Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 I COMMUNITY DEVELOPMENT Permit#: FPS2015-00025
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/19/2015
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 alarm: Add new fire alarm control&dialer and monitor a new hood suppression system.
Contractor: AMERICAN SECURITY ALARMS, INC. Owner: ROIC OREGON LLC
5411 SE MCLOUGHLIN BLVD 8905 TOWNE CENTRE DR, STE 108
PORTLAND, OR 97202 SAN DIEGO, CA 92122
PHONE: 503-231-0303 PHONE:
FAX: 503-230-1044
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/19/2015 $64.54
12%State Surcharge-Building 02/19/2015 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 02/19/2015 $25.82
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 02/19/2015 $10.00
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: Yes Alarm Type: Automatic
Pull Station Required: No Smoke Detectors Req: Yes
Battery Calcs Provided: Cut Sheets Required: Yes
Total $108.10
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $975.00
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 by calling 503.232.1987 or 1.800.332.2344. /
tie
Issued By: (�:i Permittee Signature: -
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.
•ilding Permit Application
1 ~otection System RECEIVED 1 ()It ()I I It I l `l l)•l '
City of Tigard Received gm Permit No.:F--, a_eva ,3,S
Date/0 :
.- • 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review •
IN
Phone: 503.718.2439 Fax: 503.5901 7 2015 Date/By:f y\ •• • er Permit: AttPaollt eti 7 8
1 1,,_.,is , Inspection Line: 503.639.4175 Date Read is . lurk: 65 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method:. fil i5 Agifk Supplemental Information
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❑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.
❑ I-and 2-family dwelling CommerciaUindustrial Valuation: $
❑Accessory building Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
' ;,4OB`S I'1'R`INFORMATION ANDD LOCATION Total number of floors:
Job site address: /,35 )d ,55✓ pa-c-(/ c �l�ir/y 52,d•T /7 New dwelling area: square feet
City/State/ZIP: 7G19n ) C'g- /7L Z3 _ Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: M/Z(�r"t I �eAFFt_
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.
/12.1.4 -7 !t-76--1ri--/ 'c,Yrv/ - /�� Valuation: $ y7.�.�ll-
aam /'ee>i r 7 v? • A ` V !1- ,(PO 5 te,T.S. -) Existing building area: square feet
Si S.G New building area: square feet
_� F t,! t 7+ :'6I,, ` ,-• _ : C sib
Number of stories:
Name: Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax ( )
F ,zT-kx� r g .. New:
L, : .
� w. ter. Or" NOTICE
Business name: 19}�j ems/e7-,r-1-1 z Lr=/ ' .."7, G C. All contractors and subcontractors are required to be
Contact name: /�"f •L A/./44-c. licensed with the Oregon Construction Contractors Board
Address: 570/ St /vIC� �iv� ��� under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed.If the
City/State/ZIP: Pjy-11 ,4 Gym 7 id -Z applicant is exempt from licensing,the following reasons
S ) Z apply:
Phone:(
3(-030- I Fax: 030 /04Y
E-mail: ,fot'77t �j CiL'1'!srt 5 - C/-7'yj
`: '1,!.. `. a . F:5}' CONTRACT01t
BUILDING PERMIT FEES*
Business name: Z T/c -- Al.7 ) kic, (Please efertofeeesehedult
Address: .57 / Sciv/C,1 c K../r-i e Alti.
Permit fee: f
City/State/ZIP: /1-die --1 0 _._ 9 7 j?. y State surcharge(12%of permit fee):
Phone:(�j ) "Z3 03 C7 FLS plan review(40%ofpermit fee):
3 I Fax:(,533) 2.30 / O Y f{ (Due upon application.)
CCB lie.:
/-61-4 0 Total permit fees:
Authorized signature: (� I Amount received:
/0.-6.,../ �/ This permit application expires if a permit is not obtained
Print name: 1 cy.�r' t !•t( I Date: L.- /r� . l within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
1:1BuildinglPermitsVPS-PermitApp.doe Rev 01/05/2012 Service Board.
440-4613T(1 I/02/COM/WEB)
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
998 Alarm Final
PASS - No C of O
FPS2015-00025
Jeff Grove
Violation Summary:
Inspector Contractor