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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2013 -00052 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/23/2013 Parcel: 2S102AA00490 Jurisdiction: Tigard Site address: 12085 SW HALL BLVD 120 Project: Arellano's Market Subdivision: TIGARD HIGHWAY TRACTS Lot: 13 Project Description: Installation of a pyro chem PLL -460 restaurant fire suppression system into an exhaust hood Contractor: UNIVERSAL FIRE EQUIPMENT Owner: ARELLANO, OMAR 18260 SW 100TH CT 12085 SW HALL #120 TUALATIN, OR 97062 TIGARD, OR 97223 PHONE: 503 - 691 -9000 PHONE: 971- 645 -6825 FAX: 503 - 691 -9004 FEES Description Date Amount Specifics: Permit Fee - COM 04/23/2013 $102.20 12% State Surcharge - Building 04/23/2013 $12.26 Type of Use: COM Plan Review - Fire Life Safety - COM 04/23/2013 $40.88 Class of Work: FPS Type of Const: VB Info Process /Archiving - Sm $0.50 (up to 04/23/2013 $8.00 Occupancy Grp: A -2 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: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $163.34 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $2,450.00 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 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. Issued By: Permittee Signature: vim✓ 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 Application Fire Protection System RECEIVED FOR OFFICE USE ONLY Received r /1!� .10 . 3 l City of Tigard Da te/B l f a _ Permit No.: ( dl/ I (�Sp — ° 13125 SW Hall Blvd., Ti ard,OR 97223 APR 2 3 2013 0 g Plan Revie I, „vv �� l Other Permit: 0 / � I oh - JU)-- 3 Phone: 503.718.2439 Fax: 503.598.1960 Date /B : `;1 1 TI G n R D Inspection Line: 503.639.4175 CITY OFTIGARD Date Re. y: r/ , "ow. Juris: ® See Page 2 for Internet: www.tigard or.gov BUILDING DIVISION Notified/Method: /O 11 Supplemental Information SiokE (d/t'/1 yv TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New co ction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling er cial/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: / z v g _57_5-1) 1 /)3 )(..k.( New dwelling area: square feet City /State /ZIP: ✓ / 2 � O is 9 7 ZZ 3 // Garage /carport area: square feet Suite/bldg. /apt. no.: / Project name ee 4.4,70 c /`. -tiaf 6.4_,, Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value ( rotded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ Z y c2 f L - 4 / O c e-� 7 L! ,..,4,-.) i t e s W eess -,� Existing building area square feet $ r 5 tr e+ / f 4.1.1 eX hA,viS -74- ,4 3 O-e C , New building area: square feet ❑ PROPERTY OWNER NANT Number of stories: Name: © , /4 ev_ //A-no S Type of construction: Address: / '20 R- r ��, /../-0._ / f tJc.....< Occupancy groups: City /State /ZIP: ,,n,� 02 ` Q j "7�2 Existing: Phone: (C-7 7) to Y _6g Z.S- Fax: ( ) New: PLICANT NTACT PERSON NOTICE Business name: ah /0 et j �;- r_ LE / � All contractors and subcontractors are required to be name: 6- l e' ....../.. licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: / 8' a 6 a /6 /0- 70 A , jurisdiction in which work is being performed. If the ,a_. Ala... -1--e: h d , 2 ` X7©4 - Z a t is exempt from licensing, the following reasons City/State/ZIP: —7 4 apply: Phone: 5 3)( / - 9p c9c� Fax: :617?) 6.9 /_9-0 0 E -mail: CONTRACTOR BUILDING PERMIT FEES* (Please refer to fee schedule) y-� p Business name: , c i ap ALs /460a-e._ Permit fee: Address: City /State /ZIP: State surcharge (12 %ofpermit fee): FLS plan review (40% ofpermit fee): Phone: ( ) Fax: ( ) (Due upon application.) CCB lic.: g -7 2 3 Total permit fees: Authorized signature: .�' `. Amount received: This permit application expires if a permit is not obtained Print name: � .. r ..,_,7 2° - i_4 I Date: L, z.? —/3 within 180 days after it has been accepted as complete. * Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\FPS- PermitApp.doc Rev 01/05/2012 440 -4613T(11 /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: El 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 ❑ 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. I: \Building \Permits \FPS - PermitApp.doc Rev 01/05/2012 2