Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
.111
• . COMMUNITY DEVELOPMENT Permit#: FPS2022-00071
T t G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 6/1/2022
Parcel: 1 S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 400
Project: KPA Subdivision: METZGER,TOWN OF
Lot: 9
Project Description: Fire sprinkler permit: Relocating(16)and adding(1)sprinkler head.
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 05/23/2022 $112.96
12%State Surcharge-Building 05/23/2022 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 05/23/2022 $45.18
Class of Work: ALT Type of Const: IIIB Info Process/Archiving-Sm$0.50(up to 05/23/2022 $6.00
Occupancy Grp: B Height: 55 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: $3,850.00
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: A aid4,11
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 ONLY
City of Tigard RECEIVE ,eceived
Date/By: �"� l,, / 7— Permit No.. r y (
r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /��"�' / � ` 'v 7`
Phone: 503.718.2439 Fax: 503.598.1960 ylay 11 ZV = i..]' / Other Permit: �y�i/1./
1'1 Date Ready/By:
e "' fff ��' W
Inspection Line: 503.639.4175 Date Read/B Juris:
TIGARD Y YSee Page or
Internet: www.tigard-or.gov Notifie hod: Supplemental Information
ALICITY OF TIGARD �,
TYPE OF WORK:',' ' ` 't REQUIRED D• A: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
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling 0 Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10220 G re e nbu rg Rd. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: 40 0 Project name: KPA T . I . Covered porch area: square feet
Cross street/directions to job site: 2 Lincoln Center 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.
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.
Relocate (16) sprinklers and add (1) Valuation: $ 31 R.570
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: S h o r e n s t e i n Properties Type of construction:
Address: 5885 Meadows Rd. Occupancy groups:
City/state/ZIP:Lake Oswego, OR Existing:
Phone:( ) Fax: ( ) New:
❑ APPLICANT 0 CONTACT PERSON
NOTICE
Business name: McKinst ry Co . LLC All contractors and subcontractors are required to be
Contact name: Alex Forker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 16 7 9 0 NE Mason S t . Suite 100 jurisdiction in which work is being performed.If the
applicant is exempt from licensin the followingreasons
City/State/ZIP: Portland, OR 97230 pp p g'
apply:
Phone:( 97D-420-755 0 Fax: :( ) P#'
F- il:AlexF@mckinstry . corn
ma
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee
Business name: MCKinstry Co . LLC schedule)
Permit fee:
Address: 16790 NE Mason St . Suite 100
State surcharge(12%of permit fee):
City/State/ZIP: Portland, OR 97230
FLS plan review(40%of permit fee):
Phone:(9 7 B—4 2 0—7 5 5 0 Fax:( ) (Due upon application submittal.)
CCB lie.: 172811 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.Print name:Alex Forker Date: 0 5/10/2 0 2 2
* Fee methodology set by Tri-County Building Industry
Service Board.
is\Building'Permits\FPS-Permit App_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:
❑ New system Number of sprinkler heads: 17 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 ❑ 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 Light
Density 1
Design Area 2 2 5
K. Factor 5 . 6
Sprinkler Project Valuation: $ 3, 850
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): $
.r;. 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: $
4 . I:\Building\Permits\FPS_PermitApp_031016.doc 2
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