Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
_ n COMMUNITY DEVELOPMENT Permit#: FPS2022-00003
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1/27/2022
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 550
Project: KPD Insurance Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinkler permit-relocate(20)&add (3)sprinklers
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 01/24/2022 $112.96
12%State Surcharge-Building 01/24/2022 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 01/24/2022 $45.18
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 01/24/2022 $6.00
Occupancy Grp: B Height: 65 ft 11x17)
Stories: 5
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No 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 $177.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,500.00
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
Issued By: No{(9 Va w D2 V tge, Permittee Signature: Ow Apritizalizrn.
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 RECEIVED i3-
Fire Protection System FOR OFFICE USE ONLY
City of Tigard JAN 4 2022 Received ))� ��.
Date/By: 0(/('/N --i/� Permit No.:�l`VLC/� ✓`�`�`� v
;. ' • 13125 SW Hall Blvd.,Tigard,OR 97223 NA i Y OFTIGARD Plan Review - Other Permit:
Phone: 503.718.2439 Fax: 503.598.19 Date/By:
Inspection Line: 503.639.4175 1ILDING DIVISION Date Ready/By: // ' 3 IiI See Page 2 for
'[IGAk_l� // Supplemental Information
Internet: www.tigard-or.govhfied/Method: Yy
TYPE OF WORK REQ r IRED 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
50 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 ®Commercial/industrial Valuation: $
ElAccessory building El Multi-familyNumber of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: lOZloO S W GCeeanbt r 12 New dwelling area: square feet
City/State/ZIP: -T'I qQ. 0i . Ok-i ZZ�j T_ „G f e r Garage/carport area: square feet
Suite/bldg./apt.no.: 0 51 St0 Project name: �Qv t y^'J4 Covered porch area: square feet
Cross street/directions to job site: 1, {ytfi0\vt. l'OtAi J 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
DESCRIPTION11 OF WORK work indicated on this application.
10(Al"t, Ti8 ay,.. tn.d0 l S�i';st)[,1GEC5 Valuation: $ 35�
�'
Existing building area: square feet
New building area: square feet
[a PROPERTY OWNER ❑ TENANT Number of stories:
Name: S\Aucev1Sk tvk Type of construction:
Address: 5"7 r c yyte40143c e a t '?f Occupancy groups:
City/State/ZIP: 444 Noel() 01; eilo3' Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Mc K i n s t rY Co . L L C All contractors and subcontractors are required to be
Contact name: Alex Fork e 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: p O r t 1 a n d, OR 97230 applicant is exempt from licensing,the following reasons
apply:
Phone:( 971)-420-7550 Fax: :( )
E-mail:AlexF@mckinstry . corn
CONTRACTOR BUILDING PERMIT FEES*
Business name: MCKinstry Co . LLC (Please refer to fee schedule)
Permit fee:
Address: 16790 NE Mason St . Suite 100
City/State/ZIP: p o rt land, OR 97230
State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( 9 7 y-4 2 0-7 5 5 0 Fax:( ) (Due upon application submittal.)
CCB lie.: 17 2 811 - Total permit fees:
Authorized signature: Amount received:
Al'
This permit application expires if a permit is not obtained
Print name: I'let, co,tioci. Date: d)�7 jl Z z within 180 days after it has been accepted as complete.
" Fee methodology set by Tri-County Building Industry
Service Board.
1:1BinldingiPermirsFPS-PermitApp_031016.doc 440-4613TO 1,02iCOMiWEB)
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: Z3 Number of alarm devices:
a Addition or LI 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:
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 1.41ltia-
Density
Design Area
K. Factor __ _ S;[a
Sprinkler Project Valuation: $ 3 to
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: $
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