Permit •
FIRE PROTECTION SYSTEM PERMIT
• CITY OF TIGARD
C ` COMMUNITY DEVELOPMENT Permit #: FPS2013 -00035
TIGARD- 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/25/2013
_ 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: Install fire alarm system.
Contractor: WESTERN STATES FIRE PROTECTION Owner: BV CENTERCAL LLC
13896 FIR ST STE B ATTN: FRED BRUNING
OREGON CITY, OR 97045 7455 SW BRIDGEPORT RD
TIGARD, OR 97224
PHONE: 503 - 657 -5155 PHONE:
FAX: 503 - 657 -5182
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/25/2013 $112.96
12% State Surcharge - Building 03/25/2013 $13.56
Type of Use: COM Plan Review - Fire Life Safety - COM 03/25/2013 $45.18
Class of Work: ALT Type of Const: VB Info Process /Archiving - Lg $2.00 (over 03/25/2013 $2.00
Occupancy Grp: A -2 Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 03/25/2013 $7.50
11x17)
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: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $181.20
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,300.00
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 Notific tinn ('enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtai , copy of the rules
or dire uestions to 0 by calling 503.232.1987 or 1.800.332.2344.
Iss ed By: /° / Permittee Signature:
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.
Building Permit ApplicapE
Fire Protection System FOR OFFICE USE ONLY 8 V ED
y MAR 3 201
City of Tigard Received 3 I ' t s 1 3
Dale /By: Permit No.: F,5 ao� - +,0035
13125 SW Hall Blvd., Tigard, OR 972 2 Plan Review !� /j
C Phone: 503.718.2439 Fax: Kenya. Date /By: ' '� �( r ` rJ Other Permie /olttQ�p�i� gp�7l
T I G A R D Inspection Line: 503.639.41 1 (1 Date Ready /By: / i huts: ® See Page 2 for
Internet: www.tigard- or.govb0'LDING � Notified /Method: 4 f' .; Supplemental Information
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 (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.
❑ I- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 17003 SW 72 "" Ave. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Twig's Bistro and Martini Covered porch area: square feet
Cross street /directions to job site: Lower Boones Ferry Rd. Deck area: square feet
The old Macaroni Grill in Bridgeport Village Other structure area: square feet
REQUIRED DATA: COMMERCIAL - 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
DESCRIPTION OF WORK work indicated on this application.
Installing a fire alarm panel and sprinkler monitoring system with notification. Valuation: $$3,300.00
Like for like replacement of existing system. 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: Duston W. Yacapin licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13896 Fir Street, Suite B jurisdiction in which work is being performed. If the
City /State /ZIP: Oregon City, OR 97045 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 657 -5155 I Fax: : (503) 657-5182
E - mail: duston.yacapin @wsfp.us
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Western States Fire Protection
Permit fee:
Address: 13896 Fir Street, Suite B
City /State /ZIP: Oregon City, OR 97045 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 657 -5155 Fax: (503) 657 -5182 (Due upon application.)
CCB lie.: 104570 Total permit fees:
Authorized signature: ct Amount received: /
This permit application expires if a permit is not obtained
Print name: Duston W. Yacapin Date: 3/12/2013 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1: \ Building \Permits \FPS - PermitApp.doc Rev 01'052012 440- 4613T( 1 1' 02 /COM /WEB)
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
El 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: $
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
C:\ Users \duston.yacapin \Desktop \Permit Applications \Tigard Fire Alarm Permit.doc Pkv 01/05/2012
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
17003 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Fire Protection System
998 Alarm Final
03/27/2013 00:00
FPS2013-00035
FAIL
No representative for test
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
17003 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Fire Protection System
998 Alarm Final
03/27/2013 00:00
FPS2013-00035
FAIL
No representative for test
Violation Summary:
Inspector Contractor