Permit CITY OF TIGARD
FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2011 00065
TIG AD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Date Issued: 06/10/2011
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Parcel: 2S109DA14900
Jurisdiction: TIGARD
Site address: 15326 SW SUMMERVIEW DR
Project: Arlington Heights No. 3, Lot 68 Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 68
Project Description: 13D fire sprinkler system for 2,711 sq ft residence.
Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES
9095 SW BURNHAM 16869 SW 65TH AVENUE #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 06/10/2011 $246.45
• 12% State Surcharge- Building 06/10/2011 $29.57
Type of Use: SF Info Process /Archiving -,Lg Sheet (over 06/10/2011 $4.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: R -3 Height: ft Info Process / Arrchiving - Sm Sheet (up to 06/10/2011 $13.50
Stories: 2. 11x17)
• Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 4.9
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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: $0.00
Residential Square Footage: 2711
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 Notif . ". . enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain ay of th- rules
• or direct .uestions to UN • c•Ili. 503.232.1987 or 1.800.332.2344.
Issue: By: 4F Permittee Signature: - /
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Call'503.639.4175 by 7:00 a.m. for the next available inspectio • date.
This permit card shall be kept in a conspicuous place on the job site until :.mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
' -fr ,. Building Permit Application .
Fire Protection System RECEIv V VV FOR OFFICE USE ONLY ' g �{
3 t.A.R"Lr #„t sr.. �`£. �.`'"�.'�.w / „t"�_` $�%v h u+��
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Syr C I Tigard, ED R eceived /A �� _ `J of Ti b Date%B C-r, Pemvt No.:, Q Q Q� �
, 13125'SW Hall Blvd., Tigard, OR 97223 , i; '' + Plan' Rey a v. /
, . ' - Phone: 503.639.4171 Fax 603.698.1960 £ ' d 28, j / a� Other Permit: 9 1-460
TIG 'ARD' In spection Lin - 03 639 4175 C1 Date El See Pa 2 for
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_ Noti fied %Meffiod: Supplemental
Internet: www.tigard-or.gov Information
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„ 'REQUIRED DAT 1 AND' 4
.New 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
= _ _ _ kW - _ a� - • work indicated on this application.
W f1 , ' ,_. -,: .. ',, :. CATEGORY" OF CONSTRL7GT10 jkge- is a ,iii ., �
and 2- family dwelling ❑ Commercial/industrial Valuation: $ /67i '�
❑ Accessory building ❑ Multi - family Number of bedrooms: •
❑ Master builder ❑ Other: Number of bathrooms: 2--/2-
' " '
::» ; �, = "� , �.� Total number of floors:
J OB ' * q.T.E= 11YF.OR11 4AT=ION'':AN D.L CATl4 : �'t : :'
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Job site address: 1 t� 3- 5J /p ,1 e, �� New'dwelling'area:- 2 ' square feet
' City/State /ZIP: 116 7) t j a__ 9 -7 Z 2..._4_ Garage/carport •area: 'square feet.
Suite/bldg. /apt. no.: Project name: ,46-12t/46 att --2- j Covered porch area: square -feet
Cross street/directions to job site: Deck area: square feet
Other Stricture area: square feet
• i tREQLI'IREY Mith�'aftWi`RCI lareit'ECKLIST
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, S ubdivision: Lot no.: 5 Permit fees* are based, on the value of the work performed. ,
Tax ma /, arcel no.: In ue dicate the val (rounded to the nearest dollar) of all
P -P equipment „materials, labor, overhead; and the,profit for the •
Y. >' kF:. y; L x� x 7 u ` , 1,t A x `1',',45- �c:,.'+�:."
n•�. �`i z %,1?" ' _£,.>x ��.za. -x i ii,- �d`'•�. uf; •
` _ :;::: "'' -F, - .,.. - , ux : <, W work indicated on this application. '?� >� >�����,: � <= "DESCIUP�'ION•�,OF'.�, =�oRIC , . � <.,r.�:�.,� � ,:x:;�,; PP
PalJ'VWDv, NCJ c I ?i p/e Ml &e7 6 Y6 Valuation: $ .
2 —Z % Existing building area
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New building area: square feet
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�.s ;;;TEN1V1¢. ,:4„- • „4;" Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: • Existing:
Phone: ( ) Fax: ( • " ). • . New: •
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Busuies ,
sname: � All contractors a nd s ubcon t ra c tors are'required to be
Contact -name: licensed with the Oregon Construction Contractors'Bbard
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. 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:
:
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C/ Permit fee:
Address: �
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City/State /ZIP: 1 - 7 6. 472 . 49 ,. '� 1 7 State surcharge (12% of permit fee):
J FLS plan review (40% of permit fee):
Plione: (5 6 6 4..- 9 Ze° Fax: (5753) (, 64, 96 57 (Due upon application.)
CCB lie.: 4t 77 Total permit fees:
Authorized signature:
t' L J ,)/- Amount received:
This permit application expires if a permit is not obtained
Printname: Et,C��Ae/ LA Date: 5 - 6) - I) within 1'80 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
. • Service Board.
I•\ Building \Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(1 l /02 /COM/WE5)
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City of Tigard: Fire Protection Permit Checklist
Page .2 - Supplemental Information
c b6wor >k:to`Mbe.,done:.; - :a �:�',,:.;.�<
1.) ❑ New 2.) Modification to spri iklerheads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration X11+ heads: Plan review required.
❑ Repair ^ � I
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Number of sprinkler heads: !�
Additional description of work:
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❑ Wet • ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
I� Factor
• Sprinkler Project Valuation: $
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-Hoed Project Valuation:'
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SubmittaLshall - Battery_Calculations ❑ Yes - - -- - - - -- include: Individual Component ❑ Yes
Cut Sheets
• Fire Alarm Project Valuation: $
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Square Footage: Permit Fee: a==`'' "``' `"''F < •
$1.87.50 ' ;
0 to 2,000 � ';� % „ >��� ���; ;m� =
001 to 60 £:»
> 3, 0 $232.50 � ,,3 ,,,, : . '� �,
:-.N'0 <0.
..: ` 4
:,., =`;' '
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3,601 to 7,200 $292.50
Win.
7 201 and greater $381.50 x % _` :. _ „ ...
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): $
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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 /docstFPS- PernvtApp.doc 2
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