Permit (3) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2022-00117
Date Issued: 9/13/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 200
Project: Spec space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm devices. Suite 200-250
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX ST BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/12/2022 $123.72
12%State Surcharge-Building 09/12/2022 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 09/12/2022 $49.49
Class of Work: ALT Type of Const: VA Info Process/Archiving-Lg$2.00(over 09/12/2022 $10.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 09/12/2022 $6.00
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 Calcs Provided: Yes Cut Sheets Required: Yes
Total $204.06
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $4,400.00
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: y) GN14 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.
RECEIVED
,ti:4", AUG 2022
Building Permit Application N a`sd�l0i , r +
Fire Protection System �c1d FOR OFFICE USE ONLY
�� a'+ eived C.4�e,
City of Tigard �� � w � /�� Permit No.: "'� aa-Q-J I 7
13125 SW Hall Blvd-,Tigard,OR 97223 PlanReview IS Other Permit:
' Phone: 503.718.2439 Fax: 503.598.1960 Qataial
DateBy: �`���'�„�,,,
T I GARD Inspection Line: 503.639.4175 Date ReadyB "y: Juris: 63 See Page 2 for
Internet: www.tigard-or.gov ',otifred/Ivtethod: Supplemental Information
�,11�i ' 41 ! .;i .s 1 1 e
IndicatePermit fees*are based on the value of the work performed.
lil New construction El Demolition
. . . to the nearest dollar)
rEl Addition/alteration/replacement El Other: , ,,, , ., ,, ., .,., ., , , equipment,materials,labor:overhead,and the profit for the
AAN, work indicated on this application.
` o R Rl '
V
,VI
■ Rr ► • ! Number of bedrooms:
0 Accessory building EI Multi-family
■ ■ • al
••
JOBil. ' li' ' 1 3 x,
•. site address: 10200 SW GreenburgRoadLincoln)
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:200-250 Project name:VSP 200-250 Covered porch
Cross street/directions to job site: Deck
•
mtithilLgmtogo,,,, ," T._tJSI C
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
.4.iiiciii,,,,,!.4,,,a„,,,, , ® ! ® ® work indicated on this application.
. Valuation: $4,400.00
Install fire alarm dices per submitted plans.
Existing building area: square feet
New building area: square feet
® • ° M7grSOY31:407ve, ✓3 N Number of stories:
Name:Shorenstein Realty Services Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
Business name: .�rye QS Cc,n c.V-/ contractors . . • • . .-
Contact name: "b ' OregonConstruction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exemptlicensing, following
apply: reasons
Phone:( ) I Fax::( )
E-mail: 4kr 'G 4 � pt...)
ill !,'
Business name:Capitol Electric Company,Inc.
ease,, er toee sch edu le `:
Permit fee: 123.72
Address:11401 NE Marx Street
City/State/ZIP:Portland,OR 97220 State surcharge(12%of permit fee): 14.85
FLS plan review(40%of permit fee): 49.49
Phone:(503)255-9488 Fax:(503)255-1966 (Due upon application submittal.)
CCB lie.:48748 Total permit fees: 188.06
Authorized signature• S
Ni fiLV\i( Amount received:
IThis permit application expires if a permit is not obtained
Print name:Shane Tercek Date:8/19/22 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(l 1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
""Descr be:work to be d sir ;`
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: 11
® Addition or ❑ 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
❑ 11+ heads: Plan review required and ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
E e.of 5sten�: Gtd-ef,. = � E ,bit ;'i"b ��
°'�<Y:; :: :...,"'�,'';; :i."'.' �:= �; �,„`
':z�^'"�' =:�� �r '" fi • > __
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes El No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
aa. }
�'?`�r�!";�,• :�F °.,s i.E ! $ xa,Yv. „�' lem• `?�: .. ,'.:�ar°�.•a<.r•^ " "—`"�;w,q>\�t :�=-'�"• °e���`'...a .� ^,,,.✓,. .e
Po
Hood Project Valuation: $
ige
`. Yire",AI y p. 1k.,;,
,,.- -x`. s,,, ;;F,,Q .. of 3..Gn r , h ' ........iiR. ..� .. _ .. ,z ..
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 4,400
��}_ «�•��. _��;., ,`, ;&,_ ,..,;, ,,,�;�;; .,max; 7, s.a;,`;y�„�„�,�. ,,.,,...
'.i�; a..�/;., .. �• •' �•,
E ii:- °;�'� = ., .. ��i:%3.,',�t,..
Ai $< ;,
.. �md9' �9/,ii%",. ��...`. ..>. .. ... ,i„ �.,aa.Xs.-'u...:��,.•
Square Footage: Permit Fee: '`"`"
0 to 2,000 .19875
$
2,001 to 3,600 $246.45 °" •
3,601 to 7 200 $310.05y';" ?'
7,201 and greater $404.39 =$ n ...: R ;-" • •'
Sprinkler Project Square Footage: sq. ft.
;> ARV* :Fire Prate ficitf Permit Fees
Project valuation subtotal(see A,B & C above): $ 4400
Permit fee based on project valuation (see fee schedule): $ 123.72
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 14.85
FLS Plan Review(40% of permit fee): $ 49.49
TOTAL: $ 188.06
Q:\Fire Ala rm\FA Jobs\zz221500-45 VSP 200-250 @ 5L\job info\1 FPS_PermitApp 20Z17.0126.doc
Capitol RECEIVED
Electric Co., Inc. AUG 2'2 2022
CITY OF TIGARD
BUILDING DIVISION
August 19, 2022
Plans Examiner
City of Tigard
Building Services
13125 SW Ha11 Blvd.
Tigard, OR 97223
Re: Tenant Fire Alarm System Additions
VSP @ 5 Lincoln Suite 200-250
10200 SW Greenburg Road
Tigard, OR 97223
Please find attached building and electrical permit applications,three sets of plans,
calculations, and product submittals for the fire alarm tenant improvements at the address
shown above.
Occupancy Group: B
The fire alarm system design includes the following:
1. Install (11) fire alarm notification devices in the tenant space.
2. We will pre-test the fire alarm devices prior to requesting a final fire alarm
inspection.
Please contact me if you have questions or comments.
Resp ctfully,
il<,-ritzv\,
Shane Tercek
Project Manager/Estimator
Fire/Life Safety Division
Capitol Electric Company, Inc.
(503) 262-0405 Direct
shane@cepdx.com
NICET Level III, Fire Alarm Systems#140599
,,,,
1i'if i E $16 xsu;& o i' l 1,(idre 9 )/b-1 ON 1' 5i)35 488X .$oftixc161:2157-7121
C( ri 4 i4.§ Makk).4MiSf 1 ficco.com