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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2010 -00040 Date Issued: 07/07/2010 ',T1CaARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S109DA18000 Jurisdiction: TIGARD Site address: 15243 SW SUMMERVIEW DR Subdivision:, ARLINGTON HEIGHTS NO. 3 Lot: 109 Project: Arlington Heights Project Description: Owner: FEES STONE BRIDGE HOMES, NW, LLC Description Date Amount 16869 SW 65TH AVE., #505 LAKE OSWEGO, OR 97035 Permit Fee - RES 07/07/2010 $246.45 12% State Surcharge - Building 07/07/2010 $29.57 PHONE: 503 - 387 -7577 Contractor: PHONE: FAX: Type of Use: SF Class of Work: ALT Type of Const: VB Occupancy Grp: R -3 Height: ft Stories: 2 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 $276.02 Valuations: Required Items and Reports'(Conditions) Sprinkler Valuation: 0 Residential Square Footage: 3140 Fire Alarm Valuation: 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 Oa: •52-00-1.0e 0 through OAR 952 - 001 -0100. You may obtain a copy o(the' rules or direct questions to OUNC by calling 503. • • = �.- Issued By: = 'ermittee Signature: Call 5 y 7:00 a.m. for an inspection that business day. This permit card shall be „kept`in a conspicuous place on the job site until completion of the project. Approved plansrare required on the job site at the time of each inspection. " uikt ng,Permt Alicati ip on � F R " usE • Pp R6��j➢../� IV ED ref t, :b?�t s3�'•r�r l'al �"i a fx ,, , Al 4. :, , m f4vy ,.., : ,; Fire Protection System . „e : r . °nl °AT E SLY , •Y, ,1 0 1 3125 SW Hall Blvd. Tigard, OR 97223 i City g s °` / 09./r1.l1� �i / y „ �' Cit of Tigard U 1� �� t Date/13 Permit No.: ! ��a�� e �C:U C i �, g Plan : e — �j RD / Other Permit: 71 ' P hone: 503 Fax: 503.598.13 t �1G l ' ' OF Date/13y: 4� VO V/ I© T Insp ILO ection Line: 503.639.4175 iNO DIN%SION Date Ready : y: Jur is: H See Page 2 for x` ?1G�.a7f7�111e • Internet: www.tigard- or.gov Notified/Method: 1 Supplemental Information ft D 3 o 1/1 1,A 55 >� t iTYPE QF s s � ' .. t a... , RE UIRED I AND 2 FM1ILYDWEGLIl\G . ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 4ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the � �� b r � '°- ° � L ' y it work indicated on this application. ' CAtfEGORY O CIN r ' Valuation: $ &)Z--0,01, i,1- and 2- family dwelling mmercial /industrial • Accessory building 111 Multi-family Number of bedrooms: 5 CI Master builder El Other: Number of bathrooms: `_ / Total number of floor ,* , r r aii4 SITE INFO[i i AN LOC gE `'''' a (7,9______ , a a _ .., _. ,ivy:,,.. . a, srw e (41, � . +, a- .. , s a ��` zl'.,.,.. _ Job site address: 15 z_1-` 5ixj 5 n4 j''� [.V i�) New dwelling area: ;r �% square feet 3 ) I-() City/State/ZIP: -1 / 04 . 9 7224 Garage /carport area: 3 `v Z square feet Suite/bldg. /apt. no.: Project name: 5't)j ». y, , RE-s Covered porch area: square feet Cross street/directions to job site: Deck area: square feet • . Other structure area: square feet REf2UIRED:D TAiG AAiir AL LISE CHECKI a.. 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.: equipment, materials, labor, overhead, and the profit for the s 7 l MFrd x <;., l wry r 1,, -'4 K '' D�,SCRIPTIw _ WORK .. a � ., work indicated on this application out .,., iii,. „�.. >.�..�., ,a.,_, .., . .�._>t ,.. ..Fr..' „ d,u „ 4.. .c':��. .,u..F T/Cp V/ 0� / ?; D SP/� -I N)C_ . S (- E Valuation $ • • u 30 f 9 s Q r / *o u 5& Existing building area: square feet / , New building area: square feet ❑ PROPERT OWNER F' r,, ❑ TENAN �, Number of stories: E 'ilit1 ._ ._ 0 ..4.•ik .,�< x r .. f �,, Rte, , TT >.YAa , .,,, Nance: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: • Phone: ( ) Fax: ( ) New: PPUIGANT "% i - eNTAe ERSON V 6 s v, u r j r m s �.. _ ri -F.... «.,.fr „ r ...�,�,,t���d,. .:*.:,,.• . _,. N OTIC u�� �. n � Business name: s-- d ,, 7 [� All contractors and subcontractors are required to be Contact 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 a apply: Phone: ( ) Fax: : ( ) E- mail: ;.' z y ar r .:: x x CO ;l ; : wR . v ,� ' 4 '' pi a} ' s . - .: , a 4 �, 7� � /� -C �1'c �.' 1 l / �/`� . . d � 1 ( e i ( r oe d ! r r E S - Business ma 7J / /r mitf dule � W .... . .... 777 ' ' / Q y�� h� /� Permit fee: Address: 9'09 5 VJ B L)RJ J ( t . /7 � -r � ;�� p�n (y State surcharge (12% of permit fee): City /State /ZIP: • a/�j / (f / 7 z•Z 3 o �/ FLS plan review (40% of permit fee): Phone: ( Z Fax: (503) `-� - (Due upon application) CCB ]ic.: ( 0 4- n 7 7 Total permit fees: 0.2 7Ce. v � Amount received: (9” Authorized signature: — ' ) — j' This permit app lication expires if a permit is not obtained Print name: v l 7 ) �J . �� .� Date: Z9 -/D within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. • [:\Building \Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(11 /02 /COM/WEB) • „, City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information S :. �u ` , a Lx' ': mss, i e :. £ T z ig- 3 ,o � '. D escribe, wo rk to be done , . ..., . : . z� .,� , .r. > ,,. � . _ .. ;x: r„ F. 1.) , 1-1'e 7: '-- ; ;— New 2.) Modification to spr h ly ID Addition El 1 -10 heads: No plan review re El Alteration El 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of System ( Comp l e te A B C, o D as a Pr)hcable) <�R� _'. . _... 'A�) Ca'mmerctal Sprinklef ' pi , El \ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ 4B) Ty e I Hood Ftre HSuppressxon System , � 5 Hood Project Valuation: $ II �� -aft `'z a 1 `� a x y z'`�` h t ` r •”- �, �s; C Fire Ala rm 5 1 Submittal shall Battery Calculations El Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ O identt S Alone S ystem ) R ,, . _,. . ..,g,�_..; _.:._say a . �_3; Square Footage: Permit Fee: � ti � 0 to 2,000 $187.50 jl, 2 001 to 3,600 2��> • f. 3,601 to 7,200 $292.50 . � , � a l 7,201 and greater • $381.50 - '�, .. _ . 3 / Sprinkler Project Square Footage: „'., �-. sq f140 r �' F t> Protectton Perm Fee ff ,,; a * Pl ,., ,�,:,, :. , .: .. _ rN�., _, P 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): $ 07, '�� FLS Plan Review (40% of permit fee): $ TOTAL: $ 27 (�� Plan review requires a completed application and 2 sets of plans, at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. • http: / /www.ci.ti /city_ hall / departments /cd /dots /FPS- PermitApp.doc 2