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Permit
• CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2012 -00166 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/06/2012 Parcel: 2S 109DA16500 Jurisdiction: Tigard Site address: 15306 SW OAKMONT PL Project: Arlington Heights No. 3, Lot 84 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 84 Project Description: Install new 13D fire sprinkler system to 3,617 sq ft house. Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES NW 9095 SW BURNHAM 4230 GALEWOOD ST, SUITE 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 11/06/2012 $310.05 '12% State Surcharge - Building 11/06/2012 $37.21 Type of Use: SF Info Process /Archiving - Lg $2.00 (over 11/06/2012 $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 11/06/2012 $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 $362.26 Valuations: Required Items and'Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 3617 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 a c..y the the les or direct que •• so.- C by callin 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: 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 City of Tigard Date./13 : Permit No.: PS,„p / -pp 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie • M Phone: 503.639.4171 Fax: 503.598.1960 r 3 9 Ofe( DateB : �ik -W Other Permit /(90 Inspection Line: 503.639.4175 Date Read'": Jug: E:1 See Page 2 for TIGARD p Internet: www.tigard- or.gov c p p � /(F T I i A Notifies/ e .od: // IJ . v Supplemental Information ll ll J�< VV�� i J1�VJ[llulvWr // TYPE OF W 14 REQUIRED DATA: 1- AND 2- FAMILY DWELLING w 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. � 1- and 2- family dwelling El Commercial /industrial Valuation: $ 3 9, t Accessory building ❑ Multi- family Number of bedrooms: G 1=I Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /5 3k/ ©, r/ ,--- 7(,4-i New dwelling area: /._.r-7 square feet City/State /ZIP: -1 I p ©2 7 2-2_21- Garage/carport area: . 6,54 square feet Suite/bldg. /apt. no.: Project name: i gUitta ia,(/ h 14-'r5 Covered porch area: I / i square feet Cross street/directions to job site: Deck area: 2'2.:Z square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: Lot no.: gy¢ 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 � �n, DESCRIPTION OF WORK work indicated on this application. 74 2.0 / ✓i�s /.// / 5L pi 2� s p /V� SsL�i i Valuation: $ - 1(/ V/ '- z ) 3 `_ / 7 S G C ) • F rA / Li , 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: 0-APPLICANT ❑ CONTACT PERSON NOTICE Business name: , . ('24)--/ 71.-- 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* Business name: wlf/ � ` -/� � /c-t r e.:720 v (Please refer to fee schedule, Permit fee: q �} ' , / Address: 06 6Kf bW2J -W ei J7 `jr City/State /ZIP: 1/6 0 n 2 9 72.2._ State surcharge (12% of permit fee): r FLS plan review (40% of permit fee): Phone: (5273) (Og3Y�- -z9 z . Fax: ( 3) (p g¢ - 9657 (Due upon application.) CCB lie.: & ` 1077 Total permit fees: Authorized signature: C %/ Amount received: we Thi perm app expires if a permit is not obtained Print name: ll6 J � "_.19 p Date: / 0/`6// 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- 4613T(I1 /02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information D "escribe work.to be, done: 1.) E 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration i2T 1-1+ heads: Plan review required. ❑ Repair qq Number of sprinkler heads: Z/ Additional description of work: Type of Systerri ( Complete; A ,. B °C oi` "D• as ; :: A. "Conimer iial : ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor • Sprinkler Project Valuation: $ Hood Fire: Suppression:.Systeiri; Hood Project Valuation: $ C. G Fire: Alarm � Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets - Fire Alarm Project Valuation: $ D. , Residential:S`prinkler .Staind�Aloiie System Square Footage: Permit Fee: 0 to 2,000 $187.50 ,; a _ 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 PermitFees:' 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 / departments /cd /docstFPS- PermitApp,doc 2 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 15306 SW OAKMONT PL, TIGARD, OR, 97224 Residential - Fire Protection System 999 Sprinkler Final 03/04/2013 00:00 FPS2012-00166 FAIL Test results paperwork needed all else ok Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 15306 SW OAKMONT PL, TIGARD, OR, 97224 Residential - Fire Protection System 999 Sprinkler Final 03/05/2013 00:00 FPS2012-00166 FAIL Cancelled Violation Summary: Inspector Contractor