Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2010 -00029
yt Date Issued: 04/08/2010
T [ G AR L? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 305
Subdivision: LINCOLN THREE Lot: 0
Project: Comsys
Project Description: Install (3) fire alarm strobes for TI. 4/8/10, 2 hour inspection fee paid for after hours inspection.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee COM 04/06/2010 $80.68
CALIFORNIA ST 49TH FL 12% State Surcharge - Building 04/06/2010 $9.68
PHONE: Plan Review - Fire Life Safety - COM 04/06/2010 $32.27
Houlry Building Rate 04/08/2010 $180.00
Contractor: Hourly Building 12% State Surcharge 04/08/2010 $21.60
SAFE TECHNOLOGY GROUP INC
6400 NE HWY 99 SUITE 375
VANCOUVER, WA 98665
PHONE: 360- 699 -2130
FAX: 360- 719 -1527
Type of Use: COM
Class of Work: ALT Type of Const: IB
Occupancy Grp: B Height: ft
Stories: 5
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: No Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $324.23
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 1600
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 ... • spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility ■ • 'cation Center. •se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or •' ect questions to OUNC by . ing .246.6699 or 1.800.332.2344.
ssued By: Permittee Signature: K
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
I I . .
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Building Permit Application 1 ,, k oft ,!1 AeSi i 1 . •
Fire Protection System , 'i L -, 6 � «I FOR :OFFICE USE ONLY
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� R e ceive d Ili .; 1; •
City of Ti g ard APR 0 6 2010 Date /B • `_ ', Permit ` 't' • a 13125 SW Hall Blvd., Tigard, OR 97223 ^ , ��' �. P O Pemv l 27 ) b' (, ,
f gar Plan Review
r Phone: 503.639.4171 Fax: 503.598.1960 Date /B : / 1 v
CIi Y O frT IGARD -
f L G ARD Inspection Line: 503.639.4175 > Date Ready :y: � H See Page 2 for
'r` Internet: www.tigard- or.gov BUILDING DIVISII k otified/Method: Supplemental Information
.TYPE OF WORK 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
® Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION. .
work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10220 SW Greenburg Road New dwelling area: square feet
City /State /ZIP: Portland.OR Garage /carport area: square feet
Suite /bldg. /apt. no.: 305 Project name: Comsys Expansion 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 ail
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK • work indicated on this application.
•
Install 3 fire alarm strobes for tenant improvement Valuation: $$1,600.00
Existing building area: square feet
New building area: square feet
• ❑ PROPERTY OWNER ❑ TENANT Number of stories: I
Name: Type of construction: (v
Address: Occupancy groups: 13
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) / rem
New:
• ® APPLICANT ❑ CONTACT PERSON NOTICE •
Business name: Safe Technology Group Inc. All contractors and subcontractors are required to be
Contact name: Jason Sweet licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6400 NE Hwy 99 Suite G375 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: Vancouver WA 98665
apply:
Phone: (360) 699 -2130 Fax: : (360) 719 -1527
E - mail: sales @safetechnology.net
CONTRACTOR
•
BUILDING PERMIT FEES!
Business name: Safe Technology Group Inc. (Please refer rofeeschedule)
Permit fee:
Address: 6400 NE Hwy 99 Suite G375
State surcharge (12% of permit fee):
City /State /ZIP: Vancouver WA 98665
FLS plan review (40% of permit fee):
Phone: (360) 699 -2130 Fax: (360) 719 -1527 (Due upon application.)
CCB lic.: 173731 Total permit fees:
Authorized signature: Amount received: i a (
This permit application expires if a permit is not obtained
Print name: Date: 3 -5 -10 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri County Building Industry
Service Board.
1: \Building \ Permits \FPS- PennitApp.doc 10/01/09 440- 4613T(1I/02/COM /WEB) \ is
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done: _ .
1.) ❑ New 2.) Modification to sprinkler heads only:
® Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, C. or D as applicable):
A:) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.): Type I 'Hood Fir a Suppression System
Hood Project Valuation: $
C. Fire.Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1,600
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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
\ \Safeserver \d$ \ SAFE \Forms \Use these forms \Permit Apps \Tigard \FPS- PermitApp4ic 10/01/09