Permit 1� y p CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 2 ; COMMUNITY DEVELOPMENT Permit#: FPS2015 00035
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/11/2015
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 720
Project: Ameriprise Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Relocate(1)fire sprinkler for TI
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 03/11/2015 $53.78
12%State Surcharge-Building 03/11/2015 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 03/11/2015 $21.51
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 03/11/2015 $0.50
Occupancy Grp: Height: ft 11x17)
Stories: Misc Administration Fee 03/11/2015 $0.50
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $82.74
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $600.00
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio, date.
This permit card shall be kept in a conspicuous place on the job site until co pleti•• of the project.
Approved plans are required on the job site at the time of each inspection.
FROM :MCKINSTRY FAX NO. :5033316906 Mar. 05 2015 02:30PM P12
Building Permit Apj catio>tlECEIVED
rt�ut>t1�I( L1 ,I ()NI �
Fire Protection System MAR 0 5 2015
City of Tigard
11CBcd 3�/S ��' Permit NojOSo�4/� 10��.5r
IN,..,-- a 13125 SW Hall Blvd.,Tigard,Uk 9�Y OFTIGARD Plan Rnvio Other Perm i( p ��W0.5�
I Phone: 503.7111.2439 Fax: 503,59 • Dete/tly: „,___
Inspection Lilo; 503.139.4175 BUILDING DIVISION 1)atc Ready/ kris: _ >a See page 2 for
I Y t;)I;I) Notified/Method: 776,-- Supplements!htfo
rmation
Int ernet:
www-tigard-or.gov
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New construction ❑Demolition ,. indicate the value(rounded to du;nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
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ID 1.and 2-(family dwelling 1E Commercial/industrial
.. - Number of bedrooms:
Accessory building C]Multifamily
Number of bathrooms:
❑Master buckler (]Other: -
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New dwelling arch; square feet
Job site address:10260 SW Grecnburg Road
Garage/carport area: square feet
City/state/GIP:Tigard,OR 97223 .- .
Suite/bldg./apt-no.:720 [-Project name:Ameriprise Suite 720 Covered porch area: square feet
Cross street/directions area: square feet
directions to job site: -._ .
'•• Other structure area: square Feet
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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.: equipment,materials,labor,overhead,and the profit for the
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l{nh !. t,r t.,Yrrwr.•r Valuation; $5600.00
Relocate 1 sprinkler head - -
Existing building area: 1902 square feet
,
"— : Now building area: 1902 square feet
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._ .,. •.-
Name:Shoruistein Properties LLC Type of construction: _ M
Address:235 Montgomery Street,16*Floor — Occupancy groups
City/5tate/7.TP;San Francisco,CA 94104
Existing:
Phone:(415)772-7000 Fax ( ) New:
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Business name:McTCinstry Co.
All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Coutadt.name:Antonija ICrizanac - ,, under ORS 701 and may be required to be licensed in the
Address:16790 NF.Mason Street,Suite 100 jurisdiction in which work is being performed.Tf the
.. applicant is exempt from licensing,the following reasons
City/State/7TP:Portland,OR 97230 ,. ._ ,_ .„_ apply: .. - - .
Phone:(503)331-0234 Fax::(503)331-6906
E-mail:antonijak@mckinstry.com
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Business name:McKinstry Co. „__ Permit fee:
Address:16790 NE„Mason Street,Suite 100 State surcharge(12%of permit fee): -
^City/State/Z1P:Portland,OR 9'/230 FLS plan review(40%of permit Iee): W
.m,
Phone:(503)331-0234 1 Pax:(503)331-6906 __ (pus upon application submittal.) ,.,
•- —, Total permit tees:
CCB lie.;172811 -- -•-
” Amount received; •
Authorized signature: f/'— This permit appiicatinu expires if a permit Is not obtained
”` within 180 days after it hat:been accepted am complete.
•
Print name: p p�.ei C Date: * pee methodology set by Tri-county Building Industry
w.__. - ►�•�.
Service Board.
1:13tnldiny\Teri I FI's-eermitApp_071514.due 441-451.4 L(II/02/C'OM/W1113)
FROM :MCKINSTRY FAX NO. :5033316906 Mar. 05 2015 02:30PM P13
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
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1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
El New system Number of sprinkler heads: 1 Number of alarm devices:
1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
❑ Addition or ® q
Alteration (3)copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
systetxi.
❑ 11+heads: Plan review required and ❑(6 sets of devices: Plan review required and
(3)sets of plans.
Additional description of work:
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® Wet .- ❑_Dry _ ._
Additional Standpipes _ _
Information: Hazard Group Light ,. .
