Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
3111 •�
Is COMMUNITY DEVELOPMENT Permit#: FPS2014-00050
Date Issued: 03/13/2014
TIGARD 13125 SW Hall Blvd.Tigard OR 97223 503.718 2439 Parcel: 1 S135A601002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 235
Project: Randstad Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinkler modification,adding(3)heads and relocating(3)heads
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 03/13/2014 $59.16
12%State Surcharge-Building 03/13/2014 $7 10
Type of Use: COM Plan Review-Fire Life Safety-COM 03/13/2014 $23.66
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 $89.92
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $740 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 s ions to-OUNC by calling 503.232.1987 or 1.800.332.2344
Issu d By: � 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 the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received
hr RECj Rt�"B�: S /3 /t/ ( ,s_ Permit No.: F 1y.ef�
Er
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /� n`n / ,j /
Phone: 503.639.4171 Fax: 503.598.1960 Date By: Other Permit: 11 tt0 y G 'T
Inspection Line: 503.639.4175 MAR 13 .,
TIGARD L Date Ready By: Juns: ® See Page 2 for
Internet: www.tigard-or.gov C� Notified Method: Supplemental Information
�O� .
TYPE OF WO REQUIRED DATA 1-AND 2-FAMILY DWELLING
❑New construction ❑ Demolition Permit fees*arc 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 -IA work indicated on this application.
' Valuation: $
❑ 1-and 2-family dwelling ®Commercial industrial
1:1 Accessory building ❑Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10220 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97233 Garage/carport area: square feet
Suite/bldg./apt.no 235 Project name:Randstad Suite 235 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
3 Lincoln Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: J 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.
Relocating(3)sprinkler heads and adding(3)heads Valuation: $740.00
Existing building area: square feet
NIcKinstry Job#71393 New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name:Randstad Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) I fax:1 1 New:
❑ APPLICANT ® CONTACT PERSON
NOTICE
Business name:McKinstry Company,LLC All contractors and subcontractors are required to be
Contact name:Antonija Krizanac licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:16790 NE Mason Street,Suite 100 jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97230 applicant is exempt from licensing,the following reasons
apply: _
Phone:(503)2783971 Fax: :(503)331.6907
E-mail antonijak'n mckinstrv.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:McKinstry Company,LLC (Please
nfi,rofecttbedut<t
Permit fee: 61. /CO
Address:Same as applicant — -
City/State/Z1P: State surcharge(12%of permit fee): 7. /C)
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application) .73•(de
CCB lie.:172811 Total permit fees: Zi• r�
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name:Antonija Krizanac Date: 3 (t i I(ii within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:•BuildingPe-mits FPS-PcrmitApp.doc 03/23/06 440-4613T(I 102 COM,WEB)
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 (21 1-10 heads: No plan review required.
® Alteration ❑ 11+heads: Plan review required.
❑ Repair
Number of sprinkler heads: 1
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 t✓;5v. I—
Density - 1 0
Design Area .mss cJ b
K.Factor S -
Sprinkler Project Valuation: $ c $r
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 Fcc:
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): $ 1-L A.0
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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Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 235, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler Final
2014-04-08 00:00:00
FPS2014-00050
PASS - No C of O
Violation Summary:
Inspector Contractor