Permit (234) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2018-00063
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/09/2018
T EP' t°�a 9 Parcel: 1 S 136AD04300
Jurisdiction: Tigard
Site address: 11477 SW PACIFIC HWY
Project: Bannings Restaurant Subdivision: VILLA RIDGE Lot: 2
Project Description: Install(2)new fire suppression systems in new type I hoods.
Contractor: GUARDIAN FIRE PROTECTION Owner: WESTSIDE INVESTMENT GROUP LLC
PO BOX 1555 PO BOX 2166
ALBANY, OR 9733397321 LAKE OSWEGO, OR 97035
PHONE: 541-926-4920 PHONE:
FAX: 541-926-4942
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/09/2018 $123.72
12%State Surcharge-Building 07/09/2018 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 07/09/2018 $49.49
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 07/09/2018 $27.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes 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 $215.56
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $5,000.00 1 Anso system
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 - 1-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.8 .332.2344.
Issued By: jog/ Permittee Signature: �
Call 503.639.4175 by 7:00 a.m.for the next available inspecti date.
This permit card shall be kept in a conspicuous place on the job site until completion of the proj-ct.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard -i°ed rp / -�"�
II ' 13125 SW Hall Blvd.,Tigard,OR 97223 'y �d�%0 �"�I PermitNo �" ��-�� �
Phone: 503.718.2439 Fax: 503.598.1960RE C / I to eviey`I . 1, Other Permit:�}/� `rim f�L���y
Date/By: 6b )` J
T1(2,A R D Inspection Line: 503.639.4175 Date Ready/By: / Juns: I ® See Page 2 for
Internet: www.tigard-or.gov L01.�.tified/Metho. �/ �(� /./....-e4 Supplemental Information
3 fie, .. '� �..r. r .. ', :,. .�.:�..,...� ., -,..
;- ,_ TYPE OF WORK C r Q 1#>�"w,. t .,"r' REQUIRED DATA:1 AND 2-FAMILY DWELLING .,:
El New construction ❑DeniviSON Permit fees*are based on the value of the work performed.
lYp+ r 7 Indicate the value(rounded to the nearest dollar)of all
Ef Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
0 1-and 2-family dwelling ['Commercial/industrial Valuation: $
ElAccessory building 1:1 Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
.; JOB^"SITE INFORMATION AND LOCATIOI „%"" € Total number of floors:
Job site address: f'r Li 7 7 _I—L..„, , 4C/ic,G H c,,i, , New dwelling area: square feet
City/State/ZIP: .--/-16 A .,j c,01 c? 7 2. 2 3 (;/� Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:.s',L'/)/N(U., 1&:,(7-4 tf.e.4 iv( Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DAT CO RCIAL- ® -7A---
Subdivision:
USubdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
s k% i ESCRIPTI N OE work indicated on this application.
o<, ,, , i s ..
rites'T�.�'t I L < �s Valuation: $ L?�
s-yf j s�(1 /,i 4'EL") ly p E Z 7..7 0c7 Existing building area: square feet
New building area: square feet
-.3y Mit TY a ' RTENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( )
New:
:` , 'li CANT " s=ue, �r0� -CONT z` 'E a. £NO'>t ,rte:
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( )) Fax::( )
/
E-mail: I" / rke (<Qrl'('/pE /) f7 ire (.)r e'0 ill
..6'.14-.r.e -" ,., ' CO _ . ;' OR# ,; ,.- BOLDING PE' .,l.. FEES*.
,rw :(Please refer to fee schedule nx :1w ".
Business name: t{-iq e_6(A Al 'l 12 F
Permit fee:
Address: 100 go?(,- 13$- State surcharge(12%of permit fee):
City/State/ZIP: 4 t.,641L' o R. Ci 7 3 J
Y FLS plan review(40%of permit fee):
Phone:(5 yl)L7 24, Y q-2 o Fax:( ) (Due upon application submittal.)
CCB lic.: /0 C'3 53-- Total permit fees:
Authorized signature: A.10 4_, ��e
Amount received:
This permit application expires if a permit is not obtained
Print name: 14,1 4 it 'C, 1 OA,/ Dater ////j* 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(ii/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Desd4 e work'to b . onie:
x
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 System mplete A, C or D as a" cable) 4
4
Coe '1,
f erg �p &� v + #^ .e .•' y N vs. ,..� �.. .a.'
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes EI No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ ,..„.....,,,,,...,:i , ,,,.,,,,,,,, .c.,',::,,,,,,,,r.,,:
B ) Type}f I� Fie ppr' n. stein ,.. �4L
Hood Project Valuation: $
F� a ,11
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
R ; entia n• {Stam Mo Sy to li-v''',;',...,,,,,,
.` '2,i.,.,._;,..,5?, � I .
Square Footage: Permit Fee: � �
0 to 2,000 $198.75 '` 3 *
2,001 to 3,600 $246.45 � .
3,601 to 7,200 $310.05 7 �•
7,201 and greater $404.39 h
Sprinkler Project Square Footage: sq. ft.
1 F3 arotecti•o Perot F ;
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: $
L\Building\Permits\FPS_PermitApp_031016.doc 2