Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2015-00199
Date Issued: 12/22/2015
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 550
Project: KPD Insurance Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm for TI:7 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 12/22/2015 $134.48
12%State Surcharge-Building 12/22/2015 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 12/22/2015 $53.79
Class of Work: ALT Type of Const: IB Hourly Building Rate 12/22/2015 $180.00
Occupancy Grp: B Height: ft Hourly Building 12%State Surcharge 12/22/2015 $21.60
Stories: 12 Info Process/Archiving-Lg$2.00(over 12/22/2015 $8.00
11x17)
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: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $414.01
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,230.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Stale 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 Notificati Gen r. 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 stions to OUN 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 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
City of Tigard "ei
�� /(o !5
Permit No.:
a 13125 SW Hall Blvd.,Tigard,ORd Plan Revie
Phone: 503.718.2439 Fax: 503.5 8.1960 1� Date/By: / ZZ they Permit:ffi4y�(S
Inspection Line: 503.639.4175 ((' DateReady loris: See Page 2 for
Internet: www.fgard-or.gov O�ha H Notified/Method: Supplemental Information
TYPE OF REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 'L Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwellingValuation: $
Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JO SITE INFORMATION AND LOCATION Total number of floors:
Job site address: GREENBURG RD New dwelling area: square feet
City/State/ZIP:TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg./apt.noa500-9={O�tekA Project name: ikPD Insurance ,1w' Covered porch area: square feet
Cross street/directions to job site:LINCOLN TOWER ® 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.
FIRE ALARM add 7 strobes Valuation: $5230.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: B
Phone:( ) Fax:( )
New: B
® APPLICANT I ❑ CONTACT PERSON
NOTICE
Business name:SAFE TECHNOLOGY GROUP INC. All contractors and subcontractors are required to be
Contact name:JASON SWEET licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:6400 NE HWY 99 STE G375 jurisdiction in which work is being performed.If the
City/State/ZIP:VANCOUVER WA 98665 applicant is exempt from licensing,the following reasons
apply:
Phone:(360)699-2130 Fax::(360)719-1527
E-mail:SALES@SAFETECHNOLOGY.NET
CONTRACTOR BUILDING PERMIT FEES*
Business name:SAFE TECHNOLOGY GROUP INC Please refer to fee schedule
Permit fee:
Address:6400 NE HWY 99 STE G375
City/State/ZIP:VANCOUVER WA 98665 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(360)699-2130 Fax:(3.60)719-1527 (Due upon application submittal.
CCB lic.:173731 Total permit fees:
Amount received:
Authorized signature: �' This permit application expires if a permit is not obtained
Print name:JASON S T Date:12/16/2015 within 180 days after it has been accepted as complete.
- Fee methodology set by Tri-County Building Industry
Service Board.
I:kBuilding\Pe its\FPS-PermitApp-071514.doc 4404613T(11/07/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: 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 BattCalculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 5230
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 onsquare footage see D above): $
State Surcharge 12%of permit fee): $
FLS Plan Review 40%of permit fee): 1 $
TOTAL: 1 $
Y:\SAFE\Forms\Use these forms\Permit Apps-Inspection forms\Tigard\FPS-PermicAQp.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 550, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2015-00199
Jeff Grove
Violation Summary:
Inspector Contractor