Permit (6) n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II
g, COMMUNITY DEVELOPMENT Permit#: FPS2016-00063
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/06/2016
Parcel: 2S110CB13500
Jurisdiction: TIGARD
Site address: 12050 SW AUTUMNVIEW ST
Project: Southview Heights,Lot 23 Subdivision: SOUTH VIEW HEIGHTS Lot: 23
Project Description: Stand alone fire sprinkler system for 2665 sf new residence.
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 04/06/2016 $246.45
12%State Surcharge-Building 04/06/2016 $29.57
Type of Use: SF Info Process/Archiving-Lg$2.00(over 04/06/2016 $4.00
Class of Work: ALT Type of Const: 11x17)
Occupancy Grp: R-3 Height: ft Info Process/Archiving-Sm$0.50(up to 04/06/2016 $50.00
Stories: 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 $330.02
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,576.00
Residential Square Footage: 2665
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 obtain a copy of the rules
or direct questions toto\OUNC bycalling 503.232.1987 or 1.800.332.2344.
Issued By n I. 040 Permittee Signature:
CI
BJ �_
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 compl-tion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System
E i E ...Hi, I: I sI:O\1.\
City of Tigard Received a
'u /o PermitNo.: %
Jn" /r-�o�
3Date/By:
13125 SW Hall Blvd.,Tigard,ORkk97223 Plan Review/1)4
H 4 , y ' J f C Other Permit: '4Ji
Phone: 503.718.2439 Fax: 503A18.1960 �16 PlanR . 1)4 i '�f5 l�O� lI
Inspection Line: 503.639.4175 Date Ready/By: ��I rl / loris: I ® See Page 2 for
116,\RD
Notified/Method: Supplemental Information
Internet: www.tigard-or.gov[ ITV OE .pi-4 1311 PP
1 A A
''" . ,";: 1 t a5;1 i i 14 °c r j"r RFQUIItED D T :lx 24*iar 35:: i„,i(4.es
®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
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
,* ,, tt � ri L k*'N .< fw r x. work indicated on this application.
- s *° C 1"1 CART OF,,.�O; CT>l01 A ,•,; :',Vre', ,`_cif'.
® 1-and 2-family dwelling Valuation: $2576
0Commercial/industrial
ElAccessory building ElMulti-familyNumber of bedrooms: 4
ID builder 0 Other: Number of bathrooms: 2.5
r ” y JOBS SIT ^ 1 FORMAT ON AND f CATION."';.:%.'t-' ,`{t''' Total number of floors: 2
Job site address:12050 SW AUTUMN VIEW ST New dwelling area: 2665 square feet
City/State/ZIP:TIGARD,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:SOUTHVIEW HEIGHTS LOT 23 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 Lot no.: p_'72 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
r ,4 4t DESCRIPTION OF WORKS 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
:.t 0 PROPERTY OWNER i--•❑:,TENANT -^., Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
IC's.. - ® APPLICANT,. ,'
® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Max Colley 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:m.colley@wyattfire.com
- ` :, ` r. .s v CONTRACTOR .>
r.. BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (PeesenfamJeexhe/ale)
Permit fee:
Address:
City/State/Z1P: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.:64077 Total permit fees:
i
Amount received: f 3 3,0,0.2"
Authorized signature:
c� This permit application expires if a permit is not obtained
Print name:Max Colley J- Date:4/1/16 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Peniis\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(I1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Descnbe�Gvorko'
hedone ;.. � a�a� '' � 6° '�
1.) ® New 2.) Modification to sprinkler heads only:
El Addition El 1-10 heads: No plan review required.
❑ Alteration Z 11+ heads: Plan review required.
E l Repair
Number of sprinkler heads: 2Q
Additional description of work:
cl
Typo£ ,, e.S (Completes3t�`A P a „`1 phcabte)
1,41"' 'eti? _
r ommerc><a rinkler ° ' zry 44
El Wet El Dry
Additional Standpipes --
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.)''rType I Hood Fire Suppression System"
Hood Project Valuation: $
C.) Fire Alami
eV .
Submittal shall Battery Calculations El Yes
include: Individual Component El Yes
Cut Sheets
Fire Mann 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
r
3,601 to 7,200 $310.05
� 5
7,201 and greater $404.39
Sprinkler Project Square Footage: 2665 sq. ft.
Fire Protection Petnit Fees. . , ;:E
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:AMax\1112 PERMIT APPLICATIONS\Southview Development.doc Rev 01/05/2022
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
12050 SW AUTUMNVIEW ST, TIGARD, OR,
97224
Residential - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2016-00063
David Young
Ames model 2000B, serial # 29822
Violation Summary:
Inspector Contractor