Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111111 s COMMUNITY DEVELOPMENT Permit#: FPS2014-00072
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/24/2014
Parcel: 2S 109 DA 18300
Jurisdiction:
Site address: 12719 SW WILLOW POINT LN
Project: Arlington Heights No.3,Lot 112 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 112
Project Description: Fire sprinklers for new SF
Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES NW LLC
9095 SW BURNHAM 4230 GALEWOOD ST#100
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-RES 04/24/2014 $246.45
12%State Surcharge-Building 04/24/2014 $29.57
Type of Use: SF Info Process/Archiving-Lg$2.00(over 04/24/2014 $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 04/24/2014 $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 $295.02
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 3295
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 .t started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the es adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You , obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: - ermittee Signature: /
Call 503.• •. •y 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completio of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit AppliANCEIVED
Fire Protection System It/It OI f 1( I 1 .i Ov1.1
City of Tigard APR 2 3 2014 Received Man PermitNo.: fPS�/ t0 7e
13125 SW Hall Blvd.,Ti OR 97223 Date/B .
• gam. Plan Review �
Phone: 503.718.2439 Fax: 50 Date/B . jg, ✓� `�= •her Permit: /167-poi (J0pp'l4
••• TIGARD
TIGARD Inspection Line: 503.639.4175 DIVISION Date Read "'" Juria: See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVI. Notified/Method: Supplemental Information
TYPE OF WORK 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.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $3256
111 Accessory building ❑Multi-family Number of bedrooms: 3
111 Master builder ❑Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address:12719 SW Willow Point Ln New dwelling area: 2727 square feet
City/State/ZIP:Tigard,OR Garage/carport area: 568 square feet
Suite/bldg./apt.no.: Project name:Arlington Heights 112 Covered porch area: 277 square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
SubdiN isian: Lot no.: Permit fees*are based on the value of the work performed.
Tax ma trccl no.: Indicate the value(rounded to the nearest dollar)of all
I'1'` equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Stand alone lire sprinkler s■stem for new single family home Valuation: S
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Stone Bridge Hones Type of construction:
Address:4230 Galewood St Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97035 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Payne licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham Rd jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)684-2928 Fax::(
E-mail:a.payne@wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Please rejerWjeesuiedafe1
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lie.:64077 Total permit fees:
Amount received:
--O gn �
This permit application expires if a permit is not obtained
Authorized signature:
within 180 days after it has been accepted as complete.
Print name:Ashley Payne Date:4/22/2014 * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Pumits\FPS-PermitApp.doc Rev 01/05/2012 440.4613T(11/02/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:
El Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 2
Additional description of work:
Type 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 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
C:\Users\Ashley\Desktop\TigardApp.doc Rev 01/05/2012 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12719 SW WILLOW POINT LN, TIGARD, OR,
97224
Residential - Fire Protection System
999 Sprinkler final
FAIL
FPS2014-00072
George Heimos
1. Provide rare sprinkler backflow tests results.
2. Relocate fire sprinkler head away from vertical drop in adjacent ceiling as shown on
pg FS-2, initialed and dated.
3. Recall inspection when corrections have been completed.
Violation Summary:
Inspector Contractor