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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 2 COMMUNITY DEVELOPMENT Permit #: FPS2011 -00053 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2011 Parcel: 2S 110CB 10200 Jurisdiction: TIGARD Site address: 15408 SW ARLINGTON TER Project: Arlington Heights No. 3, Lot 90 Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 90 Project Description: Residential sprinkler system, 3,015 square feet. Contractor: WYATT FIRE PROTECTION INC. Owner: TIMBERLAND HOMES INC 9095 SW BURNHAM 12670 SW 68TH AVE #300 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 - 684 -2928 PHONE: 503 - 620 -8860 FAX: 503 - 684 -9657 FEES Description Date Amount Specifics: Permit Fee - RES 05/03/2011 $246.45 12% State Surcharge - Building 05/03/2011 $29.57 Type of Use: SF Info Process /Archiving - Lg Sheet (over 05/03/2011 $4.00 Class of Work: ALT Type of Const: VB 11x17) Occupancy Grp: R -3 Height: ft Info Process /Archiving - Sm Sheet (up to 05/03/2011 $13.50 Stories: 3 11x17) 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 $293.52 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $2,800.00 Residential Square Footage: 3015 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 adoptee by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtai 4 6 of t. - rules or direct questions to OU► by calling 503.232.1987 • . • • , Issued By: • - rmittee Signature: 1 Call 503.639.4175 by :00 a.m. for the next available insp tion date. This permit card shall be kept in a conspicuous place on the job site un it completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Fire Protection System FOR OFFICE USE ONLY 11111 . City of Tigard `' Rete Received Permit No.: _ " 13125 SW Hall Blvd., Tigard, OR 9 ` a_ G•••` WI /� Phone: 503.639.4171 Fax: 503.59 Plan ,� e C Da teB • ►�1 ia � Other Permit: of J r TIGARD www.tigard-or.gov Line: 503.639.4175 i t° t� Date Ready/By: y: p e,, See Page 2 for Internet: ww.tigard or.gov PQ R - 4 . ....eI/ Q� ethod' 7 (/ly 'Call Supplemental Information o �Wjs// m TYPE OF WO REQIIIRED •DATA 1 AND 2 FANIILY DWELLING New construction ❑ illok • 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 `' work indicated on this application. "� ' CATEGORY Ok' CONSTRLTGTION y q a nd 2-family dwelli • a uaton: $ - y ng ❑ Corrunercial/industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: 4 ❑ Master builder ❑ Other: Number of bathrooms: !f' ` JOB SITE INFORMATIOt' A.t R )hOCATibN , 'v , F Total number of floors: 5 Job site address: , 54-n 5 Ski A p f 1 a 7Q New dwelling area: 34I square feet City/State /ZIP: /l , / 972-2-4 Garage/carport area: 30 square feet Suite/bldg. /apt. no.: Project name bN IaIT 75 # 2 Covered porch area: — square feet Cross street/directions to job site: Deck area: _-- square feet Other structure area: square feet 0 b A r�f�IMI+; C •,-4M' 0.141$11 3,g k �. .,`� r„�<,.., �. �$,.....5,. ., b,3Pa�: rF" ... �a� �`�i �.' Subdivision: Lot no.: Q 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 ��'qq equipment, materials, labor, overhead, and the profit for the S.. .. h r /� . V " ,&n t rigs+ , F t ! �+ ® C work indicated on this application. P , o w o y� - i 3 ) JP/2 -4N, : 6 y / e Valuation: $ / G (/ , 10 3015 IP ,Loft (, Existing building area: square feet New building area: square feet ❑ iarii2T�-0'V�.I(I1 �' o 11m t E Number of stories: Name: Type of construction: Address: • Occupancy groups: City/State/ZIP: Existing: Phone: ( ) Fax: ( ) New: t' , t : w I'L1CAN � z a 3 s �, ` 1 4' �147� PEII6n 5 -�. m 3 , , "r t . .x.. �,..., � -�� ... .,,,e o- . `fit? t.�,. m.��w „. ,. _ . ,,ey � `�' � .�.. t '?; .. tom: «;s { , � `y� ' " a��r� Business name: e-P -i�-- � /©/L 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: ( ) • Fax:: ( ) E -mail: ., ' , :, NTRACTOR: ,,.r . . ,, °��` F , f r_, •; z ,. ,'�- BUIL P 'I T FEES' ` I ' ` k .. .� <, _ CO fi g . R a DING i .+ . Business name: /4 ) pa, p/2.07 �/t - °� i� (Ple Jaesckedrt7e2 ` Permit fee: Address: 9095 c sw , #(') T, State surcharge (12% of permit fee): City/State /ZIP: 7(1� n� 97 Z y� ` , / FLS plan review (40% of permit fee): Phone: (j03) 6 54 _ Z9 Z g Fax: (5D3 be3 - - �� 5 7 (Due upon application.) CCB lic.: 64n 7 Total permit fees: Authorized signature: ' Amount received: — "� This permit application expires if a permit is not obtained Print name: �(/4 /,,4./?'�> Date: -z.0.-// within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits \FPS- PemitApp.doc 03/23/06 440- 4613T(i1 /02 /COM/WEB) • City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) $ New Modification to sprinkler h- . • -only: ❑ Addition • 1 -10 head • • ' • p an review required. ❑ Alteration - - . • s: Plan review required. ❑ Repair Number of sprinkler heads: 2� Additional descriptio orr f work: ®e f� S stern , n ®lete2A; $ ®4 a ® call t as v; } Cotnmerc`ia 5prnkle ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ • ,.. u ou F •3u e e xe w t . Hood Project Valuation: $ iR * U 1IINiIfII&IIIIiIIIItI g a Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone Sy tem) Square Footage: Permit Fee: 0 to 2,000 $187.50 ✓ 2,001 to 3,600 $232.50 3,601 to 7,200 $292.50 7,201 and greater $381.50 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.tigardor.us /city hall/ departments /cd /dots /FPS- PermitApp.doc 2