Permit ,, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
` COMMUNITY DEVELOPMENT Permit#: FPS2015-00182
Date Issued: 11/30/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
•
Parcel: 1S126BC01500
Jurisdiction: Tigard
Site address: 9000 SW WASHINGTON SQUARE RD
Project: Embassy Suites Hotel Subdivision: 2005-035 PARTITION PLAT Lot: 3
Project Description: Fire sprinklers-Install/replace Type I hood in restaurant area
Contractor: UNIVERSAL FIRE EQUIPMENT Owner: FO PORTLAND PROPERTY LLC
18260 SW 100TH CT BY WINSTON HARTON HOLDINGS LLC
TUALATIN, OR 97062 745 FIFTH AVE 33RD FL
NEW YORK CITY, NY 10151
PHONE: 503-691-9000 PHONE:
FAX: 503-691-9004
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/30/2015 $102.20
12%State Surcharge-Building 11/30/2015 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 11/30/2015 $40.88
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 11/30/2015 $10.00
Occupancy Grp: R-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 $165.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,850.00
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 . ica ion .- ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or cl ect questions to O C . -•fling 503.232.1987 or 1.800.332.2344.
Is-ued By: „,
Permittee Signature: 5
Call 503.639.4175 by 7:00 a.m.for the next availabl in ction dat
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
in riNN
Fire Protection System y FOR OFFICE USE ONLY
City of Tigard Received
Date/By: if f 9 /sr (4:305 PermitNo.: , p5c`S-•,. Q614A,
14 a 13125 SW Hall Blvd.,Tigard,OR tiQ y33 y Plan Revi j (I �j�
Z •jj d 9 2015 e/H�j \\1�_ I Other Permit: ��P��J�'��
Phone: 503.718.2439 Fax: 503.5 8.196 Date/By:
T t G A R D Inspection Line: 503.639.4175 Date Ready y. / orris: ® See Page 2 for
Internet: www.tigard-or.gov CI Y Of f IGAIRl.i Notified/Method: /i, ��,, Supplemental Information
BUILDL T"1 IVISI®�p (it, ,, (preyTYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
ew construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ommercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
• JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 490—g-0 <' 4
g) h i,,,.,"(..0,1 s4.�(t New dwelling arca: square feet
City/State/ZIP: 7V ! ', (9-R /t7'0.2_ Garage/carport area: square feet
Suite/bldg./apt.no.: 1 Project name: --.),),7 6.7f-SJ Y c!{csS 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.
c:SIValuation: $ �� D
. 19cT -�� i e4 /a`i 541/2--t•c Z
Existing building area square feet
3, g--CCU `, --1,1-, 5- .,.., jh fz+ 64-----t
ee\ h.qe-i
h New building area: square feet
ROPERTY OWNER 0 TENANT Number of stories:
Name: &AI, ,k,.9 ShySGl r • S Type of construction:
Address: 9c'c,_„ , 1.2,. t5 ,a51,,, S ` 2r. Occupancy groups:
City/State/ZIP:S-•r n-.er 7 ZZi Existing:
Phone:(JT /' .2-7 /9v c7 Fax:( ) New:
PLICANTNTACT PERSON NOTICE
Business name:zzt ✓�S, tn� g7 ^nom per,( All contractors and subcontractors are required to be
Contact name: 6r". / J licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be lensed in the
Address: /5-2.6- O J jurisdiction in which work is being performed.If the
/vim _ c - ,
/State/ZIP: applicant is exempt from licensing,the following reasons
City/State/ZIP: Tu r7 !�— `pig e�• 57c 7 apply:
Phone:6--02) 65/_S ty J Fax: :( )
E-mail:anNelcft (' 6 �`J,,*5nrt7e.H.,ei,A)f,,-/J:(.. Cc,, ,„
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: 5,4"--,e__ S 4-6-0.-.�at_ Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%ofpermit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lie.: Qt6 7 'ay Total permit fees:
Authorized signature: "� / Amount received:
This permit application expires if a permit is no o tained
Print name: —6—
within 180 days after it has been accepted as complete.
Date:/( * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_071514.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 heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or El 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
El 11+ heads: Plan review required and El 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 Arca
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component El 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 fcc schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $
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