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Permit � CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT li COMMUNITY DEVELOPMENT Permit FPS2012 00018 ' - Date Issued: 02/15/2012 ric Akio; ; 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S109DA17400 Jurisdiction: Tigard Site address: 15351 SW SUMMERVIEW DR Project: Arlington Heights, Lot 103 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 103 Project Description: 13D residential fire suppression system. Contractor: WYATT FIRE PROTECTION INC. Owner: COLUMBIA STATE BANK 9095 SW BURNHAM 17800 SE MILL PLAIN BLVD, STE 10 TIGARD, OR 97223 VANCOUVER, WA 98683 PHONE: 503 - 684 -2928 PHONE: FAX: 503 - 684 -9657 FEES • Description Date Amount Specifics: Permit Fee - RES 02/09/2012 $246.45 12% State Surcharge - Building 02/15/2012 $29.57 Type of Use: SF Info Process /Archiving - Lg $2.00 (over 02/15/2012 $4.00 Class of Work: ALT Type of Const: VB 11x17) Occupancy Grp: R - Height: ft Info Process /Archiving - Sm $0.50 (up to 02/15/2012 $15.00 Stories: 2 11x17) Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Wet Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 4.9 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $295.02 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 3144 .. 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 dir: questions • sUNC by -fling 503.232.1987 or 1.800.332.2344. Is ued By: A / Permittee Signature: / A de ' all 503.639.4175 by 7:00 a.m. for the next available inspecti. 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 0)4C) FOR:OFFICE USE ONLY 14 '� Received - City 13126 SW Hall Bl of T i g a v rd d., DateB ) /,Z PernvtNo.: j).. _ 4, Tigard, O 999 ��� '�1, �O Plan Review Other Permit: Phone: 603.639.4171 Fax: 60 960 �� f1 Date/By; J,1� '� / 6 ! a TIGARD Inspection Line: 603.639 ` C t � � S Date Re � (�7 See Page l for Internet: www.tigard -or gov Notified/Method: „a tp,I Supplemental Information a T1 PEI V .tt y . .t..r., z? a QUIREDtDATA f $' 2 F Y D3VELLING ` „,,,,v,,,,,...„.„ 7 .4..,-,0A' '., ' - _.. t - � �' � ' . - - az :..�.=t .a - - - -= z. n ...- ...<...,r - -�. iE New construction [7&emolition 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 :.:.�> p;'di �,;. ;«'.� ''nE ,:,,t:araM:r -'.a x�,;- :: ,'xz`�.�;_,�.t:;. ;;, `y= �,�:_ -�, ;� - ;�i,>.�t' v,� work indicated on this application. ;> t -, :: CA, ..GF..�,;._- OE CQNSTRUCTION - =,,, _ jg1- and 2- family dwelling 111 Commercial/industrial Valuation: $ ❑ Accessory building El Multi-family Number of bedrooms: El Master builder El Other: Number of bathrooms: s',r'< �:. +R : >�i`LYi •? rn?$e,.gF.ox .: , ^:3L ". . ,;-.., <r '' -, 'JOB ;SITE 3LVFORAIAT za , ,s-,,_ t, -,: . F : Total number of floors: „ >. ?. -_. ;..., - ,L„ ..:..... . . �: -.. - -.� NSA ON � I� ND��LOC t p °`T { �„ r � ` _ ., ,,. s ..y ... z- .,,. sa �R+K ^ � �:.. ©_ �4. 1 a�^ = <.< ��':,�°_:� „ ,, ,, P ,, , , ./.1: - .- .` « r�A*� �' ;� ��''�`'� '� , � g., .. -e., Job site address: /e j 0IL -pp_ dwelling area: 3 144 square feet City/State /ZIP: 116 - � J l lL . l ' , 97z-2-4- Garage/carport area: 52'2,..... square feet Suite/bldg. /apt. no.: Project name: [4 LL J..J I S Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet • y-'.'IaptILREI D. fi-r T ':, .,,, CO1vIlv1ERC1AL” [ SE.� lite TS ..; T > , :t. , „..: �*•....,,mg, - 2. 3, 4e.:. -3'F:, ° :n'*,,,$ :,,, , .,„404 ,,,, Subdivision: Lot no.: 10 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 . ;.::', .<.0 , - ..,,'.<, ': ,:.,- s,::. " -' :. P,;a,;..:'- ..,,,,., , overhead, and the profit for the rr equipment, materials, labor, a e r .:•� ,•9�; ° w� & �'��_: - .'" �'° �' >__ � "� work indicated on this application. DESCRIC''!.V,.i OF ;WO &' ; <r _;, <v � c if . �,.,.,,:' _ -.6,� > -.. . �: �,�, rt• , �xe,�u¢ x.-.. _ . ;.�:'A„ � _. , �.=3..��,a°> ,, -mow ^: - _..,__ .<'ac�c,L`°��.:,._ . = �'<�`�,:�'r":' =1l `D Vi D - NO0 1.b r I A'L— F. /R- Valuation: $ .PP-i)■),v i ` e S 1 � ti /- 3 4 4 , , Existing building area: square feet r t I 1) 5 l J`F� l New building area: square feet '•; =rA- r'G ash„ �•z.r�:r > .z��. , _. :'•� 't° r��; „x�,. ,.,: 1 P.ROPEIt 01' I�E ". (, :° ,c.,..;1., T'E1VAN - ,.. Number of stories: ,x r <= • �- '� »t,..�- „�,,�;��. -'.,, ,,,•°lira -,��.� :..: <: �t . - .. Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) . Fax: ( • ) New: . Sat; ,4,;, t, ;j, - a. ,,, ;. ,• xt_ ,,a', \ v4V'.� V b ” -", s ;:. ,, -,:• ,. ,., ANT:", :.. ::'�;�; ,�::' . %� , ' COIN Cr . ,�" �. r� .� u �.K� � J'fl1C'T�rI'ER,SO `;' " +' �;;� -' .�,. ll, a ...2' .._ 1.:'.' - >;ii ,- ;.; nom, �, - _ ,,� . ... � _., .,...� „fir_ �t;t „'�.:- � >s. , �- :,t�:`�'ta ,,,,, ,w- - ., >v.�x�as ,,— ., . ,t �: , -a_. � � �” . . _ �';� �'':,..<� - ` +;.- ;.� "�,:. NO TICE+ t;` ;; W - k : ;:_�.�����,..,�>r.�� � �;� : Business name: „_ �,p:`M« .«_:_- „ ��.�.�: ;; Y�„ � °:a_;��' _, j e._ r �© All contractors and subcontractors are required to be Contact naive: licensed with the Oregon Construction Contractors Board under ORS 701 and may be 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: .�,.., a...r - - -:,: , . ,.,ne t .. - <•,< <;. _.. CONTRA rt�1x' �;. '- :;�,:; *,, �:. < - ,r� ... „ .. .,, w,, � „ - �R ,�. . ,, ..., ,r ..... . . . .. . „, _ .... ��:�,.,... -'- r BUILDIN PERMIT = FEES , , : , A , 4, ! , 1 ', ; , : . -_ ,. . .. . �,�.�.. -� ...:fix. -- ..,.c,. .ra� ... . �� s'_,,.., p.....__:. , .. �s�a *. ;E -,” G' , � , � =;< ;iar `' < <a.,*,, T',��..':', . ., 'Zx! ,. ,:, = F «iSi ",g" .:+ -'' �;�j�igg�+,, e p ..P.d xe-. :. 