Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I COMMUNITY DEVELOPMENT Permit #: FPS2013 -00044
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04 /09/2013
Parcel: 2S109DA15300
Jurisdiction: Tigard
Site address: 15337 SW GREENRIDGE PL
Project: Arlington Heights No. 3, Lot 72 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 72
Project Description: 13D fire sprinkler system for 2,833 square foot residence
Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES NW
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 04/09/2013 $246.45
12% State Surcharge - Building 04 /09/2013 $29.57
Type of Use: SF Info Process /Archiving - Lg $2.00 (over 04/09/2013 $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 04/09/2013 $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: 2833
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 'cation - - r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. •u -y obtain a copy of the rules
or dir ct questions to OUN • by . in • 03.232.1987 or 1.800.332.2344. A
/ .
Iss d By: ` L_ / ��. Permittee Signature: , ,�• ► � , `-
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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System
REcENED FOR OFFICE USE ONLY
City g
Ci of Tigard Received � Permit /
13125 SW Hall Blvd., Tigard, OR 97223
Date/13 . ' e • "A,,,,?, f`
2 Phone: 503.639.4171 Fax: 503.598.1960 AP R 0 W 20 13 D : a Other Permit.
TIGARD Inspection Line: 503.639.4175 T (� &� Date Read 7 . See Page 2 for
Internet: www.tigard- or.gov C` 1 (Vtrx� �1 Notifie. ethod: T 47,7:01,,,.,- Juris: ® Supplemental Information
iffy
r fr a� r ;mom v"", ' �€ �"a kern .. , r �z n -- >�* . ,
C Y :r' i 4-41.1-'' P,la'i T .W.4. * A . ' A ss . . . . � . -- 1 1 . _ _ , 1 11
Dlaw construction ❑Demolition Pemait 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
fi x R . ® -# ,, t k1 , , y -, work indicated on this application.
1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ g 5507 �7
�
❑ Accessory building ❑ Multi- family Number of bedrooms: �j
❑ Master builder ❑ Other: Number of bathrooms: 2, s
t ' : ;-. r „ ® +fi t , ®s � v k: • �2 ` 7: Total number of floors: •
Job site address:/ 3S7 .6)4/ 6,e... � ,1 DGE 7Li New dwelling area: 2833 square feet
City/State/ZIP: -La 0 / D/L 97 Z14- Garage/carport area: tP 3 d square feet
Suite/bldg. /apt. no.: Project name:/4. 4.) 1. 5 Covered porch area: 3 square feet
Cross street/directions to job site: Deck area: / 2 D square feet
Other structure area: — 1 square feet
REQUIRED DATA: COIIMERCIA1. -USE CHECKLIST
Subdivision: I Lot no.: `J.. 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
$ �iO4 1,� ( 4 t ::, work indicated on this application.
Ra VIDI� 1/1GC 13D File. 5p,e4v�Lt Z SYS i Val uation: $
Cy (/ 2 / S-" s c), F (A i D �,; � Existing building area: square feet
`� `r New buildin g area: square feet
q
� s
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: • Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) I Fax: ( ) New:
,PPLICANT 1 ❑ CONTACT PERSON NOTICE
Business name: ea) r t_70,e__ 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: ( ) • I Fax: : ( )
E -mail:
��� la zt, � _ ' � Pe ��e� 2, � 1M .�, ,,,.', i � x " �. '� �x'"a z �r
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Business name: � .,�..�m:....�,.� t �tl�'L�.brt..rm,.sF..� .
R S� � ..e._ , Pernut fcc.
Address: 4 60122m/07
City/State/ZIP: -`(3 �L D O,- 97 ZZ plan review surcharge (12% of permit fee):
Q � / FLS pliew (40% of penult fee):
Phone: (.5 & & ° N -- -2_9 Z f Fax: (W3 61542- - 9 G7 (Due upon application.) —
CCB lic.: (41)77 s Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: , e06 415 l*I.") Date: O4 - i j -/ ?, within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
I:\BuildingtPermits \FPS- PermitApp.doc 03 /23/06 440- 4613T(11/02/COM/WEB)
. •
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
1.) lef-New 2.) Modification to sprinkler heads only
El Addition 0 1-10 heads: No plan review required.
Alteration stir.--11+ heads: Plan review required.
Repair
Number of sprinkler heads:
Additional description of work:
t A) Commercial Spririlder
Wet [I Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
Hood Project Valuation:
C)FifeA1arth- -. '• 4 ' ,• 7; . ,
:
Submittal shall Battery Calculations Yes
include: Individual Component El Yes
Cut Sheets
File Alain' Project Valuation: $
• ▪ 4 . • ). , 7 _
4 _
1)4.
, esideijiaf riikle r :- j;
Square Footage: Permit Fee:
0 to 2,000 $187.50
2001 to 3,600 $232.50
3,601 to 7200 $292.50
7,201 and greater $381.50
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 NICET level "3" technicians.
http://www.ci.tigard.or.usicity_hallidepartments/cd/docstFPS-PermitApp.doc 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15337 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Fire Protection System
999 Sprinkler Final
05/28/2013 00:00
FPS2013-00044
PASS - No C of O
1" Ames model 2000B, serial no. 22365
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15337 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Fire Protection System
910 Sprinkler Rough-In
04/10/2013 00:00
FPS2013-00044
PASS
Violation Summary:
Inspector Contractor