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Permit
• y � CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT • �r'1 �'` COMMUNITY DEVELOPMENT Permit #: FPS2012 -00160 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/29/2012 Parcel: 2S109DA15400 Jurisdiction: Tigard Site address: 15272 SW GREENRIDGE PL ' Project: Arlington Heights No. 3, Lot 73 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 73 Project Description: Install 13D fire sprinkler system in 3,220 square foot residence. • 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 10/29/2012 $246.45 12% State Surcharge - Building . 10/29/2012 $29.57 Type of Use: SF Info Process /Archiving - Lg $2.00 (over 10/29/2012 $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 10/29/2012 $11.00 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 $291.02 • Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 3220 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 . cop of the rules or direct • - stions to 'UNC by calling 503.232.1987 or 1.800.332.2344. Issued : , - Permittee Signature: tt . .. _ _ _ _ 7 7 i a 1 Ad. L _ i fi ' A i r Call 503.639.4175 by 7:00 a.m. for the next available inspection • ate. This permit card shall be kept in a conspicuous place on the job site until c• pletion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Fire Protection System - FOR OFFICE USE ONLY • ` Da DateB l0 /4 /A PemutNo.: ✓ I / ^ `00 /i GiJ p 13125 SW Hall Blvd., Tigard, O City of Tigard ° RECEI Plan Review , ^ I w Phone: 503.639.4171 Fax: 503.598 e Date/By: L 'T'1 ( Other Permit: 11 _e0 /Ail TIGARD Inspection Line: 503.639.4175 � 1 6 2012 Date Ready/By: � kris: El See Page 2 for Internet: www.tigard - or.gov Notified/Method: ` ,� 1 -rt U Supplemental Information CITYOFTIGARD I•rc. TYPE EWI NG DIVISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING • 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. Valuation: $ Z q /9 " 1— and 2- family dwelling ❑ Commerciallindustrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: c/‘ Job site address: /5 272 4J � y ea R/z) e„, kit New dwelling area: 3 Z2'9 square feet City/State /ZIP: -/ 1 0 ©K q7 zZ¢ Garage/carport area: 18 D square feet / Suite/bldg./apt. no.: Project name: pp �� _ I Covered porch area: i D8 square feet Cross street/directions to job site: Deck area: Z 04 square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: Lot no.: 7� Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. T/ZDv /OE- Al -e-> /.3b 1//2 ,5P -L -)( S J` %�yf Valuation: $ fy 9 3 / z ZL c p l - ? / O C R i . Existing building area: square feet — yt 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: ! /Dle__- 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 BUILDING PERMIT FEES* I' / (Please refer to fee schedule) A Business name: l )11-77-1 f/2_ �i� ` ��D� / / Permit fee: Address: 90 /p 5 � k7 6 v� 2J -/ 72? 3 / , City /State /ZIP: I/ /1- ) ©� 72_2_3 State surcharge (] 2% of permit fee): / FLS plan review (40% of permit fee): Phone: (503) ( g34- -2 Z' Fax: (fib j) ( t 4- 9E 5-7 (Due upon application.) CCB lic.: 197 7 Total permit fees: Authorized signature: Amount received: This permit application expires if a permit is not obtained Print name: "a6- ` Date: 1 /j( /` Z 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.doc 03/23/06 440-461 3T( I l /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: Additional description of work: T e 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 Sprinkler 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. htt p:/ /www.ci.tigard.or.us /city_ha11/ departments /cd /dotstFPS- PermitApp.doc 2