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Permit (101) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit#: FPS2017-00144 T GA.R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/04/2017 Parcel: 1S136CD02200 Jurisdiction: Tigard Site address: 7850 SW DARTMOUTH ST Project: Costco Subdivision: PALMER ACRES Lot: 3 Project Description: Fire sprinkler permit:Removing and replacing sprinkler heads for deli remodel. Contractor: SIMPLEXGRINNELL LP Owner: COSTCO WHOLESALE CORPORATION 6305 SW ROSEWOOD ST. PROPERTY TAX DEPT 111 LAKE OSWEGO, OR 97035 999 LAKE DR ISSAQUAH,WA 98027 PHONE: 503-683-9000 PHONE: FAX: 503-675-6521 FEES Description Date Amount Specifics: Permit Fee-COM 10/02/2017 $475.94 12%State Surcharge-Building 10/02/2017 $57.11 Type of Use: COM Plan Review-Fire Life Safety-COM 10/02/2017 $190.38 Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 10/02/2017 $6.00 Occupancy Grp: M Height: ft 11x17) Stories: 1 Info Process/Archiving-Sm$0.50(up to 10/02/2017 $6.50 11x17) Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Hazard: ORD2 Density: .20 Design Area: 1500 K Factor: 5.6 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $735.93 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $41,963.00 Residential Square Footage: 0 Fire Alarm Valuation: $0.00 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1'`8000.332.23344.. Issued By: � `./ Permittee Signature: �J Call 503.639.4175 by 7:00 a.m.for the next available inspe ' date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application ir, lir .-4''$ s Fire Protection System ' ,, _, FOR OFFICE LSE ONLI" Cityof Tigard Received /) //�� _ g Datem -7//S Permit No.: f' ��(� ! et 14 ii 13125 SW Hall Blvd.,Tigard,OR 97223i , Y 1 i _; k", p � �} _1.,a( Plan Review- `,� Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �\ 9 Other Permit of P'oL Ul7-CL Inspection Line: 503.639.4175 3 Date Read/B Jun s.r Y o f� ?eePage2for Internet: www.tigard-or.govti i 1 s r I I Notified Method: /7 Supplemental Information t G " L- �` > a .{,lel ..)7::'40.e. construction ❑DemolitionE��7 'ermit 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 C Y C 'o work indicated on this application. �. 'and .,..±x".. N i;£�3 '; : Ern s .., „ P'C ❑ I-and 2-family dwelling gl Commercial/industrial Valuation: $ ❑Accessory building EI Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: ry S " ® ° Q 1'"moi ..,.-6.,-3 y,; Total number of floors: Job site address: 50 0f ©u,L. New dwelling area: square feet City/State/ZIP: �j , C�ce y -7 3 Garage/carport area: square feet Suite/bldg./apt.no.: J Project name: 5c� Covered porch area: square feet Cross street/directions to job site: ?9' Deck area: square feet Other structure area: square feet Subdivision: Lot no.: PerInmit fees*arevalue based on dethe value of the work performed. Tax map/parcel no.: Indicate the (round to the nearest dollar)of all ,. ,, yr equipment,materials,labor,overhead,and the profit for the may A b '' Ads�' w " w work indicated on this a.plication. ��L �r� �yC�� /06144.0 tel(.[ ,� f Valuation: $��( q� d �t Yi )cIR.! Existing building area: square feet New building area: square feet .x .. -re " �. �. 'A n Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Fax:( ) New:Phone:( ) .. AI , I vn Business name: G. uL Q t l •Ulz�i All contractors and subcontractors are required to be Contact name: jock._ kid. licensed with the Oregon Construction Contractors Board under ORS 7.01 and may be required to be licensed in the Address: 3 �' 1ZOS P jurisdiction in which work is being performed.If the City/State/ZIP: L /ifs, �r 0 J 0 t . G,1 703 5 applicant is exempt from licensing,the following reasons Phone:(s-a3)6 U- ' o'1 Fax: : )�7 ' (o E-mail: (jv•lni!J t-%A.4.,PtiZ,t4gs — ,,,," 7 -� t© .. Business name: r r �� , z 1'°'=ise" to` .aoe � . �� r ays �Ap I,cC.rtit Address: Permit fee: City/State/ZIP: State surcharge(12%of permit fee): FLS plan review(40%of permit fee): Phone:( ) Fax:( ) (Due upon application submittal.) CCB lic.: /q G [ z / Total permit fees: Authorized signature. \J� 1 Amount received: This permit application expires if a permit is not obtained Print name: Aw Attic�,� Date: A..1s,Z e>1."� within 180 days after it has been accepted as complete. l�► I * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB) , City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information F ce woi ,'.,b do:ni " � w . .�� .;*.5ff !:r:: .,��,.€ 4 zs~ v.. � Yes.. 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: g. Addition or ❑ 1-10 heads: Affidavit required and El 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 92 11+ heads: Plan reviewrequired and El6+ devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work: � w lic 's ' y"' s c Bos •frm(T e© • xom c Sprtnke: , x er Sprinkler Type Wet [ Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group Q 14 Density C Zi) Design Area / K. Factor c Sprinkler Project Valuation: $ ) T3'P. . 'Hoodi5pr"u *ion a ry w; x Hood Project Valuation: $ �1 fir° Submittal shall Battery Calculations EI Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ .. £ a ' ✓.;`*; q .zr a .': xs '. x'' . "x , u , llte Systen). §tea1. l sprinkle ..max Square Footage: Permit Feer 0 to 2,000 $198.75 :<' t 2,001 to 3,600 $246.45 a �` 3,601 to 7,200 $310.05 '_ x 7,201 and greater $404.39 tl Sprinkler Project Square Footage: sq. ft. Fire rotes t ermtt.F es R . 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 % of permit fee): $ FLS Plan Revi ((41020%00 40(12% of permit fee): $ TOTAL: $ 2 C:\Users\jonnelson\Downloads\FPS_PermitApp(1).doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 7850 SW DARTMOUTH ST, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Fire Protection System FPS2017-00144 Inspection Type: Inspector: 999 Sprinkler final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor