Permit u CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I ' COMMUNITY DEVELOPMENT Permit#: FPS2021-00022
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/23/2021
TIGARD Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 150
Project: Corvel Healthcare Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire Sprinkler permit-relocating fire sprinklers for new floor plan-AFFIDAVIT SUBMITED
Contractor: BASIC FIRE PROTECTION INC Owner: LINCOLN CENTER LLC
8135 NE MARTIN LUTHER KING BLV BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97211 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-285-1855 PHONE:
FAX: 503-285-0713
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/19/2021 $91.44
12%State Surcharge-Building 02/19/2021 $10.97
Type of Use: COM Plan Review-Fire Life Safety-COM 02/19/2021 $36.58
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 02/19/2021 $2.00
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 10 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 $140.99
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,000.00
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. j�/� r �±,�
Issued By: es
Permittee Signature: v1 ` a ,1 l Wl 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 Applicatio ECEIVE S- 2l'7/Z
Fire Protection System
FEB 17 2021 Received
City of Tigard Date/By:® Permit No.:, 1--19��
• 13125 SW Hall Blvd.,Tigard,OR 97223�'I-r/OF TIGARD ARC Plan Review Other Perrt �/"QQ2220240 (/V
Phone: 503.718.2439 Fax: 503.598, (ggq(, ry ^'^ Date/By:
I 1 h A R D Inspection Line: 503.639.4175 i V ILDING DIVISION Date Ready/By: I/ �t + • (a See Page 2 for
Internet: www.tigard-or.gov Notified/Method: in
/r^�% "" 1 e Supplemental Information
l/IC!
TYPE OF WORK 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
III 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 II Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
ElMaster builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10200 SW GREENBURG RD New dwelling area: square feet
City/State/ZIP:TIGARD, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:150 Project name:CORVEL TI 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.
Relocate fire sprinklers for new floor plan. Valuation: $2000.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ID TENANT Number of stories:7
Name:Corvel Type of construction:Concrete
Address:10200 SW Greenburg Rd Occupancy groups:Office
City/State/ZIP:Tigard, OR 97223 Existing:Office
Phone:( ) Fax:( ) New:
❑� APPLICANT ❑ CONTACT PERSON
NOTICE
Business name:Basic Fire Protection Inc. All contractors and subcontractors are required to be
Contact name:Uwe Parth licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:8135 NE MLK Jr Blvd jurisdiction in which work is being performed.If the
City/State/ZIP:Portland OR 97211 applicant is exempt from licensing,the following reasons
apply:
Phone:( )503-285-1855 Fax: :( )
E-mail:Uwe@basicfire.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Basic Fire Protection Inc. Permit fee: ii /.r?
Address:8135 NE MLK Jr Blvd
City/State/ZIP:Portland, OR 97211 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( )503-285-1855 Fax:( ) (Due upon application submittal.)
CCB lic.:48641 Total permit fees:
Uwe Parth 4"'" Amount received:
Authorized signature: o.,..e,,.,�,a,..�.�..„ ��°,�.�.�
This permit application expires if a permit is not obtained
Print name:Uwe Perth Date:02.17.2021 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1-\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(1 1/02/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: 1 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
❑ 11+ heads: Plan review required and 0 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: Relocate sprinkler for new floor plan
Type of System (Complete A,B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type Concealed ❑■ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line 1" ❑■ Yes El No
Hazard Group Light
Density
Design Area
K. Factor
Sprinkler Project Valuation: $2000.00
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:A Building\Permits\FPS PermitApp_031016.doc 2
RECEIVED
City of Tigard FEB 1 7 2021 Permit No.: 1S '•'61G9
U 13125 SW Hall Blvd.,Tigard,OR 97724.,,
I Phone: 503.718.2439 Fax: 503.598440 OF TIGARD Date Received: Q / !Z�j2�1�/]�
Inspection Line:g503.639.4175 A��G DIVISION, By: ���r l� "/ f -141 �eo
TIG.AIlD Internet: www.ti and-or. ovUI�DIIu
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS) OFFICE COPY
Project Name: 5 Lincoln Occupancy: Office
Job Address: 10200 SW Greenburg Rd Type of Construction: Concrete
Suite: 150
Contractor: Basic Fire Protection Inc. Phone: 503-285-1855
Number of Proposed or Altered Heads: 1
Type: Concealed Hazard: Light Density: •10
I, Basic Fire Protection Inc. Oregon Construction Contractors Board No. 48641
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 protection system permit.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Uwe Parth DN:cnysigned ert Uwe Parth
DN:cn=Vwe Parth,o=BFP,ou,email=uwe@basicfire.com,c=US 02.17.2021
Signature: Date 2021,02.17 08 41 02-08'00' Date:
Print Name: Uwe Parth
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