Permit •� CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11111 ' COMMUNITY DEVELOPMENT Permit#: FPS2015-00068
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/29/2015
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 417
Project: Cypress Semiconductor Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Clean agent suppression system.
Contractor: NORTHWEST FIRE SUPPRESSION INC Owner: LINCOLN CENTER LLC
1800 NW 169TH PL, STE C600 BY SHORENSTEIN PROPERTIES LLC
BEAVERTON, OR 97006 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-644-7720 PHONE:
FAX: 503-644-8289
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/29/2015 $177.52
12%State Surcharge-Building 04/29/2015 $21.30
Type of Use: COM Plan Review-Fire Life Safety-COM 04/29/2015 $71.01
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 04/29/2015 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/29/2015 $20.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Unknown
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 $293.83
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $10,000.00
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 othe
applicable law. All work will be done in accordance with approved plans. This permit wi - e if work is not started within 180 day/f
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requir; you to ,low the rules adopted •• the •"gon
Utility N• -: - enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-401-0090. •u may obtain a ••• of t•- rules
or•• -ct questions to O► C by calling 503.232.1987 or 1.800.332.2344.
Issued By: , 4/ , Permittee Sig ure: —�
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 ED FOR OFFICE USE ONLY
City of TigardECEIv DateBea Jrl.) Permit No.: l3
13125 SW Hall Blvd.,Tigard,OR 9 Plan Review C I t _ 4
I e. Phone: 503.718.2439 Fax: 503.598.1960 PR 1% 2015 Date/B : �I �� Other POfmit: I _ /420/�/,I
T I G A R D Inspection Line: 503.639.4175 A Date Ready :y: tuna: ® See Page 2 for
Internet: www.tigard-or.gov O,F TIGARD Notified/Method: �,�/ WC Supplemental Information
CITY SIGN 0 I t L4
TYPE OF REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
X Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling Commercial/industrial Valuation: $ f O
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
OB SffE IN ORMAT AND LOCATION Total number of floors:
Job site address: M # i ( 17 New dwelling area: square feet
/ V
City/State/ZIP: r7( AO- P k_ Garage/carport area: square feet
Suite/bldg./apt.no.: At t 7 Project name: Li, '('PRE-'f Soi((�„�x./�,r ._ Covered porch area: square feet
Cross street/directions to job site: 1+y°'""�JIf Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.
LC 0 66-E- lr S/'tPtg��ld�, Valuation: $
c/5 ill L/ Existing building area square feet
—
f 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: WCj 4L.4fji F her . orr 5 Ye./ All contractors and subcontractors are required to be
Contact name: T A,j LG {-- licensed with the Oregon Construction Contractors Board
� under ORS 701 and may be required to be licensed in the
C6 Address: ( 0 0 l.j (Al (6,alfrif 5 lJ/7-&-- 6 0 0 jurisdiction in which work is being performed.If the
City/State/ZIP: D E 14 V c/Qro RJ 6/z ( 7c90-6, applicant is exempt from licensing,the following reasons
apply:
Phone:( )533--4414_7-lac, Fax::( ) 6 LI q_fa 6-r
E-mail: ( c \ (0e_ @ ' w l { `- c c
M CONTRACTOR BUILDING PERMIT FEES*
Business name: S pi- t 'l - 4L3 V -------- (Please refer to fee schedule,
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.:(pc6 Total permit fees:
Authorized signani c Amount received:
This permit application expires if a permit is not obtained
Print name: 0 pc /v Lojl) Date. %J_ /3 -- '-- within 180 days after it has been accepted as complete.
`' * Fee methodology set by Tri-County Building Industry
Service Board.
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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:
❑ Addition or ❑ 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
❑ 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
❑ Wet Dry Qt LE LT
Additional Standpipes
Information: Hazard Group
Density
Design Area
K Factor
Sprinkler Project Valuation: I $
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: I $
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 &C above): $
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: $
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