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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 111 COMMUNITY DEVELOPMENT Permit #: FPS2009-00029 T 1GAg Ey 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/26/2009 Parcel: 1S135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD 320 Subdivision: Lot: 0 Project: Ameriprise Project Description: TI - Fire alarm Owner: FEES LINCOLN CENTER LLC Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee COM 05/11/2009 $62.50 CALIFORNIA ST 49TH FL Tax - 12% State Surcharge 05/11/2009 $7.50 PHONE: Plan Review - Fire Life Safety - COM 05/11/2009 $25.00 Contractor: CAPITOL ELECTRIC CO INC 11401 NE MARX STREET PORTLAND, OR 97220 PHONE: 503 - 255 -9488 FAX: 503 - 255 -1966 Type of Use: COM Class of Work: FPS 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: Manual Pull Station Required: Yes Smoke Detectors Req: No Battery Calcs Provided: Yes Cut Sheets Required: No Total $95.00 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: 0 Residential Square Footage: 0 Fire Alarm Valuation: 1500 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 Canter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules Iss (ed By: Permittee Signat .e• _ 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. it1b1 FRI - E F+ tt.3cclt c,- 10 '2 6- - tlT e'- -"32 ` Building Permit Application 2 Li s..C,c c 1. Fire Protection Systen4 CEIVED s FOR OFFICE USE ONLY C ity of Tigard Received (DAM 7213 5 // a `l)o'1G10? -4 5 ; Er '� 13 125 SW Hall Blvd. Tigard, IWYdU72 1 2009 Plan R Permit No.: iej�= Phone: 503.639.4171 Fax: 503.598.1960 Date/By: L )�. Other Permit: TIGARD Inspection Line: 503.639.41m OF TIGARD Date Ready /By: Jurts: ® See Page 2 for Internet: www.tigard -or. -B TILDING DIVISION 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 Valuation: $ y g ® Commercial /industrial ❑ 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. (Two Lincoln) New dwelling area: square feet City/State /ZIP: Tigard., OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: 320 Project name: Ameriprise Financial T.I. 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. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the . DESCRIPTION OF WORK work indicated on this application. . Install Fire Alarm Notification Devices In Tenant Space Valuation: $1500 Existing building area: square feet New building area: square feet Z PROPERTY OWNER ❑ TENANT Number of stories: Name: Shorenstein Realty Services Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ .APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR BUILDING PERMIT FEES* Business name: Capitol Electric Company, Inc. (Pleuse.rejer to feeschedule) Permit fee: Address: 11401 NE Marx Street State surcharge (12% of permit fee): City /State /ZIP: Portland, OR 97220 0 FLS plan review (40% of permit fee): Phone: (503) 255 - 9488 Fax: (503) 255 - 1966 (Due upon application.) CCB lie.: 48748 A Total permit fees: Authorized signature: g'(/‘\11( Amount received: This permit application expires if a permit is not obtained Print name: Dan Wilson Date: 5/8/09 within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I: \Building \Permits \PPS- PemttApp.doc 03/23/06 440- 4613T( I 1/02 /COM /WEB) c City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information • Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only El Addition El 1 - 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: $ $4,500 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): $ 1,500.00 Permit fee based on project valuation (see fee schedule): $ 62.50 Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ 7.50 FLS Plan Review (40% of permit fee): $ 25.00 TOTAL: $ 95.00 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. U: \FA Jobs \z290652 -45 Ameriprise, 2Linclon -320\ 1 FPS- PemiitApp.doc 2 TRI- COUNTY COMMERCIAL APPLICATION CHECKLIST r i. RECEIVE Date: 5/8/2009 M AY 12009 Project Name: AMERIPRISE FINANCIAL T.I., SUITE 320 @ 2LINCOQFTIGARD Project Address: 10220 SW GREENBURG TIGARD, OR 97223 BUILDING DIVI5i0N Scope of Work: INSTALL TENANT FIRE ALARM NOTIFICATION DEVICES Reference # : Map & Tax Lot #: Contact Person: Name: Dan Wilson Phone: (503) 255 -9488 Cellular: (971) 506 -3072 