Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11111
_ - COMMUNITY DEVELOPMENT Permit#: FPS2015-00008
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2015
Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 740
Project: Pollmeier Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm for TI
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/27/2015 $102.20
12%State Surcharge-Building 01/27/2015 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 01/27/2015 $40.88
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 01/27/2015 $10.00
Occupancy Grp: B Height: ft 11x17)
Stories: 7 Info Process/Archiving-Sm$0.50(up to 01/27/2015 $5.00
11x17)
Misc Administration Fee 01/27/2015 $5.00
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: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $175.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,100.00
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 questions to OUNC by calli g 503.232.1987 or 1.800.332.2344.
Issued By: ( Permittee Signature: �� 10 4/ -/e //
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 RECEIVE
Fire Protection System FOR OFFICE USE ONLY
Received ��801 5---co City of Tigard JAN Receiv3� l��/� Permit No.: !7
• 13125 SW Hall Blvd.,Tigard,OR 97223 2 0 205 Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.196 IfTv Date/By: A 'V/ ( ( > a pao/ (9 3
TI G A R D Inspection Line: 503.639.4175 ((,,1 II OF TIGARD Date Ready :y luris: 55 See Page 2 for
Internet: www.tigard-or.gov BUILDING p Notified/Method. Supplemental Information
'VISION
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
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $
111 Accessory building ❑Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10200 SW Greenburg Rd Tigard,OR(5-Lincoln) New dwelling area: square feet
1
City/State/ZIP:97223 Garage/carport area: square feet
Suite/bldgiapt.no.:Ste 740 Project name:Pollmeier T.I. 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 WORK work indicated on this application.
Install fire alarm devices per plans Valuation: $2,100.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Shorenstein Realty Services 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:( ) Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Capitol Electric Company,Inc.
Permit fee: 102.20
Address: 11401 NE Marx Street
City/State/ZIP:Portland,OR 97220 State surcharge(12%of permit fee): 12.26
FLS plan review(40%of permit fee): 40.88
Phone: 255-9488 Fax:(503)255-1966 (Due upon application)
CCB Ii 748 Total permit fees: 155.34
Authorized signature:
C )-71.//-\..____■:"--- Amount received:
This permit application expires if a permit is not obtained
Print name:Dan Wilson Date: 1/19/2015 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp.doe Rev 01/05/2012 440.4013T(11/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10200 SW GREENBURG RD 740, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00008
Jeff Grove
Violation Summary:
Inspector Contractor