / cy within 180 days after it has been accepted as complete.
fi �
* Fee methodology set by Tri- County Building Industry
Service Board.
I:\Buildmg\Permits\FPS- PermitApp.doc 03/23/06 440- 46t3T(11 /02 /COM/WEB)
•
f
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_
❑ Wet ❑ Dr
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 p 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 (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.
"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
Jan 07 2008 9:30AM CAPTIVE AIRE SYSTEMS 4252125998 p.3
Fire Suppression l ive-, (9 .7 e l e g -Ct ,C/ 7-
System Distributor Certificate of /nstallaf
To be Completed by Regional Office
Job Name Hilltop Cafe
Job Number 694997
Job Address Verify
Type of System: Ansui yes
7320 SW Hunziker ST
Pyrochem ❑
Portland OR 97223
Other
To be Completed by Fire System Distributor
Company Name G Ul /2 /4Ly r :Or✓
System Model i'ej I�
Address /0/0 S ‘-.i ,'
Serial Number
C' ) ��Lis
Fuel/Energy Shut Off Device Gas Valve: Mechanical B Electrical ❑ Sizej2V____.
Installed. Tested on £ Electric E ui
Date q pment Shut -down Tested: g Oly
This Fire Suppression System is installed in accordance with the Manufacturer's instructions and
drawings, NFPA 96 and 17 (current issues) and all applicable state and local codes. All electrical
work or work performed by others to complete the installation of this s
Exceptions to the above are noted below. (Use back of sheet If necessary m has been completed.
Installer's Name O /-<n/ _C,, ( ✓ /0
Signature ,-----
Date -1 -nom
To be Completed by Owner or Owner's Representative
1 have received a copy of the Fire Suppression System Owner's Manual and I understand it I also
understand that it is the recommendation of the National Fire Protection Association (NFPA) that
the system be Inspec e ix months to maintain its reliability.
Signature
Date e
To be Completed by the Authority Having Jurisdiction
Functional tests have been witnessed and the system performs as designed.
Print Name / .r-4 l L7l
Phone Num 7i r� Jurisdiction
Signature — b -t, �G y�
Date 2 e) 6
Fire Suppression System Distributor Certificate oflnsurence, v25-1-07
. .
CITY OF TIGARD
BUILDING DIVISION A t. PERMIT #: BUP2008-00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/8/2008
Phone: (503) 639-4171 ,, ,aviI
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 5/5/200; TIME: 7:01AM PAGE: 36
SITE ADDRESS: 07320 SW HUNZIKER RD 106 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WOODEN SHOE DELI
DESCRIPTION: Fire suppression for Type I hood.
OWNER: ROBINSON DEVELOPMENT, PHONE #: 503°646-8531
CONTRACTOR: GUARDIAN FIRE PROTECTION PHONE #: 541-76'2-22GB
Inspection Request Scheduled For: Date: 5/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 069340-01 603-209 Y
Corrections/Comments/Instructions:
(6) PAS CANCEL NO ACCESS
l iARTIAL APPROVAL
fl El
F --- FAIL CALL FOR INSPECTION 11] ADDITIONAL FEES ASSESSED
Inspector: . AL 4111111 Date: --. Phone #: (503) 718- 76- Y7
Illb,
—' , • ' .
CITY OF ��vn o n-�w mm�m�mum��
BUILDING DIVISION PERMIT #: @NP2008- 00012
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21812008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 �8�W- -iii—
INSPECTION WORKSHEET FOR DATE: 6/5/2008 TIME: 7:01AM PAGE: 33
SITE ADDRESS: 07320 SW HUNZIKER RD 106 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WOODEN SHOE DEU
DESCRIPTION: Fire suppression for Type I hood.
OWNER: ROBINSON DEVELOPMENT, PHONE #: 503-045'8531
CONTRACTOR: GUARDIAN FIRE PROTECTION PHONE #: E41-7512258
Inspection Request Scheduled For: Date: 5/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
295 Misc. inspection 069541'01 541'752-2268 N
Corrections/Comments/Instructions:
.
r PA .
�� CANCEL �� NO ACCESS
• FAIL
-- CALL FOR INSPECTION E /\OD|T|ONALFEES ASSESSED
. � -
' ��
Inspector: Date: -----
�� �� ���z Phone #: (503) 718-
^ ^
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SW2008-00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/8/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 5/7J2009 7:00AM PAGE: 42
SITE ADDRESS: 07320 SW HUNZIKER RD 106 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WOODEN SHOE DELI
DESCRIPTION: Fire suppression for Type I hood.
OWNER: ROBINSON DEVELOPMENT, PHONE #: 603-645-8531
CONTRACTOR: GUARDIAN FIRE PROTECTION PHONE #: 541-752-2268
Inspection Request Scheduled For: Date: 5/2/2008 Pour Time:
1 0) :SO
Code # Inspection Description Confirm # Contact # Me% -
295 Misc:. inspection 069211-01 541-752-2258 Mr
c,a.c../.._ tR,e-z-rt-Ay
Corrections/Comments/Instructions:
IIM'Y .
Wo Pl■
— 4
. _ .
III
P , .., ,.. L. e.,-7.-T-a-- /4 R.
) A-1 A-_/A.1 y - 7 -- 7,k--1 -
_A-0 / V / , ( 2- 'S lizt__'
• PASS PARTIAL APPROVAL El CANCEL I NO ACCESS
• PM ' • CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED
,
Inspector: 1..........- Date: S 0,2 Phone #: (503) 718- -
'II
441