Permit n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' COMMUNITY DEVELOPMENT Permit#: FPS2015-00110
Tigard OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 07/20/2015
TIGARD 9
Parcel: 1 S 135A603400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 900
Project: Guild Mortgage Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Adding(1)sprinkler head. Affidavit submitted.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-331-0234 PHONE:
FAX: 503-331-6907
FEES
Description Date Amount
Specifics:, Permit Fee-COM 07/20/2015 $64.54
12%State Surcharge-Building 07/20/2015 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 07/20/2015 $25.82
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 07/20/2015 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 0 Design Area: 250
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 $98.60
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $940.00
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: -
alC l 503.639.4175 by 7:00 a.m.for the next available inspection ate.
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 �D FOR OFFICE USE ONLI
Received
City of Tigard Q G5\1 D:riv : 7 _=� Permit No.. _• o_ s •
:1 13125 SW Hall Blvd.,Tigard,OR 9p2Ya G plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 el Q 201`l Date/By: Other Permit:/3/„Age i 5-7_00
t 7
T I G A R D Inspection Line: 503.639.4175 .U Rp Date Ready/By: June See Page 2 for
Internet: www.tigard-or.gov OG 110 c;n‘•.A Notified/Method: ' Supplemental Information
11 /
` {
TYPE OF1 '" 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
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
u d''°` V ,Y f 4 t _ '. r E work indicated on this application.
❑ 1-and 2-family dwelling I/ ommercial/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:10260 Greenburg Road New dwelling area: square feet
-
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:900 Project name:Guild Mortgage Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMIIIERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel nn.: 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.
1 Valuation: $
A(� , `�I,n,n1�AQy VcQcxlY�
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Shorenstein Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name_McKinstry Co. All contractors and subcontractors are required to be
Contact name:Rebecca Fitzsimmons licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 16790 NE Mason Street,Suite 100 jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97230 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)331-0234 Fax::(503)331-6906
E-mail:rebeccaf @mckinstrv.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:McKinstry Co.
Permit fee:
Address: 16790 NE Mason Street,Suite 100
City/State/ZIP:Portland,OR 97230 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)331-0234 Fax:(503)331-6906 (Due upon application submittal)
CCB lie.: 172811 Total permit fees: iltir (00
Authorized signature•
Amount received:
This permit application expires if a permit is not obtained
Print name:Rebecca Fitzsimmons Date:`? cos— - within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\FPS-PennitApp_071514.doe 440.4613T(I 1/02/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: 1 Number of alarm devices:
M. 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
0 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
51 Wet ❑ Dry
Additional Standpipes
Information: Hazard Group LS k,ti-
Density
Design Area -
K. Factor .41
Sprinkler Project Valuation: $ g 1O
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: _ $
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 C12% of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $
I:\Building\Pe:mits\FPS_PermitApp_071514.doc 2
RECEIVED
City of Tigard 2 O 2 015
11,1 • Permit No.: F/Cj,, j 1s—(IOI 10
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 II IL Date Received: 7 iD t S
Inspection Line:g503.639.4175 CIN OF-�'GARD
r 1 G A t;l? Internet: www.tigard-or.gov
BUILDING DNISIONBy' raAAW ,70'
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: e7 u; j. etcv1-c\04je- Occupancy:
Job Address: /0)40 ) C-Yoe4,.vs Type of Construction:
Suite: 9D0
Contractor: c_Vtyt-t Phone: 7 c()- 410 d
Number of Proposed or Altered Heads: I
Type: 56 vdeu-A Hazard: 1-c, 4 Density:
I, .12450-4.4-r.--. tik-z vtitAvvvcv.S Oregon Construction Contractors Board No. /
certify the following 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.
b) 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 be available for all inspections.
Signature: . Date: 1/ 7 / is
Print Name: IlececCc`
I:1Building\Forms\FireSprinklerAflidavit_071514.docx Page 1 of 1