Permit „ CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2020-00085
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/17/2020
TIGARD Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 570
Project: Maxim Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm permit:(16)devices for TI.
Contractor: POINT MONITOR CORPORATION Owner: LINCOLN CENTER LLC
5863 LAKEVIEW BLVD STE 100 BY SHORENSTEIN PROPERTIES LLC
LAKE OSWEGO, OR 97035 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 08/17/2020 $177.52
12%State Surcharge-Building 08/17/2020 $21.30
Type of Use: COM Plan Review-Fire Life Safety-COM 08/17/2020 $71.01
Class of Work: ALT Type of Const: VA Info Process/Archiving-Lg$2.00(over 08/17/2020 $6.00
Occupancy Grp: E Height: 55 ft 11x17)
Stories: 5 Info Process/Archiving-Sm$0.50(up to 08/17/2020 $6.00
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: Yes Alarm Type: Automatic
Pull Station Required: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $281.83
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $9,434.00
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.
Issued By: *&;7- )4-1-E(LE7 Permittee Signature: 'el-.
// 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 FOR OFFICE USE ONLY
City of Tigard E(�.J ���.r+' Received
t. Dare ; : "7 >A� �»
IN • 13125 SW Hall Blvd.,Tigard,OR 9722F Plan Revi•
Phone: 503.718.2439 Fax: 503.598.19 0 Date/B : ` Other Permit. e
TIGARD Inspe.cnon Line: 503.639.4175 jUL 15 202p Notified/Method DateReadyBy:: / V�1 V • Supplemental r See Page2fo inrformation
Internet: www.tigard-or.gov
L- 4 E
WD
TYPE OF .i7 t - �+
� �i��` D1V1Si414 ,, REQUIRED DATA:1 AND Z-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
® Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling ElCommercial/industrial Valuation: $
❑Accessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10220 SW Greenburg Rd.. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:570 Project name:Maxim @ Lincoln 2 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.
FIRE ALARM NOTIFICATION DEVICES Valuation: $9,434.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name:Maxim @ Lincoln 2 Type of construction:
Address:10220 SW Greenburg Rd.Suite 570 Occupancy groups:
City/State/ZIP:Tigard,OR 97223
Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON _. NOTICE
Business name:Point Monitor Corp. All contractors and subcontractors are required to be
Contact name:Brooke Williams licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5863 Lakeview Blvd#100 jurisdiction in which work is being performed.If the
City/State/ZIP:Lake Oswego,OR 97035 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)627-0100 Fax: :( )
E-mail:bwilliams@pointmonitor.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Point Monitor Corp. (Please refer to fee schedule)
Permit fee:
Address:5863 Lakeview Blvd#100
City/State/ZIP:Lake Oswego,OR 97035 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal.)
CCB lie.: 135901 Total permit fees:
'cl�l C Amount received:
Authorized signature: c,
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Ben Breit Date:7/14/2020
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Petmits\FPS-PermiiApp 031016.doc 440-4613T(I I/02/COM/WEB)
,City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
El New system Number of sprinkler heads: Number of alarm devices: 16
Addition or El 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+ heads: Plan review required and ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: Fire Alarm Notification Devices
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkles Supply Line El Yes El No
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 Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 9,434
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: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (sec 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: $
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