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Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT s • COMMUNITY DEVELOPMENT Permit #: FPS2012 00059 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/27/2012 Parcel: 2S109DA18700 Jurisdiction: Tigard Site address: 12734 SW WILLOW POINT LN Project: Arlington Heights No. 3, Lot 116 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 116 Project Description: New 13D fire suppression system for a 3,085 sq. ft. home. Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES 9095 SW BURNHAM 4230 GALEWOOD ST SUITE 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 04/27/2012 $246.45 12% State Surcharge - Building 04/27/2012 $29.57 Type of Use: SF Info Process /Archiving - Lg $2.00 (over 04/27/2012 $4.00 Class of Work: ALT Type of Const: 11x17) Occupancy Grp: R - Height: ft Info Process /Archiving - Sm $0.50 (up to 04/27/2012 $11.00 Stories: 2 11x17) Commercial Sprinkler System: Sprinkler Required: No Sprinkler Type: Wet 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: $3,085.00 Residential Square Footage: 3085 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 • ' . ion . = 'ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a c• • of the rules or dir= t questions to OU ` , • s li r • • 503.232.1987 or 1.800.332.2344. y Issu By: 4 Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection d. e. This permit card shall be kept in a conspicuous place on the job site until comp etion 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 of Ti Rec eive d Tigard R" Da[eB : ,� Permit No.: •—/ ` , — r '� 13126 SW Hal] Blvd., Tigard, OR 97223 0 a L 1 C \� PLw Revie ,( "j Other Permit: Phone: 603.639.4171 Fax: 603.698.1960 % (, DateBy: tar ■ ""t' TIGARD Inspection Line: 503.639.4175 n p � , Date Ready/By: tu 0 See Page 2 tor Internet: www.tigard- or.gov P ` e . ed /Method: y a y /, • A J Supplemental Information TI'PE OF WORK : ^ REQUIRED; DATA 1 AND 2 F AMILY D,WEL A Iew construction ❑ Demon 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. dwelling / Valuation: $ L �' 04_ and 2-family g ❑ Commercial/industrial � �' ❑ Accessory building 0 Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: 3 JOB SITE INFORMATION AND,-LOCATION', Total number of floors: r Job site address: /S734- 7 k/ WILL ow ?0/ Z4- New dwelling area: square feet City/State/ZIP: �`� � / © 7 972 Garage/carport area: 4& 0 square feet Suite/bldg. /apt. no.: Project name: L.) u r , A i fs6f4- ` S Covered porch area: f 85 square feet Cross street/directions to job site: Deck area: 2G4.. square feet Other structure area: square feet REQUIRED'DATA:. -USE CHECKLIST'' Subdivision: Lot no.: / / ep 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 1j'ESCRIPTION /D OFF WORK ` / � work indicated on this application. IP__DVi Dt� JU j l � F / /L -t— oi/)y r!Q_a SYS . Valuation: $ 2 )( G v s b �e � s S FT i j j Existing building area: square feet New building area: square feet ® ,PROP.ERTY. - OWNER , - . _ D. TENANT . Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone: ( ) Fax: ( ) New: - , 14APPLICANT IF CONTACT-' PERSON Business name: 5 6.1 All contractors and subcontractors are required to be ' Contact name: 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: .:CONTRACTOR:. ;.':"`'.,E,:: } ,.r _ , ( ';BUILDING PERVIIT)13J t i � � , N a ".•, Business name: W )04-11" /'� � Q � , %� �e'j.0A + Permit fee: (Rcase'rejar fofc w . . Address: �— c � ! [ XO9 6k .% 'ThuR._Aj/l.29...7).- ST, City/ State/ZIP: �/ 6,w D ©� 9 7 22,_.s State surcharge (12% of permit fee): !! / FLS plan review (40% of permit fee): Phone: i 3) 6 0¢ - 2_9 Z 8 Fax: (S7 3) 6p04 95-7 (Due upon application.) CCB lie.: (, 4 )77 • Total permit fees: Authorized signature: Amount received: ��� This permit application expires if a permit is not obtained Print name: ( 14-77 ) Date: 4- _1 Z__ 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 03123/06 440- 4613T(11 /02/COM/WEB) I City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information 1.) tg..New 2.) Modification to sprinkler heads only fl Addition 1-10 heads: No plan review required. Alteration 11+ heads: Plan review required. El Repair Number of sprinkler heads: Additional description of work: Systei*(ccimplei6 , , Commercial Sprinkler n Wet Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ 13.) ,1 2 : '." • Hood Project Valuation: C) Fire Alarm Submittal shall Battery Calculations 0 Yes include: Individual Component 0 Yes Cut Sheets Fire Alarm Project Valuation: $ D ) ' -• 7 ; :7' ``, , Residetiti41:Spririklet (8tRodAlo.ii'SiTsfein) 7 . Square Footage: Permit Fee: 0 to 2,000 $187.50 ; 2,001 to 3,600 $232.50 3,601 to 7,200 $292.50 7,201 and greater $381.50 , • Sprinkler Project Square Footage: sq. ft. ireR; P ermii 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 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_hallidepartrnents/cd/docs/FPS-PermitApp.doc 2