Permit ,
' CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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*'` '! COMMUNITY DEVELOPMENT Permit #: FPS2009-00068
TLGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/12/2009
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1165
Subdivision: LINCOLN TOWER Lot: 0
Project: Buchner /Greenspan
Project Description: (3) notification devices.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee - COM 08/05/2009 $62.50
12% State Surcharge - Building 08/05/2009 $7.50
PHONE: Plan Review - Fire Life Safety - COM 08/05/2009 $25.00
Contractor:
SAFE TECH
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: IB
Occupancy Grp: B Height: ft
Stories: 12
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: Automatic
Pull Station Required: Yes Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $95.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 1325
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 Notificati.. enter. 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 of. -stions to O. C • :Ili• • 503.246.6699 or 1.800.332.2344.
Issue. By: / i`l / Permittee Signatu c t
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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 - ��
Fire Protection System RECEIVE FOR OFFICE USE ONLY ,
OR 97223
Tigard, SW Hall Blvd., of Tigard AUG 0 5 2009 Received �� Permit No.: rta
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City and a
g 2009 Date/B � � �r � io
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— ❑ ]Tv D CITY Plan TI(i R D Date /By: + It/ 8 mea _ear - J I
TIGARD Ins . 4175 B [1IL ° I DI SI sateReadyBy. r s H See Page
Internet: www.tigard- or.gov VV 11 o f fled Method: �( • I �ri� 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
❑ Accessory building 1:1 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10260 SW Greenburg Rd New dwelling area: square feet
City /State /ZIP: Tigard OR Garage /carport area: square feet
Suite /bldg. /apt. no.: 1165 Project name: Bucher & Greenspan Covered porch area: square feet
Cross street /directions to job site: Lincoln Tower 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.
3 new notification devices Valuation: $51,325.00
Existing building area: 1319 square feet
New building area: 0 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing: B
Phone: ( ) Fax: ( ) New: B
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Safe Technology Group Inc. All contractors and subcontractors are required to be
Contact name: Jaon 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 G375 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:
CONTRACTOR BUILDING PERMIT FEES*
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Business name: Safe Technology Group Inc. (Please refer to fee schedule)
Permit fee:
Address: 6400 NE Hwy 99 Suite G375
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: �y
Authorized signature: /�i,+r^
(r Amount received: Q 5 • Vl)
This permit application expires If a permit is not obtained
Print name: Jason Sweet Date: 7 -27 -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 03/23/06 440 4613T(11/02 /COM/WEB)
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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 ❑ 1 -10 heads: No plan review required.
® Alteration El 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: $ 1780
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.
\ \Safeserver \d$ \SAFE \Forms \Use these forms \Perrmt Apps \Tigard \Tigard Fire Perm .doc