Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s �
' 2 , COMMUNITY DEVELOPMENT Permit #: FPS2009-00061
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/20/2009
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 100
Subdivision: Lot: 0
Project: Panda Express
Project Description: Fire suppression system.
Owner: FEES
SN PROPERTIES PARTNERSHIP Description Date Amount
1121 SW SALMON ST Permit Fee - COM 07/10/2009 $69.65
PORTLAND, OR 97205 12% State Surcharge - Building 07/10/2009 $8.36
PHONE: Plan Review - Fire Life Safety - MF 07/10/2009 $27.86
Contractor:
SANDERSON SAFETY SUPPLY CO.
1101 SE 3RD AVE
PORTLAND, OR 97214
PHONE: 503 - 238 -5700
FAX: 503 - 238 -6443
Type of Use: COM
Class of Work: FPS Type of Const: VB
Occupancy Grp: A -2 Height: ft
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $105.87
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 0
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B Permittee Signature: () 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 Permit Applica
Commercial i s B 'CE IVED FOR OFFICE USE ONLY
Received
C ity of gad � L 10 2009 Date/B . _ /� 9 A , Pemut No ,q)5 0,1 e d i 0 ,
Plan Rev
• Phone: S 0 Hall Ti B lvd. r , Tigard, OR 9 s °S Ot her Permit:
a Phone: 503.639.4171 Fax: 503.5 Date/B a` 7 , [B1 , / /r' - / i • -
TIGARD
Internet Line: 503.639.4175 G FTIGARD DateR
503.598_1960_ Received
.� O ^� Ms. HI See Page 2for
t: www.tigard-or.gov BUILDING DIVISION Notified/Method: C / Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
0 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/alterationheplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling 1i1 Commercial/industrial
❑ Accessory building ID Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITEINFORMAATION AND LOCATION Total number of floors:
Job site address: 16 � 3 o sit) ar, t Ci 1-L 1l� 5 i / i Op New dwelling area: square feet
City/State/ZIP: - �� r 2_2)1
/ Garage/carport area: square feet
Suite/bldg. /apt. no.: 1 Project name: a,J 4e -e_ re SS - Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CRECICLIST
Subdivision: l 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.
` r Valuation: $ ^(,,)
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: 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: apply:
is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR
Business name: 5 o g yu ctev5 04. C D 0...4-41 BUILDING PERMIT FEES*
Address: 1 t ■ € 3 �d (Please refer to fee schedule)
t Structural plan review fee (or deposit):
City/State/ZIP: e { La t , C Or--
Phone: 6 O3) g "3 [ 1 Z____ Fax: 66.5) g t q '? l ei FLS plan review fee (if applicable):
CCB lic.: A )n Total d upon application: / Q 5
Amount received: $ IDS '
Authorized signatur . This permit fees application expires if a permit is not obtaided A. within 180 days after it has been accepted as complete. Li
Print name: /i _ a � 1 Date: > /� * Fee methodology set by Tri County Building Industry
Service Board.
•
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.
El 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: $ 3 oco p,='_
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 (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- PerrnitApp.doc 2