Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11111 1 COMMUNITY DEVELOPMENT Permit#: FPS2015-00098
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/23/2015
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 305
Project: Matrix Absence Management Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Installing(2)strobes and(3)horn strobes. Affidavit submitted.
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND,OR 97220 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/23/2015 $77.99
12%State Surcharge-Building 06/23/2015 $9.36
Type of Use: COM Plan Review-Fire Lite Safety-COM 06/23/2015 $31.20
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 06/23/2015 $0.50
Occupancy Grp: Height: ft 11x17)
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 Reg:
Battery Calcs Provided: Cut Sheets Required:
Total $119.05
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,500.00
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: ermittee Signature:
Call 503. . 5 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
Received
City of Tigard Permit No Air 15^ �-dp.13125 S W Hall Blvd.,Tigard,OR 9722 Plan Review: i 5 J�
_ g ECEIVE� Plan Review
Phone: 503.718.2439 Fax: 503.598.1 / Date/B : Other Permit: g /e 9` Si
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: r% See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplementallnformation
k 8 015
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑ I)emolitir Permit fees*are based on the value of the work performed.
11VU pn''(.IA Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: i r equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
❑ 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 Tigard,OR(3 Lincoln) New dwelling area: square feet
City/State/ZIP:97223 Garage/carport area: square feet
Suite/bldg./apt.no.:Ste 305 Project name:Matrix Absence 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Install(2)Strobes&(3)Horn/strobes per submitted plans Valuation: $$1,500.00
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:
Address:11401 NE Marx Street
City/State/ZIP:Portland,OR 97220 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(530)255-9488 Fax:(503)255-1966 (Due upon application.) _
CCB lie.:48748 1� Total permit fees: 1�9
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name:Dan Wilson Date:6/18/2015 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
t�Buitding\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(11/02/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 ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
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
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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: $ 1500.00
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): $ 1500.00
Permit fee based on project valuation (see fee schedule): $ 77.99
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 9.36
FLS Plan Review(40% of permit fee): $ 31.20
TOTAL: $ 135.54
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
\\CE-VSBS11\RedirectedFolders\Dan\FA Jobs\zz151177-45 Matrix(4)3Lincoln-305\ FPS-PermitApp.doc Rev 01/05/2012
If
City of Tigard Permit No.: /47 ,tea 5/ t
IPII
• 13125 SW ,Tigard,OR 2
Q Phone: 503.7182439 Hall Blvd. Fax: 503.598.1960 9723 Date Received: , 4,////
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Inspection Line: 503.639.4175
!'?c AKD Internet: www,ti d-or. ov J 1 B
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FIRE ALARM SYST .AFFIDAVIT FOR ALTERATIONS
L T
OR T1 IMPROVEMENTS
(M44 U, fOF 5 DEKCES WITHOUT'PLANS) .
Project Name: Matrix Absence Occupancy: Group B .
Job Address: 10220 SW Greenburg Rd. Suite: 305
Contractor: Capitol Electric Co., Inc. Phone: 971-506-3072
Valuation of work: $1500
Type of System: (check one) ❑Required [Non-required
(check one) ❑Automatic Manual 0 Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max 5) /To be Relocated(man 5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max5) 5 /To be Relocated(max 5)
1, Dan Wilson Oregon Construction Contractors Board No. 48748
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
0 Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
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.
• Electrical permit.
• A copy of tis document with a copy of the sketch attached shall be available for all inspections.
Signature: Date: 6/23/15
Print Name: Dan Wilson
I:\BuilduigWorms\FireAlarmAffidavit_071514.docx Page I of I
Capitol
Electric Co•, Inc.
RECEIVED
JUN
June 18, 2015 18 2015
CI TV oF TIGABD
BUILDING DIVISION
Plans Examiner
City of Tigard
Building Services
13125 SW Hall Blvd.
Tigard, OR 97223
Re: Tenant Fire Alarm System Additions
Absence Matrix, Suite 305 @ 3Lincoln Tower
10220 SW Greenburg Road
Tigard, OR 97223
Please find attached building and electrical permit applications, three sets of plans,
calculations, and product submittals for the fire alarm tenant improvements at the address
shown above.
Occupancy Group: B
The fire alarm system alteration includes the following:
1. Install ADA synchronized fire alarm notification devices in the tenant space
including (2) strobes & (3) horn/strobes.
2. We will pre-test the fire alarm devices prior to requesting a final fire alarm
inspection.
3. Fire alarm design by Simplex-Grinnell, installation by Capitol Electric Co.
Please contact me if you have questions or comments.
Respectfully,
Dan Wilson, SET
Project Manager/Estimator
Fire/Life Safety Division
Capitol Electric Company, Inc.
(503) 262-0411 Direct
dan @cepdx.com
NICET Level IV, Fire Alarm Systems #104512
11401 NE Marx • Portland, Oregon 97220-1041 • 503-255-9488 • Fax 503-257-7121
CCB# 48748 • www.capitolelectricco.com
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
10220 SW GREENBURG RD 305, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00098
Chip Barnett
Violation Summary:
Inspector Contractor