Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 o COMMUNITY DEVELOPMENT Permit #: FPS2010 00097
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/23/2010
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 125
Subdivision: LINCOLN THREE Lot: 0
Project: Hood River Distillers
Project Description: Fire alarm alteration
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
Permit Fee COM 09/23/2010 $80.68
CALIFORNIA ST 49TH FL
12% State Surcharge - Building 09/23/2010 $9.68
PHONE: Plan Review - Fire Life Safety - COM 09/23/2010 $32.27
Hourry Building Rate 09/23/2010 $180.00
Contractor: Hourly Building 12% State Surcharge 09/23/2010 $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: IIB
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: Smoke Detectors Req:
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 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 by calling 503.246.6699 or 1.800.332.2344.
Issued By: AT / Permittee Signature:
� 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 Applicatio
Fire Protection System Fou oui ic[: usu: o�►.%
S E P 0 7 2010 Received (�
City of Tigard Date/B : f 1 10 t Permit No.:
11, a 13125 SW Hall Blvd., Tigard, OR 98N OF TIGARD Plan Revie YA
r f q Other Permit: �: ' SIO D 'OD (
Phone: 503.639.4171 Fax: 503.59. Date/B : / I 10 I
T I G A R D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready : y: Brno See Page 2 for
Internet: www.tigard - or.gov Notified/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: $
1:1 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 Rd New dwelling area: square feet
City/State /ZIP: Tigard OR Garage /carport area: square feet
Suite/bldg. /apt. no.: 125 Project name: Hood River Distillers Covered porch area: square feet
Cross street/directions to job site: Lincoln 3 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 Valuation: $$1,600.00
Existing building area: 3000 square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing: B
Phone: ( ) Fax: ( ) New: B
® 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
City /State /ZIP: Vancouver WA 98665
applicant is exempt from licensing, the following reasons
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 to fee schedule)
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: -®--'
This permit application expires if a permit is not obtained
Print name: Jason Sweet Date: 9 -5-10 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
I: \BuildinglPermits'FPS- PermitApp.doc 10 /01/09 440-4613T( I I /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) El New 2.) Modification to sprinkler heads only:
El Addition El 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: I $
C.) Fire Alarm
Submittal shall Battery Calculations g Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $ / (f5 p
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.
\ \Safcscrvcr \dS \SAFE \Forms \Usc these forms \Permit Apps \Tigard \FPS- PermitApp.tc 10/01/09