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Permit y n CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2013 -00022 TIGARD- 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/12/2013 Parcel: 2S 109DA14200 Jurisdiction: Tigard Site address: 12639 SW MOUNT VISTA CT Project: Arlington Heights No. 3, Lot 61 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 61 Project Description: Provide 13D fire sprinkler system for new SF 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 Specifics: FEES Description Date Amount Type of Use: SF Class of Work: ALT Type of Const: Vg Permit Fee - RES 02/12/2013 $310.05 Occupancy Grp: R -3 Occupancy Load: 12% State Surcharge - Building 02/12/2013 $37.21, Info Process /Archiving - Lg $2.00 (over 02/12/2013 $4.00 Dwelling Units: 11x17) Stories: 3 Height: ft Info Process /Archiving - Sm $0.50 (up to 02/12/2013 $11.00 Bedrooms: Bathrooms: 11x17) Value: $3,458 Floor Areas: Total Area: Accessory Struct: Basement: Carport: Covered Porch: Deck: Garage: Mezzanine: Total $362.26 • Required: Required Items and Reports (Conditions) Fire Sprinkler: Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: 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. • • • • •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 .11-0010 through 0 • - 952-101-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23 • • . I sued By: / / - t4 �� / Permittee Signature: 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. 4- 4 Building Permit Application RECEIVED Fire Protection System FOR OFFICE USE ONLY - Yom` - � 7 r City of Tigard Received • S PermitNo.: fPS , 0 (3- )C'. .. . F L B 6 2013 Re eiv I:: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie • 1 ® Phone: 503.639.4171 Fax: 503.598.1960 . � D ateB Other Permit: tts•(40( c_' Inspection Line: 503.639.4175 CITY 1 OF�G� g ate Ready tur : 0 See Page 2 for TIGARD Internet: www.tigard- or.gov BUILDING DNISIO I otified/Method: a I Supplemental Information IL-14A— / TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING ' Slew 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 " work indicated on this application. CATEGORY OF CONSTRUCTION � 4-/5 S , 0-1.. and 2- family dwelling ❑ Commercial/industrial Valuation: $ S ❑ Accessory building ❑ Multi- family Number of bedrooms: 4 ❑ Master builder ❑ Other: Number of bathrooms: 3 , S JOB SITE INFORMATION AND AND LOCATION Total number of floors: - Job site address:174 6w 4Uy T VG�7 New dwelling area: 35/5 square feet City/State/ZIP: i/. 6 0 ©12 91z Garage/carport area: 60 9 square feet Suite/bldg. /apt. no.: Project name: A} Gon) 6 37- Covered porch area: g 9 square feet Cross street/directions to job site: Deck area: Z p square feet Other structure area: ------ square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: 6 J 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 y � DESCRIPTION OF WORK work indicated on this application. Tigo v i v6 �t f 3D ` /F 5// J44 /-.Ei , yJT / Valuation: $ /v t / j) 3l e / 1 - Q. P i D . 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: g Phone: ( ) Fax: ( ) New: APPLICAANNTT ❑ CONTACT PERSON NOTICE Business name: -% e Z- nc____Die, All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and maybe 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: w Y4- Fig. Z �'C - 0/..) (Please refer do fee scliedule� Address: 9 c 1 t'� j )� m 4'T , Permit fee: State City/State /ZIP: 12 74 0 ©1 7 Zz- LS p am review (12% of permit fee): ` ° FLS plan review (40% of permit fee): Phone: (f2 6,g4- - 2 ZE Fax: ( 903 ) 6 g4 - 9 & s 7 (Due upon application.) _ CCB lic.: (040 7 7 s Total permit fees: Authorized signature: Amount received: ie------ / / This permit application expires if a permit is not obtained Print name: V6 L4-rj7-7--g-"-) Date: a -06 1 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(11 /02 /COM/WEB) if City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to bedone 1.) 15-New 2.) Modification to sprinkler heads only: LI Addition 0 1-10 heads: No plan review required. LI Alteration . .fr11+ heads: Plan review required. 0 Repair Number of sprinkler heads: Additional description of work: ;A;.) Commercial S wet El 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 LI Yes include: Individual Component 0 Yes • Cut Sheets Fite Alatm Project Valuation: $ B) Resideiftial Sprinkler (Stand Alone System) $ 3 --;5; • „ :,;(•• . Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3600 $232.50 • 3,601 to 7,200 $292.50 Li 7,201 and greater $381.50 „ 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. hrtp://www.ci.tigard.or.us/city_ha.11/departments/cd/docsrFPS-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 12639 SW MOUNT VISTA CT, TIGARD, OR, 97224 Residential - Fire Protection System 999 Sprinkler Final 04/29/2013 00:00 FPS2013-00022 PASS - No C of O 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 12639 SW MOUNT VISTA CT, TIGARD, OR, 97224 Residential - Fire Protection System 910 Sprinkler Rough-In 03/07/2013 00:00 FPS2013-00022 FAIL 1. Provide stamped and approved plans. PLUMBING MECHANICAL. PASS Violation Summary: Inspector Contractor