Permit 41 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
�' COMMUNITY DEVELOPMENT Permit#: FPS2016 00005
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/24/2016
Parcel: 2S110CB13000
Jurisdiction: TIGARD
Site address: 12065 SW AUTUMNVIEW ST
Project: Southview Heights,Lot 18 Subdivision: SOUTH VIEW HEIGHTS Lot: 18
Project Description: New 13D fire suppression system for a 2,830 sq.ft.house.
Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES NW LLC
9095 SW BURNHAM 4230 GALEWOOD ST, STE 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 02/24/2016 $246.45
12%State Surcharge-Building 02/24/2016 $29.57
Type of Use: SF Info Process/Archiving-Lg$2.00(over 02/24/2016 $4.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: R-3 Height: 32 ft Info Process/Archiving-Sm$0.50(up to 02/24/2016 $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: $2,735.00
Residential Square Footage: 2830
Fire Alarm Valuation:
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 obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: mittee Signature:
Call 503.• 6.4175 by 7:00 a.m.for the next available inspectio •ate.
This permit card shall be kept in a conspicuous place on the job site until co pletion of .
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System RECEIVED FOI t)FFll: l sI:0NI.1
City of Tigard Received
. (l0 /„ Permit No.: 4, , • , , 4
14 N u 13125 SW Hall Blvd,Tigard,OR 97223 JAN 6 2016
Phone: 503.718.2439 Fax: 503.598.1960 Plan Date/BrReview �
� Other Permit:Aii a0 l _,40
-1-I(,A R I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: loris: ® See Page 2 for
Internet: www.tigard-or.gov n otified/Method:p1 /(r /(a J� Supplemental Information
BUILDINGDIVISI• ovi: shle
r� ,. -� , TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY,DWELLING
®New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
. ., work indicated on this application.
1` µ5�"��r , 5 CATEGORY OF CONSTRUCTION pp
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $2735
❑Accessory building ❑Multi-family Number of bedrooms: 3
0 Master builder 0 Other: Number of bathrooms: 2.5
1 ;} JOB-SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address:42465SSW Autumnview St New dwelling area: 2830 square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 703 square feet
Suite/bldg./apt.no.: Project name:Southview Heights 18 Covered porch area: 91 square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: 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 application.
�`� �' '�- � work indicated on this a lication.
Stand alone 13D fire sprinkler system for single family home Valuation: $
Existing building area: square feet
New building area: square feet
,, 0 PROPERTY OWNER .u,t, 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 CONTACT PERSON
,_ �� "� , NOTICE r4 . . �;�
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Nishihara 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.nishihara@wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Please refer rofee schedule)
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 lic.:64077 Total permit fees:
Amount received:
Authorized signature: keir, ' e
This permit application expires if a permit is not obtained
Print name:Ashley shihara Date:1/6/16 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pamits\FPS-PermitApp.doe Rev 01/05/2012 440-4613T(I1/02/COM/WEB)
I
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
12065 SW AUTUMNVIEW ST, TIGARD, OR,
97224
Residential - Fire Protection System
999 Sprinkler final
Scheduled
FPS2016-00005
David Young
Violation Summary:
Inspector Contractor
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
12065 SW AUTUMNVIEW ST, TIGARD, OR,
97224
Residential - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2016-00005
David Young
1" Ames model 200B serial # 28800
Note: sliding barn doors installed at main level office/den in place of overhead door.
Violation Summary:
Inspector Contractor