Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11111 I COMMUNITY DEVELOPMENT Permit#: FPS2015-00029
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/25/2015
Parcel: 1S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 400
Project: Maxim Healthcare Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm modification of(12)devices.
Contractor: COCHRAN INC Owner: LINCOLN CENTER LLC
7550 SW TECH CENTER DR#220 BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97223 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO,CA 94104
PHONE: 503-234-6564 PHONE:
FAX: 503-238-2098
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/05/2015 $145.24
12%State Surcharge-Building 03/05/2015 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 03/05/2015 $58.10
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 03/05/2015 $10.00
Occupancy Grp: B Height: ft 11x17)
Stories: Hourly Building Rate 03/25/2015 $180.00
Hourly Building 12%State Surcharge 03/25/2015 $21.60
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 $432.37
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,982.00
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 Noti •• enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire, questions to•. C by calling 503.232.1987 or 1.800.332.2344.
Iss •d By: = Qp( Permittee Signature:
47 LA"f' -
`� 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 RECEIVED 1 Olt UhII( I. l tik: U\I 1
14 41 City of Tigard Date/I3 d : Permit No.: / ollejr 4:19,11
13125 n 850 Hall .2 39 Tigard,OR 972 pp p� 3 2015 Plan Revte � 64,12.10/5-_,0 D
Phone: 503.718.2439 Fax: 503.598.�J6d� Date/13 : r 1.75— Other Permit: /
ICiI� �
Inspection Line: 503.639.4175 Date Ready i : wr kris: la See Page 2 for
T I c.n tt n Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method::.;4 - 6—/ Supplemental Information
BUILDING DIVISION fox
TYPE OF WORK RE fi U •ED 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.
ID 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑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: 10220 SW Greenburg Rd. New dwelling area: square feet
City/State/ZIP:97223 Garage/carport area: square feet
Suite/bldg./apt.no.:400 Project name:Maxim Healthcare 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 strobes and horn strobes in remodeled suite Valuation: $$6,982.00
Existing building area: square feet
New building area: 4,982 square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Shorenstein Properties Type of construction: commercial
Address:555 California St. 49'h Floor Occupancy groups:
City/State/ZIP:San Francisco,CA 94104 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name:Cochran Inc All contractors and subcontractors are required to be
Contact name:Stephanie Swenson licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:7550 SW Tech Center Dr.Suite 220 jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:(971)205-4256 Fax: :(
E-mail:sswenson @cochraninc.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Cochran Inc.
Permit fee: 145.24
Address:7550 SW Tech Center Dr.,Suite 220
State surcharge(12%of permit fee): 17.43
City/State/ZIP:Tigard,OR 97223 FLS plan review(40%of permit fee):
Phone:(971)205-4242 Fax:(971)205-4268 (Due upon application submittal.) 58.10
CCB lie.:72942 Total permit fees: 220.77
signature:
/Authorized Amount received:
This permit application expires if a permit is not obtained
Print name:Clayton Koler Date:2/25/15
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building\Permits\FPS-PermitApp_071514.doc 440-4613T(I1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices: 12
® Addition or El 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
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
system
El 11+ heads: Plan review required and ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Li \Vet ❑ Dr`
Additional Standpipes
—
Information: Hazard Group
Density
Desi Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm ,', ' 4,i ,4w fr . of
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: I $ 6,982
'��"'�," ' t� 2vr't .`�Ft�,F�-3c�3rs�+F: °: ;_ T•'''ss,»#o'�+�' '` ._:� +'��,'J{P i�•'�2�4,..
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.
Fjp,P,rptection Permit Fees
Project valuation subtotal (see A,B &C above): $ 6,982
Permit fee based on project valuation (see fee schedule): $ 145.24
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $ 17.43
FLS Plan Review(40% of permit fee): $ 58.10
TOTAL: $ 220.77
http://www.tigard-or.gov/document_cen ter/Building/FPS_PermitApp.doc 2
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