Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
le COMMUNITY DEVELOPMENT Permit#: FPS2014-00082
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14/2014
Parcel: 1 S126CA01000
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 145
Project: Bambuza Vietnam Kitchen Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Tenant improvement for new restaurant.
Contractor: UNIVERSAL FIRE EQUIPMENT Owner: CAFARO NORTHWEST PARTNERSHIP
18260 SW 100TH CT PO BOX 422
TUALATIN, OR 97062 FLORHAM PARK, NJ 07932
PHONE: 503-691-9000 PHONE:
FAX: 503-691-9004
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/06/2014 $102.20
12%State Surcharge-Building 05/06/2014 $12.26
Type of Use: COM Plan Review-Fire Life Safety-MF 05/06/2014 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 05/06/2014 $15.50
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 $170.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,650.00
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 the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r
Issued By: Permittee Signature:goer
Call 5: -• ; by 7:00 a.m.for the next available inspection da3y.
This permit card shall be kept in a conspicuous place on the job site until compl lion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System 11 1lz ()Mt l 1 ,,E '1\11
City of Tigard � �
Received
: . ltI Permit No.: i• ,-�, 4
13125 SW Ilan Blvd.,Tigard,OR . Plan Re•e,� inin
II Phone: 503.718.2439 Fax: 503. 9 (k Date/B : 4...20.,_ Other Permit: ! /`0
T I�;n K l) Inspection Line: 503.639.4175 P� 6��� Date Ready:y: �T1 % See Page 2 or
Internet: www.tigard-or.gov Q� Notifiedthod:l /3 1�� r Supplemental Information
((((����¢¢¢r¢[cikl`ek "'Al! C''
TYPE OF WO 4A`�nc� REQUIRED DATA:1-AND 2-FAMILY DWELLING
w construction n Permit fees*are based on the value of the work performed.
❑ ` Indicate the value(rotded 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.
❑ 1-and 2-family dwelling mmercial/industrial Valuation: $
❑Accessory building 12 Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address 9-r 9 444 i-,44 1/g Aid New dwelling area: square feet
City/State/ZIP: 17144,-e. 4.5.,e, 1 722 7 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:g4 M 6.CZ14 ke S µa4 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(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.
Valuation: $ �-J
-�. / �,, m-tF ,� Lyra ft-4—Y‘a �6 s�o
i�� / 4"/9444 C ri s ,re-S-S-fib Lt c� ` �`-L Existing building area square feet
�:kV��`�■191.1 (e..)ch AiK h 630,0,..6 New building area: square feet
❑ PROPERTY OWNER I IlfrENANT Number of stories:
Name: a0-.77 LD u ? eG tjryq k,^0gyf f9 Type of construction:
Address: 9 0-a ci 5:4...b.?. //A!/f /t3 /i�� Occupancy groups:
City/State/ZIP:T Biec ?7��' Existing:
Phone:z 3 )7t G(SC Fax:( ) New:
PLICANT ga.< (TACT PERSON NOTICE
Business name: ahAle�r // `iz,m`o4 74 All contractors and subcontractors are required to be
Contact name: ��h '" /' licensed with the Oregon Construction Contractors Board
under ORS 70I and may be required to be!tensed in the
Address: eg G o .?� /001:4_, G�/ jurisdiction in which work is being performed.If the
City/State/ZIP: G.� ` applicant is exempt from licensing,the following reasons
�1��.0-T'r-� ®Q. 0 6 +? apply:
Phone.-e)697` /9�/o�49,.E Fax: :(573?) 61�-f/_lo�.
E-mail: /71Ve- ,0 - 4-4P-L /neo. AN I./14#1*5.(4 C cD4'1---
COgTRAftOR BUILDING PERMIT FEES*
Business name: R/3-f'✓J-e )49--c 6 o-t/-�� (Please refer tofee schedule)
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.: . 6 7Z Total permit fees: l ` 7O �/,.i
Authorized signature: Amount received: 7 11
This permit application expires if a permit is not obtained
Print name: --5-- - 4 /k DaterG 7 within 180 days after it has been accepted as complete.
h \ c * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\FPS-PermitApp.doe Rev 01/05/2012 440-4613T(I1/02/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
Flood 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\FPSPeemitApp.doc Rev 01/05/2012 2