Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
m COMMUNITY DEVELOPMENT Permit #: FPS2012 -00103
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/17/2012 •
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 300
Project: Jason & Leiberan Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Modify existing fire alarm circuitry and devices as required for TI
Contractor: STONER ELECTRIC Owner: LINCOLN CENTER LLC
1904 SE OCHOCO BY SHORENSTEIN PROPERTIES LLC
MILWAUKIE, OR 97222 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 -462 -6500 PHONE:
FAX: 503 - 659 -4968
FEES
Description Date Amount
Specifics: Permit Fee - COM 07/17/2012 $102.20
12% State Surcharge - Building 07/17/2012 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 07/17/2012 $40.88
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 07/17/2012 $8.00
Occupancy Grp: B Height: ft 11x17)
Stories: 5
Commercial Sprinkler System:
Sprinkler Required: No Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $163.34
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. Yo may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Ai
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.
Building Perm Applicati *l iyED
va. • a.
Fire Protection System JUL 17 2012 FOR OFFICE USE ONLY
City of Tigard INSMUINPFINI Permit ' el.) - eco3
° 13125 SW Hall Blvd., Tigard, OR OFTIGARD Plan Reviews ' ffi
C Phone: 503.718.2439 Fax: 50 C Date/B : `a ��� �� er Pe I e�
�l . ' 0012 Inspection Line: 503.639.4175 0 I � 1 �N� DIVISION Date Reach • v. la See Page 2 for
T I G A R D N otified A tethod: Supplemental Information
Internet: www.tigard- or.gov 1 — PP
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.
f=1 1- and 2- family dwelling ® Commercial /industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
•
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORILATION AND LOCATION Total number of floors:
Job site address: 10300 SW Greenburg Rd., Suite 300 • New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldgJapt. no.: 300 Project name: Jensen & Leiberan Covered porch area: square feet
Cross street/directions to job site: 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.
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 \PORK work indicated on this application.
Modify existing fire alarm circuitry and devices as required for Suite 300 TL Valuation: $$2,830.00
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/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax: : ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: Stoner Electric, Inc (Please refer ro fee schedule)
Permit fee:
Address: 1904 SE Ochoco Street
City/State/ZIP: Milwaukie, OR 97222 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 462 -5248 Fax: (503) 659 -2765 (Dne upon application.)
CCB lie.: 44823 Total permit fees:
Authorized signature: 4 .0
Amount received:
t This permit application expires if a permit is not obtained
Print name: Dave Litzenberg I Date: 7/16/2012 I within lair days after it bas been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board
l:tB ldirgP'ermitsffS- PennitApp.aoc Rev 01 /05!2017 - 440- 4613T(11 /O2ICOM/WEB)
City of Tigard: Fire Protection Permit Checklist cP.S�I a-' 0
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
❑ W \ ❑ Dry
Additional Standpipes
Information: 1- Iazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Mann
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 2,830.00
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B LR C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12"o of permit fee): $
FLS Plan Review (40 of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
O: \STS \_Accounts\Jensen & Leiberan \FA Permit App.doc Rev 01/05/2012 2
III ° Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description: k(A (A 6 A9I.7-0i
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: (,T Occupancy Group: .' Type of Construction: ZC
*Type of Use: Occupancy Load: Oregon Specialty Code: Ur)
SPECIFICS
Number of Stories: Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back _
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: CD Fire Alarms: YeS Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 2) 0 C ) I FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ 102.....) Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 2.. 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ 6.;c0 Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ ft ,3.4 - ToTiu. FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \ Building \Forms \OTC BUP.docx 07/01/2012