Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• COMMUNITY DEVELOPMENT Permit#: FPS2015-00157
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/21/2015
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 710
Project: Axiom EPM Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinkler: adding(12)heads&relocating(66)heads.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-331-0234 PHONE:
FAX: 503-331-6907
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/21/2015 $177.52
12%State Surcharge-Building 10/21/2015 $21.30
Type of Use: COM Plan Review-Fire Life Safety-COM 10/21/2015 $71.01
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Sm$0.50(up to 10/21/2015 $0.50
Occupancy Grp: B Height: ft 11x17)
Stories: 12
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 Design Area: 1500
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 $270.33
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 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
issua•• , • • k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U ity Notification Ce : . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
•r direct questions to OUN► by c. ing 03.232.1987 or 1.800.332.2344.
Issued By: //. / / Permittee Signature:
•
./ me—CM ca.,/
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 �j1 FOR OFFICE ISE()NIA
City of Tigard CYAN,l)11JJ, Date Received e i PennitNo.: `/ As _ -
- ° 13125 SW Hall Blvd.,Tigard,OR 97a Plan Revie MUM Phone: 503.718.2439 Fax: 503.598.1960 Date/B : �I: Other Permit: ,/
Inspection Line: 503.639.41 75 ' 1 L Date Ready/By: ® See Page 2 for
T I G A R D OI Notified/Method: 0 S(S E Supplemental Info
rmation Internet: www.tigard-or.gov
TYPE OF % ON riAl %O�' REQUIRED DATA I-AND 2-FAMILY DWELLING
�jr. Permit fees*are based on the value of the work performed.
❑New construction �biiticn
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.
El 1-and 2-family dwelling ®Commercial/industrial Valuation: $
1:3 Accessory building El 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: 10260 SW Greenburg Rd. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:710 Project name:Axiom Suite 710,Lincoln 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.
Adding(12),relocating(66) Valuation: $$10,000.00
�?r.'nik4r heil{.s
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER CI TENANT Number of stories:
Name:Axiom Type of construction:
Address:same 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:Tria Day 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)278.3917 Fax::( )
E-mail:triad @mckinstry.com
CONTRACTOR f; ,I P I:i 1 Ht
Business name:McKinstry Co. Permit fee:
Address:same
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.: 172811 Total permit fees:
Authorized signature: s7 , Amount received:
/ This permit application expires if a permit is not obtained
Print name:Tria Day Date: 10/6/15 * within 180 days after it has been accepted as complete.
Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(11/02/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: 78 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
Z 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
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor s, (.
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: $
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: $
W:\Projects\N-R\Russell Construction\104385 Axiom Suite 710,Lincoln Tower\001 M2chanical Construction\Permits\FS\FPS-PermitApp.doc
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
10260 SW GREENBURG RD 710, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2015-00157
Jeff Grove
Violation Summary:
Inspector Contractor