Permit •
C ITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00273
COMMUNITY DEVELOPMENT DATE ISSUED: 8/12/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135AB-01002
SITE ADDRESS: 10220 SW GREENBURG RD 601 ZONING: R -12
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT: 009 JURISDICTION: TIG
PROJECT: MATRIX
Project Description: Add (2) sprinkler heads and relocate (3) heads.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 425.00
Owner: Contractor:
SHORENSTEIN REALTY SERVICES PACIFIC FIRE SYSTEMS LLC
ONE SW COLUMBIA ST #300 6704 RIVERIA CT
PORTLAND, OR 97258 WEST LINN, OR 97068
Phone: 503 Contact #: PRI 503 - 710 -6646
Reg #: LIC 180140
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/12/2008 $62.50
[TAX] 12% State Surch 8/12/2008 $7.50
Total $70
•
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 than 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 thes- • - • -ct questioas, to OUNC by calling 503.246.6699 or 1.800.332.2344. .
Issue. :y: ' I 4 .� �� 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.
_ mg Permit Application
Fire Protection System RG - • FOR OFFICE USE,ONLY •
G p
City of Tigard Date/By: 0 /� u Permit No , 'Pee/ � a
75
_ !� 13125 SW Hall Blvd., Tigard, OR 9722a� 1 2 2 Plan Review
' : • Phone: 503.639.4171 Fax: 503.598.1 �p Date /By: Other Permit:
TI GA RD Inspection Line: 503.639.4175 `B F TiGN�D Date Ready /By: 1 See Page 2 for
Internet: www.tigard- or.gov 011 O � Notified/Method: I ® Supplemental Information
a It 111 N.N if E
`� 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
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
. JOB SITE. INFORMATION' AND' .LOCATION;'' w , .
Total number of floors:
Job site address: 1 6 ,Z 0 5(,J s2 /eC' New dwelling area: square feet
City /State /ZIP: (�� eNe Garage /carport area: square feet
Suite/bldg. /apt. no.: ‘'
O Q / Project name: Me.1/t I'p- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
2 i [Q f It —5 Other structure area: square feet
REQUIRED DATA: :COMMERC USE CRECKI IST
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
w ork indicated on this application.
- ��a DESCRIPTION,OF:WORK �, '• °-'t `- , PP
4J J 2 I 5 y iee /acct.. /'P 7 1,]f-Ccg Valuation: $ '%25,,
Existing building area: square feet
New building area: square feet
-'a i PROPERTY ON; N • , . ' ... ' ❑ TENANT ' '' Number of stories:
Name: cXjOGc 1-r-�S i-c71--t. Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
- - -'❑ APPLICANT', ' . r fi • ❑,CONTACT - PERSON, - -r: . ' 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
applicant is exempt from licensing, the following reasons
City /State /ZIP:
apply:
Phone: ( ) Fax:: ( )
E -mail:
�CONTR_ACTORt .
,,� - . BUII..DING,PERMTT, FEES*
. ' ' _: .- , .(Please refer to fee s " '
Business name: f r ;2� S r STS r
/ Permit fee:
Address: 6 70g , i vl'- 4vc... ! r
City /State /ZIP: ‘42.,e5-7,-- / 0 4 G 704k- State surcharge (12% of permit fee):
�l�t � r 7 / FLS plan review (40% of permit fee):
Phone: (3'03) 7() r' y% Fax: (3'03 ) '3� 7 — 3G' �f''5 (Due upon application.)
CCB lic.: / ti / yd Total permit fees:
Amount received: il ,G C
Authorized signature: j -- 1 �° notnot This permit application expires if a permit is not obtained
7� " within 180 days after it has been accepted as complete.
Print name:
,. 1/4.
Print . Q 6„ Date: �2 — O S
q , * Fee methodology set by Tri -County Building Industry
( Service Board.
1:\ Building \Permits\FPS- PermiApp doc 03/23/06 440- 4613T(11/02/COM /WEB)
City of Tigard: Fire Protection Permit Checklist
Pa 2 - Supplemental Information
Describe; kork to, be= done:.
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 - heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
TypeFof.: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 h�- 'Hood :Fire - Suppression,Systeiri�
Hood Project Valuation: $
',C.)
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) ~Residential Sp` tnkler` (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.
Fite Protection Pe'rimit 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.
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