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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT - COMMUNITY DEVELOPMENT ; Permit #: FPS2011 -00078 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011 T"` - Parcel: 2S109DA14700 Jurisdiction: Tigard Site address: 15262 SW SUMMERVIEW DR Project: Arlington Heights No. 3, lot 66 Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 66 Project Description: Residential fire protection, 13D system, 2,283 sq ft Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES NW LLC 9095 SW BURNHAM 16869 SW 65TH AVE, STE 505 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 06/30/2011 $246.45 12% State Surcharge - Building 06/30/2011 $29.57 Type of Use: SF Info Process /Archiving - Lg Sheet (over 06/30/2011 $4.00 Class of Work: ALT Type of Const: VB 11x17) Occupancy Grp: R -3 Height: ft Info Process /Archiving - Sm Sheet (up to 06/30/2011 $11.00 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 $291.02 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 2283 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 to OUNC by calling 503.232. •, ;.. ' 344. Issued By: Permittee Signature:�� ,/ Ca x 63 .4175 by 7:00 a.m. for the next available inspectio- date. This permit card shall be kept in a conspicuous place on the job site until ompletion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Fire Protection System � FOR OFFICE USE ONLY City g R .EC E ED Received /�� h5ie 1 7 iii C1 of Tigard DateBy ( p f Permit No.: " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie .. � Phone: 403.639.4171 Fax: 403.498.1 N 2 3 rynlf Date/13y: : IlltrgEgrAll0111 Other Perniit: 17" /,1 jQ/`.-eabg6 TIGAItD Inspection Line: 403.639.4174 Date Re "er: p / J a See Page 2 for Internet: www. tigard - or.gov CITY OFTi Notified/Method: (7 / Supplemental Information ANS TIPS OF RO Wit, .. e&v. T2E QD IREDDATA I A LYDWELL`IIl'G `'. w 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 I Y work indicated on this application. CATEGORY OF CONSTRUCTION - - and 2- family dwelling Valuation: $ ' (� ❑Commercial /industrial I ❑ Accessory building [1] Multi- family Number of bedrooms: 1=1 Master builder Number of bathrooms: Z ❑ Other: N JOB SITE: INFOR114ATIONtAND'LOCATIUN m� tv Total number of floors: Job site address: /5Z/Z_ 3 k SL) /4 /ElA // e D/2 , New dwelling area: 2_2_ square feet City/State /ZIP: -77 l /' 9 7 ZZ4L Garage /carport area: 4n,0 square feet Suite/bl /apt. no.: Project nname:y4 -e Q,&j 7 - -/ ,N.- 7 5 Covered porch area: / 2_ 9 square feet Cross street/directions to job site: Deck area: / 355 square feet Other structure area: square feet IREQ1,lIREb DATA : eOMMER.C- IISE CIIFO KLIS i. Subdivision: u no.: Lot no.: • (, . — Indicate the value based the e value of ork,p performed. ep the work performe the nearest dollar) of all p ma/ equipment, materials, labor, overhead, and the profit for the r 'fl DESCRIPTION OF WO L` ' ' it f F work indicated on this application. - t i2OV/De, • / 3 D FfP s 77 t / i Valuation: $ _ r . rvi j _ L � � � Existing building area: square feet New building area: square feet t ° r t> 'tea fi-_ y w 4A� „°' {"; a - PROPERRTN OWN R � TE1N - Number of stories: Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: APPLICANTV ni a ❑sCONTACT PERSON z O M t x V r at, �` ,11 `�..,. .. .� ... �.,. .�. ,. . _ , , _ .� -, ,, .., t �/ / � � � � con an su `� �� ��s Business name: tors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and maybe required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) • Fax:: ( ) E -mail: n m : t CONTR CTO g , 10 t.$ z .- „ ]. «a ..t-:, O N E F g' ::: l'A _', • �,,,,� N ..� egMq° ISM &� 4 0 ( • :#0LD PERMIT FEES rg g Business name: L�l Y1J- / F/ € 7),e_07--e___7-7 c�� ° ,R 1easB. refer t SCItE r � ` =r 3, a Address: 9c) 95 .Sw 6 wej_i 5 Permi fee: City/State /ZIP: State surcharge (12% of permit fee): f �� / ©� 7 a-i 3 FLS plan review (40% of permit fee): Phone: 603) 6 j 4 _ z9 Z t) Fax: (5D3) d., E4-- -e9 E%.7 (Due upon application.) CCB lie.: ( 4 0 7 7 Total permit fees: Authorized signature: Amount received: / This permit application expires if a permit is not obtained Print name: / / 6.� �` j }5 Date: e — Z 3 — l' within ] 80 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I: \Building\Permits \FPS- PermitApp. doc 03/23/06 440- 4613T(1 I /02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information tiPZ rxbe work �o I .d.. ne c n•1 a1 1 s 1 '� _.< <v �_. �.,�T r_���r�?" =sit. _ -.� _. E _.;, �,� _.._ �.�.� ���. �., , „ -� _< �:. 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ` 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: f.D Additional description of work: Type o£ Sys ai (C6irif k e A, B: C ii asapphcable) 1 g R 6 ... , ... 4 ; ., ; E ° A) Commercial Sprxnkler O r m A v' ^' ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area • K Factor Sprinkler Project Valuation: $ ,k w*o v ;m q * At h g apt E , B..} Type � F Haod Fx�re Sup r� ,., stem t � Hood - Pro ect Valuation gogigmagmaimwsks x �n x .. r a ?- ' , 'F` 3, ' E l ''51401000:040104 °� £ �a°3 3 OI C) „�� Fire Alarm ' IA 3 s y �' u tAwn ;2;* �� � a .:� tea,. <., - , *410,, .Submittal_shall __ __ .__ Battery Calculations -❑ —Yes - -- - - - - - -- include: Individual Component [I Yes Cut Sheets • Fire Mann Project Valuation: $ mgen tr i t Er geMPAIWOOVIMILVITTMOVHOOMEMSIMPAIMAIMAIPA DS Residentxal Sprxnkler (Stand lone'SYste n y^ % �� t . M Square Footage: Permit Fee: '��� � p �� 0 to 2,000 $187.50 �� f tat ,+ :; tiO A V 2,001 to 3,600 $232.50 * r 3,601 to 7,200 292.50 � . 7,201 and greater $381.50ral �� , „75._ Sprinkler Project Square Footage: sq. ft. •s t t� a �- ,� -- t�s a w:' a s a a,.. # a�s a r s$�” ” n F,:. .. x _ . ,,..: ..a . ,..; ,g F xe Protg la Permit; Fees V a ,. V .. t ,_ Ni x.. ..v 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 2 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. http: / /www.ci.tigard.or.us /city_hall/ departments /cd /dots /PP$- PermitApp.doc 2