Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
. COMMUNITY DEVELOPMENT Permit#: FPS2015 00142
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/24/2015
T1�'i,°LRD Parcel: 1S135AB01002
Jurisdiction: TIGARD
Site address: 10220 SW GREENBURG RD 551
Project: Apex Systems Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Relocating(5)fire alarm strobes.
Contractor: SAFE TECHNOLOGY GROUP INC Owner: LINCOLN CENTER LLC
6400 NE HWY 99 STE G375 BY SHORENSTEIN PROPERTIES LLC
VANCOUVER,WA 98665 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 360-699-2130 PHONE:
FAX: 360-719-1527
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/18/2015 $51.09
12%State Surcharge-Building 09/18/2015 $6.13
Type of Use: COM Plan Review-Fire Life Safety-MF 09/18/2015 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 09/18/2015 $2.00
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: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $79.66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $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: . Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection te.
This permit card shall be kept in a conspicuous place on the job site until pompletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System • FOI„.oFFICE.USE ONLY .
•
City of Tigard Date/By:Received
q/4 ( /T F405420 tr"
4S420tr" [c(4C
„ 7 Permit No.:
74
13125 SW Hall Blvd.,Tigard,OR 97223 Review
Phone: 503.718.2439 Fax: 503.598.196 CEI Date/By: Other Permit: do. „?..30
T 1G`AR'D Inspection Line: 503.639.4175 Date Ready/By: q Juri` 0.1pgiot
ee Page 2 for tJ�
• • Internet: www.tigard-or.gov �� 2 15 Notified/Method:/f ile�b+�"" -ra.-4. Information
TYPE OF WORK [�V OF rrD� ' REQUIRED DATA:1-AND 2-FAMILY DWELLING
L �p� G �V1SIC" Permit fees*are based on the value of the work performed.
❑New construction
❑ 9V'Jl& Indicate the value(rounded to the nearest dollar)of all
lin Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
0 1-and 2-family dwelling I: Commercial/industrial
Valuation: $
Number of bedrooms:
❑Accessory building ❑Multi-family
0 Master builder 0 Other: Number of bathrooms:
. . JOB SITE INFORMATION AND.LOCATION Total number of floors:
Job site address: 10 a,g.0 ca 6 eelrl bur PRh New dwelling area: square feet
City/State/ZIP: Ti6-)Arn OP— Ct9 a/3Garage/carport area: square feet
Suite/bldg./apt.no.: 5S-i Project name: APE X �l s�Crs Covered porch area square feet
Cross street/directions to job site: L i nC o L n 3 r 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.
1zetC� '�•� c Fi re- Marin S-Cro� es-
aluation: $ 00
ems
Existing building area square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT - ❑.CONTACT PERSON• •
NOTICE'
Business name: 5 ic.,Fe_ Te.,tn.n O t c J EiCo u p J J . All contractors and subcontractors are required to be
Contact name: 75 C9a �� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6 I,/co WE Hoy, R q 50 j.#e. 6 3 7 5 jurisdiction in which work is being performed.If the
City/State/ZIP: y�C e U Ver ' 4 4 g &(06' applicantppis exempt from licensing,the following reasons
j //!Y r� p-� o G /�
apply:
Phone:(3(p0 Ill -"i ....a`2)0 Fax: :(3406 ' 1 I t y ` !J A
E-mail: ,_ "0(,1 2.5 .ca Fe `OChno lG'JIyi A/ &
CONTRACTOR ✓ V BUILDING PERMIT FEES*
t (Please refer to fee sclsedule)
Business name: 5 Af to �'Qcv,0,,(vd vitt,u p ,A!,
Address: 60 LI 00 t o H lug y o f„�e e75- Permit fee:
dp State surcharge(12%of permit fee):
City/State/ZIP: VO(\CoUv-er Ivo- 1 0 (ea
/ ,�y FLS plan review(40%ofpermit fee):
Phone:(34, (Q Qa—2-1 30 Fax: 66i 17/y r�,.• ”/ (Due upon application submittal.)
CCB lie.: % ri 3 9 31 / Total permit fees: 179. 64
Authorized signature: .... 2's9' Amount received:
This permit application expires if a permit is not obtained
Print name: �p� �� Date: Q' within 180 days after it has been accepted as complete.
�J CC.. 00 �.—
S * Fee methodology set by Tri-County Buildin Industry
Service Board. it,i
I\BuildingWermits\FPS-PermitApp_071514 doc 440-4613T(11/02/COM/WEB)
6 / 3
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
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: $
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: $
L\Building\Permits\FPS_PermitApp_071514.doc 2
City of Tigard E C E 1 D Permit No.: FP-520/6 — j►�Z
n 13125 SW Hall Blvd.,Tigard,OR 972 3
' _;. Phone: 503.718.2439 Fax: 503.598.1960 Date Received: q/7/15—
TIGARD Inspection Line: 503.639.4175 SEP 9 2015
Internet: www.tigard-or.gov By: er74 / s n) (rq, q,y —
CITY OF TIGARD KJ
FIRE ALAR tiqX AVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS OFFICE COpy
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: APEX Occupancy: B
Job Address: 10220 SW GREENBURG Suite: 501-551
Contractor: SAFE TECHNOLOGY GROUP INC., Phone: 360-699-2130
Valuation of work: $1600.00
Type of System: (check one) ®Required [Non-required
(check one) nAutomatic ®Manual nBoth
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(max 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) /To be Relocated(max 5) 5
I, JASON SWEET Oregon Construction Contractors Board No. 173731
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.
f) 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 this document with a copy of the sketch attached shall be available for all inspections.
Signature: IGV7r Date: 9/4/15
Print Name: JASON SWEET
I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1