Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• Permit #: FPS2011 -00128
COMMUNITY DEVELOPMENT
Date Issued: 10/21/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1180
Project: NSKB, LLC Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Adding (2) sprinkler heads to existing system.
Contractor: AFP SYSTEMS INC Owner: LINCOLN CENTER LLC
19435 SW 129TH BY SHORENSTEIN PROPERTIES LLC
TUALATIN, OR 97062 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE 503 - 692 -9284 PHONE
FAX: 503 -692 -1186
FEES
Description Date Amount
Specifics: Permit Fee - COM 10/21/2011 $53.78
12% State Surcharge - Building 10/21/2011 $6 45
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required Yes Sprinkler Type. Wet
Standpipe Required Hazard: LT
Density: 10 Design Area: 0
K Factor. 5 6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided Cut Sheets Required
Total $60 23
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $525.00
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
or direct questions to OUNC by calling 503 23� : • 0. 32 2344
Issued By: Permittee Signature: / 'l
I�
Call 50 .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.
OCT -20 -2011 THU 10:08 AM AUTOMATIC FIRE PROTECT FAX NO, 5036921186 P. 03
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Fire Protection System �V -
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i! Phone; 503.639.4171 Fax: 1 • % y �
V , DeteRmtly/By / supplemental Interwove
Inspection Line: 503.639:1175 , C tC�� xatiflcdlMaul
t ' r�,,tt�? Interact; www,tignrd•or.6ov Q �'4�. �
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" " • ' Permit fees+ are b,3sed on the value of this work performed.
0 New construction i_c_ Ilion - 'indicate the value (rowtde(l to lha nearest dollar) doll
equipment, materials, labor, overhead, and dic profit for the
Addition/alteration/replacement ❑ Other: ::l . work indicated on this application•
^� ', r M1 -,,--7.,1177,-;•,17,7757-.7n,• : i,r ,•i ':'i {;,: •
^` ,':'''''''':''':'4;'''''':;11:'";,''''6.1': r "''.. ' ' �%}jQ� 4a'��ll! t-, �a�" ;�Q ;:, dr' � .i l';i�,nn�::'tl: Valtlat S
0 L- and 2- flimily dwelling NCornmercinl /ituhlstritd —_ Number of bedrooms:
D Accessory building D Multi- family - _ - ��
Number of bathrooms:
u Master builder Other: �, y C
rl x , .,,,•,
, ,. 11 .. ; � I ' n l� Sr]''i.: 7" " , LQ 1' . l � t v ,' , ' •�� I• ,'j , °Il,jl^ fi � r yl l ' Total number of floors:
,, ;' , , TOA . Sl#g'illti ,!-!1T . ,1 �a,,. I ' ,yl: _ c feet
• Now dwelling area: squat
job site address: j p 2_10 b s N t a- o n b < square feet
CSiut&YLLP T, a,r i , n Z. C1 21,-'i _ Qarnge /caiperl area:
Suite/bldg. /apt. no.: k \ 0 I Project name: N S v.: .._ .
Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
I . Other structure area: square feet
L CO�� �e�. �C
_ i Q 0� 12 • V ' ' r$i i 1 t $ ;; IIECl>` 11
no.: Permit fens' are based on the value of the Work performed.
SubdlvisiPn: -~ v� I Lot t� — Indicate the value (rounded to thoneairest dollar) of all
Tax map /parcel no.: tSi n orpiment, materials, labor, overhead, and the profit for the
'',i:' ..' '„ .,,�, i.i, 4 ., .r I , ' a .,1"":"7"7"77:77,- "lI I ':j s, . ' , ' ' � 6,1 ! ', 4 'a ,, ' , ' ,(. ` ' y ,''' work indicated on this application.
