Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IN
COMMUNITY DEVELOPMENT Permit #: FPS2010 00145
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/01/2010
TIGARD Parcel: 2S109DA17800
Jurisdiction: TIGARD
Site address:_ 15287 SW SUMMERVIEW DR
Project: Arlington Heights Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 107
Project Description: Sprinkler system.
Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES
9095 SW BURNHAM 16869 SW 65TH AVE #505
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
PHONE: 503 - 684 -2928 PHONE: 503 - 387 -7577
FAX: 503 - 684 -9657
FEES
•
Description Date Amount
Specifics: Permit Fee - RES 12/01/2010 $246.45
12% State Surcharge - Building 12/01/2010 $29.57
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: Yes Sprinkler Type: Wet
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 4.9
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: $2,378.00
Residential Square Footage: 2703
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 obtai cosy of the rules
or direct questions to 0 • C by calling 503.232.1987 • , .,z! — 344. -
Issued By: 'ermittee Signature: / /
Call 51'is� by 7:00 a.m. for the next available inspe• ion date.
This permit card shall be kept in a conspicuous place on the job site unt I completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System -0) FOR OFFICES USE ONLY
Received
City of Tigard j � Date /B : L PenultNo.. " d 0 -, a
'! 13125 SW Hall Blvd., Tigard, OR 97223 yb°� $ �Q1� Plan Review L ' j
°
'ilr •' ", Phone: 503.639.4171 Fax: 503.598.1960 � DateB : Other Permit: . a �� ll
TI ` Inspection Line: 503.639.4175 �� a te Ready /By: p Juris: H See Page 2 for
Internet: www.tigard- or.gov �C ,W) • O ► 11 '' i0 err"----
Supplemental Information
i ..77 C* &n 1 p ,' 7- t(,l ; c
g . - ` T Y PE , OF ORK i ai ' .,-u�./nw 3,._ /,r #, ,,. _ k I RE R DATA A 2 FA a i WELLING s ,>
ew construction ❑ Demolition Permit fees* are based on the value of the work performed.
e Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
fe r work indicated on this application.
'' dwelling Valuation: $
)'- and 2-family g ❑ Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOQ NFORINATION AND LOCATION - - Total number of floors:
Job site address: 15 z-- 514 gi . 1.. i � Lti) New dwelling area: square feet
City /State /ZIP: �` i 0 j 7 Z24 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 30)7/ \/` [,> #h.7� Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
yREQaii DATA tCOMMER a I7SE CHECKLIST 41
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 D 'ESCRIPTION Q ' WORK ! work indicated t on this lapplication. ead, and the profit for the
�i Valuation: $ � 7S . co
Ivy Y I DE, �d �W 1?- P� �Y2-t� K L��-
� 7 �: 1 �� "� t /< _ / 2 _ 7 3 � I j 7TLa�t7�ry .— , Existing building area: square feet
/Y Y Z � New building area: square feet
il PROPER -� OWrR , i TENANT m Number of stories: AWN
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
at B' P w , :gvw NT o a ii C I'AC PFt'RSON
,. ,... ,:. ,,.... � . . � ,. N OT•
Business name: dv/(f��,/CL. —" 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
applicant is exempt from licensing, the following reasons
City/State/ZIP:
apply:
Phone: ( ) • Fax: : ( )
E -mail:
F3
'x 4 CONTRAGEOI2 k t k UIL ITl EES A Fi
�
i �;.;,1 �'� {Pl sc hedrital �.�� „�.,... .�,
Business name: � ,) Pi �� � �/ Permit fee:
Address: g I) qs .5\,,d L)!2_M )4
State surcharge (12% of permit fee):
City /State /ZIP: 2- ) 9 7 Z Z FLS plan review (40% of permit fee):
Phone: (5D3) - L� z_ Fax: (SD3) 4., j 4- - 9 s-7 (Due upon application.)
CCB lic.: l,`1 -V 7 Total permit fees:
Amount received:
Authorized signature: �� e
cc✓✓' C This permit application expires if a permit is not obtained
Print name: 6 067S/Ve, 7 , // - /-.L) � Date: I i — 2..2 — / C) within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1'. \Building \Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(1 I /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe wank to bMone A v; ' . t x ,. �.. eta
K
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
El Alteration 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: SZ
Additional description of work:
hype of S W1117 (Complete 1 iffi C oz „D asp p )
r � a placable � •�
) C Sp r Rr
❑ Wet I=1 Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
a B )Thai l „H'oo � t Suppression S
.... � .�.�_� -�.�„ r.�, �.. om . � ..�?�.... a...�.,, -- , `§:�.., .� �`x; � ",�:.....- aia .,� > . • „� .v.� .9r.a
Hood Project Valuation: $
ti C )� Fire�`�Alarm � E ,� ; , y � �
_�. .. „ ,_ _ .W,„ - ;L,.4. ; ,, .._ .,irk.0. :N.i: _ .-
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
R l •x` �' % 5 �
esicleritlallSprtnkler (Stand Alone S)stm) _ i a ,
Square Footage: Permit Fee:
0 to 2,000 $187.50
Atir 2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50 ot,ligg.MAXNICAZZIS
Sprinkler Project Square Footage: sq. ft.
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 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.tigard.or.us/ city_ hall /departments /cd /dots /FPS- PermitApp.doc 2