Permit CITY OF TIGARD BUILDING PERMIT
1111
COMMUNITY DEVELOPMENT Permit#: FPS2022-00069
Date Issued: 5/12/2022
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 225
Project: Furniss, Shearer, &Leinweber Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Fire sprinkler permit: Relocating(6)and adding(1)sprinkler head. Affidavit submitted.
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
Specifics: FEES
Description Date Amount
Type of Use: COM
Permit Fee
Class of Work: ALT Type of Const: COM 05/12/2022 $64.54
12%State Surcharge-Building 05/12/2022 $7.74
Occupancy Grp: Occupancy Load: Plan Review-Fire Life Safety-MF 05/12/2022 $25.82
Dwelling Units:
Info Process/Archiving-Sm$0.50(up to 05/12/2022 $0,50
Stories: Height: ft 11x17)
Bedrooms: Bathrooms:
Value: $1,000
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $98.60
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 Notificaton enter. 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 2 987 or 1.800.332.2344,
Issued By: 1, 01.rtp Permittee Signature:
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 Application
Fire Protection System FOR OFFICE USE°NL't
E C E I V E D Received
City of Tigard DateB y. Permit No.:/•
r 13125 SW Hall Blvd.,Tigard,OR 97 2 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : J Other Permit: ,J4
T I G A R D Inspection Line: 503.639.4175 MAY 1 1 2022 Date Ready/By: o See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 1 EN Supplemental Information
nrr
TYPE OF WORK 1I.1; O1 k/!!c lON11 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
E1 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONST t dCTION work indicated on this application.
El 1-and 2-family dwelling ,A. Commercial/industrial
Valuation: $ ..�Q Q n n n
❑Accessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10220 SW G r e e n b u r g Rd. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: �2.5- Project name: F S L Suite 225 Covered porch area: square feet
Cross street/directions to job site: )-S5 S " 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 ma parcel no. Indicate the value(rounded to the nearest dollar)of all
P p` equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Relocate (6) and Add (1) fire sprinkler head Valuation: $ 1y `
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
Name: Shorenstein Realty Services Type of construction:
Address: 5335 Meadows Road, Suite 275 Occupancy groups:
Cityistate/zIP: Lake Oswego, OR 97035 Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: McKinstry C o . LLC All contractors and subcontractors arc required to be
Contact name: Alex For ke 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 rt l and, 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*
fee schedule
Business name: McKinstry Co . LLC (Please refer to
ermit fee:Permit
Address:16790 NE Mason St . Suite 100
City/State/ZIP:P o rt l an d, OR 97230 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(9 71)-4 2 0—7 5 5 0 Fax:( ) (Due upon application submittal.)
CCBlic.: 172811 Total permit fees:
Authorized signature: Amount received: 6/�
This permit application expires if a permit is not obtained
Print name: Alex F o r ke r Date: within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
is Building'Permits FPS-PermitApp_031016.doc 440-4613T(I 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:
El New system Number of sprinkler heads: 7 Number of alarm devices:
X❑ Addition or [3 1-10 heads: Affidavit required and El 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
El 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 (Co plete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type [t Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line _ ❑ Yes El No
Hazard Group Light
Density 1
Design Area 2 2 5
K. Factor 5 . 6
Sprinkler Project Valuation: $ 10 0 0 . 0 0
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El 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:\Building\Permits\FPS_PermitApp_031016.doc 2
City of Tigard Permit No.: FAY a-Mk,
• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: —,//%t
Inspection Line: 503.639.4175
TIGARD Internet: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS vv
OR TENANT IMPROVEMENTS RECEIVED
(1 to 10 SPRINKLER HEADS WITHOUT PLANS) NAY 11 202Z
CITY OF TIGARD
BUILDING DIVISION
Project Name: Furniss Shearer & Leinweber Suite 225 Occupancy: B
Job Address: 10220 SW Greenburg Rd. Type of Construction: 1-B
Suite: 225
Contractor: McKinstry Phone: 971-420-7550
Number of Proposed or Altered Heads: 7
Type: Hazard: Light Density: 1
I Alex Forker/McKinstry Oregon Construction Contractors Board No. 172811
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 ocument with a copy of the sketch attached shall be available for all inspections.
Signature: — Date: 05/09/2022
Print Name: Alex Forker
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1