Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
`1 1 • ' COMMUNITY DEVELOPMENT Permit#: FPS2019-00059
T u A IF f.) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/30/2019
I
Parcel: 1 S136DA00700
Jurisdiction: Tigard
Site address: 11530 SW PACIFIC HWY
Project: Lu's Sports Bar Subdivision: None Lot: None
Project Description: Fire sprinkler.Adding(36)sprinkler heads for TI.
Contractor: WYATT FIRE PROTECTION INC. Owner: LU,XU JIAN
9095 SW BURNHAM HUANG,WEN HUI
TIGARD, OR 97223 4798 AUBURN LN
LAKE OSWEGO, OR 97035
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/17/2019 $145.24
12%State Surcharge-Building 05/17/2019 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 05/17/2019 $58.10
Class of Work: ALT Type of Const: VA Info Process/Archiving-Lg$2.00(over 05/17/2019 $2.00
Occupancy Grp: A-2 Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 05/17/2019 $25.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 0.1 Design Area: 900
K Factor: 4.2
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $247.77
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $6,390.00
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 1.800.3 .2344. /J
Issued By: Permittee Signature: (V/7,
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 LSE ONLY
Received
City of Tigard T f i c;a Date/By: c�� Permit No.: Aq_0�151
■ 13125 SW Hall Blvd.,Tigard,OR 97223 -, Plan Review
O Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit �"
-J3-- j9 �J ` vt t-CYJ3
T I G A h D Inspection Line: 503.639.4175 Date Ready/By: Jnris: Ei See Page 2 for
Internet: www.tigard-or.gov L.... - . , ...1,,,„,)j Notified/Met /,d: ` 7 / Supplemental Information
❑New construction ❑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 Off,CO - O work indicated on this application.
El1-and 2-family dwelling ❑■ Commercial/industrial Valuation: $
111Accessory building I:Multi-family Number of bedrooms:
El Master builder 1=1 Other:
Number of bathrooms:
JOB Sff ,ORMAT.ION AND LOCATION- Total number of floors:
Job site address:11530 SW Pacific HVVY New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Lu's Sports bar Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
R (WIWI DATM O RRCl1181 cIJCXLJ
Subdivision: I 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
,' DESCRIPTIONOF Wo work indicated on this application.
Extend existing fire sprinkler system Valuation: $6,390
Existing building area: square feet
New building area: 0 square feet
❑ IPROI'E OWN ll ❑;TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax ( )
New
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ronin Campbell licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:( )503.684.2928 I Fax: :( )503.684.9657
E-mail:r.campbell@gmail.com
lfase relta.O'iell `3 ..
Business name:Wyatt Fire Protection Permit fee:
Address:9095 SW Burnham
State surcharge(12%of permit fee):
City/State/ZIP:Tigard, OR 97223 FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.)
CCB lic.:64077 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Pint name:Ronin Cam bell Date:5/2/19 within 180 days after it has been accepted as complete.
- -
* Fee-methodology-set by Tri-Counry-Bnikting Industry
_-
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(l1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
. �xe_w r ►be:doh,
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
El New system Number of sprinkler heads: 36 Number of alarm devices:
0 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 cif System(Complete , C or I a apphcable)x .
A.) Commercial Sprinkler
Sprinkler Type ssP-QR • Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Light Hazard
Density o.i
Design Area 900
K. Factor 4.2
Sprinkler Project Valuation: $6390
"Type I, , od.Fire Suppres�ox�..sytex.:. .
Hood Project Valuation: $
Cts Fite Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05 ## p
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
. . Fire Pr tection to at 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: $
W\Perm is\Pemut Application Forms(U datedJuIy 2017)\figar i ire Permit App doc 2