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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 11 1 " COMMUNITY DEVELOPMENT Permit #: FPS2011 -00054 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2011 Parcel: 2S110CB09900 Jurisdiction: TIGARD Site address: 15368 SW ARLINGTON TER Project: Arlington Heights No. 3, lot 87 Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 87 Project Description: 13D fire sprinkler system. Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES 9095 SW BURNHAM 16869 SW 65TH AVENUE #505 TIGARD, OR 97223 TIGARD, OR PHONE: 503 - 684 -2928 PHONE: 503 - 387 -7577 FAX: 503 - 684 -9657 FEES Description Date Amount Specifics: Permit Fee - RES 05/03/2011 $310.05 12% State Surcharge - Building 05/03/2011 $37.21 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 $12.50 Stories: 3 11x17) Commercial Sprinkler System: Sprinkler Required: Yes 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 $363.76 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 3622 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 obtain • rules or direct questions to OUNC by calling 503.232.1 • : .: / Issued By: ' Permittee Signature: Call 503.639 by 7:00 a.m. for the next available inspec • • n date. This permit card shall be kept in a conspicuous place on the job site unt' completion of the project. Approved plans are required on the job site at the time of e. ch inspection. . Building Permit Application Fire Protection System FOR OFFICE USE ONLY 1111 Cit of Ti RECEIVED Date/Bea ireo/ Permit No.: / " a " 13125 SW Hall Blvd., Tigard, OR 97223 Tigard, P lan Review ., Phone: 503.639.4171 Fax: 503.598.1 Date/B : Other Permit: 2 TIGARD Inspection Lin 503 APR f ppp R 2 2O�� Date Ready :y: ../.. / Jam: 8 See Page 2 for Internet: www.tigard No • d/Method 7 ( Supplemental Information CITY OF TIGARD W . ... 4 TYPE OF _ .._ ....1, ,, Q ,ter r DATA 1 AND 2 FAMILY DWELLING J :. � 4ew 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 CO s , work indicated on this application. and 2- family dwelling ❑ Commercial/industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: y JOB SITE INFORMATION p LOCATION , t' 4 4 14 t, Total number of floors: Job site address: / 5340 e, A jj 7 , _) New dwelling area: square feet City/State /ZIP: --12 C� ,P q- /L D I ©te_ 6 ) - 7 z.z 4- Garage/carport area: square feet Suite/bldg. /apt. no.: Project name:A/L d <0>J �/c',q -TS # Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet 44 1 *ms s i l° ` z 0 s E, Subdivision: Lot no.: L;37 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 equipment, materials, labor, overhead, and the profit for the � ; , t ,. .; _„.„ . o 1 work indicated on this application. 7i vibes /tit,(.) /3 i> /ir_ 5Pp1JJ /c 5Y �. �, S r Valuation: $ /� � &)104_ / &D,6 /' / go y Existing building area: 3( Z'ZSquare feet �! New building area: ° square feet vo pt� I�ROI' ,'R' , 4 � , , : Number of stories: Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: t o 4 mot F , , `ACT PERSO1" u ' ' 'W`( wW F .ewa,_ - ,,,, ;4 ,,,,,,,* ,k ,R•US,. �s>.,s e3,,,,,*:::,> ,FS,n 4 _..l •,, + `p } h' RR Business name: 5i f_e,./t) .e All contractors and subcontractors are required to be ' Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and maybe 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: g 3 0 4. 4 ,0 ✓ ,, a ; . 1 .;, N a t 4 ,4TIVILD C E RII>l ' FEE Business name: W y4_/ f/2� P47-r�� ®� a - n �_ • -(Please: r :! z- .. ; n ', 1 Permit fee: Address: 90. 9 r-� 614/ �0i`_ t'M'V z' 5� City/State /ZIP: `(� (r" 9 6 LZ State surcharge (12% of permit fee): / / s FLS plan review (40% of permit fee): !O Phone: (503) 4 -Z9z_t3 Fax: ( 7 4.. ( i $ - 2k,5-7 (Due upon application.) CCB lic.: (p4© 77 Total permit fees: Authorized signature: ` Amount received: This p ermit application expires if a permit is not obtained Print name:�6 / 4_,4-17/- Date: 4 _ j , _ l/ within 180 days after it has been accepted as complete. * Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits \FPS- PermitApp.d°c 03 /23/06 440- 4613T(I I /02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be "done. � •. , 1.) 0 2.) Modification to sprinkler heads only. ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration iZ11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of stem (Complete A, B, C or D as applicable): A) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B. Type I - Hood Fire Suppression Sy stern. -444044:f*" vc Hood Project Valuation: $ � � Alarm .. �r� '��y`F3n £ a. �� f„407 * �d 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 $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. 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 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. ht tp: / /www.ci.tigard.or.us /city_hall/ departments /cd /docs /FPS- PermitApp.doc 2