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Permit
y CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2009 -00060 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/08/2009 .TIGARD Parcel: 1S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 850 Subdivision: LINCOLN TOWER Lot: 0 Project: Mortgage Express Project Description: Relocate (3) heads Owner: FEES LINCOLN CENTER LLC Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 CALIFORNIA ST 49TH FL Permit Fee - COM 07/08/2009 $62.50 12% State Surcharge - Building 07/08/2009 $7.50 PHONE: Contractor: PACIFIC FIRE SYSTEMS LLC 6704 RIVERIA CT WEST LINN, OR 97068 PHONE: 503 - 710 -6646 FAX: Type of Use: COM Class of Work: FPS Type of Const: Occupancy Grp: Height: ft Stories: Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: 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: 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 issuanc- ' • suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utili otification Cente . Thos- rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a cop • the rules or 9 irect questions to OUN. . c -fling . X.246.6699 or 1.800.332.2344. I ued By: �� `,, �' / Permittee Signature: ,/411W. 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. ding Permit Application Fire Protection System RECEW FOR OFFICE USE ONLY y of Tigard R eceived Date /B n / • Al" Permit No.: 0 r - St" , °C) ' City . '" 13125 SW Hall Blvd., Tigard, OR 97223 la o $ 20 O(3 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit: TIGARD Inspection Line: 503.639.4175 OF TIG IRD Date Ready /By. Jur' ® See Page 2 for Internet: www.tigard- or.gov CI S Notified/Method: ( Supplemental Information pIVISION BUILDING v 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 A ddition /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: $ ❑ 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: l Q 2. 6 C 5 6,0 e7H { kui,i1 i2 ci New dwelling area: square feet Cit /State /ZIP: — Garage/carport area: s y � � Qvc.- O � square feet q Suite ldg. /apt. no.: S Ifroject name: J4 ' . 7 L / , e � Y Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQU RED'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. 4 / ? i (� / g Valuation: $ �� 7 ,45/7a 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: 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 /Z1P: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: ' CONTRACTOR BUILDING PERMIT. FEES* " • (Please refer to fee schedule) Business name: r, t', , C i 4. 0 ‹y S -1 Permit fee: Address: 0L-/ l21✓/t City /State /Z1P: !N L •� a D2 7065''' State surcharge (12% of permit fee): , / � FLS plan review (40% of permit fee): Phone: ( $a3) 71 b - C6 [ Fax: ( ) (Due upon application.) CCB lie.: /V-e)/t2/ Total permit fees: Authorized signature: Amount received: # 7 ,oc) 2.,>‘)A, This permit application expires if a permit is not obtained Print name: Date: 7 - 5.-- U °r 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 doe 03/23/06 440 -46 t 3T(11 /02 /COM /WEB) 411L, 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: $ 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. I:\ Building \Permits \FPS- PcrmitApp.doc 2