Permit (172) 1
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 3: COMMUNITY DEVELOPMENT Permit#: FPS2018-00167
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 12/06/2018
T[tat .CS 9
Parcel: 1 S 134 BC00300
Jurisdiction: Tigard
Site address: 12286 SW SCHOLLS FERRY RD A
Project: Koba Grill Subdivision: None Lot: None
Project Description: Installation of new kitchen hood fire suppression system.
Contractor: MAINSHEET INC Owner: FW OR-GREENWAY TOWN CENTER LLC
15515 NW WESTBROOK WAY PO BOX 790830
PORTLAND, OR 97229 SAN ANTONIO,TX 78279
PHONE: 503-807-6554 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/05/2018 $123.72
12%State Surcharge-Building 12/05/2018 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 12/05/2018 $49.49
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 12/05/2018 $16.50
Occupancy Grp: B Height: ft 11x17)
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: Yes Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $204.56
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 adopte. by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You rga9 obta' opy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. _
Issued By: c..40 /
Permittee Signature:
Li'
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 RE !V FOR OFFICE CSE oNL'
City of Tigard NOV q 2018 Daceivyd s f/t, Pe > 9Cl .-t/1'00/(07
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review p NNP�r
Phone: 503.718.2439 Fax: 503.598.1960 CITY Or T ir-s,,T f. Date/By: i I--aQ- 'f� 9 .Jvt /()l g 3
TI GARD Inspection Line: 503.639.4175 Date Ready/By: T Tuns: B1 See Page 2 or
Internet: Line:www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information'
TYPE OF WORK REQ ��' 1*VVG
��A 0 4. �._,�..vn
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGOR1 '+ CC�NSTRUC ION work indicated on this application.
0 1-and 2-family dwelling ®Commercial/indust ial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION
'' �` Total number of floors:
Job site address:12286 SW Scholls Ferry Road New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
•
Suite/bldg./apt.no.: Project name:Kobe Grill Covered porch area: square feet
Cross street/directions to job site:Strip Mall next to Burgerville Deck area: square feet
Other structure area: square feet
REQEIt.EA,I}*mliCt3I AICrIAF °SE,sil;K.IST
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
DESCRIPTION rOF WORK ., work indicated on this application.
Installation of new kitchen hood fire suppression system Valuation: $4734.00
Existing building area: 300 square feet
New building area: 300 square feet
0 PROPERTY OWNER e TENANT T Number of stories: I
Name:Koba Grill Type of construction: Unkown
Address:12286 SW Scholls Ferry Road Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing: Unknown
Phone:(971)777-0574 Fax:( ) New: A2
se1•�APPLICANT 0 CONTACT PERSON
Business name:Huser Fire Fighting Equipment All contractors and subcontractors are required to be
Contact name:Eric Hopper licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:231 N Tillamook St jurisdiction in which work is being performed.If the
City/State/ZIP:Portland OR 97227 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)248-1948 Fax::( )
E-mail:eric@huserfire.com • N
CONTRACTOR '$I) LRI TO?' VES*
Business name:Same as applicant • Ieeser feiafe ej4,y4 R....
� � // — Permit fee:
Address: 1 9s---t ,`V`414/ t,tJ $ biT0o�.
City/State/ZIP: / f i '' State surcharge(12%of permit fee):
y " / FLS plan review(40%of permit fee):
Phone: 5173- (- 2 -- i:,` ;"--:5'"-,-/ I Fax:( ) (Due upon application submittal.)
CCB lic.: 7i7 00L/7' Total permit fees:
Authorized signature: tL / / Amount received:
+ i / This permit application expires if a permit is not obtained
Print name: Date: Jill) J2 /'Y within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(1 1/02/COM/WEB)
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 nkler heads: 3.) Addition/alteration only to alarm devices:
0 New 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 sh(,wing area (3) copies of sketch showing area
to existing of work within building.tructure 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 + r.D as apl:ieate)
A) Commercial Sprinkler s.
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
Hood Project Valuation: $ 4734.00
C.) Fire Alarm
Submittal shall Battery Calculati()ns Li Yes
include: Individual Comp)nent ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage:
Perms Fee:
0 to 2,000 $19H75
2,001 to 3,600 $24(,45
3,601 to 7,200 $311 .05
7,201 and greater $401.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project Valuation subtotal (see A,B &C above): $ 4734.00
Permit fee based :)n project valuation (see fee schedule): $
Permit fee based on square footage (see D abov_e): $
State Surcharge (12% of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $
P:\2018 Kitchen Hoods\Koba Permit application.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12286 SW SCHOLLS FERRY RD A, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00167
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor