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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2013 00032 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/13/2013 Parcel: 2S109DA14400 Jurisdiction: Tigard Site address: 15211 SW GREENRIDGE PL Project: Arlington Heights, Lot 63 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 63 Project Description: 13D fire sprinkler system for new 2,838 square foot residence Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES NW 9095 SW BURNHAM 16869 SW 85TH AVE #505 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 03/13/2013 $246.45 12% State Surcharge - Building 03/13/2013 $29.57 Type of Use: SF Info Process /Archiving - Lg $2.00 (over 03/13/2013 $4.00 Class of Work: NEW Type of Const: VB 11x17) Occupancy Grp: R -3 Height: ft Info Process /Archiving - Sm $0.50 (up to 03/13/2013 $15.00 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 $295.02 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: Residential Square Footage: 2838 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, for if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Noti -= '• - - . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of th- rules or dire •uestions to OUNC ; calli : or 1.800.332.2344. Issu d 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 RECEIVE . , = FOR OFF7CE USE ONLY r' - • ' 4 7,1 City of Tigard Date/B 3 /I / 13 i Permit No.: FPS,�-(�i 3- COO 3 D-- F ' MAR 1 1 2013 y r 1312 SW H all Bl vd., Tigard, OR 97223 Plan Review CfIYonTIGARD Date/By: / Other Permt Phone: 503.639.4171 Fax: 503.598.1960 11 1 Vl ilVA1W y: ( VI (� • - Inspection Line: 503.639.4175 Date Ready El See Page 2 for Information �, TIGA o g B J 5O Supplemeotal � �'. -�- . r . ' Internet: www.ti or. Ull D1NGDNISI ®�otified/i�4ethod:0�� 7 7 t 95et TYPE OF WORK REQUIRED DATA: 1 -AND 2- FAMILY DWELLING 0A2ew construction El 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. 1241.- and 2- family dwelling ❑ Commercial/industrial Valuation: $ 2.676� ❑ Accessory building ❑ Multi- family Number of bedrooms: 5 1=I Master builder CI Other: Number of bathrooms: 2 .� JOB SITE INFORMATION AND LOCATION Total number of floors: 2. Job site address: /12I 51'/ 6 -SR 7 J D3e New dwelling area: Ze3E, square feet City/State/ZIP: -r a D 1 () 2 9722 tP Garage/carport area: 61- square feet Suite/bldg. /apt. no.: Project name:/1--N f it)6 / t S t / -7 S Covered porch area: r 2- square feet Cross street/directions to job site: Deck area: 1 1 square feet Other structure area: —-- square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: (J 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. 7 AC 13 F /,P_ S7/ k L L S`6. Valuation: $ l it) u J 3 C� ' 55 e� , / / 7; , Existing building area: square feet c/ New building area: square feet ❑ PROPERTY OWNER I ❑ TENANT Number of stories: Name: Type of construction: Address: • Occupancy groups: City/State/ZIP: Existing: Phone: ( ) Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: • . e_1)4) -� 7o� 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: ( ) ' I Fax:: ( ) E -mail: CONTRACTOR - BUILDING PERMIT FEES* - Business name: ', J �Er, 0� (Please refer -to fee schedule `* ��`' — `� � l Permit fee: 1 Address: 9 ©9 5 ig --7--7 City/State/ZIP: f`�/9 / 02 ) 7 ZZ� State surcharge (12% of permit fee): FLS plan review (40% of permit fee): Phone: ( 7 j) 6)&4 - zozg I Fax: (5D3) ( t' _ 96, S 7 (Due upon application.) CCB lie.: &407 7 Total permit fees: Authorized signature: ` - Amount received: This permit application expires if a permit is not obtained Print name: /�-�GG U 6 ) ) 5 24- 77,-/9">\-) Date: z).? —`1 —/ within 180 days after it has been accepted as complete. * Fee methodology set by Tri -County Building Industry Service Board. IABuilding\Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(t 1 /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 0 Addition 0 1-10 heads: No plan review required. 0 Alteration lg....11+ heads: Plan review required. Repair Number of sprinkler heads: 2-3 Additional description of work: Type of System (Coinplete A, B,Cor D as applicable) Cdphirci"A1:81iriptiOi , El Wet U Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ , ; „ • Hood Project Valuation: C) Fire Alarm Submittal shall Battery Calculations 0 Yes include: Individual Component 0 Yes Cut Sheets Fite Alarm Project Valuation: $ it4tictliloo D) Resideritial Sprinkler (S Square Footage: Permit Fee: 0 to 2,000 $187.50 K 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. Fiti',Pioteetibi4Vainit 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.citigard.onusicity_hall/departrnents/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 15211 SW GREENRIDGE PL, TIGARD, OR, 97224 Residential - Fire Protection System 999 Sprinkler Final 04/29/2013 00:00 FPS2013-00032 PASS - No C of O Violation Summary: Inspector Contractor