Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I. COMMUNITY DEVELOPMENT Permit#: FPS2014-00102
T t G A R C7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/16/2014
Parcel: 2S 109DA18400
Jurisdiction: Tigard
Site address: 12723 SW WILLOW POINT LN
Project: Arlington Heights No.3,Lot 113 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 113
Project Description: Stand alone fire sprinkler for new SF,approximately 2748 sq ft.
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 06/16/2014 $246.45
12%State Surcharge-Building 06/16/2014 $29.57
Type of Use: SF Info Process/Archiving-Lg$2.00(over 06/16/2014 $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 06/16/2014 $17.50
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 $297.52
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 2748
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 no .red within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the , les a opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You m. obta a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 4.
Issued By: , Permittee Signature:
LAJi
Call 503.639.4175 by 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 completion o e project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Applicatio
Fire Protection System ECF11IFQ FOR OFFICE USE ONLY
Received /�
City of Tigard II 9 n Date/B G( 9 /Lt/ � PermitNo.: /�`Jf4�(>Q/��
13125 SW Hall Blvd,Tigard,OR 972231 9 2014 Plan Review �`
WOW a her Permit:
Phone: 503.718.2439 Fax: 503.59 Date/B . i/�%W OW r1rx/ ��
,, Ai:l,
Inspection Line: 503.639.4175 o'WARD Date Ready tuns: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING Wise p i Date Read ethod �� Supplemental Information
TYPE OF WORK REQUIR 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: $2077
❑Accessory building ❑Multi-family Number of bedrooms: 4
-
❑Master builder ❑Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 12723 SW WILLOW POINT LN New dwelling area: 2255 square feet
City/State/ZIP:TIGARD.OR 97223 Garage/carport area: 493 square feet
Suite/bldg./apt.no.: Project name:ARLINGTON HEIGHTS 113 Covered porch area: 196 square feet
Cross street/directions to job site: Deck area: 0 square feet
Other structure area: 0 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: 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
DESCRIPTION OF WORK work indicated on this application.
STAND ALONE FIRE SPRINKLER SYSTEM FOR NEW SINGLE FAMILY HOME Valuation: $
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:
® APPLICANT CO 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 (Pleaserefumfeeuhedale)
Permit fee:
Address:
City/State/ZIP: - State surcharge(12%of permit fee):
- FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lie.:64077 Total permit fees:
I -
Amount received:
Authorized signature: --4
This permit application expires if a permit is not obtained
Print name:Ashley Payne Date:6/9/2014 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:.Building PermiIS`FPS-Pemiwppdoc Res 01 05 2012 440-4613T(I1,02/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:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ® 11+ heads: Plan review required.
El Repair
Number of sprinkler heads: 20
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
I lood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component El 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: 2255 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.
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