Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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II ' COMMUNITY DEVELOPMENT Permit#: FPS2016-00032
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/01/2016
Parcel: 2S 110CB13400
Jurisdiction: TIGARD
Site address: 12068 SW AUTUMNVIEW ST
Project: Southview Heights,Lot 22 Subdivision: SOUTH VIEW HEIGHTS Lot: 22
Project Description: Stand alone fire sprinkler system for new 2,750 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:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-RES 03/01/2016 $246.45
12%State Surcharge-Building 03/01/2016 $29.57
Type of Use: SF Info Process/Archiving-Lg$2.00(over 03/01/2016 $4.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: R-3 Height: 32 ft Info Process/Archiving-Sm$0.50(up to 03/01/2016 $18.00
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 $298.02 j
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Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,658.00
Residential Square Footage: 2750
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 copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: Permittee Signature: i
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 RECEIVED FOR OFFIC1.: l SI:OyI.1
Received 02�S/lv * ,69.0g.,-coo 32
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 FL-P 2 5 206
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Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 4 1 16 Other Pemit: h��l�
77
Inspection Line: 503.639.4175 Date Ready/By: Juris: 65 See Page 2 for CID/ a /� nInternet: www.tigard-or.gov Notified/Method: //(p
itir Supplemental Information
MIMING DIVISIONSiErnAt(.,+ frICAK
':':'f; _ TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ii 1-and 2-family dwellingValuation: $2658
❑ Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms: 3
0 Master builder 0 Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address:12068 SW AUTUMN VIEW ST New dwelling area: 2750 square feet
City/State/ZIP:TIGARD,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:SOUTHVIEW HEIGHTS LOT 22 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.
STAND ALONE FIRE SPRINKLER SYSTEM FOR NEW SINGLE FAMILY HOME Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Max Colley 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:mcolley@wyattfrre.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Please refer tofee scheduk1
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 lic.:64077 Total permit fees:
Amount received:
Authorized signature:
L This permit application expires if a permit is not obtained
Print name:Max Colley Date:2/25/16 within 180 days after it has been accepted as complete.
—�! * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pemits\PPS-PemitApp.doc Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) ® New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 20
Additional description of work:
Type of System (Complete A,B C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
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 ❑ Yes
include: Individual Componcnt ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: 2750 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.
W:AMax\1112 PERMIT APPLICATIONS\Southview Dcvclopment.doc Rev 01/05/2002
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12068 SW AUTUMNVIEW ST, TIGARD, OR,
97224
Residential - Fire Protection System
999 Sprinkler final
PASS - No C of O
May 27, 2016 at 11:17:15 AM
FPS2016-00032
David Young
Violation Summary:
Inspector Contractor