Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 COMMUNITY DEVELOPMENT Permit#: FPS2014-00157
Date Issued: 10/13/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 30
Project: 'chi Teriyaki Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Hood fire suppression system.
Contractor: FIRE EXTINGUISHER SERVICE CTR Owner: ROIC OREGON LLC
3460 SW 209TH AVE 8905 TOWNE CENTRE DR, STE 108
BEAVERTON, OR 97005 SAN DIEGO, CA 92122
PHONE: 503-643-3309 PHONE:
FAX: 503-356-1736
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/01/2014 $102.20
12%State Surcharge-Building 10/01/2014 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 10/01/2014 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 10/01/2014 $5.00
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 $160.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,350.00
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. Sped. Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is '• :rted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folio ; adopted by the Oregon•
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 . obtain a copy of the rules
or direct questions to OUNC by calling 503.232.19: • . . • /
Issued By: _ ) Permittee Signature: /
Call 503.• '.4175 by 7:00 a.m.for the next available in,•e• ion •
This permit card shall be kept in a conspicuous place on the job site it •• •n of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received
'. Permit No.. _. .i �. if 1
•II 13125 SW Hall Blvd.,Tigard,OR Plan Revie
• Phone: 503.718.2439 Fax: 503. Date/B : ` / Other Permit:
Et1',E 'J . � -AMP'
d�ti y
I'I c;n It l> Inspection Line: 503.639.4175 Date Ready :y: % See Page 2 for
Internet: www.tigard-or.gov Notified/Method: l� �� Supplemental Information
I T 1 2' , 0/ M . rk-
TYPE OF '_ r�r'��!► - REQUIRED DATA:1-AND 2-FAMILY DWELLING
1 q,IIMS,�I�J Permit fees*are based on the value of the work performed.
ew construction P
ii Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement • er: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1-and 2-family dwelling ommercial/industrial
Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATI N Total number of floors:
Job site address: j 35-60 3(,f/6�,7.P.yC gD New dwelling area: square feet
City/State/ZIP: 1 ' /1, 6-� G�f�.. Garage/carport area: square feet
Suite/bldg./apt.no.: 13• W Project name: 1' / t2/y4.1z.„/ 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: 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 t Olga.
�tJ J • (')( c . (�VYtfi 1O� Valuation: : � $
'�` . �/ LAP. Existing building area square feet
-- ,u '.
. L) c J New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: e , e nt Type of construction:
n:
Address: 7��J0 I �i-,(J 3� Occupancy grou s:
City/State/ZIP: I rn(A 00/ ! 2� Existing:
Phone:(7 ) �„ �'(� / Fax ( ) New:
C� "PPL`ICANT -CONTACT PERSON NOTICE
Business name: f f f � n . ;_d, j5 I_ .{ S�c, ( All contractors and subcontractors are required to be
Contact name: � �"` licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be Icensed in the
Address: A%-%, 3 i., 4.0.3r)9/4N jurisdiction in which work is being performed.If the
City/State/ZIP: G f- i N q7 6r-- applicant is exempt from licensing,the following reasons
f /� apply: _
Phone:(93)CLI 3-33 I Fax::(93i 33s 7 t % _
E-mail: b,„6,_ . . p�'t�o►, l ,Gdl�
5 CONTRACTOR BUILDING PERMIT FEES*Afe Business name: (ti.` S ) I C4 (Please refer to fee schedule) _
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%ofpermit fee):
Phone:( ) I Fax:( ) (Due upon application submittal.)
CCB lic.: 7 • N. Total permit fees../G��,3 /
Authorized signatu `' Amount received:
� j��` This permit application expires if a permit is not obtained
Print name: Ar •!I/ 7' Date: l t) / 9d within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PcrmitApp_071 514 doe 440-4613T(I 1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of\Fork: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3)copies of sketch showing area (3)copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3)sets of plans.
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: I $
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: I $
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 Surchae (12%of permit fee): $
FLS Plan Review(40% of permit fee): $ .
TOTAL: $
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