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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT s : - COMMUNITY DEVELOPMENT Permit#: FPS2013 00103 T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2013 Parcel: 2S 101 AC01600 Jurisdiction: TIGARD Site address: 7100 SW HAMPTON ST 130 Project: Commerce Plaza Deli Subdivision: BEVELAND NO.2 Lot: 18-19,P Project Description: Fire suppression system for Type I hood. Contractor: UNIVERSAL FIRE EQUIPMENT Owner: NEIMEYER,JOHN 18260 SW 100TH CT 15 82ND DR STE 210 TUALATIN,OR 97062 GLADSTONE,OR 97027 PHONE: 503-691-9000 PHONE: FAX: 503-691-9004 FEES Description Date Amount Specifics: Permit Fee-COM 08/07/2013 $102.20 12%State Surcharge-Building 08/07/2013 $12.26 Type of Use: COM Plan Review-Fire Life Safety-COM 08/07/2013 $40.88 Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 08/07/2013 $8.00 Occupancy Grp: A-2 Height: ft 11x17) Stories: 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 b cal'''. 503.232.1987 or 1.800.332.2344. Issued By: � Permittee Signature: 2/; Call 503.639.4175 by 7:00 a.m.for the next availa re in ection da . This permit card shall be kept in a conspicuous place on the j ' until comp! ' n of the project. Approved plans are required on the job site at the ime of each inspection. Building Permit Application Fire Protection System RECEIVED D FOR OFFICE USE ONLY Y City of Tigard Received /� Date/B 7 ... Permit No riS fie/5 _0010 ti 13125 SW W Hall Blvd.,Tigard,OR 97223 Plan Review F� ��c av 3 7 / + 1 3 Other Permit: �Q 1� C Phone: 503.718.2439 Fax: 503.598.196QI I,I L 3 0 /313 Date/By: ,' v 1 T I G n R D Inspection Line: 503.639.4175 Date Ready : : p/ Juris: ® See Page 2 for Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: 11/ 7/13 6� Supplemental Information BUILDING DIVISION (i)SPi i't'`" £'J, TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ew construction 0 Demolition Permit fees*are based on the value of the work performed. - Indicate the value(romded to the nearest dollar)of all ❑Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1-and 2-family dwelling mercial/industrial Valuation: $ El Accessory building 12 Multi-family Number of bedrooms: El Master builder 12 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:7/CO(SA)74-/A-1.70 ti-c9�, 1 'o New dwelling area: square feet City/State/ZIP` 25 Cr,q t/ 0-e„._ ) e....7 3 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:�jy,I�,�,t ��/4,�yp 3,G/ 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(rouided to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. 13s1/sA (/l fl gi r) C.-/-t e,,,, /°C L-30 a Valuation: $ P fC7D t P eS !� _ _ �,y � r4-1, Existing building area square feet e 36 1��P��q s-4V-0`�. New building area: square feet [�PItOPERTY OWNER ❑ TENANT Number of stories: • Name: 111' /��y /e-d /yyrn,�r_....P. /O/tq Zia Type of construction: Address: `7/0_,, 6-� -,/,04., /20 Occupancy groups: City/State/ZIP:' R _ 9'7 ZZ...? Existing: Phone:X3):0 -1- G 3 Fax:( ) New: _ PLICANT ACT PERSON NOTICE Business name.611 fy,erS�1��Y g,,, ,O�, All contractors and subcontractors are required to be Contact name: � . / licensed with the Oregon Construction Contractors Board '77` _/ under ORS 701 and may be required to be licensed in the Address:1 O 26 a J l c)i /67p`�pp� X47 jurisdiction in which work is being performed.If the City/State/ZIP: TZ•,. /i .-,q hr e e.-c.. /62 0- 6 Z applicant is exempt from licensing,the following reasons _ apply: Phone: 3) 445/ —1 cr Fax::6"t,3)4/ ei©a CK E-mail: CONTRACTOR BUILDING PERMIT FEES* -� `n S (Please refer to fee Permit f e: Business name: f^y-' Permit fee: Address: City/State/ZIP: State surcharge(12%ofpermit fee): FLS plan review(40%ofpermit fee): Phone:( ) Fax:( ) (Due upon application.) CCB lic.: O 7 Z3 Total permit fees: - Authorized signatur . — Amount received: This permit application expires if a permit is not obtained Print name: n 4 1 Date: 7--g0 --/ within 180 days after it has been accepted as complete. • * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permils\FPS-PermitApp.doc Rev 01/05/2012 44046131(1I/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information Describe work to be d o ne: 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 ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ 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 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