Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
8COMMUNITY DEVELOPMENT Permit#: FPS2015-00193
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/08/2015
TIGARD Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 550
Project: KPD Insurance Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Adding(2)and relocating(2)sprinkler heads. Affidavit submitted.
Contractor: PACIFIC FIRE SYSTEMS LLC Owner: LINCOLN CENTER LLC
6704 RIVERIA CT BY SHORENSTEIN PROPERTIES LLC
WEST LINN, OR 97068 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-710-6646 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/08/2015 $59.16
12%State Surcharge-Building 12/08/2015 $7.10
Type of Use: COM Plan Review-Fire Life Safety-COM 12/08/2015 $23.66
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/08/2015 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .10 Design Area. 0
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 $90.42
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $780.00
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 N. • . . . -nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir questions to • NC by -fling 503.232.1987 or 1.800.332.2344.
Is- ed By: // 4 / Permittee Signature:
y
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 roR orrlc 1: 1 Sr ON I.1
City of Tigard Received _
g �`�� DateBy: I/1 7 i Permit No.: pS ?
. a 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review r �`S_U)3O
Phone: 503.7182439 Fax: 503.59 1� Date/By: Other Permit: P;10!s-Cx.)3 J p
T I G A iZ D Inspection Line: 503.639.4175 Q �0 Date Ready/By: .runs: ® See Page 2 for a
Internet: www.tigard-or.gov �`C D QQNotified/Method: Supplemental Information
TYPE OF WO `A`GO v^ REQUIRED DATA:1-AND 2-FAMILY DWELLING
Permit fees*are based on the value of the work performed.
0 New construction �on
Indicate the value(rotnded to the nearest dollar)of all
( 4ddition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
0 1-and 2-family dwelling 0.Commercial/industrial
CIAccessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /O p 51,J 6n-e<.-t t9<e2-42 '-1 New dwelling area: square feet
Cit /State/ZIP: 40.14-4 7y 1722_3 Garage/carport area: square feet
gi'.ldg./apt.no.: 55c) Project name: X00tels„ts-c, C t 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.
/fold ,2 iketd Valuation: $ e'_
�- /�Ioc Zfp s -7.�
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 0 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*
Business name: act �� �� 5 (r✓��S (Please refer to fee schedule)
Address: 6 7 U If. /et'„t.-c ` Permit fee:
< State surcharge(12%of permit fee):
City/State/ZIP: .L) -7' Z_iv,// /O� tai 70 e8'
FLS plan review(40%ofpermit fee):
Phone:(03) 7/0—,4 6 Cf' Fax:( ) (Due upon application submittal.)
CCB lic.: / d /5/ Total permit fees: �/
Authorized signature: / � Amount received: ?a '[ 2'
This permit application expires if a permit is not obtained
Print name: ;���T �Z,P Date:Lt....48.� * within 180 days after it has been accepted as complete.
Fee methodology set by Tri-County Building Industry
Service Board
I:\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(11/02/COM/WEB)
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 550, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2015-00193
Jeff Grove
Violation Summary:
Inspector Contractor