Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• COMMUNITY DEVELOPMENT Permit#: FPS2020-D0130
Date Issued: 1/4/2021
T I C;A It C} 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 650
Project: VSP Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinkler permit:Adding and relocating a total of(23)sprinkler heads.
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 01/04/2021 $112.96
12%State Surcharge-Building 01/04/2021 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 01/04/2021 $45.18
Class of Work: ALT Type of Const: IIIB Info Process/Archiving-Lg$2.00(over 01/04/2021 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 01/04/2021 $12.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: 0.1 Design Area: 1500
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 $186.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,200.00
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: \\I:\fj � \ �� 03
Q, l Permittee Signature: Q`^ A�DI
�
VCall`503`639.4175 by 7:00 a.m.for the next available inspection date. l f
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 RECEIV■ X.^I f /20
Fire Protection System FOR OFFICE USE ONLY
City of Tigard DEC 1 6 1010 DatReceived�y v217,,\‘-tout `
Zb �-tout Permit No.:%5267.0-pp\-50
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGAR-Pate/BY 1a-a la"-i:ZA --ft _ Other Permit:
T I G AR D Inspection Line: 503.639.4175 to ReadyBy: J lurk: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIO tified/Method://L/)j/ y - ITri. Supplemental Information
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
❑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: $
ElAccessory building ❑Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
`"RRM 70B SIl'E 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.: 650 Project name: VS P — Suite 650 LT Covered porch area: square feet
Cross street/directions to job site: Lincoln Tower Deck area: square feet
Other structure area: square feet
EQbIRED 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.
Add/relocate (23) sprinkler heads for new layout Valuation: $ 3200. 00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER El TENANT Number of stories:
Name: Shorenstein Properties Type of construction:
Address: 10220 SW Greenburg Rd. Occupancy groups:
City/State/ZIP: Tigard, OR 97223 Existing:
Phone:( ) Fax: ( ) New:
❑ APPLICANT ir0 CONTACT PERSON
NOTICE
Business name: McKinst ry Co. All contractors and subcontractors are required to be
Contact name: Alex Forker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 16790 NE Mason St. Suite 100 jurisdiction in which work is being performed.If the I
City/State/ZIP: Portland, OR 97230 applicant is exempt from licensing,the following reasons
apply:
Phone:( 971) 420-7550 Fax: :( )
E-mail: alexf@mckinstry. com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule(
Business name: McKinstry Co. Permit fee:
Address: 1 67 90 NE Mason St. Suite 100
State surcharge(12%of permit fee):
City/state/z[P: Portland, OR 97230 FLS plan review(40%of permit fee):
Phone:(9 71) 4 2 0—7 5 5 0 Fax:( ) (Due upon application submittal.)
CCB lic.: 172 811 Total permit fees:
Amount received:
Authorized signature:
0/ This permit application expires if a permit is not obtained
Print name: Alex Forker Date: 12/16/2 0 2 0 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Buiiding\Permits\FPS-Permit App_031016.doc 440-4613i(11/02/COMJWEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 23 Number of alarm devices:
❑ Addition or ❑ 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
❑x i 1+ 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 Pendant ❑x Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group Light
Density
Design Area
K. Factor 5. 6
Sprinkler Project Valuation: I $ 3200.00
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: I $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
s•
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(Yo of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $
I:\Building\Pcmtits\FPS_PermitApp_031016.doc 2
Branden Taggart
From: Branden Taggart
Sent: Thursday, December 31, 2020 2:16 PM
To: 'Alex Forker'
Subject: VSP Permit: FPS2020-00130 - 10220 SW Greenburg Rd Suite 650
Attachments: Invoice.pdf
Hi Alex,
The sprinkler permit for VSP is ready to issue now. The balance due is$186.20, and I have attached an invoice above for
you to reference. The permit fees can be paid online through our
website: https://aca.accela.com/tigard/Default.aspx. From there,click on the Building tab, enter the permit number
(FPS2020-00130) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits@tigard-or.gov, and we will place this permit and the approved site copy set of plans in our open
Permit Center conference room for you to pick up between the hours of 8:00 a.m. and 5:00 p.m., Monday through
Thursday. We are closed on Fridays. No appointment is necessary to pick up.
Thanks,
Branden Taggart
City of Tigard
d1. Senior Permit Technician
Community Development
13125 SW Halt Blvd
Tigard, OR 97223
(503)718-244R
brandent@tigard-or.gov
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