Permit tf CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
g.-. COMMUNITY DEVELOPMENT Permit #: FPS2009 -00090
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/07/2009
lC1+GARD Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 340
Subdivision: Lot: 0
Project: VSP
Project Description: Install (1) fire alarm horn /strobe for TI.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104 Permit Fee - COM 10/07/2009 $62.50
12% State Surcharge - Building 10/07/2009 $7.50
PHONE: Plan Review - Fire Life Safety - COM 10/07/2009 $25.00
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: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
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: Alarm Type: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $95.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 1000
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: r _^ 6 I\ . 1 L Vt- Permittee Signature:
,Jj ( �' 1 J� Vi r.S� _�� \ 1 +nC.l�1J
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.
414
Building Permit Application
R - .
Fire Protection System T FOR OFFICE USE ONLY y�c .
City of Tigard O I O 7 200 Dale /B a ,4 Permit No : ' • 2 t A • gioO
III - " 13125 SW Hall Blvd., Tigard, OR 97223 CITY OF TIG ° Plan Review
Other Pt: it Phone: 503.639.4171 Fax: 503.598.1960 . y.
.a te/B OQ�e•
TIGARD Inspection Line: 503.639.4175 Pa e Ready/By: B See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVIS sn: ified/Ivtethod' BM 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.
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
111 Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder 111 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 97223 Garage /carport area: square feet
Suite /bldg. /apt. no.: 340 Project name: VSP 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 l FIRE ALARM HORN /STROBE FOR TENANT IMPROVEMENT Valuation: $1,000.00
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 refer to 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:
Amount received: QS ' 00
Authorized signature: orty s_
This permit application expires if a permit is not obtained
Print name: ADAM SWEET Date: 10 -7 -09 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1: \ Building \Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(11/02 /COM/WEB)
ti �
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: $ 1,000.00
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): $ 1,000.00
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 Perm.doc