Permit I
•
•
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
- s COMMUNITY DEVELOPMENT Permit #: FPS2012 -00069
• T t G A R 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012
Parcel: 2S109DA18600
Jurisdiction: Tigard
Site address: 12758 SW WILLOW POINT LN
Project: Arlington Heights No. 3, Lot 115 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 115
Project Description: Install 13D fire sprinkler system for new SF
Contractor: WYATT FIRE PROTECTION INC. Owner. STONE BRIDGE HOMES
9095 SW BURNHAM 4230 GALEWOOD ST, STE 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 06/04/2012 $310.05
' 12% State Surcharge - Building 06/04/2012 $37.21
Type of Use: SF Info Process /Archiving - Lg $2.00 (over 06/04/2012 $4.00
Class of Work: ALT Type of Const: VB 11x17) •
Occupancy Grp: R -3 . Height: ft Info Process /Archiving - Sm $0.50 (up to 06/04/2012 $15.00
Stories: 3 11x17)
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 .1 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 $366.26
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 4357
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 c• •y of the rules -
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
• Issued By: Permittee Signature: /
Call 503.639.4175 by 7:00 a.m. for the next available inspecti • date.
This permit card shall be kept in a conspicuous place the job site until • ompletion of the project
Approved plans are required on the job site at the time of e. h inspection.
Building Permit Application
-Fire .Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard Received / Permit No.: Date/B : 61 j _�� /5 N
111 ' 13125 SW Hall Blvd., Tigard, OR 97223 APR 3 0 2012 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/13 : �'�� r - :FAM s ther Permit: )1l- d'evia—Qa/7g1
TIGARD Inspection Line: 503.639.4175 Date Ready ey: / kris: 0 See Page 2 for
Internet: www.tigard- or.gov C ITY OF TIGARD N oiSed/Method: W / /L a rt• ' Supplemental Information
BUILDING DWG( :' u ssq-
L
TYPE OF WORK • REQUIRED DATA: 1-AND 2-FAM Y DWELLING
few 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
CATEGORY OF CONSTRUCTION work indicated on this application.
.1" and 2- family dwelling ❑ Commercial/industrial Valuation: $ e. 9 Z®
Fr-
❑ Accessory building ❑ Multi- family Number of bedrooms: 5
❑ Master builder ❑ Other: Number of bathrooms: S
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /2 756 374 /4) 1L.L 1 pow,- Liu . New dwelling area: 4.3 57 square feet
City/ State/ZIP: �`67412----7) 1)i2_ 972 Z4 Garage/carport area: 7/0 square feet
Suite/bldg. /apt. no.: Project name: ketjid 6) r l t to j T. j , Covered porch area: f / 4_ square feet
Cross street/directions to job site: Deck area: /4 square feet
Other structure area: square feet
• REQUIRED DATA: COMMERCIAL -USE CHECKLIST - -
Subdivision: Lot no.: 115 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 work indicated on this application.
Pn D /3 i1 F/ D r rlYl y1�/� Y/--r 1 Valuation: $
/k/10(/
V D !1/ /3D 4s5-7 q K / � F � l ' � j - � � I [ e-i C • � Existing building area: square feet
New building area: square feet
❑. PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: • • Occupancy groups:
City/State/ZIP: Existing: .
Phone: ( ) Fax: ( )
New:
%APPL.ICANT ❑ CONTACT PERSON NOTICE .. .
Business name: // --C,72,12„ 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 • BUILDING PERMIT FEES* , . .
Business name: AI mil-- i F/g. , p� ! e_. N . (Please refer to fee schedule
S �1� Permit fee:
Address: f��9 �� l � u �+*�, �-7 � 1 ,
City/State/ZIP: -170( et--4 J �f 9 < Z Z 3 S tate surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: ( ) b 84.. —29 Fax: (603) b 4 -9k 57 (Due upon application.)
CCB lic.: 6,4D7 7 Total permit fees:
Authorized signature: Amount received:
' This permit application expires if a permit is not obtained
Print name: C/V 1 , v --73/ frew Date: 4 -3D-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 03/23/06 440-4613T(I I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
1.) ',.N 2.) Modification to sprinkler heads only:
Addition 1-10 heads: No plan review required.
• Alteration 1=Z-1 .1+ heads: Plan review required.
• Repair
Number of sprinkler heads: . S.7
Additional description of work:
A) Commercial Sprinkfrr
Plat,AA
.•-?. !
‘:
El Wet El Dry
Additional Standpipes
Information: Hazard Group
Density
• Design Area
K. Factor
Sprinkler Project Valuation: $
•
134 0090-"Fite•:SuppieisicS*Sy§keliris:*'' •
Hood Project Valuation:
C ) Fire Alarm
•
Submittal shall • Battery Calculations fl Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $
•
D) esidentia1 Sprinkler (8tandrAliide
Square Footage: Permit Fee:
0 to 2,000 $187.50 '4!
" -
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.
- ,;7A ' , •
, F ire rotection Perinii 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.
" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
http://www.c.i.tigard.or.usicity_hallidepartments/cd/docsrFPS-PermitApp.doc 2