0 Plea ` z , ; it + :,4 : ,` ',i' x e...,,: ; `" ° a( se .r e "/er < fd e, 's' c ' %l ediilej . ,. , ,� -^ :. Business name: 1)(1-71." )` t 1 't l� p �� °� � e",10 Permit fee: Address: 9 0 9 3 6141 x5 tvzitt � S l , State surcharge (12% of permit fee): City/State /ZIP: f `64 0 j� 97ZZ 3 / FLS plan review (40% of permit fee): Phone: (5 3) 6 b 29 zS Fax: (5t3) F54 96 5. 7 (Due upon application.) CCB lie.: '.,?4() 77 *Ili , Total permit fees: Authorized signature. ,...,- received: e--t(2---- This permit application expires if a permit is not obtained Print name: /16.c.? y i ,1r� 1,(_ L�,a Date: z — — Z * within 180 days after it has been accepted as complete. �`” Fee methodology set by Tri -County Building Industry Service Board. i'\ Building \Permits\FP5- PemtitApp.doc 03/23/06 440- 4613T(11 /02 /COM/WEB) n City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Des.cribekwo to3 be... hdo ne' , - ....�. 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ..7.; heads: Plan review required. ❑ Repair ' Number of sprinkler heads: 2 Additional description of work: ,te . ... -, .. -�-. .. ,�..,_. -..: ,M.• „"<„ ,,..- ..., <<,. ,,:x <_..; , . a , ?x .< -.�'. s. 3ifL�:- -a�F�: -��;.. �” S R� S- �� - - . .,r „ >: 4• > €.. ,';_ ,$.� 'a,>.,,�_ {xc Asa * - -'.=< R._r:2 ::Y.":.,.,.a <- ,:,,."s', t- .x " >. <- - :rte ercial���S rmklei�: "':�> . �:,� ; ..., ;, • ,: - ... , -,.. _:; " ,:.�_ >�.� a, fix Ate ,. � � ���' .. .�.r. ..,��.. � �. <�.., ,... • .,,,'�; ":. �.;�:,. ,�, . ; . a > : �:� »..... < �:AAt:,74 ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area • K. Factor Sprinkler Project Valuation: $ • k$.< ;'� �n 3,< 'x. - - ., Hood Project Valuation: $ <":_'._ q'� '.%�3 .:tea., :.."��m�: . `s=� �; >,:,;. "'' ,,.fie .,:, .. 6 4r .X,. , <5,,,,. a wad,e - a t r .oEL _ . R ,, q ",. , Submittal shall Battery Calculations ❑ Yes • include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ :- �,.:�" ;g :•sz3vm� • >';% Fes.;;' «•,4 �;;>> ,j • Vin.,, ,, ,.,x :, �� � ��� •:,� , ;� _: <�; � �. '';tom >:-�: .:fir. ` :��'' "���".�, >,.,�. ,, .�� °7 ,.x.,.,. ex -.r .a #s� ,��., . ,,.- , :�. � a .:�Alo = tTL�.�.". , x ".� t- ��.'.'�r " "�ridi. ,�„,.; r:t'�' . •a3:,,. , , c�. - s c�'ettha'lS: iritilera :; =5�t nclrie,�S..stern. ..,��- �.,..�.`,x p�� = -•:� �e >, �_, a , .., ,. ^+, a "§�: ��4: " <•P?;_ � ' 3 "' ,• s. -.,.. ' ,; ,k;., Y$ � k`�, -7 ,.,, , &,'��d•.,,. Ws, , Saz�: °;',mow ; Square Footage: Permit , ,,, a;<>'at,: ',� ;' ' g ermit Fee:` ` ` 2,000 $187.5 f „rr 2,001 to 3,600 $232.50 `-'"`'t'”' "�' `�': tsy ,_..<"�z :k.e�,- m:��' yF3' 3,601 to 7,200 $ 2 92.50 '`''k s = �x :,. • - WX $381.50 7,201 and greater �.' `�,��:�, , h �",. „ O°��_ F �: Sprinkler Project Square Footage: sq. ft. 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 NICErlevel "3" technicians. http: / /\wwv.ci.tigard.or.us/ city_ hall/departments /cd /dots /"PPS- PermitApp.doc 2