Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1114 �. COMMUNITY DEVELOPMENT Permit r$: FPS2014-00005
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/15/2014
Parcel: 2S109DA16100
Jurisdiction- TIGARD
Site address: 15468 SW SUMMERVIEW DR
Project: Arlington Heights No 3, Lot 80 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 80
Project Description: Fire sprinklers for new SF.
Contractor: WYATT FIRE PROTECTION INC Owner: STONE BRIDGE HOMES NW LLC
9095 SW BURNHAM 4230 GALEWOOD ST#100
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-RES 01/15/2014 $246.45
12%State Surcharge-Building 01/15/2014 $29 57
Type of Use: SF Info Process/Archiving-Lg$2.00(over 01/15/2014 $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 01/15/2014 $12.50
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 5292 52
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage 2432
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, o • , is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility • • ification Cen - Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or di -ct questions to OU • •y C. in9-603.232.1987 or 1.800.332.2344.
• +,/y Ir
Issued By: 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 I (tit t)1 11( E USE ONLY
111 City of Tigard IVED Date;B � Permit Nu.: r� D/ —DDOG S
• 1 hone SW Hall Blvd,Ti Plan Review I J� ( / ��5r�,3� ;yg
a Phone: 503.718.2439 Fax: 503.598.1960 Date/By. 1 a other Permit: f�[i
TI G R[ Inspection Line: 503.639.4175 n tA'' 6 Date Ready/By: / tuns: 0 See Page 2 for
Internet: www.tigard-or.gov ,AN 6 2014 Notified/Method: ` 1�/y , Supplemental Information
tg}.-. Icd.
TYPE OF rARI) REQUIRED DATA: 1-AND 2-FAMILY DWELLING
® New construction ❑ Doi ti lition 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: $2205
ID Accessory building ❑Multi-family Number of bedrooms: 4
❑ Master builder ❑Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address:15468 SW Summerview Dr New dwelling area: 2,432 square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 460 square feet
Suite/bldg./apt.no.: Project name:Arlington Heights Lot 80 Covered porch area: 90 square feet
Cross street/directions to job site: Deck area: 160 square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: 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.
Valuation: S
A/2f_ `�PQr 4 k-Lat-S rd� /v�-w Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Stone Bridge Homes NW Type of construction:
Address:4230 Galewood St,Ste 100 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Payne licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham Rd jurisdiction in which work is being performed. If the
City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)684-2928 Fax::( )
E-mail:a.payneCwyattfire.com
CONTRACTOR _ BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Please refer to fee schedule)
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) , Fax:( ) (Due upon application.)
CCB lie.:64077 Total permit fees:
} Amount received: ���
Authorized signature: �,1 This permit application expires if a permit is not obtained
IPrint name:Ashley Payne VV Date:1/3/2014 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building\PermirsFPS-PcrmitApp.doe Rev 01'05.2012 440-46131(11/02/COM+WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be clone:
1.) ® New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration (3 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 22
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
® Act ❑ Dry
Additional Standpipes
Information: Hazard Group Dwelling
Density 2 heads @ 7psi
Design Area
K. Factor 4.9
Sprinkler Project Valuation: $ 2205
B.) Type I- Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets _
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 5198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit 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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
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