Density .10
Design Area 150() . .
K.Factor 5.6
Sprinkler Project Valuation: I $ 600
.
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Wood Project Valuation:tty, $
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,1!Ir, ,t•.,a,';2tl Submittal i ° .1rllu.,3*:;1...III),1„ t,lti6n''nerl',,,,:,
shall 13attcty Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets ,•
-,•:,{.,-,'.. Fire Alarm
Project 1 t Ir iVi a. l 1A!u a r t i o nr : L$
- -^R,. g}' ',4,•'$477.04$;71772$1;$.,r�-t,r 41 r /„ { � 4 ,,y. rilr„)1',/,' •;1' yr o
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H. ,{1 , , $ ,; P .'( .{ . 1 .r a .V,rI,,,�.. r e 1, { H,r ,..�, {� F I 1 r{ , ' ! A',,. ,t. 4 ,4 ,lf'/ r n ,; r$,, 1�� 1 ytt,, {
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uarc.Footage Permit FCC: l r , 1 4 i 'ii; na i A �`7r +r Npi 1 P
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"
.._ 198.75 . r , 1 l y P, 4 i , 0 h
1 i i t{. rr I, I 1 ld.`{; ly 1 1t
0 to 21000 ~ iT` 4,44 �),,I ; l l./(f , rl( 1 ti f, u
2,001 to 3,bU0 $246.45 1 ,, i< r'0 r 11t!! �{7 ,i+ d eii� �. '
_ _ ,,+}r r+,l'rx ,ri , rtr Ec, i '4 >t'L14.ni ,i.r � d, .
3 601 to 7,200 $310,05 f!1 , . $s{ ( l #4,1 44 } i 4 0M )',01.'10,''',4;+ r '
rt ; , f rNr, I 1 q,q I, r y,t
.
7,201 and greater $043_9 ;:!r, t :r ,:.a { r V{,t :tfJS 117{`: tt 4 d L{., h
Sprinkler Project Square Footage: sq. ft.
- •'$"$'' , :1, ,,r.n,'r;w "F ,f, i,,,I,r { 0 ;;I ,',7 ryr'lr 70 1 .M.1r'i
rgn,•,-,r,,p..i , 1., gilq,,t. i.I.v r ,r+'yr1r, a 1, t!+„.,is l.. f !t. j $ 1al'r! ' ;' tf)rf..,
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Project valuation subtotal(see A,B&C above): $
Permit fee based on project valuation(see fee.schedule): $
Permit fee based on square footage (see L)a.bove)_ $
" State Surcharge(12%of permit fee): $ -
FT Plan Review(40f/o of permit fee): $
TOTAL: $
R/;\1'rn cn\N-R\Rume{t Conetnictic+n\101704 Atneriptisc Ste 720 T,;ncttln Twt\1Ali Costnictittn\Pcnttits\I PS-PerrnitA17p.doe
FROM :MCKINSTRY FAX NO. :5033316906 Mar. 05 2015 03:40PM P1
RECEIVE!)
F3!.25 ty of Tigard MAR 0 5 2015 PermitNo.: �iqsa4/-5_ 040
hone S50 F,71 ,2439 Tiger:, 03181 OF TIGARD MY
Phone: 5o3.71R,2a39 Fax: so3. A Date Received: 3 /�
In�cet: Line: 503.639.4175- rgov BUILDING DIVISION �--..
Internet: www.tigerd�r.gnv By'
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: AlI en.Ovc? i SIB /),D Occupancy:
Job Address: 1()4).Lv n SvJ k e e7)Icn V GL Type of Construction:
Suite: 17
Contractor: LAcGns f a . Phone: SO 2> -- ?31 T al LI
Number of Proposed or Altered Heads: 1
Type: .V i T ' Hazard: (t/1 lc Density: ,
I, f'ftl v,,( i- 14,in t vw-c-» Oregon Construction Contractors Board No. t-1 7-.t>1 I,
certify the follwing is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
h) Positions of sprinkler heads relative to architectural features such as soffits,beams,partitions,walls, etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop(exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads(see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
In addition,I understand the following is required:
• Submit(3)copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• A copy of this document with a copy of the sketch attached shall he available for all inspections.
Signature: - . Date: . 1SiiS -
•
Print Name: A v t I'1 v-I�2yr.:c_—�
l:\Suild ng\FnnndFireSprinkterA ndevit_071514.dncx Pngc I of 1
FROM :MCK I NSTRY FAX NO. :5033316906 Mar. 05 2015 REtEtVEJ)
g� �� MAR 0 5 2015
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