Permit •
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
.
• COMMUNITY DEVELOPMENT Permit #: FPS2012 -00046
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/06/2012
Parcel: 2S109DA17600
Jurisdiction: Tigard
Site address: 15319 SW SUMMERVIEW DR
Project: Arlington Heights No. 3, Lot 105 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 105
Project Description: New 13D residential fire suppression system for a 3,070 sq. ft. house.
Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES NW LLC
9095 SW BURNHAM 15319 SW SUMMERVIEW DR
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 684 -2928 PHONE: 503 - 387 -7577
FAX: 503 -684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - RES 04/06/2012 $246.45
12% State Surcharge - Building 04/06/2012 $29.57
Type of Use: SF Info Process /Archiving - Lg $2.00 (over 04 /06/2012 $4.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: R -3 Height: ft Info Process /Archiving - Sm $0.50 (up to 04/06/2012 $14.00
Stories: 2 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 $294.02
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,748.00 •
Residential Square Footage: 3070
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 Lis suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N cation Center,, Th. = Ies are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dire questions to OUNC calling 0 2.1987 or 1.800.332.2344.
Issue By: I /: // Permittee Signature: / ` /, � •
Call 503.639.4175 by 7:00 a.m. for the next available inspect , n 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.
s Building Permit Application
Fire Protection System RECEIV D FOR OFFICE USE ONLY i -
City of Tigard
Received a ^ CN
y Re e 3 iT PermitNo.: l,
_ " 13126 SW Hall Blvd., Tigard, OR 9 2 7 glIZ Plan Revie . - �
' Phone: 503.639.4171 Fax: 503.59 871960 Date/B : t( Other Permit
TIGARD Inspection Line: 603.639.4176 Q., OF �GARD* Date Ready/By: 77, Li � / Juris: El See Page 2 for
Internet: www.tigard- or.gov �G �IY��i . Notifed/Meth - 5cp Supplemental Information
%
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-- -:: -; .:
TYPE OF WORK . - .•REQUIRED D. ATA: 1= ,:AND FAMtiY DVVEL7;l]VGr..■
V tlew 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
' • •• - - • r . ' work indicated on this a lication.
-` .. - CATEGORY_ OF CONSTRUCTION.., ., - - PP
- and 2- family dwelling ❑ Commercial/industrial Valuation: $ `L '7 toe"
`� ❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: 2 r'
• - Total number of floors:
- � JO B SlTE,�INBOR +11"hAT70YV� ANDS LOCATION , .- ,' • �
Job site address: is-31q 5 kK_/ g t }4 AV' ) DR_ New dwelling area: 3D70 square feet
City / State/ZIP: Hamm f 0 62 9-712-4 Garage/carport area: 99 square feet
Suite/bldg. /apt. no.: Project name: JU)J2 I f- 7 $ Covered porch area: 17( square feet
Cross street/directions to job site: Deck area: — square feet
Other structure area: square feet
REQUIRED DATA: COMIVIERCIAL4USE.CI EC1CLISTY'.
. Subdivision: - Lot no.: I d 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
.. DESCRIPTION OF WORK - work indicated on this application.
P ►WVI e- ! ` ► 1.61) F lie G �o pyl 10/L — / Ot Valuation: $
‘(5 1 � 8 1 ) 7 0 50, FT' Existing building area: square feet
' jrJ ,)e- , New building area: square feet
❑,,PROEERTY. OWNER ' I TENANT ' . Number of stories:
Name: Type of construction:
Address: • Occupancy groups:
City/State/ZIP:
Existing:
Phone: ( ) Fax: ( ) New: .
: : °.. APPLICANT • ❑ CONTACT :PERSON ", '
Business name: • C 6 - CD CTDp.- 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:
. .. : CON.TRa1 •
�CTOR � .. ,
....., _ � • L TFE
- ,:•- '' /, ' •" ' BUI ,D1NG � ES *� '. �:
:: �
Business name: (Pl ease refdr.:tojac�scli'edirle1': ,
Address: q D .j V 731, D 1.4401 sT Permit fee:
State surcharge (12% of permit fee):
City/State/ZIP: -? hD o '_ 9 7 Z Z � FLS plan review (40% of permit fee):
Phone: ( 5C. ) &64._ - Z9 2,f Fax: (5013) (c ! i 4_ 9 (. - 7 (Due upon application.)
CCB lic.: b 4 5 77 Total permit fees:
1
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: � / /4 1 1 - 1/4 - 7 ,....) Date: p 3 -Z7 -/ Z within 180 days after it has been accepted as complete.
rIV //411-1/4-7,....) * Fee methodology set by Tri-County Building Industry
Service Board.
I: 1 Building \Permits\FPS-PermitApp.doc 03/23/06 440-4613T(I 1 /02/COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
'De`s6ribe'work-to-13 done•
1.) ❑ New 2.) Modification to sprinkler heads only
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 1Z-
Additional description of work •
Type •of Syste'it* (Co A,,B C',or'D °.as',.a licabl "e
A:)' 'Commercial Sprinkler •
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinlder Project Valuation: $
13:), Type I Hood'• Fire Suppression Sys;tein. .
Hood Project Valuation: $ •
Cy Fire Alarm •
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; P'�rotection PermitF_ees'' . _ , _..
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.
hrtp: / /www.ci.tigard.or.us /city_ hall/departments /cd /dots /FPS - PermitApp.doc 2