Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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1111 m COMMUNITY DEVELOPMENT Permit #: FPS2009 -00066
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/14/2009
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 120
Subdivision: Lot: 0
Project: Little Caesars Pizza
Project Description: Installation of new fire sprinkler system.
Owner: FEES
SN PROPERTIES PARTNERSHIP Description Date Amount
1121 SW SALMON ST
PORTLAND, OR 97205 Permit Fee - COM 08/14/2009 $62.50
12% State Surcharge - Building 08/14/2009 $7.50
PHONE: Plan Review - Fire Life Safety - COM 07/29/2009 $25.00
Contractor:
FIRE SYSTEMS WEST INC
600 SE MARITIME AVE #300
VANCOUVER, WA 98661
PHONE: 360- 693 -9906
FAX: 503 - 289 -2208
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Type of Use: COM
Class of Work: FPS Type of Const: VB
Occupancy Grp: A -2 Height: ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $95.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 1800
Residential Square Footage:
Fire Alarm Valuation:
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: g)rit,� Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
,
re Fire Protection System
Buildine Permit ADDlicati i ,CEIVED Fc)R of l ic1. l psi: O 1.1
City of Tigard Da , . 7 gQ c9 0.71 Permit No.: /5.A01...e2X) •
13125 SW Hall Blvd., Tigard, OR 9721Th 2 p Plan Revi Other Permit:
503.639.4171 Fax: 503.59>; t� i7 2009 Date/B. Am`lki, Tm on MI
r I < A R D Inspection Line: 503.639.4175 Date • +'s i r e ' : y . ® See Page 2 for
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Internet: www.tigard -or.gov CITY OF TIGARD Notified/Methotl: :. , • d ! A Supplemental Information
BUILDING DlV1JI N
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
pf Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2 -family dwelling Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi -family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
• JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I C 2 51/4„) Q 1 f t C. 1414 p 6,./p4 if New dwelling area: square feet
City /State/ZIP: 1-1 Li A bp_ Garage /carport area: square feet
Suite/bldg. /apt. no.: /,.„0 I Project name: L. fi tie col Sa¢S Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
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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 work indicated on this application.
WO RO 9 ?z6'pi 1 /1 F-4- ( SP2iUK�cf� -j Valuation: $ ' '
Existing building area: square feet
New building area: square feet
b PROPERTY OWNER I ❑ TENANT Number of stories:
Name: l��E 1Ltt'5 (opif f j � -uCnOJ Type of construction:
NA
Address: Qccupancy groups:
City /State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
• APPLICANT ❑ CONTACT PERSON NOTICE
Business name: f t fLL S y/S-T . J G A I - 1 . 7 - All contractors and subcontractors are required to be
Contact name :tp�f S,gywplaL licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: (0..CD > S r /K p r iw - is 3, jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City / State/ZIP: V ( / U A Q / apply:
Phone: 04,0 )693Q 9 I Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule) �
Business name: i„„f Permit fee: � .6 U 0
• Address:
State surcharge (8% of permit fee):
City / State/ZIP: FLS plan review (40% of permit fee):
Phone: ( ) I Fax: ( ) (Due upon application.)
CCB lic.: 4 g -? .32
Total permit fees:
. Authorized signature: ---....„.......,.7,, Amount received:
"'...... This permit application expires if a permit is not obtained
I Print name: • j cifIvi y s�.l I Date: "7 - 21 - oc? , within 180 days after it has been accepted as complete.
Fee methodology set by Tri -County Building Industry
Service Board.
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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 ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
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Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
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Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
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C.) Fire Alarm
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 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
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 (8% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
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