Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a COMMUNITY DEVELOPMENT Permit#: FPS2015-00082
T(G A R n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/04/2015
Parcel: 1 S135BA00102
Jurisdiction: Tigard
Site address: 10218 SW WASHINGTON SQUARE RD
Project: Noodles&Co. Subdivision: OAKBURG Lot: 9
Project Description: Hood fire suppression system.
Contractor: SANDERSON SAFETY SUPPLY CO. Owner: PPR SQUARE TOO LLC
1101 SE 3RD AVE PO BOX 847
PORTLAND, OR 97214 CARLSBAD, CA 92018
PHONE: 503-238-5700 PHONE:
FAX: 503-889-3192
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/04/2015 $69.92
12%State Surcharge-Building 06/04/2015 $8.39
Type of Use: COM Plan Review-Fire Life Safety-COM 06/04/2015 $27.97
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 06/04/2015 $10.00
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 $116.28
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,150.00
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 copy of t e rules
or direct questions to OUNC by calling 503.232.1987 or 1.800
Issued By: Perms • - • ature:
Call 50 .• 5 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.
1
• Minding Permit Application
Fire Protection System FOR OFFICE USE ONLY
Citc Received
City of Tigard �G �V Date/B : S lap Pernut No: .m11/° -690"
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review rill��,
C I Other Permit: /
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : % I /5:— / .
T►G A R D Inspection Line: 503.639.4175 MAY 12 2015 Date Ready :y: .. Jugs: See Page 2 for
Internet: www.tigard-or.gov Notified/Method: S o2/ ,(s leaf Supplemental Information
•1`rY ,,-,F TIG RD 101/ gEO`-
TYPE OF ii14 DING DIVISIUN Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
New construction ❑ Demolition equipment,materials,labor,overhead,and the profit for the
❑Addition/alteration/replacement ❑Other:
work indicated on this application.
CATEGORY OF CONSTRUCTION Valuation: $ (5 0
❑ 1-and 2-family dwelling Commercial/industrial
Number of bedrooms:
❑Multi-family Number of bathrooms:
Accessory building y
❑Master builder ❑Other: Total number of floors:
JOB SITE INFORMATION AND LOCATION New dwelling area: square feet
Job site address: tU 11 6 SUN Lthi 1J.t uaee., Garage/carport area: square feet
City/State/ZIP: po p, p'(L an. Z 3 Covered porch area: square feet
Suite/bldg./apt.no.: I Project name: NDVaUtS All 1 Deck area: square feet
Cross street/directions to job site: Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Permit tees*are based on the value of the work performed.
Subdivision: I Lot no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
Tax map/parcel no.: work indicated on this application.
DESCRIPTION OF WORK Valuation: $
1161,A)..3. .s. e_&. 0.,5Vo Existing building area: square feet
New building area: square feet
Number of stories:
❑ PROPERTY OWNER ❑ TENANT Type of construction:
Name: Occupancy groups:
Address:
Existing:
City/State/ZIP:
New:
Phone:( ) Fax:( ) NOTICE
,APPLICANT ONTACT PERSON All contractors and subcontractors are required to he
Business name: licensed with the Oregon Construction Contractors Board
Contact name: �� ^j P�t}�� under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed.If the
Address: applicant is exempt from licensing,the following reasons
_ , LIYIt J apply:
City/State/ZIP: rr'
Phone:( ) I Fax::( )
E-mail:
BUILDING PERMIT FEES*
CONTRACTOR (Please refer to fee schedule)
Permit fee:
Business name: Sahat CS M Sa_Ctiell
Address: \Ld L se 3rd State surcharge(12%of permit fee):
City/State/ZIP: (1a(.k-10,�� G(., 91-ZIt( FLS plan review(40%of permit fee):
t t� (Due upon application submittal.)
Phone:(503) 23�— 5' DU I Fax:Go ) gg°I .31'12- Total permit fees:
CCB lic.: Co t-( cl l9 cl Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: U, -5 ('k Date:5/IL/15 I * Fee methodology set by Tri-County Building Industry
Service Board.
REQUIRED DATA:1-AND 2-FAMILY DWELLING
I\Building.Permits FPS-Permit App 571,14 doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 -Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler 3.) Addition/alteration only to alarm devices:
heads:
❑ New system Number of alarm devices:
Number of sprinkler heads:
❑ Addition or ❑ 1-5 devices: Affidavit required and
Alteration ❑ 1-10 heads: Affidavit required and (3) copies of sketch showing area
to existing (3)copies of sketch showing area of work within building structure
system of work within building structure
❑ 6+devices: Plan review required and
❑ 11+ heads: 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 $ f 1
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 $31 0.05
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: $
C:\Users\sanderson fs\AppData\Local\Temp\FPS_PermitApp.doc 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
10218 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Fire Protection System
920 Suppression trip test
PASS
FPS2015-00082
Jeff Grove
Violation Summary:
Inspector Contractor