Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00094
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2016
T r C;A I..ng Parcel: 2S102AA00490
Jurisdiction: Tigard
Site address: 12085 SW HALL BLVD 130
Project: Arellanos Sports Bar Subdivision: None Lot: None
Project Description: New NFPA 13 fire sprinkler system.
Contractor: FIRE ONE FIRE SYSTEMS INC Owner: HALL STREET CROSSING LLC
PO BOX 734 BY MR&MRS ROGER W TOM
OREGON CITY, OR 97045 8067 SW RIGERT COURT
BEAVERTON, OR 97007
PHONE: 503-557-9050 PHONE:
FAX: 503-557-9268
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/19/2016 $209.80
12%State Surcharge-Building 10/19/2016 $25.18
Type of Use: COM Plan Review-Fire Life Safety-COM 10/19/2016 $83.92
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard:
Density: .10 Design Area: 1500
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 $318.90
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $13,000.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, St. - of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will a .ire I work is not started within 180 days of
issuance, or„if.-.work, is suspended for more the 180 days. ATTENTION: Oregon law requires yo . fo ow the rules ad-: :• by the Oregon
Utility Nptlfication Cen Those rules are set forth in OAR 952-001-0010 through OAR 952-00 -009r. ou may obtain a copy of the rules
or dire?f questions to OUNC , c. g 503.232.1987 or 1.800.332.2344.
111111121Issue By: / ,/ /� Permittee Signature: ; / "-1111111_`��
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 ®�� FOR OFFICE t SE()NIA
�� Received �Q J'
City of Tigard 1 Q` Date/By: /I / Permit No.:/_7 S 14,..
IN '. 13125 SW Hall Blvd.,Tigard, R 7223 '� y Plan Review/ �. ' ��
■ V i 1 Other Permit:
Phone: 503.718.2439 Fax: 503.598 r:P� Date/By: , , 1 D7,4,I)
TlGAKDInspection Line: 503.639.4175 c.Vt?1SU Date ReadyBye T /) Juris: ® See Page 2 for
Internet: www.tigard-or.gov 1�� r O`V Notified/Method:10/ / 6�'' Supplemental Information
(``\1 ISAN�l7 I* 1psi 0mor' 4-��,,�0,tzAAi, lC
TYPE Op-41401..—RK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction El 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.
El1-and 2-family dwelling ,Commercial/industrial
Valuation: S
El Accessory building ElMulti-familyNumber of bedrooms:
El Master builder ID Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: i 12_0005
��j �L t~,j 0 New dwelling area: square feet
.-r(City/State/ZIP: �( �� } _" 1r _3�t-p- c "t 2 ' Garage/carport area: square feet
Suite/bldg./apt.no.: r ) Project name: Aae- L....L_oes,sky 6.)S -laiSkR., Covered porch area square feet
Cross street/directions to job site: xit y 9 q 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.
Valuation: $�--k? v'7 )---1-- Ct 'Yl,� 7.i l i s 73/010
F-1 l R J•719 \ �- rs t?. (3 Existing building area square feet
L L �C 1� t� �.J New building area: square feet
0 PROPERTY OWNER I 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
V City/State/ZIP: Existing:
�J1 Phone:( ) Fax:( ) New:
lig APPLICANT (CONTACT PERSON NOTICE
Business name: P l)' .L5 (5tE fr- '('t 45 - 15 All contractors and subcontractors are required to be
Contact name: / licensed with the Oregon Construction Contractors Board
K1 I L, )C e _t under ORS 701 and may be required to be licensed in the
\)-- Address: 0 1 Br, lo`--1 jurisdiction in which work is being performed.If the
• • City/State/ZIP: C5�1 ids^t) c v-t \- o A. �,Cj C..t �G`. applicant is exempt from licensing,the following reasons
14 �t�ca /� apply:
Phone: 3) ;515-1 ._aj,05a _ )(50 J.'r2''q,-`-i4 S 1
E-mail: . 1 rip,L okt i' 6 " 1,11'`x6 i 1 7
t CONTRACTOR BUILDING PERMIT FEES*
4Business name: (Please refer tofee schedule)
Permit fee:
Address: (ffitrY/c 4
L State surcharge(12%of permit fee):
City/State/ZIP: o
FLS plan review(40%ofpermit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.: t g( (.,.) Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: Ge_^,_ _ PL Date: 5:11 _16, within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\PermitsWPS-PermitApp.doc 02/01/2011 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) -N 2.) Modification to sprinkler heads only:
El Addition El 1-10 heads: No plan review required.
El Alteration 14..5+ heads: Plan review required.
El Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
et El Dry
Additional Standpipes A44–
Information: Hazard Group 0 r1.
Density i/O
Design Area J5Zri%
K. Factor
Sprinkler Project Valuation: $ i 3/ )
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 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: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
LI:\Building\Permits\FPS-PemutApp.doc 02/01/2011 2