Permit q CITY OF- OGAI�® FIRE PROTECTION SYSTEM PERMIT
IN
COMMUNITY DEVELOPMENT Permit #: FPS2010 -00077
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/17/2010
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 120
Subdivision: LINCOLN ONE Lot: 0
Project: Genex
Project Description: Adding (2) strobes to fire alarm.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Houlry Building Rate 07/27/2010 $180.00
Hourly Building 12% State Surcharge 07/27/2010 $21.60
PHONE: Permit Fee - COM 07/27/2010 $75.30
12% State Surcharge - Building 07/27/2010 $9.04
Contractor: Plan Review - Fire Life Safety - COM 07/27/2010 $30.12
SAFE TECHNOLOGY GROUP INC
6400 NE HWY 99 SUITE 375
VANCOUVER, WA 98665
PHONE: 360 - 699 -2130
FAX: 360 - 719 -1527
Type of Use:
Class of Work: Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler Svstem:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $316.06
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct qu '• : •UNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: A
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY •
City of Tigard ��� Da eBva —' _
Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 r Plan Review ► e'� r AWE I —
114
C Phone: 503.639.4171 Fax: 503.598.196�� �1Q DateBv: 9 ��1 Other Permit: I4 �:
T 1 G AR D Inspection Line: 503.639.4175 �� Date Ready ' y: See Page 2 for
Internet: www.tigazd Or.gov `\ `� r � Notified/Method: l' q / Supplemental Information
JV �I�v� C 1Q1` M �!✓ �! l�$f
TYPE OF WORK � —c -A REQUIRED DATA: 1 -AND 2- FAMILY DWELLING , '
❑ New construction ❑ Demo ioo \) 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: 10300 SW GREENBURG RD New dwelling area: square feet
City /State /ZIP: PORTLAND OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: 120 Project name: GENEX Covered porch area: square feet
Cross street/directions to job site: LINCOLN 1 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 all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
FIRE ALARM -ADD 2 STROBES Valuation: $1400
Existing building area: 1350 square feet
New building area: 1350 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing: B
Phone: ( ) Fax: ( ) New: B
a 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 re/erta fee schedu[e -
Permit fee: i 0 )- 0 7-0, - 57. )
Address: 6400 NE Hwy 99 Suite G375
City /State /ZIP: Vancouver WA 98665 State surcharge (12% of permit fee): l
FLS plan review (40% of permit fee):
• P ne: (360) 699 -2130 Fax: (360) 7194527 (Due upon application.) ()-2-- CCB lic.: 173731 Total permit fees: .
���j- -- Amount received: ¢ 33> . )-5 Authorized signature: ���� %! rY
T his permit application expires if a permi is not obtained
Print name: JASON SWEET Date: 7 -26 -10 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1:\Building\Permils \FPS- PermitApp.doc 10 /01/09 440- 4613T(1 l /02/COM/WEB) ---rJ—
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
® Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
El 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 ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 1400
•
•
A). 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.
Fife 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.
\ \Safcscrvcr \dS \ SAFE \ Forms \Use these forms \Permit Apps \'Tigard \FPS- PerniitApp.c c 10/01/09