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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2012 -00041 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/23/2012 Parcel: 2S109DA15500 Jurisdiction: Tigard Site address: 15298 SW GREENRIDGE PL Project: Arlington Heights No. 3, lot 74 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 74 Project Description: New 13D fire suppression system for a 4,180 sq. ft. house. Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES 9095 SW BURNHAM 4230 GALEWOOD ST, STE 100 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 03/23/2012 $310.05 12% State Surcharge - Building 03/23/2012 $37.21 Type of Use: SF Class of Work: ALT Type of Const: VB Occupancy Grp: R -3 Height: ft Stories: 3 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 $347.26 • Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: Residential Square Footage: 4180 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 - ..y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: .= ittee Signature: _ - Call 503.63 • ' a.m. for the next available inspe on date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Fire Protection System �® OR Received F OFFICE USE ONLY City of Tigard PermitNo.: � 13125 S W Hall Blvd., Tigard, OR 972 s t. Pi Review �, • L � Other Permit: �7- 7 Phone: 503.639.4171 Fax: 503.598.1960 ph PR 1 6 Date/By: 41111 I � / " /y � v / � /t- no TIGARD Inspection Line: 503.639.4175 tvt pppp... (� �® Date Ready/By: Jam: 0 See Page 2 for Internet: www.tigard- or.gov ` o f.1 ` \ ®, Notified/Method: �jip f A� . Supplemental Information ��((���ti?"°' ®M �Q� /re 0 '�+Qn a"f �NA'f lnGt i.IS�i .. _. • : T \FE OF WORT i )\ - / . ,7 REQUIRED DATA 1= iANDt2- FA:7VIILY- DWEL'LINGr ` fi g i 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 ,, .: in icated on this p CATEGORY' OTt CONSTRUCTION , : work d application. catio n. „pr... - and 2- family dwelling ❑ Commercial/industrial Valuation: $ jI 7 / a ❑ Accessory building ❑ Multi- family Number of bedrooms: ( p ❑ Master builder ❑ Other: Number of bathrooms: 3 ,, .:. JOB: SITE. INFORMATION AND - LOCATION Total number of floors: Job site address: /. z9 U 5jd y K rizl ba R New dwelling area: 4 1 50 square feet � City/State/ZIP: -(� D 2 i O 9 7 2-Z2-Z_4- Z_ Garage/carport area: 6 Z, square feet Suite/bldg. /apt. no.: Project name:,4 ion j ...1_04 H-7 S Covered porch area: 1 Gc5 square feet Cross Street/directions to job site: Deck area: 4s1-- square feet Other structure area: square feet REQ'UIRED'bATAo COMMERCIAL -USE CHECKLIST`: - Subdivision: Lot no.: -74_ 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 - .. DZ SCRIPTION' OF. WORK' work indicated on this application. • P a> Y1)96 N l ' �Pnlik e S , (5 - 1/ , 7 @ Valuation: $ ikl r l ri ` -r. i s , ' f 2) vc" • Existing building area: square feet New building area: square feet ❑LPRO'P.EI2TY. OWNER , 1:3 TENANT Number of stories: - Name: Type of construction: Address: • Occupancy groups: City/State/ZIP: Existing: Phone: ( ) Fax: ( ) New: - . ,: ' PPL' :ICANT .. _ ' .' M' :CO NTACT ;PERSQ]V „NOTICFI Business name: 3 etyto -R �� © re_ 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: CONTRACTOR' G : . . t�l '.. ...<� �� � _ ,., � � ^ °c fi t: Business name: K � �� (Ptease`refcr,tofce:scl edide1 .+, . , 909,5— �/ r ��1�� /� «�(�D� Permit fee: Address: �J{I koz_ i x ,77 5-f; City/State/ZIP: T? '/ 1 O 04.-- c 3 7 ZZ 3 State surcharge (12% of permit fee): 1 FLS plan review (40% of permit fee): Phone: (3) 4,134 - z_9 2_ Fax: (5D)) 6 Sic- -96057 (Due upon application.) CCB lie.: ,¢07 7 Total permit fees: Authorized signature: Z1///----■ Amount received: This permit application expires if a permit is not obtained Print name: Gv -�` ) Date: 3 -` 6 -ft._ Z within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I:\ Building \Permiis\FPS- PennitApp.doc 03/23/06 440-4613'r(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information De'sc, be wo"rklo•ae_.._ e: ;,LL..... 1.) ❑ New 2.) Modification to sprinkler heads only ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration 'f 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: 3 Additional description of work: T' `e'of S, item :Chin^ 1efe A tB C' ot; licable) A Conittietelal 'Sprinkle f " ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ Type I - Hood' Fire`Suppre , _ ` • Hood Project Valuation: $ Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D:) Reside *ti'al rinkler (Stand Alone Sy.stem) 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. 'rG,: ti FixeP- otectoiTerint_.Fees `'• .r ', 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 /depart ments /cd /docs /FPS- PerrnitApp.doc 2