Permit (12) 1114 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00102
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2016
I I`''�1.Dg Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1250
Project: Reinisch Wilson Weier Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinklers-Add(1)head&plugging(1)head.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-331-0234 PHONE:
FAX: 503-331-6907
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/14/2016 $56.47
12%State Surcharge-Building 06/14/2016 $6.78
Type of Use: COM Plan Review-Fire Life Safety-COM 06/14/2016 $22.59
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 06/14/2016 $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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $86.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $700.00
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 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 qu- ions to •S.NC by calling 503.232.19878or 1.800.332.2344.
Issued :y: / / /&Ga='4—f 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
rir
Fire Protection System REULI FOR OFFI('E ISE ONLI
City of Tigard DateBed 15016i/0—DO11 X02
Permit No.:
' 13125 SW Hall Blvd.,Tigard,OR 9710N 1 4 2016 Plan Review / A
I Phone: 503.718.2439 Fax: 503.598.1960 Date/B Other Permit: P3oalO—GY��75'
TI G A R D Inspection Line: 503.639.4175 i i r g ly t, Date Ready/By: 7uris. RI See Page 2 for
fl
Internet: www.tigard-or.gov b v_ a 11 $ u`id.t Notified/Method: Supplemental Information
t ITJ ' DIVi� sia � ViC£a
'"a@' `'`s',6 1��"`-°•e tt,D'a±F �, -„a aa ��.n'- !A �` _��v_,.a - :-,-..,.,a._-AAaSA,_s. ,t>. w..°�.
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
rt work indicated on this application.
GOR C}F (INSTRtJGTI(ti PP _
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
0 Accessory building ElMulti-familyNumber of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
/ * Total number of floors:
Job site address:10260 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:1250 Project name:Reinisch Wilson Weier Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
4
litiotAtai4
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
a a a p �, + ��{ a E a � work indicated on this application.
ppmpat, it
Add(1)head&.i (e ) Valuation: $700
Existing building area: square feet
New building area: square feet
PROPIRT<* �a a a a Number of stories:
Name:Reinisch Wilson Weier Type of construction:
Address: Occupancy groups:
P Y�' P
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
ill t
/ 0 � �,• � `::. yt� ppt RSI � �P..
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)331-0234 Fax::( )
E-mail:triad@mckinstry.com
�•., ,rte 6 a, t,,s,� ?'„” �^ _ {c ,,,, tti?r; z
Business name:McKinstry Co.
00,11!".10,;, ,,4k5tom Orli .
Permit fee:
Address: 16790 NE Mason Street,Suite 100
City/State/ZIP:Portland,OR 97230 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)331-0234 Fax:( ) (Due upon application submittal)
CCB lic.:172811 Total permit fees: !/
Authorized signature: Amount received: 466, 3 r
7 Cf�7This permit application expires if a permit is not obtained
Print name:Tria Day Date:6/14/16 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.dot 4404613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
�z €> �....:OONSOIC : )
?c�`��3
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
El New system Number of sprinkler heads: 2 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: Plug(1) head, add (1) head
T f S s1e�� caplet '-ii-4,104•111.14:45 -84•4 ViiiigaW4A1M6040
a f -F V •r- _ a �•`w ea:
1 l4
ar _ �9-,�"-"��••.'�c a. ...a - ..,a»�� ,.V4- -04stiaYa .a ..m ,iirigg,-- ?; X.�,.,a..o�, o�i��i
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group Light
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $
. YPe I . pad Fk4 prpression y
Hood Project Valuation: $
11re �1a 6 ibi sy z v g 2
�'' ,' 2 �\\ktO -":R. , gai ,, „ . 3 s ,a , �,°e„�a , 1>;;. _ a ��- c`�r>.- o, '..,
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
,,,,k4memosigaisagm 9<
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 �R
Sprinkler Project Square Footage: sq. ft.
0
tceptvo
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\108007 Reinisch Wilson Weier-Ste 1250 LT\0011ech Const\Permits\FS\FPS-PermitApp.doc
City of TigardPermit No.: (✓pS .9-01 & -001OZ
7,1
4 13125 SW Hall Blvd.,Tigard,OR 97223
a Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 62114//0
Inspection Line: 503.639.4175
r I GA P.D Internet: www.tigard-or.gov By: sCil. 01262444-4-14
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Reinisch Wilson Weier Occupancy: .'
Job Address: 10260 SW Greenburg Road Type of Construction: TI
Suite: 1250
Contractor: McKinstry Phone: 503.331.0234
Number of Proposed or Altered Heads: 2
Type: Commerical Hazard: Light Density: •10
I, Tria Day Oregon Construction Contractors Board No. 172811
certify the following is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
b) Positions of sprinkler heads relative to architectural features such as soffits,beams,partitions,walls,etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop(exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads(see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
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.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: —7 5„,1 :2), Date: 6/14/16
Print Name: Tria Day
I:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1