Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IN *4
COMMUNITY DEVELOPMENT Permit#: FPS2020-00047
Date Issued: 05/13/2020
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S1356C00700
Jurisdiction: Tigard
Site address: 10795 SW CASCADE AVE
Project: Wiggle Land Subdivision: None Lot: None
Project Description: Install fire suppression system in cooking hood.
Contractor: ABC FIRE EXTINGUISHER INC Owner: CASCADE FUTSAL LLC
3201 SE 50TH AVE 5010 NE OREGON ST
PORTLAND, OR 97206 PORTLAND, OR 97213
PHONE: 503-772-1643 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/11/2020 $123.72
Plan Review-Fire Life Safety-COM 05/11/2020 $49.49
Type of Use: COM Info Process/Archiving-Sm$0.50(up to 05/11/2020 $6.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: A-3 Height: ft 12%State Surcharge-Building 05/11/2020 $14.85
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 Calm Provided: Cut Sheets Required:
Total $194.06
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 QUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 4,..47." , � Permittee Signature: eiv
1-770h/
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 USE ONLY
Received 1 / 4 V
City of Tigard ` '� D DateBy:7 Permit zd--Oa)'/7
11
13125 SW Hall Blvd.,Tigard,OR 9 Plan Revie w� Other Permit:
' Phone: 503.718.2439 Fax: 503.598. DateBy: �7 �� e��
TIGAR D Inspection Line: 503.639.4175. �1 Date Ready/By: orris: ® See Page 2 for
Internet: www.tigard-or.gov A pD g 2.OZQ NotiSed,Method: �� �(/n Supplemental Information
TYPE OF....,0 — itGAIRD Es` Ff'IL ants
�� T' �i� �+ REQUIRED DATA:I-AND 2-FAMILY DWELLING
�q�New construction lIt rI Dt\JtS/O 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.
Valuation: S
0 1-and 2-family dwelling commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
ElMaster builder ❑Other: Number of bathrooms:
• JOB SITE'INFORMATION AND LOCATION Total number of Floors:
Job site address:/0735 ,SW 0.st{� 6,, New dwelling area: square feet
City/State/ZIP:411 q0. CD 57 Garage/carport area: square feet
Suite/bldg./apt.no.: aJ� Project name: W �-+�J 1, 49 le`Q Covered porch area: square feet
Cross street/directions to job site: 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK 1 ' work indicated on this application.
Svc a Tire re eV� (tl Dins Valuation S GISCO
H�� , Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ACTENANT Number of stories:
Name: HiA3
N9uye Type of construction:
Address: ^ 1 Occupancy groups:
City/State/ZIP: Existing:
Phone:474) LI Y a. //� Fax:( ) New:
APPLICANT 0 CONTACT PERSON NOTICE
Business name: e vt.fe (44G usher All contractors and subcontractors are required to be
Contact name: .J . licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: �� �Ii /'g t/G jurisdiction in which work is being performed.If the
f a 1 O applicant is exempt from licensing,the following reasons
City/State/ZIP: L N� ,,17.9.20
S+e3 ) '77 tog c ( 5f a�sq- 8833 apply:
Phone: �y�1,
E-mail: r-iX ►Cd(1Q f E"ievl
• CONTRACTOR BUILDING PERMIT FEES*
Business name: 11P Inc. (Please refer to feesckeduk,
ABC Fire ExtinguiS -� Permit fee:
Address: 4848 NE 10 Ave.
State surcharge(12%of permit fee):
City/State/ZIP: Portland, OR 97220 FLS plan review(40%of permit fee):
Phone:(69$ 7172 l tr43 TFax:( 91A 14,147 (Due upon application submittal)
CCB lie.: j 33 A I+ Total permit fees:
Authorized sign' e: Amount received:
Q ' This permit application expires if a permit is not obtained
Print name: 1iir Da[ ~' within 180 days after it has been accepted as complete.
�f * Fee methodology set by Tri-County Building Industry
Service Board.
I:1BoildingtPermits\FP$-PermitApp_o31016.doc 440>613TO 1/02/COM/WEB)
1
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
peZalew 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 (Complete A, B,C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ 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 an*
Hood Project Valuation: $if -
C.) Fire Alarm
Submittal shall Battery Calculations ❑ es
include: Individual Component �'�_es
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 S198.75
2,001 to 3,600 S246.45
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: $
1:\Building\Permit\FPS_PermitApp_0310t 6.doc 2
.14 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2020-00047
IF G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ■ Date Issued: 05/13/2020
®L1�1 Parcel: 1S135BC00700
Jurisdiction: Tigard
Site address: 10795 SW CASCADE AVE
Project: Wiggle Land Subdivision: None Lot: None
Project Description: Install fire suppression system in cooking hood.
Contractor: ABC FIRE EXTINGUISHER INC Owner: CASCADE FUTSAL LLC
4848 NE 102ND AVE 5010 NE OREGON ST
PORTLAND, OR 97220 PORTLAND, OR 97213
PHONE: 503-772-1643 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/11/2020 $123.72
Plan Review-Fire Life Safety-COM 05/11/2020 $49.49
Type of Use: COM Info Process/Archiving-Sm$0.50(up to 05/11/2020 $6.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: A-3 Height: ft 12%State Surcharge-Building 05/11/2020 $14.85
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 Gales Provided: Cut Sheets Required:
Total $194.06
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 1.800.332.2344.
Issued By: Permittee Signature:
'ball 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.