Permit (102) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
+1111 1 COMMUNITY DEVELOPMENT Permit#: FPS2019-00008
Date Issued: 02/07/2019
T 1i A it I? 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9631 SW WASHINGTON SQUARE RD FC03
Project: Ruby Thai Kitchen Subdivision: None Lot: None
Project Description: Hood fire suppression system.
Contractor: UNIVERSAL FIRE EQUIPMENT Owner: PPR WASHINGTON SQUARE LLC
18260 SW 100TH CT PO BOX 847
TUALATIN, OR 97062 CARLSBAD, CA 92018
PHONE: 503-691-9000 PHONE:
FAX: 503-691-9004
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/24/2019 $112.96
12%State Surcharge-Building 01/24/2019 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 01/24/2019 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 01/24/2019 $20.00
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: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $191.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: r' Atee* Permittee Signature: e
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System FOR OFFICE IPSE ONLv
� gg �: eceived
City of Tigard A EGF�iV - ateBy: i/1 /y4 /� - Permit No.: s-gei a}-j ,
IN n 13125 SW Hall Blvd.,Tigard,OR 97223 f7 `d Y° Plan Review CO— 1 J/ Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 t �)( Date/By: Y /
T 1 G A R D Inspection Line: 503.639.4175 JAN 1 4 !019 Date Ready/By: !� -Ju�ris:y H See Page 2 for
Internet: www.tigard-or.gov Noti ted/Method:` —` �( J- ::, Supplemental Information
TYPE or waiiIILDING OmSJON REQUIRED I$ TA:1-TA: -FAMILY DWELLING
❑New con tion ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(romded to the nearest dollar)of all
dition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTI work indicated on this application.
❑ 1-and 2-family dwelling ommercial/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: _ r a ` New dwelling area: square feet
City/State/ZIP: p,m „,( 6,2, C)7 .3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ,6,7 4-r k 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: 1 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 OF WORK work indicated on this application.
n n / Valuation: $4S15. c-lG/
-in S`,l}t/ -re4 e;f /ro 6:0/e ,i" '7- CC- oo
Existing building area square feet
v { New building area: square feet
❑ PROPERTY OWNERNANT Number of stories:
Name: kid e) 9 rA a 3 .1/ -4-4 _ } Type of construction:
Address: C1 s-,-,,4).., Li; A t�J,–.� 5,. .. , J Occupancy groups:
City/State/ZIP: •��,..„7 ,712.7? Existing:
Phone:( ,zi ) '
' ,,..��, ""�l(��3-- ��c)�y Fax:( ) New:
I�LICANT NTACT PERSON NOTICE
Business name:a;)1..J..cA—fpCi"-.7-kcia i 44 r 1-- 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: j �2 L, S) /Lt) L.4./ e-- jurisdiction in which work is being performed.If the
c _ - applicant is exempt from licensing,the following reasons
City/State/ZIP:
��--� (.L4",,,,,,(1, ,i 7 apply:
Phone:?. 3) fS/97-��c',34Z> / Fax 5',3)('C)/ f,..tye.
E-mail:tit» ,'Vc1c,q./ -t'f-c✓tCej1 )/0/3J14/'iL-6f As%t/721A%I, c`:' `�...�
/ CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: S'7* yyt f-- ,QS A-O zl -Z Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%ofpermit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.: Total permit fees:
Authorized signature:
.
/ r Amount received:
This permit application expires if a permit is not obtained
Print name: i - _ f Date: v
J J/r c- within 180 days after it has been accepted as complete.
/ � * Fee methodology set by Tri-County Building Industry
Service Board.
I:\BuildingWermits\FPS-PermitApp_0715 4.doc 440-4613T(11/02/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 heads: 3.) Addition/alteration only to alarm devices:
❑ 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 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
❑ 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: $ yr?),
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
Win.
� ems
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: $
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