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Permit
n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 111- 0 COMMUNITY DEVELOPMENT Permit#: FPS2013 00119 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2013 Parcel: 2S109DA17100 Jurisdiction: Tigard Site address: 12669 SW WILLOW POINT LN Project: Arlington Heights No.3,Lot 100 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 100 Project Description: Installing 13D fire sprinkler system in new 3,660 sq.ft. residence. Contractor: WYATT FIRE PROTECTION INC. Owner: STONE BRIDGE HOMES NW LLC 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 09/04/2013 $310.05 12%State Surcharge-Building 09/04/2013 $37.21 Type of Use: SF Info Process/Archiving-Lg$2.00(over 09/04/2013 $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 09/04/2013 $15.00 Stories: 3 11x17) Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm Sys tem_: 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: $3,318.00 Residential Square Footage: 3660 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 Notifi ti nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a •py of the rules;\..........._,,iii)\or direr uestions to NC by calling 503.232.1987 or 1.800.332.2344. �� Issu d 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 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 Received City of Tigard �� \'3 Dat Petn>itNo.: ^ `' ` 'l 13126 SW Hall Blvd.,Tigard,OR 9 3t /`�' l3 'On(l Plao Rev Other Permit: Phone: 603.639.4171 Fax: 503.598. 0 U DateBy: r�h� p.1.57,.)._013,. Pv t a�( TIGARD Inspection Line: 503.639.4175 J Date R: ,• luris: p G y: See Page 2 for Internet: www.tigard-or.gov of 1,..1 14 0,-' Notified/Mettod: Of /'3 / rp. '�/_ Supplemental Information ��" lYY TYPE OF WO. REQUIRED DATA:1=.AND 2-FAMILY DWELLING construction ❑Dolition 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. -and 2-family dwelling ❑ Commercial/industrial Valuation: $ / r ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: 3,� JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: l24,6,9 5k/ rLckt .---pO jxj-r tx_[ New dwelling area: 36 4,,,r) square feet City/State/ZIP: n8,4 2 0 © £_ 72z 4_ Garage/carport area: s56, square feet Suite/bldg./apt.no.: Project name: t- itr Covered porch area: 77 square feet Cross street/directions to job site: Deck area: _4 /C) square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: /DD 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 yn1,e' ,� l DESCRIPTION OOF�WORK �p ►�I work indicated on this application. ?�VIDe—ice L-�7 jF-E r- /�-l�K---L :'Z ��S , Valuation: $ --ki 31%, ,F(,Re 1 D v,e' • 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: PPLICANT ❑ CONTACT PERSON NOTICE Business name: 3 - de)A.ttie��ie_ 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:Y X/4-7-7- fl/�?/20' �T``D/l, (Please rifer to Address: 9O9 S S\-I e2u u i '! 57 • Permit fee: City/State/ZIP: �lCjl9 ©� 7. ZZ State surcharge(12%of permit fee): / FLS plan review(40%of permit fee): Phone:(S0-5 - Z9ZE Fax:(D 3) , .. 9 .5 7 (Due upon applications CCB lie.: Cod a7-7 Total permit fees: Authorized signature: Amount received: '�� r This permit application expires if a permit is not obtained r"U /1� k71---r/Vi n_•ZD_ 1"- J within 180 days after it has been accepted as complete. Print name:h% � Date: * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\FPS-PermiLApp.doc 03/23/06 440-4613T(11102/COM/WEB) ;. City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information rDescribe work to be done 1.) s—N ew 2.) Modification to sprinkler heads only: El Addition El 1-10 heads: No plan review required. El Alteration 1 -.11+ heads: Plan review required. El Repair Number of sprinkler heads: Additional description of work: A.) Cothmercial„ - Wet ElDry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B ) Type I -,Hood Fire Suppression System Hood Project Valuation: C.) Fire Alarm Submittal shall Battery Calculations El Yes include: Individual Component El Yes Cut Sheets Fire Alarm Project Valuation: $ D ) Residential Sprinkler(Stand Mçne System) , „ • , . 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. 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/docs/FPS-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 12669 SW WILLOW POINT LN, TIGARD, OR, 97224 Residential - Fire Protection System 999 Sprinkler Final 2013-10-29 00:00:00 FPS2013-00119 PASS - No C of O 1" wilkins model350 serial no. 23054 Violation Summary: Inspector Contractor