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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 11111 • COMMUNITY DEVELOPMENT Permit #: FPS2011 -00079 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011 Parcel: 2S110AB00200 Jurisdiction: Tigard Site address: 14411 SW PACIFIC HWY Project: Rialto Subdivision: CANTERBURY SQUARE Lot: Project Description: Fire suppression system for Type I hood. Contractor: UNIVERSAL FIRE EQUIPMENT Owner: KOLVE, G C 18260 SW 100TH CT 14389 SW PACIFIC HWY TUALATIN, OR 97062 TIGARD, OR 97224 PHONE: 503 - 691 -9000 PHONE: FAX: 503 - 691 -9004 FEES Description Date Amount Specifics: Permit Fee - COM 06/28/2011 $86.06 12% State Surcharge - Building 06/28/2011 $10.33 Type of Use: COM Plan Review - Fire Life Safety - COM 06/28/2011 $34.42 Class of Work: ALT Type of Const: VB Info Process /Archiving - Sm Sheet (up to 06/28/2011 $15.50 Occupancy Grp: A -2 Height: ft 11x17) Stories: 1 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 $146.31 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $1,800.00 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 issua rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon • ity Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a c. .y of the rules r direct questions to OUNC by ing .0 232.1987 or 1.800.332.2344. / sued By: Permittee Signature: `._ Call 503.639.4175 by 7:00 a.m. for the next availab insp- ion da This permit card shall be kept in a conspicuous place on the jo • site til corn • etio the project. Approved plans are required on the job site at th= ti • of each in- • - ion. Building Permit Application E ` t r -11° Fire Protection System FoR 91. t SE: ON1.1 d 7Q City of Tigard Dat B Receive : i dZ 1A Permit No.. %� //� 7? 1114 • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review , . t r (` �£ � 4 , j 11_,f2 3 Phone: 503.718.2439 Fax: 503.598.198.19 60 Date/By: / y: Other Permit: /� T I G A R D Inspection Line: 503.639 Date Ready/By: ti ,, , ,,,, uri See Page for Internet: www.tigard- or.gov Notified/Method: t . ; 't S upplemental Information ir , t rfl_ fTtr CY TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (romded 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. 12 ©.E 1- and 2- family dwelling eftfinercial/industrial Valuation: $ El Accessory building ❑ Multi- family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: New dwelling area: square feet City /State /ZIP: ,t1 R ' 7 2 24i Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: R 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. Tax map /parcel no.: Indicate the value (romded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. . s- + 6 fi o ! P � C/ e✓in Valuation: $ / I G� < ger° / S r4 4 S e- -e_ t . ' t Existing building area y square feet ih /-1, /0 h tC, / .444 s.+ rheln...4 New building area: square feet ❑ PROPERTY OWNER lawiL?1 NT Number of stories: Name: /Ali 11-1,4 Type of construction: Address: / y L1 L/ J % I, /j, j ot2 '7 cl Occupancy groups: City /State /ZIP: , ry ..( 7 � 2 7 V Existing: Phone: t.55:3 3Z 7 Fax: ( , ) New: [2]..4PPLICANT m►E8NTACT PERSON NOTICE Business name: I � �f� JZ i ., p-, I) , 4 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: / s' 26-0 k', / 64_, jurisdiction in which work is being performed. If the City/State /ZIP: Ti 041. -i� 0 6 — - applicant is exempt from licensing, the following reasons ��� � apply: Phone: 7) 6 5 /.....I 0 Fax: ;4 ?) 6 , (, 9,,, y E -mail: CONTRACTOR BUILDING PERMIT FEES* Business name: // J (Please refer to fee schedule) tin r � � / ��� �� Permit fee: Address: I� 2 6 :5",,,,,2j ion o State surcharge (12% of permit fee): City/State/ZIP: ty Ll'f� / ._,2� 6 lc Z FLS plan review (40% of permit fee): Phone_? ) d . /9�,�e . Fax ,7) 4" /j ! /_� �� (Due upon application.) CCB lie.: 7 21 ` Total permit fees: Authorized si e: y---(---> Amount received: This permit application expires if a permit is not obtained Print nam . t� 4 Date: a..—!/ within 180 days after it has been accepted as complete. - ..---417 * Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \Permits\FPS- PermitApp.doc 02/01/2011 440- 4613T(I1 /02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition El 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Mann Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone 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. 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: $ Plan review requires a completed application and three (3) sets of plans at submittal. Plan review fees are required at submittal. I: \ Building \Permits \FPS - PermitApp.doc 02 /01/2011 2