Permit •
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2009 -00076
Date Issued: 08/25/2009
TiGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 350
Subdivision: Lot: 0
Project: Softsource
Project Description: Relocate (4) fire sprinkler heads for TI.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee - COM 08/25/2009 $62.50
CALIFORNIA ST 49TH FL
12% State Surcharge - Building 08/25/2009 $7.50
PHONE:
Contractor:
MCKINSTRY COMPANY
12021 NE AIRPORT WAY SUITE G
PORTLAND, OR 97220
PHONE: 503 - 331 -2461
FAX: 503 - 331 -6906
Type of Use: COM
Class of Work: FPS Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard:
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $70.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 900
Residential Square Footage:
Fire Alarm Valuation:
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 t• - 1 -s adopted by the Oregon
Utility Notification Center. Ths rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. 'ou ma obtain a copy of the rule
or direct questions to OUNC by • alling- 503.246.6699 or 1.800.332.2344.
Issued By( / I a 4 t Permittee Signature: / ZLL// (12 C�
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.
Building Permit Application a 0 aY - o / S7
Fire Protection System _" FOR OFFICE USE ONLY
• /
City of Tigard C =� , r
' a `, `, Date /ByReceived : 4�`�a 9 Pennit No rAs R;0/ -eze 7 ,6
2
13125 SW Hall Blvd., Tigard, OR 972
Tigard, � ' � Plan Review
`'` '- Phone: 503.639.4171 Fax: 503.598.160 : -r -� - Date/By: Other Permit.
TIGARD Inspection Line: 503.639.4175 1 (1 Date Ready /By: fur El See Page 2 for
J QO - . Internet: www.tigard - or.gov AUG 2 L J Notified /Method: ( I ap Supplemental Information
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� °�- =TYPEt':OF:�WO � ��' °'' RE UIRED DATAi�I: "AND 2= F- AIVIILY:DWELLIN�:
, ,..... .. . \ -... - � `,,..:,,'°'; -= r 'w:. a`Y,�,' bit not -SR � •'. ^' ... ,,,�:-::...q, .� .:':� �, �- :- �:.� -c
r i11 I a?, . I v Permit fees* based the value of the k performed.
t' Vl Permt ees are ase e vaue oe wor
❑ New construction ❑�Demolrt7�n p
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
t:
work indicated on this application.
? '''' CATEGORYOF� %GONSTRiJCTIOIV; ',= � -�x �.? w
dwelling Valuation:
❑ 1- and 2-family $
y g ®C ommercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
Total number of floors:
�,., %= ,•t.:, -s` E a num er o oor
; , „, {• -',' `JOB STT INFORMATION AIYD LOCATION,',: ;,
Job site address: 10220 Greenberg Rd. New dwelling area: square feet
•
City/State /ZIP: Portland, 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:',COMJV1ERCIAL =USE CHECI�IST
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
and the profit materials, labor, overhead, a e ofit for the r
work indicated on this application.
Relocate 4(four) fire sprinkler heads for new wall layout Valuation: $$900.00
Existing building area: 4178 square feet
Mckinstry Job #70299 New building area: 4178 square feet
® :PROPERTY. %OWNERa.:, a FTEN ANT; ' Number of stories: 6
Name: Shorenstein Type of construction: I -B
Address: Occupancy groups:
City /State /ZIP: Existing: B
Phone: ( ) Fax: ( ) New: B
APPLICANT - ...... ;, � CONT °
Business name: Mckinstry Co. All contractors and subcontractors are required to be
Contact name: Diane. Parke licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 16790 NE Mason St. jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97230 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 331.2465 Fax: : (503) 331.6907
E -mail: dianep @mckinstry.com
OR
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B [LDIN �l' R
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Business name: Mckinstry Co. 7Please refer o fee schedule)
Permit fee:
Address: 16790 NE Mason St. # 100
City /State /ZIP: Portland, OR 97230 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 331 -0234 Fax: (503) 331.6907 (Due upon application.)
CCB lic.: 172811 Total permit fees:
Authorized signa re: /..}
Amount received: 70) °�
T his permit application expires if a permit is not obtained
Print name: Diane Date: 08/19/09 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 4404613T( I I /02 /COM /WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Des cnbeavork�to'ledone < -, a�,. = ,:
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: 4
Additional description of work:
k T. e of-S. stem.:: Com" lete A, B,° .o rDas a hcab1e
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�A: �C ° `'min r i ga l kle
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® Wet ❑ Dry
Additional Standpipes 2
Information: Hazard Group Light
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 900.00
`'B: :T. ''e:L- ='�I= Iood' >Fre�Su ression�S' "stem .� •. >�, � °:
Hood Project Valuation: $
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a �
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Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
Tti
,,•33;
.. ... :. .ate .
D: Resdeintiah S r><nlder Starid AloriexS.E `sfem <,.a_; _'
Square Footage: Permit Fee:'_ "'`
• 0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50 q `
7,201 and greater 381.0 a .': ` >,:, ''`:`" _, k7.
Sprinkler Project Square Footage: sq. ft.
�••9� ..FireaProtection,Perinit Fees: y; ,.::��
; . T
, =��\�s"r" —_' C,__, >ys .a::.x ✓-. � __ ,. .............e„ >. _,e .m., _F_ - _ _..- - _ - _, _, •:no�Sd • k' .:��+�,_,- s..- ,.,.��'a', _ _� ,.,m .,.,
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.
W: \PDX - Special Projects Group \Projects \ — SPG SERVICE-HARD CARD PROJEC2 \70299 Soft Source \ FireProtection-PermitApp.doc