Permit (36) ,, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00049
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2016
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD, #200
Project: Rian Group Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Relocating(5)fire alarm notification devise for T.I. Affidavit submitted.
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 03/23/2016 $123.72
12%State Surcharge-Building 03/23/2016 $14.85
Type of Use: COM Plan Review-Fire Life Safety-MF 03/23/2016 $49.49
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 03/23/2016 $0.50
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: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $188.56
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $4,335.00
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 50 . 75 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 i11Nii);) rc>K ()I, l( I I �I Oil l
&' Received
City of Tigard DateB Permit No.:
Ill in 13125 SW Hall Blvd.,Tigard,OR 97223 '101 �.) 1� _ 'y
q q Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 t t. IJ a7 1`�, DateB : Other Permit: � b
l 1CARD Inspection Line: 503.639.4175 e,'' ,c �4N 1' .Date ReadyBy: Mil See Page 2 for
Internet: www.tigard-or.gov ti S �A '(� otified/Method: Supplemental Information
TYPE OF W e 1p 1���1 1 REQUIRED DATA:I-AND-2-FAMILY DWELLING
Permit fees*are based on the value of the work performed.
❑New construction 0 Iemolition
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10300 SW GREENBURG RD New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:200 Project name:RIAN GROUP 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.
RELOCATE FIRE ALARM NOTIFIACTION DEVICES FOR TENANT Valuation: $54,335.00
IMPROVEMENT
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: B
Phone:( ) Fax:( ) New: B
E APPLICANT 0 CONTACT PERSON NOTICE
Business name:SAFE TECHNOLOGY GROUP INC. All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:JASON SWEET 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
applicant is exempt from licensing,the following reasons
City/State/ZIP:VANCOUVER WA 98665 apply:
Phone:(360)699-2130 Fax::(360)719-1527
E-mail:SALES@SAFETECHNOLOGY.NET
CONTRACTOR BUILDING PERMIT FEES*
Meese Peer*rise sa le)
Business name:SAFE TECHNOLOGY GROUP INC Permit fee:
Address:6400 NE HWY 99 STE G375
State surcharge(12%of permit fee):
City/State/ZIP:VANCOUVER WA 98665 FLS plan review(40%of permit fee):
Phone:(360)699-2130 Fax:(3.60)719-1527 (Due upon application submittal)
Total permit fees: i n. 5Z,
CCB lic.:173731
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:JASAN-SNVE-E-T Aaci S w¢,a e- Date:3/22/16 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_071514.doc 440-46131(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
*Oita*;W i01*410Ele;
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: 5
® 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
El 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(CAnnIllete A,B,Cot D as applicable):
A.) Commercial Spnnldet
❑ Wet El 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: $
\\Safeserver\d\SAFE\Customer Files\Willamette Electric\Lincoln 1 200 RianGroup\F2S-PermitApp.doc
Ci o Ti I'
City f Tigard Permit No.:
111 13125 SW Hall Blvd.,Tigard,OR 97223
• Phone: 503.718.2439 Fax: 503.598.1960 2016 Date Received: 3 3�(0
Inspection Line: 503.639.4175 \\A
,A 9S
41 5
Internet: www.tigard-or.gov 11y-;vi By: HES, " 7W-A
11
FIRE ALARM Sw YWiVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: ?...1 Occupancy:
Job Address: .0 3 0 o Suite: 2 _
Contractor: s 'V .r_L1 A 1 r s r "C_ Phone: 3b t — q - 7-I 3
Valuation of work: $ `( , 3 3 5.
Type of System: (check one) raRequired ❑Non-required
(check one) NAutomatic EManual ❑Both
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(max 5) /To be Relocated(max 5) 5
S c, E Oregon Construction Contractors Board No. i7 3 7 3
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: C/ v,-,, Date: 3 - Z /�-
Print Name: /q d c,,- 5 z 4. t
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