Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2020-00124
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/8/2020
T I ij A Ii f� 9 Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 135
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinkler permit; Relocate(2)sprinkler drops for new layout.Affidavit submitted.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON STREET SUITE 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-331-0234 PHONE:
FAX: 503-331-6907
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/08/2020 $59.16
12%State Surcharge-Building 12/08/2020 $7.10
Type of Use: COM Plan Review-Fire Life Safety-COM 12/08/2020 $23.66
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/08/2020 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 1 Design Area: 0
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $90.42
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $800.00
Residential Square Footage: 0
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.
Issued By: Permittee Signature:
aivanD[ l"►e� (IN appl;C.ctA;bh
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 ApplicationRECEIVED JP. 3/. .a°
Fire Protection System �-{ FOR OFFICE I ISE 0\1.1
City of Tigard DEC 3 2020 Received }]7 �t _�
Date/By:/ ✓/ t� Nmul No. S2 /z
III - 41 13125 SW Hall Blvd.,Tigard,OR 97223 plan Review
Phone: 503.718.2439 Fax: 503.5�8 l D F TIGARD Date By: Other Permit:
I 1 r. \I:i 1 Inspection Line: 503.639.4175 RI nt 1 Date Ready/By: Vet ® See Page 2 for
Internet'. www.tigard-or.gov ----- i" �- " DIVISION Notified/Method' j 1l� Supplemental Information
wA
TYPE OF WORK 414na. REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
1 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: $
❑Accessory building ❑Multi-family Number 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.: Ste.135 Project name: VS P — 3L Suite 135 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
3 Lincoln Building, Ground Floor 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.
Relocate (2) sprinkler drops for new layout Valuation: $ 800.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name: Shorenstein Properties Type of construction:
Address: Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( ) New:
® APPLICANT111F1' ❑ CONTACT PERSON NOTICE
Business name: McKinstry Co. All contractors and subcontractors are required to be
Contact name: Alex For ke r licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 16790 NE Mason S t. Suite 100 jurisdiction in which work is being performed.If the
City/State/ZIP: Portland, OR 97230 applicant is exempt from licensing,the following reasons
apply:
Phone:(971) 420-7550 Fax: :( )
E-mail: A1exF@McKinstry.corn
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: McKinstry Co.
Permit fee:
Address: 16790 NE Mason St. Suite 100
State surcharge(12%of permit fee):
City/State/ZIP: Portland, OR 97230 FLS plan review(40%of permit fee):
Phone:(971) 420-7550 Fax:( ) (Due upon application submittal.)
CCB lic.: 172811 Total permit fees:
Authorized signature: /Var Amount received:
This permit application expires if a permit is not obtained
Print name: Alex Forker Date: 12/03/2020
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I\Buudiog\Permits\FP5-PermilApp 031016.doc 440-4613T(11/02/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:
❑ New system Number of sprinkler heads: 2 Number of alarm devices:
❑X Addition or ❑X 1-10 heads: Affidavit required and El 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
El 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
(3)sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A,B, C or D as applicable):
A.) Commercial Sprinkler ,
Sprinkler Type ❑X Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Light Hazard
Density
Design Area
K.Factor 5. 6
Sprinkler Project Valuation: $ 800 .00
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 $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(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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2
City of Tigard Permit No.: 7020 -aa/zs'
II13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 3/Zvyo
Inspection Line: 503.639.4175 I I i P'11. Internet: www.tigard-or.gov By: earf er Wq/20
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONPECEIVED
ED
OR TENANT IMPROVEMENTS DEC 3 2020
TIG1 to 10 SPRINKLER HEADS WITHOUT PLANS) CITY OF UILDING DIVISION
Project Name: 3 Lincoln Center Occupancy: B
Job Address: 10220 SW Greenburg Rd Type of Construction:
Suite: 135
Contractor: McKinstry Phone: 971-420-7550
Number of Proposed or Altered Heads: 2
Type: Wet Hazard: Light Density: 1
I McKinstry Co. Oregon Construction Contractors Board No. 172811
certify the following is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
b) Positions of sprinkler heads relative to architectural features such as soffits, beams,partitions,walls, etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop (exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads (see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
In addition, I understand the following is required:
• Submit(3) copies of a sketch showing the area of work within the building's structure.
• Building fire r ection system permit.
• A copy of t ' cument with a copy of the sketch attached shall be available for all inspections.
Signature: Date: 12/02/2020
Print Name: Alex Forker
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