Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' COMMUNITY DEVELOPMENT Permit#: FPS2014-00147
f I c;A K D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2014
Parcel: 2S109DA18500
Jurisdiction: Tigard
Site address: 12747 SW WILLOW POINT LN
Project: Arlington Heights No.3,Lot 114 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 114
Project Description: Installation of new 13D stand-alone fire sprinkler system for
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: 503-387-7577
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-RES 09/04/2014 $310.05
12%State Surcharge-Building 09/04/2014 $37.21
Type of Use: SF Info Process/Archiving-Lg$2.00(over 09/04/2014 $4.00
Class of Work: DEM Type of Const: VB 11x17)
Occupancy Grp: R-3 Height: ft Info Process/Archiving-Sm$0.50(up to 09/04/2014 $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 $366.26
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 3772
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 adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obt ' - copy of the rules
or direct estions to•. C by calling 503.232.1987 or 1.800.332.2344.
Issu d By: Permittee Signature:
•
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. I
This permit card shall be kept in a conspicuous place on the job site until completion oft e project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System ['� FOR OFFICE USE ONLN
City of Tigard SEWnEl �Bed / PermitNo.. �5-'if 1
1141 • 13125 SW Hall Blvd,Tigard, Plan Review 1 4 2 Date/B . itmar `j m Other Permit: /1.1/ 4/4--0 )Phone: 503.718.2439 Fax: 503.5 0
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: ��`s J ® See Page 2 for
Internet: www.tigard-or.gov �TORD Notified/Method: g��/i y lir ' Supplemental Information tk,C'1TY 1
tom() / QUIRED 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 Valuation: $2905.00
® y g ❑Commercial/industrial
❑ Accessory building El Multi-family Number of bedrooms: ti
❑ Master builder ❑Other: Number of bathrooms: ,3
JOB SITE INFORMATION AND LOCATION Total number of floors: `3
Job site address:12747 SW Willow Point Lane New dwelling area: 33z0<square feet
City/State/ZIP:TIGARD,OR 97224 Garage/carport area: square feet 5-
Suite/bldg./apt. • • = Covered porch area:• •r" square feet 27J
Cross • to job site: Deck area: square feet
Other structure area: square feet.
REQUIRED DATA:COMMERCIAL-USE CHE IST
• •n: Lot no.: Permit fees*are based on the value of the work performed.
I' 1 00 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.
INSTALLATION OF COMPLETE 1 STAND-ALONE Valuation: $
Existing building area: square feet
New building area: square feet
■ PROPERTY OVVNER TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: LICIIT
Phone:( ) Fax:( ) New: LICHT
® 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*
(Please refer to fee schedule)
Business name:Wyatt Fire Protection
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:
Amount received:
Authorized signature: As Ithy. ,,,/ (
a _ Phis permit application expires if a permit is not obtained
Print name:Ashley Payne Date:9/3/14 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 Rev 01/05/2012 440-46131(11/02/COM/WFB)
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.
El Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: Sz
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet El Dry
Additional Standpipes
Information: Hazard Group 13D
Density 0.05
Design Area 2 HEADS
K. Factor 4.9
Sprinkler Project Valuation: $ 2905.00
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.
W:\Permit Applications\Tigard App.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
12747 SW WILLOW POINT LN, TIGARD, OR,
97224
Residential - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2014-00147
George Heimos
1" Ames 1" model 2000B serial no. 25507
Violation Summary:
Inspector Contractor