Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
Ie. COMMUNITY DEVELOPMENT Permit#: FPS2014-00073
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/13/2014
Parcel: 2S 102AC01101
Jurisdiction: Tigard
Site address: 12562 SW MAIN ST 100
Project: Max's Brew Pub Subdivision: BURNHAM TRACT Lot: 1
Project Description: Update restaurant fire system for additional appliance.
Contractor: UNIVERSAL FIRE EQUIPMENT Owner: 12562 MAIN ST LLC
18260 SW 100TH CT BY GEORGE DIAMOND
TUALATIN, OR 97062 2839 SW 2ND AVE
PORTLAND, OR 97201
PHONE: 503-691-9000 PHONE:
FAX: 503-691-9004
FEES
Description Date Amount
Specifics:, Permit Fee-COM 05/13/2014 $86.06
12%State Surcharge-Building 05/13/2014 $10.33
Type of Use: COM Plan Review-Fire Life Safety-COM 05/13/2014 $34.42
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 05/13/2014 $18.50
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 $149 31
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,750.00
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 cop of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800 -
Issued By: Permittee Signatures V ■
C .4175 by 7:00 a.m.for the next ay. •• e inspecti• 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 ON L1
Recciccd
City of Tigard Date/B : a�(l Y L �� Permit No.: I /)/ �D(j�JT
i• 13125 SW Hall Blvd.,Tigard,OR 9722 t .R 2 3 2014 Plan R : T,,� j �� Other Permit: yg6L -aO/7�
Phone: 503.718.2439 Fax: 503.598.1' 1
TIGARD Inspection Line: 503.639.4175 Date Ready:y: in Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notifie f th /�3 �• Supplemental Information
TYPE REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New c uction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rotnded 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.
❑ I-and 2-family dwelling ommercialJindustrial 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: 1256 2 sL✓. /t`144,1 3-..i . New dwelling area: square feet
City/State/ZIP: 7-1■, 46..e., ne. 7ZZ3 Garage/carport area: square feet
Suite/bldg./apt.no.: / 490 (Project name: /4 j`c RC¢�c) /% ( 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.
Indicate the value(rotnded 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.
Ltra"4-{--e-___ 4-11 41/11 ,,,, le p doo It°s-f-r,c.r�► Valuation: $ f B'?
c�,. . is S'l�r� 46-✓, 4a�d / o R/�- ( Existing building area square feet
it • /6/y n L- 77 New building area: square feet
❑ PROPERTY OWNER I ENANT Number of stories:
Name: /1 / / I/&i — /l4 X ts- Oe`4-L-.7 / , 6 Type of construction:
Address: l 25(2S',.<), Ice,,,, ., 3- t, Occupancy groups:
City/State/ZIP: T—", /4,,y_<, (.Q_ 9-7 222. 3 Existing:
Phone:(• ) Fax:( ) New:
PLICANT ONTACT PERSON NOTICE
Business name:iii,iV ez(Ky./&"").1.,,e_ E'j e.;�ovedt, + All contractors and subcontractors are required to be
Contact name: C C 6�,4-+y licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: ` g2 6 0 S'.k2 /p v f- jurisdiction in which work is being performed.If the
City/State/ZIP:7-k F2).--6C1-44 h t D 9 7 ( Z- applicant is exempt from licensing,the following reasons
/ G.�r`-� / � / apply:
Phone:)t 5"/--9�(7 Fax: 3) 6j 1/-c 0 a(.
E-mail:ti,) N e- l Pt YtIP C-L[ m ef( ?17■ fm Psf,I. 40"•-t
CO6iTRA&OR BUILDING PERMIT FEES*
Business name: ��y ,.."._s-/4-6(-,��, (Pleaserejertofeeschedule)
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%ofpermit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.: Q 6 7 a 3 Total permit fees:
Amount received: ._.---•
Authorized signature: 2
This permit application expires if a permit is not obtained
Print name: Date: K.2 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 02/01/2011 440-4613T(II/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.
❑ 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-PemritApp.doc 02/01/2011 2