Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a , COMMUNITY DEVELOPMENT Permit#: FPS2021-00030
Date Issued: 4/8/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 150
Project: Corvel Healthcare Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire Alarm system.relocate(4)strobes,(2)horns/strobes,add(1)strobe.
Contractor: OEG INC Owner: LINCOLN CENTER LLC
3200 NW YEON AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97210 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-234-9900 PHONE:
FAX: 503-234-1001
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/06/2021 $123.72
12%State Surcharge-Building 04/06/2021 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 04/06/2021 $49.49
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 04/06/2021 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/06/2021 $3.00
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: No
Battery Gales Provided: No Cut Sheets Required: Yes
Total $197.06
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $4,200.00
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: va wl�e/Werge Permittee Signature: 0 Applf caruri .
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.
.
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Building Permit Application $- 3I1$42.4
Fire Protection System RECEIVED FOR OFFICE USE ONLY
Received ��{{ �r
City of Tigard MAR 18 2021 Date/By:0 L I / Permit No.:Fn��ZI-dU030
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review .{.fit
t s Phone: 503.718.2439 Fax: 503.598.19 Date/By: — ± 1 Other Permit
din OF TIGARD4' �'�� 1
TIGARD Inspection Line: 503.639.4175 Date ReadyBy: r° See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION died Method: G/� ,� Supplemental Information
it'
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*arc 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.
Valuation: $
❑ 1-and 2-family dwelling IIIConunercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 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.: Project name: LINCOLN/CORVEL/SUITE 150,5L Covered porch area: square feet
Cross street/directions to job site: eU ryG( .+'jam r Deck area: square feet
"'�, Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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 FOR TENANT IMPROVEMENT Valuation $4,200.00
Existing building area: square feet
RELOCATING(4)STROBES,(2)HORN/STROBES,ADD(1)STROBE New building area: square feet
I PROPERTY OWNER 0 TENANT Number of stories: I
Name: SHORENSTEIN REAL ESTATE Type of construction:
Address: Occupancy groups: COMMERCIAL
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
IN APPLICANT ❑ CONTACT PERSON NOTICE
Business name: OEG,INC. All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
LAUREL A SEMPREVIVO under ORS 701 and may be required to be licensed in the
Address: 3200 NW YEON AVE jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
PORTLAND,OR 97210 apply:
Phone:(971 )291-2560 Fax: :( )
E-mail: laurel.semprevivogonzalez@oeg.us.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: OEG,INC. (Please refer to fee schedule)
Permit fee:
Address: 3200 NW YEON AVE
State surcharge(12%of permit fee):
City/State/ZIP: PORTLAND,OR 97210 FLS plan review(40%of permit fee):
Phone:(503 )234-9900 Fax:( ) (Due upon application submittal)
CCB lie.: 203 Total permit fees:
vww-a=,M•Mw, .. Amount received:
Authorized signature: Mark Weinbender .47^.5"":, .=!--
This permit application expires if a permit is not obtained
Print name: MARK WEINBENDER Date: 03/16/21 within 180 days after it has been accepted as complete.
* Fee methodology set by In-County Building Industry
Service Board.
Ii Beilding.Pcrmits+FPS-PermitApp 031016.doc 440-4613T(1 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:
❑ New system Number of sprinkler heads: 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 arca
to existing of work within building structure of work within building structure
system
❑ 11+heads: Plan review required and El 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 ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ 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: $
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 & (: 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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