Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
N. COMMUNITY DEVELOPMENT
Permit#: FPS2015-00155
13125 SW Hall Blvd.,Tigard OR 97223 503 718 2439 Date Issued: 10/14/2015
TIGARD Parcel: 1S135AB01003
Jurisdiction: TIGARD
Site address: 10300 SW GREENBURG RD 380
Project: MasterCare Solutions Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Installation of fire alarm strobes and horn strobes for TI
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 10/14/2015 $77 99
12%State Surcharge-Building 10/14/2015 $9 36
Type of Use: COM Plan Review-Fire Life Safety-COM 10/14/2015 $31 20
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 10/14/2015 $8.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 10/14/2015 $0 50
11x17)
Hourly Building Rate 10/14/2015 $180.00
Commercial Sprinkler System: Hourly Building 12%State Surcharge 10/14/2015 $21 60
Sprinkler Required Sprinkler Type Misc Administration Fee 10/14/2015 $5 00
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 $333 65
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: f Permittee Signature:
.1:1 _44,0zix.a:
all 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.
N
P ilding Permit Application
' Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard Received �i/r Permit No /S_. )s—_
Eri I
13125 SW Hall Blvd.,Tigard,OR 97223 T Dan Re /
Phone 503 718.2439 Fax 503.598 19Q C 1 2015 Date/By `r, ,vi .1 Other Permit ezipga�ocwoo
TIGARD Inspection Line. 503.639 4175 Date Rea.• :y Juns 0 See Page 2 for
Internet• www.tigard-or gov CITY OF TIGARD Notified/Method (1i//1) (.5— (y Supplemental Information
BUILDING DIVISION d9 1?- c,x,llfid
TYPE OF WORK 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
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: S 1:3 I-and 2-family dwellin g ®Commercial/industrial
❑ Accessory building 1:1 Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10300 SW Greenburg Rd Tigard,OR(One Lincoln) New dwelling area: square feet
City/State/ZIP:97223 Garage/carport area: square feet
Suite/bldg./apt.no.:Ste 380 Project name:Mastercare 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 devices per plans Valuation: $S1,500.00
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 E 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 n` Total permit fees:
Authorized signature: S�/,t ^^/VA/v � � Amount received:
s This permit application expires if a permit is not obtained
Print name:Shane Tercek Date:9/25/15 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board
1\Bmldmg\Permits\FPS-PermitApp doe Rev 01/05/2012 440-4613T(t 1/02/CON1/VBB)
.l.M�
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
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
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: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
\\CI -vSBSl1\RedirectedFolders\Dan\FA Jobs\zzl51856-45 Mastercare 11Ancoln-300\1 FPS-PermitApp doe Rev 01/05/2012
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
10300 SW GREENBURG RD 380, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00155
Jeff Grove
Violation Summary:
Inspector Contractor