Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
; a ' COMMUNITY DEVELOPMENT Permit #: FPS2010 -00068
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/23/2010
i C, ftiRD 9 Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Subdivision: LINCOLN THREE Lot: 0
Project: Lincoln Center
Project Description: Replace and upgrade fire alarm.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee - COM 07/23/2010 $712.58
CALIFORNIA ST 49TH FL 12% State Surcharge - Building 07/23/2010 $85.51
PHONE: Plan Review - Fire Life Safety - COM 06/22/2010 $285.03
Contractor:
SIMPLEXGRINNELL LP
6305 SW ROSEWOOD ST.
LAKE OSWEGO, OR 97035
PHONE: 503 - 683 -9000
FAX: 503- 675 -6521
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: B Height: ft
Stories: 6
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $1,083.12
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 82000
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: I I S Permittee Signature:
IS
v
Call 503.639.4175 by 7:00 a.m. for an inspection that • si� 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.
Building Permit Application
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard JUN 2 2 7 010 Date Received h !D eFa
Permit No.: 1 fj �0lD'a9om
Iii . a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date /B : 4111iLV)1 /1 ii Other Permit:
Line:
Inspection 503.639.4175 CITY F TIGARD Date Ready" ' • Juris: ® See Page 2 for
TIGARD P
Internet: www.tigard-or.gov g BUILDING b OF DIVISION Notified/Method: /d � � 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.
Valuation: $
❑ 1- and 2- family dwelling Commercial /industrial
Number of bedrooms:
❑ Accessory building ❑ Multi - family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION p Total number of floors:
Job site address: 102_20 "� C v e�h(c = ",-- .CIL. New dwelling area: square feet
City /State /ZIP: p 4 - (. oz. 9-4-2_23 Garage /carport area: square feet
t t 3 G �
Suite /bldg. /apt. no.: Project name: `,.Ur�C� \►� 1.p `ijp l f 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: 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. Oa)
Valuation: $
/(��
1 Existing building area: square feet
1 P.L.�
YN _ t o eTe rO f'7J
P . rP \ a -ea
�r e_Y- Ct.k1\.■. T ( a pS - , Si p New building area: square feet
gl PROPERTY OWNER ❑ TENANT Number of stories:
Name: 1L° j cZp � � p� ` 1 cv_s Type of construction:
Address: t '�c �py Occupancy groups:
City /State /ZIP: � c=3 ?__ 9 23 Existing:
Phone: ( ) Fax: ( ) New:
og. APPLICANT CONTACT PERSON NOTICE
Business name: ��y"...,��`.ej., C �y� All contractors and subcontractors are required to be
�1 licensed with the Oregon Construction Contractors Board
Contact name:• Cv‘.... 6 C-1A... y`e— r under ORS 701 and may be required to be licensed in the
Address: C�3os . (Z. o �7
_ jurisdiction in which work is being performed. If the
�1 ` cps,...) t � .applicant is exempt from licensing, the following reasons
City /State /ZIP: , p � o c)- - 4036 - apply:
Phone:�31 X83 _c c O I Fax: : (gam (p' ?-S c. 1
E -mail: yam., ZO.IA.vl�� Q_Sl \AdekgCjirl► . �
� " t CONTRACTOR 1 BUILDING PERMIT FEES*
(Please refer to fee schedule,
Business name: ,� _ EN ■ Permit fee:
Address: ( C� 93=>S,P a. y ip •.'• o
State surcharge (12 /o of permit fee):
City /State /ZIP: `_ /D S • ei� , p l s—,(2.. � j� FLS plan review (40% of permit fee):
Fax:
Phone: (S•63) GIBS �� (ca"n G `' 2 " 1 (Due upon application.)
permit fees:
CCB hc.: k�1Q�2 / Amount received:
Authorized signature: �Zt
• This permit application expires if a permit is not obtained
�^ —1` Date: within 180 days after it has been accepted as complete.
Print name:
C�. v`�lGlA_n
t. A - � * Fee methodology set by Tri- County Building Industry
Service Board.
i./i w)ding \Permits \PPS- PermitApp. doc 03/23/06 440- 4613T(I I /02 /C9 B) /� m e - ' L - EZS
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Des crib_ a work to be done: _
1.) ❑ New 2.) Modificat 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, B, 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 Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations KL Yes
include: Individual Component Pr . Yes
Cut Sheets
Fire Alarm Project Valuation: $ �Z , 5
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
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.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
(::\ Documents and Settings \bgiannettino \Mly Documents \Permits \City of Tigard \FPS -1)e rmitApp.doc