Permit (151) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
.' COMMUNITY DEVELOPMENT
Permit#: FPS2017-00009
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/01/2017
T l i ;�I<.t_y9 Parcel: 2S112DA00300
Jurisdiction: Tigard
Site address: 15230 SW SEQUOIA PKWY 150
Project: Flyboy Brewing Subdivision: PACIFIC CORPORATE CENTER Lot: PTS 6-7
Project Description: Installation of an Ansul R-102 4.5 gallon fire system into an exhaust hood.
Contractor: UNIVERSAL FIRE EQUIPMENT Owner: PACIFIC REALTY ASSOCIATES
18260 SW 100TH CT ATTN: N PIVEN
TUALATIN, OR 97062 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-691-9000 PHONE:
FAX: 503-691-9004
FEES ,
Description Date Amount
Specifics: Permit Fee-COM 03/01/2017 $112.96
12%State Surcharge-Building 03/01/2017 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 03/01/2017 $45.18
Class of Work: ALT Type of Const: IIIB Info Process/Archiving-Sm$0.50(up to 03/01/2017 $12.50
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 $184.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
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
Utili otificatioh :titer. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o direct questions to OU, by -ling 503.232.1987 or 1.800.332.2344.
z/.4 ...,
ssued By: //,, /� ( Permittee Signature:
`o\ (./\,..„,
Call 503.639.4175 by 7:00 a.m.for the next availa e' spectio ate.
This permit card shall be kept in a conspicuous place on the job ite until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Buildin Permit A licati
Fire Protection System CEI VED FOR OFFAL I: L SF O\l.)
City of Tigardeceived ^
g FEB�� ' Date/By: 7 Permit No.: Pjo?p/ Llr�7
11 13125 SW Hall Blvd.,Tigard,OR 97223 I
= g Plan ReZte
Phone: 503.718.2439 Fax: 503 5 Date/By:III
Z I b 11 they Permit: � l��3ld
I I G A R D Inspection Line: 503.639417 H ,t 'I/'. {E Date Rea., : /� �uris: ® See Page 2 for
Internet: www.tigard-or.gov 1...LA I (.:a i VISION Notified/Method:MeI�/lCO /7 I Supplemental Information
Oe ,e `mak(t ' �l
TYPE OF WORK REQU D 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
El Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling mercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:)'73c Sa 5re,u,p;-7,4 Alt 1474/ New dwelling area: square feet
City/State/ZIP: aL itile rtc%e 02._ C'7 Z2 C f Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:rrii buy $,y ,,•,,..1 Covered porch area: square feet
u� t
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA'COMMERCIAL-USE ChIECKLIST"
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 or WORK work indicated on this application.
Valuation: $ c
L.-I S /41,10 ,: .. J7� ..5".1--svi e-2-Zi C ..L 42�
G/- ./4 `/t,� A, 5y.s., ,, `;w t� .6t-e-1
Existing building area: square feet
e)C%d 14'5•L 17,3 New building area: square feet
0 PROPERTY OWNER `,f, ZoTIrNANT Number of stories:
Name: 1-776 o y de/ 're-..' it Type of construction:
Address: /5 2 36 i.4.J ceL,t4 l� /,1Gc t-i� Occupancy groups:
City/State/ZIP: a' ter n ,d f02` 7 ZZ Y Existing:
Phone: 3)6 517_ s,7 Z Fax:( )
New:
.e .... 0 .1' -., ;. •4•,,m, /� I ' a •„,,:s! 4,v1, I °",:i,
Business name:G-�h i f 1/ n.c 'Y;)i1e� All contractors and subcontractors are required to be
Contact name: rte`f / a licensed with the Oregon Construction Contractors Board
1 ' I, under ORS 701 and may be required to be licensed in the
Address: / d 5 /' G jurisdiction in which work is being performed.If the
City/State/ZIP: �` applicant is exempt from licensing,the following reasons
.-- / le e�-f llt �7C 6-e apply:
Phone:( 1 j 6 i ”z(9--0 s3 Fax: . 3) 69/ .9c)u 5/
E-mail:
a/1 C v � c- iTRA4tjCslit01/JI a9,/1! ccfr
7
CO CTOR BUILDING PERMIT FEES*
Business name: 5 y „t e. /51.S /4 G u ti
(Please refer to fee schedule)
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.: / 7. Total permit fees:
Authorized signatu -. ' ;,?,<7.---
Amount received:
This permit application expires if a permit is not obtained
Print name: 66' - - within 180 days after it has been accepted as complete.
ms_ -2 Date: 2_L' t` * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\FPS-PermitApp 03 016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Desetibe 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 ❑ 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 o(f 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 System(Complete A,B,C or D as applicable):
,.) Commercial Sprinkler
Sprinkler Type LiWet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
Ditesidentia
SF d Alone ystem)rinkler Stan
-.
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 z;
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: $
I:\Building\Pemuts\FPS_PemutApp_031016.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15230 SW SEQUOIA PKWY 150, TIGARD, OR,
97224
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00009
Inspection Type: Inspector:
999 Sprinkler final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor