Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
,
2 COMMUNITY DEVELOPMENT Permit #: FPS2012 -00078
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/16/2012
Parcel: 1 S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 214
Project: Gerald Miller Suite 214 Subdivision: 1991 -055 PARTITION PLAT Lot: 1
Project Description: Relocate one (1) existing sprinkler head for tenant improvement
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 331 -0234 PHONE:
FAX: 503 - 331 -6907
FEES
Description Date Amount
Specifics: Permit Fee - COM 05/16/2012 $51.09
12% State Surcharge - Building 05/16/2012 $6.13
Type of Use: COM Plan Review - Fire Life Safety - COM 05/16/2012 $20.44
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $77.66
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct que _ - • ' UNC by calling 503.232.1987 or 1.800.332.2344.
Issued : ,/ � Permittee Signat �
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM :MCKINSTRY FAX NO. :5033316906 May. 15 2012 01:18PM P2
Building Permit Application RECEIVE
Fire Protection System I O R ()11..1(.1.: I ..l : ()NT,.
City of Tigard MA Y 15 2012 IREININIMEIN Permit No.; 2.061— ip pea el
111 11
• 13125 SW Ball Blvd., Tigard, OR 97223 Plan Review
ll. Phone: 503.639.4171' Fax: 503.598.1960 O TIGA�D rraia is • (hher Pernik;
:1 I+ I , Inspection I anc; 5033,639.4'175 j f b ate [toady/Hy: turn: _.... H See lyt 2 N./.
BUILDING D � i�lOf� � ._
I' 1 (i
Internet: www.tigard - or.gov Notifiad/Me!hod; Supplemental Information
{.f I��+'n: , r ' I �� t � ll h � ll` {1 ,,, , , )f
t'r f !111i!IV:!f1y„ ;, - �' 1 i i 'i . 1 , - :- '. T!.. 41 tr.,l ri,:.., n .. _ V , 1 ... ., II A I ,-, - _ _ '''''''' -' -me
R , t }' I 11, t �1 •� '.'S!;:'I; ,'. 4 1. i1,14 l 0 . 4 1:!i4_:'_!1 i .1... ..1fi rr . ",�) 1 .y-'� I.V : 1.'
TiRlf V).f I 1 ��I {4, Jr�l. ` rl.. 4. t,' . , , ', 1 -= _.. lute a f i� lid! w...` -" , .I Ifs iti>t/'
,.. b,i,..1! rtlfr! h .rh Th,.,... 1 1 [$Lttit;r:hi A• I . d• „t f ( , i ,, 1 1, • . - I_.9 � M . nlu!> ?+rlEtit(a)(t3mtl9!wJl+;u,11;N. n tuA � --- -.- 4'...- - tilnVml oh
❑ New construction ❑ Demolition Permit rocs* arc basest 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
! 1 fi ; '' Y ' !? 1 r�10: { ;V; 7m1M • ...'fu u( wr:t w)ey:,lopum19 ;�,r . ➢i! 1 .. r1, m.: -i wI. this • p - „ Irk indi t'klctl on hi • a , tsllion,
11 1 ! r ! � I!', :,i�`�i�1 �u' vit1 � , rin,nrnnu li I �l application,
,i.o, ! ,' Irt , -'''` *4 !., 10,lirm l'; ,.'_'.r III, 1' di urlc .1�, u ' • �ifllilfiigoi Enos !e l
12 1- and 2 - family dwelling ® Commercial /industrial Valuation: •
O Accessory building El Multi-family Number of bedrooms:
❑ Mader builder ❑ Other: Number of bathrooms:
F r {;F rr i . i. c
S ' q +a J 9tl ' { ., : 1 J .. 1( ' - :; :';:1,,in lr,hl :�l'.: !!fI ii, 1 -= i-35 i.i12=Ri Ly kt
l Total number of floors:
. � '
;' 6V tI '� l r k14 , 1141�I ' �l!i(nl � mI 4:44 W 11 I. i1(
, .: i I . ` :;:
r 1 . ,I 1 i a U �l
11 , , I.; r l l" �f x u
• , zit ,', sdI ".,- , 'ii) ir{ I � tlli 7.:� II_ ���;
Job site address: 10250 SW Gr'evnburg Road Suite 214 Ncw dwelling area: square feet
City/State /ZIP: Tigard, OR 97224 Garage /carport area: square feet
.
Suite/bldg. /apt. no.: 21.4 _ Project name: Gerald Miller Suite 214 Covered porch area: square feet
Crag street /directions to job site: I)cck area: square feet
Other structure area: square feet
m?rr<fd;lrrl ,>,'y �I N
_ ..pu ? ,i t' t �I, r M 41•� I I.p; :.)il�l
.1. (;ub:Irc t :i4 .. • ,tit.1`) «,R1�;, , li '• tur!�r,mtl win , , G . ?llttatnttfaiti t t It
Subdivision: lot no,; Permit fees' arc based on the value of the work performed.
