Permit (16) IN ,,
CITY OF TIGARD
FIRE PROTECTION SYSTEM PERMIT
1 .' COMMUNITY DEVELOPMENT Permit#: FPS2018 00184
TEGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/07/2019
Parcel: 2S102CB01804
Jurisdiction: Tigard
Site address: 13305 SW PACIFIC HWY j
Project: Taco Bell Subdivision: None Lot: None
Project Description: Fire suppression for type 1 hood installation.
Contractor: GUARDIAN FIRE PROTECTION Owner: WEBER COASTAL BELLS LIMITED
PO BOX 1555 WEBER, EDUARD
ALBANY, OR 9733397321 840 CONGER ST
EUGENE, OR 97402
PHONE: 541-926-4920 PHONE:
FAX: 541-926-4942
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/07/2019 $102.20
12%State Surcharge-Building 01/07/2019 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 01/07/2019 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 01/07/2019 $3.00
Occupancy Grp: B 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 $158.34
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
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. 32 2344_
Issued By: Permittee Signature: // G�(A--',
' ‘A/64'C______
Call ' . '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.
aBuild ng Permit Application
Fire Protection SystemRECERsED FOR OFFICE USE oNLY
Received /� ��j L
City of Tigard Date/By: �A, 77 / . „" Aa� "�V f/7
-'t 13125 SW Hall Blvd.;Tigard;OR 9722. ^Lar.Review , _ /
B72018 j • _ -
Phone: 503.718.2439 Fax: 503.598.191510—CDate/By:
Inspection Line: 503.639.4175 t {r;,. _k Date Ready/By: �� 7� el See Page
L L G A R D CITY %1 s,Gp R I�'J Notified M od: Supplemental Information
Internet: www.tigard-or.gov BUILDING DIVISION ��/ PP
TYP OE ' lE� D DA`4,f, AND14 ' Y DWC,. 1G
❑New 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
:k`l I.(",„t?R `( t :,i ii11f"Ttt)`I' work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
z o iMlioI `A'nnoi Total number of floors:
Job site address:13305 SW PACIFIC HWY New dwelling area: square feet
City/State/ZIP:TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:TACO BELL Covered porch area: square feet
Cross street/directions to job site:PACIFIC HWY&PARK ST Deck area: square feet
Other structure area: square feet
ZQ H:; :i#lti co RC� E C. EcI I
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
work indicated on this application.
INSTALL FIXED FIRE SUPPRESSION SYSTEM IN TYPE I HOOD Valuation: $$2,800.00
Existing building area: square feet
New building area: square feet
'! s '.., D " ;0004/ t ANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
Business name:GUARDIAN FIRE PROTECTION All contractors and subcontractors are required to be
Contact name:MARK FERGUSON licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:PO BOX 1555 jurisdiction in which work is being performed.If the
City/State/ZIP:ALBANY OR 97321 applicant is exempt from licensing,the following reasons
apply:
Phone:(541)9264920 Fax::( )
E-mail:mark@guardianfireor.com
+t"C1tNT ."O F BUU DxNq ' : EE
r
Business name:GUARDIAN FIRE PROTECTION 01,igi1
Permit fee:
Address:PO BOX 1555
State surcharge(12%of permit fee):
City/State/ZIP:ALBANY OR 97321 0
FLS plan review(40%of permit fee):
Phone:(541)926-4920 Fax:(541)926-4942 (Due upon application submittal.)
CCB lie.:100355 / Total permit fees:
Authorized signature: /� , {� Amount received:
/// ��'�L� �c�'fZ This permit application expires if a permit is not obtained
I!( within 180 days after it has been accepted as complete.
Print name:MARK FERGUSON Date: I -2'"j * Fee ethodol ,set by Tri-cr,i,nty R,jl i;no Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/0 :COM/WEB)
• a
City of Tigard: Fire Protection Permit Checklist
Page 2 -Supplemental Information
be 4*
1.) Type of-Wolk. 2.) Addition/alLeralloll only Lo sprinkler heads. 3.) AUanioli/aheradoll only to alarm devices:
El New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or El 1-10 heads: Affidavit required and El 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:
yam. ti +te as applla ):
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line El Yes El No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
406' be S*ppmsOott ti
Hood Project Valuation: $ 2800.00
C..) Fire
Submittal shall f Battery Calculations 1 El Yes
include: individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
f
I.) lt.esidetttW,$$. i det(Sunil.lone 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.
Project valuation subtotal (see A,B &C above): $
r._._ 1_....._.a 1. f._ L schedule): $
PCl11111 ICC based vii project valuation (see lee Scl1cuu1c). P
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
C:\Users\Mark Ferguson\Downloads\FPS_PermitApp(1).doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13305 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00184
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor