Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s • COMMUNITY DEVELOPMENT Permit #: FPS2012 -00040
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/27/2012
Parcel: 1 S 135AB00900
Jurisdiction:
Site address: 10200 SW GREENBURG RD
Project: Lincoln Center Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Fire alarm upgrade.
Contractor: SIMPLEXGRINNELL LP Owner: LINCOLN CENTER LLC BY SHORENSTEIN PROF
6305 SW ROSEWOOD ST. 555 CALIFORNIA ST 49TH FL
LAKE OSWEGO, OR 97035 SAN FRANCISCO, CA 94104
PHONE: 503 - 683 -9000 PHONE:
FAX: 503 - 675 -6521
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/16/2012 $653.40
12% State Surcharge - Building 03/16/2012 $78.41
Type of Use: COM Plan Review - Fire Life Safety - COM 03/16/2012 $261.36
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 03/16/2012 $34.00
Occupancy Grp: B Height: ft 11x17)
Stories: 7 • Info Process /Archiving - Sm $0.50 (up to 03/16/2012 $26.00
11x17)
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $1,053.17
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $70,368.00
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 • - ' suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Noti -tion Center. hose -• -s are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct • 4estions to OUNC by , ing 503. 2.1987 or 1.800.332.2344.
# Issued B : /�, � � Permittee Signature:
� �
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of th roject.
Approved plans are required on the job site at the time of each inspection.
0 . I •
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Receive /By: d (. D 3U 'l a `J b PemtitNo.: — /'S0 I)- "-0 13125 SW Hall Blvd., Tigard, OR 97 REC W ED Plan Relit ► �� /
lIl . Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Y I - Other Pemtit:
Inspection Line: 503.639.4175 MAR 15 2012 Date Read /
Juris: ® See Page 2 for
TIGARD P
Internet: www.tigard - or.gov Notified/Method: J�'i f 1 IM, Supplemental Information
CITY OF TIGA WI L. u M /it r & p
-. v Co,
TYPE OF WEDING DIVIS 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
K Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling Commercial /industrial Valuation: $
El Accessory building 1:1 Multi-family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: l 02 't.. au-�t� Izzg,. New dwelling area: square feet
City/State /ZIP: ziZ �-R___2_']3 Garage /carport area: square feet
r
Suite/bldg. /apt. no.: Project name: L__6,, 'FAQ? Covered porch area: square feet
Cross street/directions to job ste: ` / ;Avo I r Ce 1— 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.: ' 5 S 0 6q..0 a equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
'� � ^ (1 Valuation: $ "� �e
y+2-- Existing building area: square feet
•
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: SA,.,_ LS' Type of construction:
Address: t�L2O st„J Gsu p a� 6 , sai , Occupancy groups:
City/State/ZIP: _ l G c) r Q 1 R 22. Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT g:L CONTACT PERSON NOTICE
Business name: ,.' All contractors and subcontractors are required to be
Contact name: /— licensed with the Oregon (instruction Contractors Board
`—� G—� under ORS 701 and may be required to be licensed in the
Address: C,2 ,_.,. _ jurisdiction in which work is being performed. If the
City/State /ZIP: 1.- C��� F)12 4+ applicant is exempt from licensing, the following reasons
A' apply:
3)
Phone: ( G2,3 a �O --I F ax:: () c' -4_<— ( c . oc - Z(
E- mail: �.lr to ( SZ 1n A�k9�t�itiQ C71/ ,
CONTRACTOR r 11 BUILDING PERMIT FEES*
Business name: ' 'Q X �� k� e �` (Please refer to fee schedule,
'w Permit fee:
p
Address: JS" C.L.,,) boi c) S'. A.
City/State/ZIP: / State surcharge (12% of permit fee):
Ci
ty �Ie- -P t tQ FLS plan review (40% of permit fee):
Phone: (�� C=, I Fax: �t --
( � = f�"2 (Due upon application.)
CCB lic.: k �C 2 ( 1 , Total permit fees: 15, f*-- Authorized signature ^ —
Amount received: f l ; vs3, ( 7
T his permit application expires if a permi not obtained
Print name: �t�t1 Date: (L( (�
* within 180 days after it has been accepted as complete.
Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits \FPS- PemlitApp.doc 03 /23/06 440-461 3T( 1 I/02/COM/WEB) . i 1i Cti,
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.
ELAlteration ❑ 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 Mann
Submittal shall Battery Calculations reI Yes
include: Individual Component I i Yes
Cut Sheets
Fire Alarm Project Valuation: $ -D
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): $ 363
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.
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