Permit CITY OF TIGARD
FIRE PROTECTION SYSTEM PERMIT
;.' COMMUNITY DEVELOPMENT Permit #: FPS2009 -00049
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/23/2009
Parcel: 1S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD, STE# 750
Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project: Western Architectural
Project Description: Install fire alarm system.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee - COM 06/08/2009 $69.65
12% State Surcharge - Building 06/08/2009 $8.36
PHONE. Plan Review - Fire Life Safety - COM 06/08/2009 $27.86
Contractor:
SAFE TECH
6400 NE HWY 99 SUITE 375
VANCOUVER, WA 98665
PHONE: 360 - 699 -2130
FAX: 360- 719 -1527
Type of Use: COM
Class of Work: FPS Type of Const:
Occupancy Grp: B Height: ft
Stories: 2
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 $105.87
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 2485
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: 'n n n ►� Permittee Signature: orAr -
►'L
1I , 1l Call 503.639.4175 by 7:00 a.m. for an inspection that business V C 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.
U k:P ' k , tOZ_ca CO 6'a -6- D
' building Permit Application ,
Fire Protection System RE CF\ ! r FOR OFFICE USE ON
Ci of Tigard Fn `t�e� Received Q
� ' /
' = Permit No.: , 0 � (f al
'I 13125 SW Hall Blvd., Tigard, OR 97223t,, p Plan
Phone: 503.639.4171 Fax: 503.5961301 O (7 2009 DateBRey v , iew � lL (� Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By. Jas: El See Page 2 for
Internet: www.tigard- or.gov CITY CF TIGARD Notified/Method: Supplemental Information
ni to nimn rttlr/lCif ill
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
�{
�l Addition /alteration /replacement ❑ Other: equipment; materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I -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: , i o 2 U A S ;Ai G. r' L a 1 G v r 3 4t o, New dwelling area: square feet
City /State /ZIP: ,f is ,., E I, n e l. . 11 � CA-- Garage /carport area: square feet
Suite /bldg. /apt. no.: •75 Project name: w¢S a.; A t• c, \A% t a c •lt'-^t / 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 all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
SiNs 'ES If - `‘r - t., Alacr\ Hac- c 6,,s Valuation: $ Z Y vo i
L / o c A L. S r11 a)( 4 - l7 L- ' L "60 CJ' Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP:
Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: s n.. a 1„1,,,,A o) e 5 y (, s 1 t,) Q All contractors and subcontractors are required to be
Contact name: / licensed with the Oregon Construction Contractors Board
A A Yh 5 we l under ORS 701 and may be required to be licensed in the
Address: t yo O r! - hi, , y 9 5 5,,, c_ G it 375 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: va h co , V `( y,, A r 5 (0 b S
apply:
Phone: (3(, v) f 11 _2,13 0 Fax:: (3( o) - 7 1 1 — 15 27
E -mail:
t3' w��.6 e 5a�s. .edc.1',holo d ,.�lt�.
CONTRACTOR 1 BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: 3 F k _ .-T,,,v1, V f u o e / _ / • 6,5" Address: Permit fee: 6
y� � >1. � H « � g ,i < G # 37 5 a .5/0 Y State surcharge (12% of permit fee):
City /State /ZIP: V t1 n Q. v v L r / w S Co L S' FLS plan review (40% of permit fee):
Phone: (t, Jo o ) ce. 9 1 - - 1 3 o Fax: (3i✓ e) 7; c — /S 27 (Due upon application.) ?. 54'
CCB lie.: i'J 3 7 , ( Total permit fees:
Authorized signature: o, t h ,, Amount received: /0 c• 87
This permit application expires if a permit is not obtained
Print name: Date: p 1 within 180 days after it has been accepted as complete.
A S v,..0...,9...
¢ Q / I * Fee methodology set by Tri- County Building Industry
Service Board.
1: \ Building \Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(1 I /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe w ork to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
J"] Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work: y n 5 E 4 it F c 4I c, 1 t< S
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 ig Yes
include: Individual Component cyf Yes
Cut Sheets
Fire Alarm Project Valuation: $ / z� s , n 4
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.
\ \Safeserver \d$ \SAFE \Forms \Use these forms \Permit Apps \Tigard \Tigard Fire Perm9.doc