•
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
., ,, : _ equipment, material;, labor overhead, and the profit for the
r r a„ I lenrµ'arnre Brut' aI. ( ' 1+ '�'
II , ,
1 t ' ' 1 ,' „ i 41 r r, Il'� , . r1 ') :.. - t i l •— ..-- -, �i l, r I n"::ei work indina tetl on this a lication.
, 1
,... � II: !�� IitKil , � !i! iI'�'L � 1 d' .. hag ; . , ,f 1 .... .._ .P.P. __.
� {. "IitIU:V11t�h�uhrYr: lda�(1, : -;:, a ItIG� t I • .r {:,.:..__-
Relocate (1) existing sprinkler head for tenant improvement Valuation: $$400.00
Existing building area: 1893 square feel
McKinstry Job #70807 Building Permit # New building area: 1893 square feet
31,1-1 ., ; r7 at;l:a;gm „ p I ry;2A 1 ' "" no r,,, r r�;t - 'J
;� I !li t'� t qu' it 11 ! 6 _,; 1 ' - .. e ( - -' ti - Number of stories; 1
( .i h,nr � r
L `ii�ItSi!'La;AD(, t{ { n'>1F1!}Ic "i "i� , I`II!i ,1, n i ..:.. ..
� i ,, lin' R, ; i -„ luet(1 .... • .- _:. ...fL l x ,l, {ut�i it
Name: Gerold Miller _ _ Typc of constructio 2 -B
Address: 10250 SW Grecnburg Road Suite 214 Occupancy groups:
City /State/ZIP: Tigard, OR 97224 - Existing: B
Phone: ( ) l+ax: ( ) - ' Ncw: II
.
1' -.,•) �jl' r ' :firi .. , .)i f.f?fit (()ifl) i . , 1 . 1 ... , , , � _ ,r n..,.` +.1 , "list , ..Ik(Hi 'ri, ,, , 11 , .
t ( . ' f R. tl 1 rfp, '..: I yl I -'t' ,i is a
V , 11+ ti itit , r .r • i _!',!; :" . I1 1 , i . - 'r.. « � ? ''! I �y n trof,;_ : d r 1 °.Il' ti ,1,, ;ni: . ' ( `;::(t r l . r .. ' . t,, i . y r 1
i.la,'.! I!rllf,.l�.t xtfifl s ef!a ;dllirhCr�H,,1� k�1.1 „L, =... ntaf � .t�r!jtn�llu� •.,,�I,c.:c",' WU i tl _,.•. :� , x ,9, l it I ".
..........1 -•- r. Ill 1 :.�)' i'��,
Ducinetls name: McKinstry Company, TIC All �._'-r: .�- ',al!' J 144, ���!= ` :-�- 1,�.tfnEvtn'- �y ;t:-: ::_r..::I,` a ._:._.,,,,, lit t....
All contractors and subcontractors are required to lie
Contact name: Janet Lipe licensed with the Oregon Construction Contractors Hoard
Address: 16790 NM Mason Street, Suite 100 under ORS 701 and may be required to he licensed in the
jurisdiction in which work is being performed. If the
i :icy /Statc/Z(T: Portland, OR 97230 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 278.3954 Fax; : (503) 331.6907 •
E-mail: l ,jancll�vmckinstry.com
I�' fiu�, ` �'� ts,1}i 1 1'�I , p p �'1 , { 11 j'��1 : 1 2 4 7 - •1f11111U,i . T7 , 4 , ! Iii diL1 y ,,., r1 , TI - ,.,p^ Ii!lilR ;::.: ;iQ
i r , y„, tl ii !" i .. A 4 u n ■ t 1 ' . 'M11 ! t it ; , y; , ,. „ , ,,,,, y 1 , 1 r ..mr' ,
-1. ,ohIH �'11' I r ,' '∎ '..1v , r •” . '�Ull, 1P i 1 )[l . iH' T ii { i'('ii �', I',,. )'t 1'
:,ih. e! . l de. ha c 1 7 1 :.) ,�RI,tS/i ilU!Il!Ii;” I t 1�i�6 ,, ,,,) t �f ry - ; ,, n ,,,, J I .)irlttlrf. UI:IYtlIVll ;Ili.= � +• �'�n II(1 I�t dI L l
yil•.' ;,. 11+1 ,, ,I, ` 1 ! 1 l:ntl it ' ^ l`.'... '
Business name: McKinney Company, T.T,C' in >t . t'1„ .''a'1, It.I :�1r:.rn.�raa ! '( ti " ,. "l .`- ',IPI'1
- Permit fee:
Address: Same as applicant _. ..._ _..., _....
State surcharge 0 2% of permit fee):
City / State/ZIP.,
A/ . -- PIS plan review (40% of permit fee):
Phone: ( ) a/ I Fax; ( ) cau pi. lium(1cm.
v
C::ii - lie.: 172011 \l - Total permit. ft m;
Authorized signal Amount received: •
rr _ This permit application expires if a permit is not obtained
Print. name: Janet Lipe I Date: 5.15.2012 within 180 days after it has been accepted as complete.
- • Pee tnelltodulogy set hy'fri-County Ruildius Industry
Service lioutd,
ut ituniloutevmitaUr s..eetm!IAmautc osaArf6 44n4o TAT( I II07/COMAVIIR)
FROM :MCKINSTRY FAX NO. :5033316906 May. 15 2012 01:19PM P3
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
'i,° "'(li }4" jlGli{ V; 91iS!! 611tRw6!L jplN ?ll SM' (;'1; i{ i I i i '� ' ii 1 P
1l 1 t, ,1,� r � i) o1, - t y . }{ fh`:! ?� - _ i yt . ; . ° l',' „
.0iieidla :SiAvnacn,n,m4:; . A,tbkr,, ,,t 3 f1". _ . 1 . , utl"'. .. i r� _ .... i r it ,,.. "., :j!fne P = n `i _ V: ". II
1 .) ❑ New 2.) Modification to sprinkler heads only.
❑ Addition ® 140 heads: No plan review required.
® Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 1
Additional description of work
, 1!, �:af ir,ni a : i e ni i }Ii!pp l nr, , , �rl ,� t „ „. i . --- •
fH'� l a i,!I ill-a . T 1 1 1 1 t' 1 `, ! } i ' ' i... .1 !{ •' l ) ',, "II e 1 .Hili_ ; 11 4 - ; . ` i • In{h'1 �: , .
u �l a t R S ., ! •..,r.• :. d ,.d. 1 t ' I) , ,10 t n, y r_ y R , ,, , { , d,l+� n} as -.
a�:,li'11, v l am J r 6 dnn n ,i L i u , '!1
}l �,1, I ( V'I T' .1li,'F,11•#"--,1°. ' �': ?: - f „ 1 „I _a +t � 1 n, - , I � T - _ " - a l , - ._. ,ti:.. _---- ' '-cu
., :,:ir '-r.`- 1 -., a ` '' `"44,1:i`i;.. ∎ - _i =ir. ?':'.:ta 'w_1 l , 17iH11'In':.'
� ',. , I �� . ,1., ,,,, ' ,� a WORD &, { 5 1, ii 1 t, lrtll fiii „ 7 : p: , , �F` .... 1— c; i n2I ; 1Y� ' :51,, , -, ,,o. 9lee;; ,:;: -
.'I r I i i;V� , ' s, i 1 1 , t .: 8,1 �4 ;;1RD i r r Il- 1 I },li , ,_ ..! ; i ' uR.: 0 hti,; ,I ; 5;
4" i ,!h•d I l 'kdr lh[ i , r• : :. , . ., -. f � �t .. n. G �..,,_ 1, :. , _1 ! 1 � ; : „�� t. _ '?I ;
i atl : �l1�t,, -... , 1 ,41 , ' �;�, r... �1 ' ," {}� h� 41 'r� , - �', pp fI �4
�' IDN- ti , ' , •ItIL,p... IPii,,,,!..I[lEl' 171''14....'`... ill i:iio,i..1`�r+ir91.i`it;•
® Wet ❑ D
Additional Standpipes
Information: Hazard Group
Density .
Design Area .
[K. Factor
Sprinkler Project Valuation: $ ,
!j I;`l ""'Hilt!liU,'' "' +';Il ';{ "Hi • t'' 3 , ".= 4 i U! i 1 - - • - •-- - -
I { I " I t it ;a { , ; � ?�?'s , 'It' I , o �y ` -` '4-;i•�Gi ,,,Iti 1- t .. n., l r I
Hood Project ',,ii l!f �, •,, th�0 ' i,11.1,a .4.4i,fi ;G•4 �,* !tr , •, r ,. `L : 1 , ', :.. -- ".:.. '-1. -,'' ::.1[ 4 I :.. ,,. h I .t¢
• � •r„ „ =vmm S� � t U ,..!� -.�5:� .,L li�r!x� . 11 , "�' • Valuation: $
1.11I, �G;jl, 1dl 9{ (l��tilri �l l l l L.f , i I N . •. ! I, wll. n.
