Permit (20) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT
Permit#: FPS2016-00142
I WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2016
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 530
Project: AG Spanos Corp Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Adding(4)fire alarm notification appliances. 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 08/23/2016 $102.20
12%State Surcharge-Building 08/23/2016 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 08/23/2016 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 08/23/2016 $2.00
Occupancy Grp: Height: ft 11x17)
Stories: Hourly Building Rate 08/23/2016 $180.00
Hourly Building 12%State Surcharge 08/23/2016 $21.60
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: No 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 $358.94
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,920.00
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:
CrLACiw,
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.
Buildin. Permit Application
Fire Protection System q FOR OFl l( i l '.t o\I_1
,L a;
Cityof Tigard 4 a Received
g ... ... DateB j >< 1�s� Permit No.: -'^", ... ` "
11 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ! `l
s0 Phone: 503.718.2439 Fax: 503.598.19 Other Permit: ./. ' 1
�> DateB : I ` ..� t
TIGARD Inspection Line: 503.639.4175 (-Mil z c d 7 h Date Ready/By: f�++ _ ;. See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
E a , imotrutto%c' .*4, -i
0 New construction 0 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
CATEGORY;OF C(INS TION =<" work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $2,920.00
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
db)0 "sat�i1RA Til4At �1 ;.. { Total number of floors:
Job site address:LINCOLN 2-10220 SW GREENBURG RD New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:530 Project name:AG SPANOS CORPORATION Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIREDDATA:-058111 RCtAL-C1$11c C T
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
1EseRin,04. ot WOR work indicated on this application.
FIRE ALARM Valuation: $
Existing building area: square feet
New building area: square feet
0"PROPERTY OWNER TEN 1T " Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: B
Phone:( ) Fax:( ) New: B
>�< LICAN�T , C CONTACT PERSON
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
CONTRA.CTOTt
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.)
CCB lie.:173731 Total permit fees: 35'.47L/
Amount received:
Authorized signature: , �..x—LA
This permit application expires if a permit is not obtained
Print name:ADAM SWEET Date:8/22/16 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board. 4.Pi
I:\Building\Permits\FPS-PermitApp_071514-doc 440-4613T(11/02/COM/WEB) J
L/if q1'
City of Tigard Permit No.: ge)j 62-- ,
111 " 13125 SW Hall Blvd.,Tigard,OR 97223 � LIG 2 x '1 116
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 3713//too
ti DInspection Line: 503.639.4175 F �,/
Internet: www.tigard-or.gov By: J� Sf�� �e
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: AG SPANOS CORPORATION Occupancy: CLASS B
Job Address: LINCOLN 2 - 10220 SW GREENBURG RD Suite: 530
Contractor: SAFE TECHNOLOGY GROUP INC. Phone: 360-699-2130
Valuation of work: $2,920.00
Type of System: (check one) ®Required ['Non-required
(check one) ®Automatic ❑Manual ['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)4/To be Relocated(max 5)
I, SAFE TECHNOLOGY GROUP INC. 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: O .. $. k Date: 8/22/16
Print Name: ADAM SWEET
I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1
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
10220 SW GREENBURG RD 530, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
PASS - No C of O
FPS2016-00142
Jeff Grove
Violation Summary:
Inspector Contractor