Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 1111 Permit#: FPS2014-00191
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/06/2015
TIGARD Parcel: 2S 102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 17
Project: Mizumi Buffet Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Fire sprinkler alteration. Adding(4)heads and relocating(14)heads.
Contractor: WYATT FIRE PROTECTION INC. Owner: ROIC OREGON LLC
9095 SW BURNHAM 8905 TOWNE CENTRE DR, STE 108
TIGARD, OR 97223 SAN DIEGO, CA 92122
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics:, Permit Fee-COM 01/06/2015 $83.37
12%State Surcharge-Building 01/06/2015 $10.00
Type of Use: COM Plan Review-Fire Life Safety-COM 01/06/2015 $33.35
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 01/06/2015 $2.00
Occupancy Grp: A-2 Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 01/06/2015 $5.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
Density: .10 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $133.72
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,602.00
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 Amos •• a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued / A , Permittee Signature:
AEA .../
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 RECEIVED Fire Protection System jR FOR OFFICE USE ONLY
City of Tigard �C(' q Ratee/By. Ia '., / Permit No.: 1 (9E5/491-"-001/9/
13125 SW Hall Blvd,Tigard,OR 97223 `� 2 2 2014 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By. ( ! /Vi ( h l Other Permit: P9i4!Cf�je g
�\I Inspection Line: 503.639.4175 CITY OFTIGARI} Date Ready/By: Juns. ® See Paget for
Internet: www.tigard-or.gov BUILDING DING DIVISION Notified Method: I I� R✓�l Supplemental Information
t.,,,'h', (�l^lfLe�
TYPE OF WORK • REQUIRED s, TA:1-AND 2-FAMILY DWELLING
❑New construction ❑ Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded 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 ®Commercial/industrial Valuation: S
❑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:13500 SW PACIFIC HWY New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: fill Project name:MIZUMI BUFFET 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(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
FIRE SPRINKLER ALTERATIONS FOR REMODEL Valuation: $$1,602.00
Existing building area: square feet
New building area: 0 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Payne licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham Rd jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)684-2928 Fax::( )
E-mail:a.payne@wyattfirc.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Wyatt Fire Protection
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) ( ) (Due upon application.)
CCB lic.:64077 Total permit fees:
9 } '� Amount received:
Authorized signature: �b
This permit application expires if a permit is not obtained
Print name:Ashley Payne Date:12/22/2014 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\BuildingPamitsFPS-Pe,mitApp.doc Rev 01/05/2012 4404613T(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:
❑ Addition ❑ 140 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 1$
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
'CW1 Wet ❑ Dry
Additional Standpipes ee-
Information: Hazard Group O rok. k (L:
Density 0. 1S"j Q.t le
Design Area 2A00 f(51:Q
K. Factor ". CO
Sprinkler Project Valuation: $ (4,02
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: 3010 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%ofpermit 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.
C:\Users\Ashley\Desktop\Permit Applications\Tigard App.dot Rev 01/05/2012 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13500 SW PACIFIC HWY 17, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2014-00191
Jeff Grove
Violation Summary:
Inspector Contractor