Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
•
• COMMUNITY DEVELOPMENT Permit #: FPS2012 -00068
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/16/2012
Parcel: 2S110CB07600
Jurisdiction: Tigard
Site address: 14998 SW AUGUSTA TER
Project: Mountain View Estates, Lot 1 Subdivision: MOUNTAIN VIEW ESTATES Lot: 1
Project Description: Install 13D fire sprinkler system for new SF
Contractor: WYATT FIRE PROTECTION INC. Owner: RUECKER, DONALD CRAIG & BEVERLY
9095 SW BURNHAM 13828 SW FANNO CREEK DR, #2
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 684 -2928 PHONE: 503 - 724 -3115
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - RES 05/16/2012 $246.45
12% State Surcharge - Building 05/16/2012 $29.57
Type of Use: SF Info Process /Archiving - Lg $2.00 (over 05/16/2012 $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 05/16/2012 $11.50
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 $291.52
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 2844
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 ac py of the rules
or dir t questions • • UNC •y calling 503.232.1987 or 1.800.332.2344.
Issu By: / ;I/ , Permittee Signature: , / i
i /i
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 c • mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
FireProtection System FOR OFFICE USE ONLY MILIRA
1,1 City of Tigard RECEIVED Daced y Jo ` Permit No.: � /���a —g
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review i , , ( � 1 it rao %� /D
.
- Phone: 503.639.4171 Fax: 503.598.1960 APR 0 012 Date/By: ether Permit:
TIGARD r Inspection Line: 503.639.4175 Date Ready/By: /< / � rum 0 See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Nod/Me yd. Supplemental Information
TYPE OF W • .4 - . REQUIRED DATA: 1 -AND 2- FAMILY DWELLING
It 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
CATEGORY OF CONSTRUCTION work indicated on this application.
dwelling Valuation: $ f G) 2-D
- and 2-family g ❑ Commercial/industrial /
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: Z a
.. JOB SITE INFORMATION AND LOCATION • , Total number of floors: Z
Job site address: / 4 9 98 6j< 7 4-060-7 . 4.. New dwelling area: 2644 square feet
City/ State/ZIP: /./ & b / ore__ 97 Z14- Garage/carport area: jo 5) square feet
Suite/bldg. /apt. no.: Project name[ 3 [,./1e/Z__ ��ittei eECovered porch area: 74, square feet
Cross street/directions to job site: Deck area: Col 5n, square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST.
Subdivision: I Lot no.: 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.
�,--DV /® /S r
]) /Le- Spgbok._ S � 1em C. Valuation: $
��,v 2-S4-4- sq, Fr - v Existing building area: square feet
` /` New building area: square feet
❑ PROPERTY OWNER ❑ TENANT . Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/ State/ZIP:
Existing:
Phone: ( ) Fax: ( )
New:
%APPLICANT ❑ CONTACT PERSON • NOTICE- •
Business name: ��Z 4 2_1b/Z-.. 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: ( ) • I Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: k/ r4./ _ F! /2 � esG�p/J , (Please refer to fee schedule)
^ (,96_ :S w f3 c)/2,04401 ts_�f Permit fee:
Address: VJ
City/State/ZIP: ,412_0 "i2_ 9 '7 Z Z 3
State surcharge (12% of permit fee):
1i
FLS plan review (40% of permit fee):
Phone: (503) e,84 — 2.0Z I Fax: (5Ls3 & ,6,4_ _9E-. 7 (Due upon application.)
CCB lie.: eptt) 7 7 Total permit fees:
Authorized signature:
0.-7
Amount received:
44(-----( This permit application expires if a permit is not obtained
complete.
i
r _
within ISO days after it has been accepted as corn
Print name:P / ` 1 �V Date: 3es .1
* y p p
Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permits\FPS- PermitApp.doc 03/23/06 440-4613T(11 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be 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: 2 ' '
Additional description of work:
Type of System (Complete A, . B, C or D as applicable):
A.)) Commercial 'Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
• K. Factor
•
Sprinlder Project Valuation: $
•
B.) Type I - Hood Fire Suppression System
•
Hood Project Valuation: $
C.) 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 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.
http: / /www.ci.tigard.or.us /city_ hall /deparunents /cd /dots /FPS - PermitApp.doc 2