Permit CITY OF TIGARD BUILDING PERMIT
II a COMMUNITY DEVELOPMENT Permit it: BUP2014-00148
T f G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/30/2014
Parcel: 25101 BA00500
Jurisdiction: TIGARD
Site address: 7600 SW DARTMOUTH ST
Project: Walmart Subdivision: HERMOSO PARK Lot: 8
Project Description: Installation of(2)freestanding monument signs,approximately 10'in height.
Contractor: RAMSAY SIGNS INC Owner: WAL-MART REAL ESTATE BUSINESS TR
9160 SE 74TH AVE BY PROPERTY TAX DEPT STORE 5935-00
PORTLAND, OR 97206 PO BOX 8050
ATTN MS 0555
BENTONVILLE,AR 72716
PHONE: 503-777-4555 PHONE:
FAX: 503-777-0220
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: Permit Fee-Additions,Alterations, 06/30/2014 $210.59
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 06/30/2014 $25.27
Dwelling Units: 0 Plan Review 06/30/2014 $136.88
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 06/30/2014 $3.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $8,600
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $375.74
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 0 throug ■•R 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.
lssu d By: // j Permittee Signature: 4�—e a.-r---"..".-- _
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
F
RECEIVED FOR OFFICE USE ONLY
Received J
City of Tigard Date/B : A , Permit No.: ' ./ /' f ..>e0/
11
- " 13125 SW Hall Blvd.,Tigard,OR 972 2 5 2014 Plan Revi 1•-, -V •
Phone: 503.718.2439 Fax: 503.598.10W Date/0 : 5jr�/ Other Permit: �� •
T I G ARD Inspection Line: 503.639.4175 #!(p r, Date Ready/By: 0 luris: Ed See Page 2 for �Qp
Internet: www.tigard-or.gov CITY�11GABU Noti ed/Method: V1 aft Supplemental lntormatidlf
TYPE OF WORK I' IRED 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
❑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 a-Commercial/industrial
Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: -kg 00 S l� 11:),,,,,,,11,4,4,,IA ,5'/_, New dwelling area: square feet
City/State/ZIP: " A.,/, OE Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: �6.-�lstk.✓74- 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: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rowded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
/ DESCRIPTION OF WORK work indicated on this application.
.1 H S/.c // (Z Fr ees H e,14ci ... -1 S c--_5 Valuation: $ CJ/_Q� 00
Existing building area Q C� 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:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: 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: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) I Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: S (Please refer to fee schedule)
Gc.rn.„ss, r ...... s
Y , Permit fee:
Address: 916,0 S' 6 -7 Li f i4vt.
City/State/ZIP: �0/rl�ie/ Q7Z Q'72o� State surcharge(120%of permit fee):
FLS plan review(40%ofpermit fee):
Phone:(5 3) —7-7 7. 4/555- I Fax:(So3) 7 77-v ZZo (Due upon application.)
CCB lie.: (.9--3/4-z.---e_ Total permit fees:
Authorized signatu
Amount received: '- )
This permit application expires if a permit is not dbtained
Print name: C // Date: Wz„S /G/ within 180 days after it has been accepted as complete.
—7u�/C 7•(yS
Fee methodology set by Tri-County Building Industry
Service Board
1:\Building\Permits'FPS-PermitApp.doe Rev 01/05/2012 440-4613T(I1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done: _
1.) ❑ New 2.) Modification to sprinkler heads only:
El Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+heads: Plan review required.
El Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet El Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I- Hood Fire Suppression System
Hood Project Valuation: $
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 $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.
I:\Building\Permits\FPS_PennitApp.doc Rev 01/05/2012 2