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Valuation: ..J L
y !f ;; j,'+ R S 5
kd A To o 1, zCia'rb — - Existing building nren square feet
�� New building area: square feet
i (.1 i,1,,7 ;'.;4;',e.,:, ;" ;;ti'w iii' -'1 17 i�ht N'1 F;S " r i j�'I,” ?`;'y;� Number of storks;
N `; ; 1 CO 4 Type of construction:
Na1L Occupancy groups:
Address: S0 ( , r.,/ 1 • . // , --L
CItyJState/Z1P: raAI � {G, c'.-�
Existing:
Pox:
New:
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Business name: V ? $ 'S '$ 4 . Ali contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Q. i„5 under ORS 701 and may be required to be licensed in the
Address: `Ct 4 3 T S W \t (i - P' -v c_ jurisdiction In which work is being performed. if the
applicant is exempt from licensing, the following reasons
City/Statt .10 G p i7.,_ 5'1 01,57- ` _ , Vi
apply- —
Phone: (t-p'9 `D-l� _ _ .. � ( .S' O -5) kyc1Z - 5 4, - -
b`mitil: 1,.� B,� TL�'S . Cv
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Business name: kG_ �� S• �Mg - \ r,t _ P emtil fee: e -� 3
Address'. lI:\ 35 S\ J i i_q Cl. av,.._ State surcharge (12 %ofpermit fee): ( • KS
CItyJS►atr /711': ( , \ + 1 0 � FLS plan review (40%of permit fee): e _______
6. Fax: (7O') \ Cl/ - \\� (. v �— (Aue won appIka1ion.J'
CC13 Ile.:
Phone: (�0'S1 \ 412 ' �{ L� `-( 4‘0..)
\,01 S.1 Total permit fee
G. Amon received: I I"
s *),•3 Autlwrized algmalure: q This permit' application expires If a perrut th o obtained
` ` 5 within I80 d after It has been accepted as complete.
W
I Print name: Q. J tz IN 9-,-3 Date: vo '7--0 ‘1, + Pee methodology set byTrl- County Building Industry
Service Board.
M Itilldles1Permilan- PermIlApp,14e0 03/23106 41001613TO lioatcomtwLla)
OCT -20 -2011 THU 10:09 AN AUTOMATIC FIRE PROTECT FAX NO. 5036921186 P. 04
City of Tigard: Fire Protection Permit Checldist
Page 2 - Supplemental Information
]�e $Oribe.wotk to.be done:
1.) El New 2,) Modification to sprinkler heads only:
0 Addition tgi 1 -10 heads; No plan review required.
ri Alteration ❑ 11+ heads: Plan review required.
Cj Repair
Number of aprinldcr heads; -
Additional description of work: y�
•� �� '. COtifl��t afr�'�Y�C`OY��Di985�1i � � "r;i '�- , =1';� : }i r 4 :,-;ti� . • . • ietclal'Sp
•
tgi . Wet n:y
Additional Standpipes _
Information; Hazard Group LI g.3
Density _4..
Design Area
K, Factor •
~� Sprinlder Protect Valuation: $ Z ..�.
' '',Type:Xi '' >Idood'Pife Suppression System
Hood Project Valuation:
Submittal shall I3�ttery Cs►lculadons ❑ Yes
include: Individual Component Q Yes
Cut Sheets
Fire Alarm Project Valuation: $
Atei,iiletAtiO;SiitiOdet!(Stand AI4tW; System)
Permit Fee: i,;;,; >i `' !i.
Square �Obt�C: ' ,i' „t?, " %' ;.�,' - '' • 'f�';;:.1;,••J('I
0 to 2000 $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 PioteationTermit 'Fcee
Project valuation subtotal see A, B & C above): $
Permit fee based on protect valuation (re fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fcc): $
FIS Plait Review (40% of permit fee): $
_ TOTAL: $
Plan review requires a completed a pplication and 2 seta of plans at submittal. Plan review fees arc requited at submittal.
L : \Eiuilding \Pennin\PS.Fccm t pp•dne 06/25/08 2