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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 1111 I COMMUNITY DEVELOPMENT Permit #: FPS2012 -00174 TR AR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/02/2013 Parcel: 2S 109DA16600 Jurisdiction: Tigard Site address: 15284 SW OAKMONT PL Project: Arlington Heights No. 3, Lot 85 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 85 Project Description: Fire sprinkler system. Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES 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 01/02/2013 $310.05 12% State Surcharge - Building 01/02/2013 $37.21 Type of Use: SF Info Process /Archiving - Lg $2.00 (over 01/02/2013 $6.00 Class of Work: FPS Type of Const: VB 11x17) Occupancy Grp: R -3 Height: ft Info Process /Archiving - Sm $0.50 (up to 01/02/2013 $15.00 Stories: 3 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 $368.26 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 4350 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 - .opted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may i a copy of the rules or direct questions to OUNC by calling t i4 503.232.1987 or 1.800.332.2344. / Issued By: / k ' 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 ompletion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application 4 Fire Protection System RECEIVED FOR OFFICE USE ONLY Cit5 SW of Hall Tigard Blvd. Tigard, OR 97223 q Received —'I 1312 NO 2 8 2 2 Plan Dates y: o /"� )S20 /°x /? Phone: 503.639.4171 Fax: 503.598.19 0 ' II ( 2 ( � � permit No Other PermiWs'e20 /*2 --4.902,5;z TIGARD Inspection Line: 503.639.4175 �IT OF TIGARD Date Ready :y: Su: 0 See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: �� r / � 3 Supplemental Information ' f() k l t 4 '' k IA °. _ TYPE OF WORK o � o t • 0 1 1 i i ' ew 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 " y {"� OI? a RU( :I1O work indicated on this application. &e1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ x-99 D° ❑ Accessory building ❑ Multi - family Number of bedrooms: S ❑ Master builder 0 Other: Number of bathrooms: Q , t, ' P .w o . � e - ® �.. t , ®',A 49 � Total number of floors: � 8 ' s" 0 / / 7- 1 Job site address: /5 . - New dwelling area: 43 50 square feet City/ State/ZIP: T (a4/L� 9,L 97 2_7_4 Garage/carport area: 4 3 3 square feet Suite/bldg. /apt. no.: I Project name: Aga NCB 7Z ) )-l( STS Covered porch area: 3 c square feet Cross street/directions to job site: Deck area: 2Z Z square feet Other structure area: - --- square feet REQUIRED DATA: ' COMMERCIAL-1 ;SE CHECKLIST Subdivision: I Lot no.: g S 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 t r . p " kao r „ work indicated on this application. Rep V l,o . /ll CJ'2 /3 J F sPL/ -' $ 6 ` i 7 Valuation $ /(' ` 4 ) -C � ) 04) t F � � 5 / � � Nc Existing building area: square feet LJ New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: 1 City/State/ZIP: Existing: Phone: ( ) Fax: ( ) New: tt , K Z 'r i �41 ❑ CONTACT I'ERSONY NOTICE . Business name: 56 C9A�ie 7 , -._ 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 l BUILDING PERMIT FEES* Business name: Nil yn i / 7 Z, L 7,,„- ,�D „LJ (Please refer to force schedule) a _ 6/'t/ vit1 "'l” ' -r. Permit fee: Address: g�g S �� City/ State/ZIP: /(� Z� ©X 9 7 Z Z3 State surcharge ()2% of permit fee): / FLS plan review (40% of permit fee): Phone: (6'03) b gei-- Z9 Z i. Fax: (say z,84 - 9 j 7' (Due upon application.) CCB lie.: i/D / 77 • Total permit fees: Authorized signature: / Amount received: This permit application expires if a permit is not obtained Print name: J f/' �- 1,41-72. Date: // —245 -/ 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•PcrmitApp.doc 03/23/06 440-4613T(I1/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describ e workto be don 1.) f24 2.) Modification to sprinkler heads only: Addition 0 1-10 heads: No plan review required. 0 Alteration 1+ heads: Plan review required. 0 Repair Number of sprinkler heads: 5 Additional description of work: A.A5 ViQkt' A.) Cnitnexial .Sprinkler ;•6: • ' , Wet 0 Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ • Hood Project Valuation: C) Fire Aiarm `4.k?;-' • " °C","• z Submittal shall Battery Calculations 0 Yes include: Individual Component Yes Cut Sheets File Alarm Project Valuation: $ -• • •-•, Square Footage: Permit Fee: ,ORRV;,', • 0 to 2,000 $187.50 2001 to 3,600 $232.50 3,601 to 7,200 $292.50 7,201 and greater $381.50 r-4:41 Sprinkler Project Square Footage: sq. ft. 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. h ttp: /www. ci. tigard. or. u s /ci ty_hallidepartments /c d/docs/FPS-P ermi tApp.d oc 2