Fax: (503) 255 -1966 E -mail: dan @cepdx.com Company: Capitol Electric Company, Inc. Please Note: • The purpose of this checklist is to help define a complete submittal package for the scope of work. Plan review will not take place until a complete package is submitted. • This checklist can be used for all commercial construction projects, including new construction, additions, alterations, and tenant improvements (TIs). • For complex projects, applicants should use the "location" space to note the item's location and page number from the plans or the specification book. • It is not necessary to duplicate submittal information, even if it is asked for in multiple sections. • n R EQUIRED means that the applicant must provide this information for plan review. • n P • means (a) if checked by the applicant, the information is provided for the plan review or (b) if checked by the plans reviewer, this information is required for the plan review. • n NA means that the information does not apply. • Choose only those sections of the checklist that apply to your scope of work. Section 1.0, "General Project Data ", must be included with each project submitted. 1 Commercial Checklist For Tri- County Building Department Jurisdictions in Clackamas, Multnomah, and Washington Counties Section 1.0 General Project Data Construction Documents No: Item: Location (sheet number or spec section): 1.1 I X I REQUIRED (Number) 3 Sets Of Plans 3 SETS PROVIDED 1.2 © REQUIRED Cover sheet title block (On Plans) 1.3 I X REQUIRED Cover sheet vicinity map (mapquest.com) ATTACHED 1.4 In REQUIRED Cover sheet index ( REQUIRED IF LARGE NUMBER OF PAGES ) 1.5 © P n NA Code summary Cover Letter 1.6 n P © NA Deferred submittal summary 1.7 I I P © NA Professional stamp and signature (For new bldg, meets intent of architect design) 1.8 In P © NA Fire and life safety plan 1.9 In P © NA Landscape plan 1.10 In P © NA Landscape specifications Supporting Documents No: Item: Notes: 1.20 In P © NA Land use or planning actions 1.21 n P © NA Required fire flow calculations 1.22 n P © NA Fire hydrant flow test report 1.23 n P © NA Fire department or fire district building survey report 1.24 n P © NA Landscape specifications 3 Commercial Checklist For Tri- County Building Department Jurisdictions in Clackamas, Multnomah, and Washington Counties Section 11.0 Fire Detection and Alarm Data Construction Documents No: Item: Location (sheet number or spec section): 11.1 © REQUIRED Floor plan(s) FP1 11.2 n P Q NA Site plan 11.3 n P © NA Reflected ceiling plan(s) 11.4 n P © NA Transverse & longitudinal cross section(s) 11.5 © P n NA Wiring schematic FP1 11.6 1 1 P © NA Elevator recall information 11.7 n P © NA Operational matrix 11.8 n P © NA Fire -rated construction details 11.9 n P © NA Standard electrical notes Supporting Documents No: Item: Notes: 11.20 n REQUIRED Structural calculations for vertical loads and lateral loads for equipment weighing over 400 lbs. No loads over 400 lbs 11.21 Ei REQUIRED Equip. manufacturer's catalog "cut sheets" Included 11.22 © REQUIRED Installer certification information Included 11.23 ©P [ I NA Battery calculations Included 11.24 n P © NA Sample fire alarm log book 11.25 n P © NA Emergency power system specifications 11.26 1 P I X I NA Monitoring station information 11.27 n P n NA Voltage drop calculations Included 14 Commercial Checklist For Tri- County Building Department Jurisdictions in Clackamas, Multnomah, and Washington Counties f FIRE ALARM INSTALLER CERTIFICATION INFORMATION Date: 5/8/2009 Project Name: AMERIPRISE FINANCIAL T.I., SUITE 320 @ 2LINCOLN Project Address: 10220 SW GREENBURG TIGARD, OR 97223 Scope of Work: INSTALL TENANT FIRE ALARM NOTIFICATION DEVICES 0 Reference # : 0 Map &Tax Lot # : 0 Contact Person: Name: Dan Wilson Phone: (503) 255 -9488 Cellular: (971) 506 -3072 Fax: (503) 255 -1966 E -mail: dan @cepdx.com Oregon License: 17231J NICET Cert.# 104512 Fire Alarm Systems, Level IV Company: Capitol Electric Company, Inc. 11401 NE Marx Street Portland, Oregon 97220 (503) 255 -9488 Office (503) 255 -1966 Fax Oregon License: 26 -496C Commercial Checklist For Tri- County Building Department Jurisdictions in Clackamas, Multnomah, and Washington Counties