Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT • Permit#: FPS2011 -00051
-i1CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2011
Parcel: 1S136CD02200
Jurisdiction: Tigard
Site address: 7850 SW DARTMOUTH ST
Project: Costco Subdivision: Lot: 0
Project Description: Add (17) sprinkler heads in new produce cooler.
Contractor: SMITH FIRE SYSTEMS INC Owner: COSTCO WHOLESALE CORPORATION
1106 54TH AVE E PROPERTY TAX DEPT 111
TACOMA, WA 98424 999 LAKE DR
ISSAQUAH, WA 98027
PHONE: 253 - 926 -1880 PHONE:
FAX: 253- 926 -2350
FEES
Description Date Amount
Specifics: Permit Fee - COM 05/13/2011 $177.52
12% State Surcharge - Building 05/13/2011 $21.30
Type of Use: COM Plan Review - Fire Life Safety - COM 04/13/2011 $71.01
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg Sheet (over 05/13/2011 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm Sheet (up to 05/13/2011 $11.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard:
Density: .385 Design Area: 2000
K Factor: 11.2
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $283.33
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $9,608.00
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: •ermittee Signature:
�1 f
Call 50 ,,•'�:y 7:00 a.m. for the next available inspe n date.
This permit card shall be kept in a conspicuous place on the job site u completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System RECEIVED , : FOR OFFICE USE ONLY 1 '
ffill City of Tigard Date /B m Permit No.: i /• 62f2:96.7 " 13125 SW Hall Blvd., Tigard, OR 97223 APR 1 ( Plan Review t
Phone: 503.718.2439 Fax: 503.598.1960 3 ? f { Date /B : ���/� �� Other Permit:
TIGARD Inspection Line: 503.639.4175 C [ Date Ready /By: Juris: 0 See Page 2 for
' Internet: www.tigard- or.gov
BUI LDING D IVISION
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
IA Addition /alteration/replacement ❑ Other: equipment, materials labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION _ work indicated on this application.
Valuation: n o t $
❑ I - and 2- family dwelling X, Commercial /industrial r
❑ 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: 7 g S
5O W par-tm c' A S• • New dwelling area: square feet
City /State /ZIP: f i ,Aro( , on f2 2 5 Garage /carport area: square feet
Suite/bldg. /apt. no.: #1 Project name: Cos-. co Prodkee Coo (v TX Covered porch area: square feet
Cross street/directions to job site: St,,, p , ,..0...-FA 4– ; W p_. f i L Hwy/ 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.: f s' I34 C 0 (922.
equipment, materials, labor, overhead, and the profit for the
'DESCRIPTION OF WORK work indicated on this application.
Adj /7 ,,, Sprin ,i t1..e nei/ Valuation: $ q, c O6
p ro d e co e r-.. Existing building area: pig670 square feet
New building area: j l u.4.(,q. square feet
.
❑ PROPERTY OWNER .TENANT . Number of stories: i •
Name: CosfCo Type of construction: vg
Address: 99, L 4 Kc Dc" Occupancy groups: M a - CA:.la `(.e_ •
City /State /ZIP: issa y► (✓'¢ ?go 2-7 Existing:
Phone: (NZS ) 3 13 V/ crC Fax: ( ) New:
APPLICANT - g.CONTA'CT NOTICE
Business name: S� J (C 5' All contractors and subcontractors are required to be
Contact name: TOM t-1 Re t4e licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: //o6 S ii- to i l• 6 jurisdiction in which work is being performed. If the
CO iv,* is exempt from licensing, the following reasons i
City /State /ZIP:
T,. �'+'L� 98' apply:
Phone: (z53 z5" g 063 9 Fax:: (ZSS) ' Z f 5
E -mail: j01-1 AA CQ. ser 4. -F, - c& . c
CONTRACTOR - ' - BUILDING PERMIT TEES*
(Please refer to fee schedule) •
Business name: Sj..q/ � F y e fyf ini- Permit fee:
Address: //G6 SS4 .1v State surcharge (12% of permit fee):
City /State /ZIP: Tit lo/M. f.1/1 `1eg2.9 °
FLS plan review (40% of permit fee):
Phone: (?.53 ) 9z J' Fax: (253 ) 9Z! 23J (Due upon application.) .
CCB lie.: / 3 !IL e-iti I ) 1 Total permit fees:
♦ %/ f , f 4 1i / ; Amount receiv
Authorized signature: 1 i "'' / __
This permit application expires if a permit is not obtained
Print name: JpL yt le efA e r — Da te `t'/ -// within 180 days after it has been accepted as complete.
* Fee methodology set by "Fri-County Building Industry
Service Board. .
I.\Building \Pet m its \FPS- PermitApp.doc 02/01/11 440- 4613T(I 1 /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinlder heads only:
DI Addition ❑ 1 -10 heads: No plan review required.
Alteration 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: /=7
Additional description of work: 4o/ plry pe-iA/oth S Pnn Kier S el 9-o vt-e`"J
WALIe p reel tice Cc, C2l
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Ix Wet ❑ Dry
Additional Standpipes
Information: Hazard Group Vorovy.e.
Density e395 9PM /5eQ-
Design Area 2000 /eni*e cooler_
K. Factor //.
Sprinkler Project Valuation: $ '1
B.) Type I - Hood Fire Suppression System •
Hood Project Valuation: $ n
C.) Fire Alarm •
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ hot_
•
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: h sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 9 60$
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 2 sets of plans at submittal. Plan review fees are required at submittal.
http: / /www.tigard- or.gov/ city_ hall / departments /cd /dots /IFS- PermitApp.doc 02/01 / ill