ff}} I y � . 1{,�1,t 9 I l r t i, 1 1 . .i l.. i,p� � 1 p' ' N 1 .IL g�71 1F� .'..n ffPi �{:g 4N � �i}1ii�';ri i. . ��14 nv'. Ai e: NINf ��Ji'.i:� 1�''tii�•.:p..v.
li 1 1 � 1 j '� d MJl lyl��fl,lt l ( , ' � ' �� ': k {' !41 te, 0, R ,ll Lt� ' w l j1 ( IIi 19 i ,nIP"l,nl f �;; I. il r f i ' � : n,. _ lt Eil il �l ?r 1 1iL a �f[INNG Iii li
, • I I l 1 1 1Ip��,,. I ; (i _ ' i t g i m==i L- p •r,� 1 lli 1 t
I I ,wilit ` iolt 1 1, f — In ; ,.. ,,a, h ,, .—,11, , ' I f { I ll o- - ,i i ", Il, :,• jj .il6 i.,i. 1 i .i! nr4;l rd 4 : i' . : --- ll . . 111,1. Y n 1
• Submittal shall Battery Calculations ' ,. a', [ ,t [] 'Iu Yes l� �.,, n t 1„ nf� i
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
I I {f 1! t h � I i l i , (j Ifs ` 1� =_ { 11 p _ .� _ i . _ "ry „,,,,,N�� _��..,1 _`.- ,'••!I {f� i-a�yt �•'. ,. R r,l�x -:
it 4iI�' , U(tIl p' I t 4' ' .,. „ i ', � , .1 H :I � �j ii ?lii;eTii. OIll;Y ..r1 �1t !1�::,,rgili 'i;�
let I 1,,,,!,11`. t' i' , 1 1 1 i , !9, , Vit : li , .I I . S-Iil -,' uln ,1.!Yljl_ i 1/4i rN r I� .1 i . .. {• it Il , I IN it
I! ! k �. q �, V �.. )f 1,, l:.�,�,��r�1 ;���.11p �����'s_�a � i•i n i r.I:cnu4:,:1 �Ivllf� ' }N'ItflNt�l!IN �H:i�Inii�1,L�''�H.4�1 {-fl Iti{ll 1 tRP� '�. �,`:
1li R, ik'fl4ii"nr, dlllGle14 ii8t`rc!k!41 lilllSlf4:?.f., ta11 :. Permit . f,ii { 4Iir'A t l Li lif.i Ni 1f,i . {r .41a ..t:, '�KL ii, j .6,
Square Foots _ Fee: Irh- '; � �n l, °-=- ! j� w i uy .
g IIf� �. tAi rf -�1 14' . Viii ���Nl �l' F!liN
0 to 2,000 $187.50 i �! g� ,]�f{ �1 ,�! 144 t ��j1 llut�ti •ui i1.6..fRVw.7,il't
7.50 �'�,'Ir /1 ^I11Y11: 11N1Nt 11 ,.�nlr 1N
c:l t Ww I. , N it L411 116 t „ l. , fu =ill i il
OM 2,001 to 3,600 $23230 3,601 to 7,200 u +; ,. n i F n �i
{ii yti;afn.. 1 . u;� ' ���
292.5 I,,{ : ,! = ._. .::::. ii
O 'll�' { �11N1 ..�1y11 -.� Ni�IIRI� � N,
L � , tl �p�� 141 � ,1 J,
Y y �' I ll F. , - :IL' : . ' CiA 1. k �11 .rei 11 n ;i lifiilll'.I,',
7,201 and greater $3R 1..50 - ; � rI `' m VEI
Sprinkler Project Square Footage: sq. ft.
E l 4 V 111 kAH1) 1 RIN, ?''x' I 1 r K; r . .,,,. 1 ' i!ik! P , �' .t!` 1 n .' • '�`• , [ 4 nNIII . .. �,iri . N. I t rr _ .'
> �I,t �fu �,, . t.,i�ff a I, `'a ,r Vti' ° '1 ,,i '' 1 a -' . � t, = , .r / .. —
.1`,Me . r;, �1ti1 ,�. �1 'hK,'r, k,�;l6i ■ , ,h,_� ° �=�.... . °,,, :: i • :.. i:• 1G "- :, ? t..I
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see I) 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 NIC:ET level "3” technicians.
W : \PDX - Mechanical Construction \ SPG-DTE 705 \ Projects \' -, S1'G SERVIC)- HARIKARI) PROJECTS \70807 Gerald Miller Sue 214 Exp \PcnniL \70807 Pii Pmlertion
PennitApp.dnc