Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
= COMMUNITY DEVELOPMENT Permit#: FPS2022-00024
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/10/2022
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 500
Project: Lincoln Tower Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm permit-add(5)strobes.AFFIDAVIT SUBMITTED.
Contractor: OEG INC Owner: LINCOLN CENTER LLC
3200 NW YEON AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97210 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-234-9900 PHONE:
FAX: 503-234-1001
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/10/2022 $134.48
12%State Surcharge-Building 02/10/2022 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 02/10/2022 $53.79
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50 (up to 02/10/2022 $1.00
Occupancy Grp: Height: ft 11x17)
Stories:
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: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $205.41
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,500.00
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: I e1 O.1 l� i n 2 // Permittee Signature: r� ,,i c ii
l X Jam' lX{_J J`Ca�ll 503.639.4175� by 7:00 a.m.for the next available inspection datee�j`J' `��l 1 v 1V
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.
710395
Building Permit Applicatio `fir ��
Fire Protection System q¢ FOR OFFICE USE ONLY
Cityof Tigard FEB '7 2022 Received h �/i22 �J1I 7
g ' Date/By:0 10 J 22 - Permit No,:F���,'�L¢
1111 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
B Phone: 503.718.2439 Fax: 503.598.I9 `y OF f IUAHLi Date/By: ��� Other Permit:
i i,,A r.i, Inspection Line: 503.639.4175 �������� DIVISION' Date Ready/By: "o/?� Jar ® See Page 2 for
Internet: www.tigard-or.govNotifie echo l 1YrT Supplemental Information
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Ill1-and 2-family dwelling ElCommercial/industrial Valuation: S
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10260 SW GREENBURG RD New dwelling area: square feet
•
City/State/ZIP: TIGARD,OR 97223 Garage/carport area: square feet 1
Suite/bldg./apt.no.: 500 Project name: LINCOLN TOWER SUITE 500 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
FIRE ALARM ADD-(5)STROBES • 5,500.00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: SHORENSTEIN REALTY Type of construction:
Address: 235 MONTGOMERY ST. 16TH FLOOR Occupancy groups:
City/State/ZIP: SAN FRANCISCO,CA Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 1 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 SEMPREVIVO GONZALEZ 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.semprevivogonzaleziaMeg.us.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: OEG,INC (Please refer to fee'Markle
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:( 971 )291-2560 Fax:( ) (Due upon application submittal.)
CCB lie.: 203 Total permit fees:
MW.Mead by Mark Wemna,aa,
s e-Mark rwx e.m. Mara Amount received:
Authorized signature: Mark Welflbl?fld lL" e.rk.r.CC-M...«.e.d.,
usm:vm or nm ecadv This permit application expires if a permit is not obtained
Print name: Date: 02/07/21 within ISO days after it has been accepted as complete.
MARK WEINBENDER * Fee methodology set by Tri-County Building Industry
Service Board.
I IBuiding\Permits\FP$-PermilApp 031016.doe 440.4613T(111021COM.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:
El 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 ❑ 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'et ❑ L)ry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes El 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 El Yes
include: Individual Component El 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%ofpermit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
I:\Building\permits\FPS_Pem itApp_031016.doc 2
RECEIVED
rtipCity of Tigard FEBy t{ Permit No.: �2O�OOO24-
13125 SW Hall Blvd.,Tigard,OR 97223 ® 1 2V2n2 !�'/ �7 /
Phone: 503.718.2439 Fax 503.598.1960 Date Received: 02 0 r/202Z
Inspection Line 503.639.4175 LiI_(�° OF I IL7AHL) [[[
TIGARD Internet vtiww.tigard-or_gov By: 0111( ar 1 lW
WILDING DIVISION
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: 710395 Lincoln Tower Suite 500 o' Occupancy: VSP
Job Address: 10260 SW Greenburg Rd. 1Cd Suite: 500
Contractor: OEG, Inc. Phone: 971-291-2560
Valuation of work: $5,500.00
Type of System: (check one) *Required ENon-required
(check one) *Automatic ❑Manual ❑Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max s) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added(max s) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) 5 /To be Relocated(ma),5)
I, Laurel Semprevivo Gonzalez Oregon Construction Contractors Board No. 203
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
0 Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
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.
• Electrical permit.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: ` `u-Q A'!�" 1 ry v1.."D Date: 02/02/22
Print Name: Laurel A Semprevivo Gonzalez
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