Permit /- to
w CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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'II. g - COMMUNITY DEVELOPMENT Permit #: FPS2009 -00083
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/23/2009
g ,,.� a:, •a , Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 350
Subdivision: Lot: 0
Project: Softsource
Project Description:
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
Permit Fee - COM 09/09/2009 $83.95
CALIFORNIA ST 49TH FL
12% State Surcharge - Building 09/09/2009 $10.07
PHONE. Plan Review - Fire Life Safety - COM 09/09/2009 $33.58
Contractor:
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: FPS Type of Const: IIB
Occupancy Grp: B Height: ft
Stories: 6
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type: Manual
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $127.60
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation:
Residential Square Footage:
Fire Alarm Valuation: 4765
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
issuan , or if work is s. - 'ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utif Notification Center. ose r -s 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 : elfin! 55 X246.6699 or 1.800.332.2344.
I sued By: / ' ii:L ' jam 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.
R.
Building Permit Application
Fire Protection System RECEIVED eceived Q FOR OFFICE USE ONLY
•
R
City of Tigard Date /B (�� Permit No I G 00, �
' � 13125 SW Hall Blvd., Tigard, OR 9 Plan Review
Phone: 503.639.4171 Fax: 503.590O 9 200 Date /By: r A pa `j. d d . Other Permit
Inspection Line: 503.639.4175 Date ReadyBy � ' See Page 2 for • TTIGARD Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: 9 • „, „ -O Afir 0 Supplemental Information
BUILDING DIVISION
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: $
ID 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 ROAD New dwelling area: square feet
City /State /ZIP: TIGARD, OR Garage /carport area: square feet
Suite /bldg. /apt. no.: 350 Project name: SOFTSOURCE Covered porch area: square feet
Cross street /directions to job site: LINCOLN 2 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.
INSTALL FIRE ALARM HORN /STROBES FOR TENANT IMPROVEMENT Valuation: $$4,765.00
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: SAFE TECHNOLOGY GROUP All contractors and subcontractors are required to be
Contact name: ADAM 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 G #375 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 (Please rejerto fee schedule
Permit fee:
Address: 6400 NE HWY 99 SUITE G #375
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 lie.: 173731 Total permit fees:
Authorized signature: ,B A.,,,_LxiC Amount received: /A7.0
This permit application expires if a permit is not obtained
Print name: fJ d en. S v e c. Date: 09 - - within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I. \Building \ Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(11 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification 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 ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 4,765.00
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 Permip.doc