Permit n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'' 1: '' . ' COMMUNITY DEVELOPMENT Permit #: FPS2013 -00028
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/26/2013
Parcel: 2S113AC01201
Jurisdiction: Tigard
Site address: 17003 SW 72ND AVE
Project: Twig's Bistro & Martini Bar Subdivision: COUNCIL VIEW ACRES (LOTS 1 -20) Lot: 18
Project Description: Fire sprinkler modification, add (3) fire sprinkler heads and relocate (13) heads.
Contractor: PATRIOT FIRE PROTECTION INC Owner: BV CENTERCAL LLC
4708 NE MINNEHAHA ST ATTN: FRED BRUNING
VANCOUVER, WA 98661 7455 SW BRIDGEPORT RD
TIGARD, OR 97224
PHONE: 360 - 699 -4403 PHONE:
FAX: 360 - 699 -4485
FEES
Description Date Amount
Specifics: Permit Fee - COM 02/21/2013 $102.20
12% State Surcharge - Building 02/21/2013 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 02/21/2013 $40.88
Class of Work: ALT Type of Const: VB Info Process /Archiving - Lg $2.00 (over 02/26/2013 $2.00
Occupancy Grp: A -2 Height: ft 11x17)
Stories: .1 Info Process /Archiving - Sm $0.50 (up to 02/26/2013 $1.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT .
Density: 0 . Design Area: 0
K Factor: 5.6 ,
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $158.34
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 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 – . . enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir t questions to C -. all' g 503.232.1987 / o a r 1.800.332.2344.
Issue By: — /10 /A , _ n !/ Permittee Signa .1/
Call 503.639.4175 by 7:00 a.m. for the next available insp= ion 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.
• Building Permit Application
Fire Protection System RECEIVED I. R u r i• i ( I. ( N ( 0\1, \
City of Tigard Rn e�crd ^ _ /� / PermitNo.: 7Q��
Date By < _ pup
u 13125 SW Nall Blvd., Tigard, OR 97223 plat Review - • ,
Phone: 503.718.2439 Fax: 503.5 0 2 Q 2013 Darr By , ` Z • Other Permit P09400
Ready 03.639.4
T I GAR D Life: 503.639.4175 Date eady By f� B See Page 2 for
Internet aww-:03.639.4 Date Method „04 p 1, Supplemental Information
CITY OF TIGARD 017,0 •
•
T11V n t �1 QUIRED 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
® Addition/alteration/replacement ❑ Other equipment. materials. labor. overhead_ and the profit fix the
CATEGORY OF CONSTRUCTION
work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial/industrial Valuation: $
❑ Accessory building 0 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORI'IRTION AND LOCATION Total number of floors:
Job site address: 17003 SW 72id Avenue New dwelling area: square feet
City/State /ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite bldg. apt. no.: I Project name: Twigs Bistro Covered porch area: square feet
Cross street/directions to job site: SW Bridgeport Raod Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit tees* are based on the value of the work performed.
Indicate the value (rounded 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.
add (3) & relocate (13) sprinklers to accommodate new ceilings Valuation 52,200.00
Existing building area: same square feet
New building area: same square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Central Properties LLC Type of construction: metal studs
Address: 1600 E Franklin Avenue Occupancy groups:
City/State /ZIP: El Sagimdo, CA 90245 Existing: same (office)
Phone: ( ) Fax: I ) New: same
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Patriot Fire Protection, Inc All contractors and subcontractors are required to be
Contact name: Ted Baker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4708 NE Minnehaha Street jurisdiction in which work is being performed. If the
City/State/ZIP: Vancouver, WA 98661 applicant is exempt. from licensing, the following reasons
aPPY
Phone: (360) 699 4403 I Fax::(360)699 4403
E -mail: tetlbaker@patdo/8re com
CONTRACTOR BUILDING PERMIT FEES*
Business name: same as above (Please refer to fee schedule)
Permit fee:
Address:
State surcharge (12 °o of permit fee):
City/State /ZIP:
FLS plan review (40°o of permit fee):
Phone: 1 ► l Fax: ( ) (Due upon applrcahon.)
CCB lie.: 70822 Total permit fees:
Authorized signature Amount received:
t_J ` This permit application expires if a permit is not obtained
Print name: Ted Baker Date: 2 -19-13 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry
Service Board.
I:\ Bailding1Pamite \FPS- PemiitApp.doc 02/01/11 440.4613r(l 1/02/COM/WEB)
Y .
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: 16
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
► ,71 \Vet ❑ Dr`
Additional Standpipes no
Information: Hazard Group light
Density .1
Design Area 225
K. Factor 5.6
Sprinkler Project Valuation: $ 2200
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
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 2 sets of plans at submittal Plan review fees are required at submittaL
G \Documents and Settings \ted.baker \ Desktop \Mate Submittal \AHJ ted \Tigard \Tie rd FPS- PerrnitApp.doc 02 /01/11