Permit ' p CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2014-00091
EGA,RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/19/2014
-f
Parcel: 2S101AB01400
Jurisdiction: Tigard
Site address: 7600 SW DARTMOUTH ST
Project: Walmart Subdivision: HERMOSO PARK Lot: 8
Project Description: Installation of an Ansul R-102 kitchen fire suppression system.
Contractor: SANDERSON SAFETY SUPPLY CO. Owner: PACIFIC REALTY ASSOCIATES LP
1101 SE 3RD AVE 15350 SW SEQUOIA PARKWAY#300
PORTLAND, OR 97214 PORTLAND,OR 97224
PHONE: 503-238-5700 PHONE: 503-624-6300
FAX: 503-889-3192
FEES
Description Date Amount
Specifics:, Permit Fee-COM 06/19/2014 $77.99
12%State Surcharge-Building 06/19/2014 $9.36
Type of Use: COM Plan Review-Fire Life Safety-COM 06/19/2014 $31.20
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 06/19/2014 $10.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1
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 $128.55
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,500.00
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 Notifi - - - - - . 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••estions to OUN • callin• 03.232.1987 or 1.800.332.2344.
Issue By: Pemlittee Signature: y
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.
E Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
('1 Received e
City of Tigard l
Date/B : I, Permit No.: Sae/ •
13125 SW Hall Blvd.,Tigard,OR 9 �/ Plan Review ►7
■ / Other Permit:
Phone: 503.718.2439 Fax: 503.59 . 60 l� DateB : 401i V g p.11� - i w r'
4175 7
I I c;n R D Inspection Line: 503.639. -°t t Date Ready/By: la See Page 2 for
Internet: www.tigard-or.gov MP� ii'' Notified/Method: �� 4%7� ' Supplemental Information
TYPE OF W i 1 ((���111510 ` REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction Wtly Permit fees*are based on the value of the work performed.
- Indicate the value(rounded 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.
1:1 I-and 2-family dwelling 0 Commercial/industrial Valuation: S
El 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:7600 SW DARTMOUTH ST. New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:WAL MART#5935 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(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
INSTALLATION OF ANSUL R-102 KITCHEN FIRE SUPPRESSION SYSTEM Valuation: $51,500.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT ® CONTACT PERSON NOTICE
Business name:SANDERSON SAFETY SUPPLY CO. All contractors and subcontractors are required to be
Contact name:GEOFF SPAHR licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1101 SE 3RD AVE jurisdiction in which work is being performed.If the
City/State/ZIP:PORTLAND,OR 97214 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)238-5700 Fax::(503-)889-3192
E-mail:GSPAHR@SANSAFE.COM
CONTRACTOR BUILDING PERMIT FEES*
Business name:SAME AS ABOVE
(Please refer m fee schedule)
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.:64969 3 z?/f(, Total permit fees:
Authorized signature: L� ZC. Amount received:
This permit application expires if a permit is not obtained
Print name:G SPAHR Date:5-20-14 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I\Building\Permits\FPS-PermitApp.doe Rev 01/05/2012 440-46131(1 I/02/COM/WEB)
� 1
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:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
El 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: $ 1500
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El 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.
http://www.tigard-or.gov/city_hall/depart ments/cd/docs/FPS-PermitApp.doc Rev 0145/2012
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
August 12, 2014 at 9:33:53
AM
FPS2014-00091
Chip Barnett
Violation Summary:
Inspector Contractor