Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2015-00186
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/04/2016Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 92
Project: Bon Baguette Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Fire suppression system for a type 1 hood.
Contractor: SANDERSON SAFETY SUPPLY CO. Owner: ROIC OREGON LLC
1101 SE 3RD AVE 8905 TOWNE CENTRE DR, STE 108
PORTLAND, OR 97214 SAN DIEGO, CA 92122
PHONE: 503-238-5700 PHONE:
FAX: 503-889-3192
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/04/2016 $59.16
12%State Surcharge-Building 01/04/2016 $7.10
Type of Use: COM Plan Review-Fire Life Safety-COM 01/04/2016 $23.66
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 01/04/2016 $4.00
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $93.92
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $800.00
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 the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. //�
Issued By: 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.
Building Permit Application
Fire Protection System V# FOR OFFICE [ISE ONLY
Re
City of Tigard a DateBed Permit No.: 1
13125 SW Hall Blvd.,Tigard,OR 9 Plan Revi n ,�t
= Phone: 503.718.2439 Fax: 503.598. G� DateB : 1 1 [1/ ' Other Permit:J 1/ ; 1 S_ 7c,
a Inspection Line: 503.639.4175 Date Ready/ lj� _ orris: See Page 2 for
Internet: www.tigard-or.gov ���� )a Notified/Method:�f/ 7 t y Supplemental Information
a
TYPEO)F WO 1I�QI 7IIiII. <.,1 ANri�-FA1IIILY.DWELLING
®New construction ❑ \ 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 CONS work work indicated on this application.
$
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation:
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB11 ""'SITE INF'ORMAT'ION AND LOCATION , Total number of floors:
Job site address:13500 SW PACIFIC HIGHWAY,SUITE 92 New dwelling area: square feet
City/State/ZIP:PORTLAND,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:BON BAGUETTE#1-TIGARD Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
IYEQC11EltED DATA 0141 IERCIAL-USE iCHE.CKLI )C F
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
pS1I2IPTION ,WWORK' " work indicated on this application.
INPPRESSION SYSTEM INTO TYPE 1 HOOD Valuation: $800
Existing building area: square feet
New building area: square feet
PROPERTY'OWNER ❑"TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
®,APPLICANT ® CE3NCACT rfIR ON
n_N{717T
Business name:SANDERSON SAFETY SUPPLY CO All contractors and subcontractors are required to be
Contact name:GEOFF SPAHR licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1101 SE 3RD AVE jurisdiction in which work is being performed.If the
City/State/ZIP:PORTLAND,OR applicant is exempt from licensing,the following reasons
apply:
Phone:(503)889-3110 Fax::(503)889-3192
E-mail:GSPAHR@SANSAFE.COM
ME
CONTRACTOR_ UILDING.PERMI
Business name:SAN �T`
.. ., ...
DERSON FIRE PROTECTION I" �r erro cesch�* "
Permit fee:
Address:SAME AS ABOVE
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) Due upon application submittal.
CCB lic.:64969 / Total permit fees:
Authorized signature: / /�� Amount received:
This permit application expires if a permit is not obtained
Print name:GEOFF SPAHR Date: 11/23/15 within 180 days after it has been accepted as complete.
* 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
Llesibe work to.be dcine."
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 ❑ 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 S stemCorn lete A,B, C'or II as a ; licalile
A) ;.Comr'nercial Sprinkler,
❑ ^Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
13. Type I- ,Hood Fire Ste` ressxoan S stun
Hood Project Valuation: $ 800.00
z
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
z
2,001 to 3,600 $246.45 r
3,601 to 7,200 $310.05
r
71201 andgreater $404.39
Sprinkler Project Square"Footage: sq. ft.
FirePr+vIton"" ermit"Fels z,"
Project valuation subtotal see A,B & C above): $
Permit fee based on project valuation see fee schedule): $
Permit fee based onsquare footage see D above): $
State Surcharge 12%of permit fee): $
FLS Plan Review 40% of pertnit fee): $
TOTAL: $
C:\Users\SANDER 1\AppData\Local\"Temp\FPS_PermitApp.doc 2