Permit (8) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
III ' COMMUNITY DEVELOPMENT Permit#: FPS2016-00161
Date Issued: 09/21/2016
-fF "sARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 365
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Adding(1)Sprinkler,relocating(3)sprinklers,and removing(2)sprinklers.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-331-0234 PHONE:
FAX: 503-331-6907
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/21/2016 $59.16
12%State Surcharge-Building 09/21/2016 $7.10
Type of Use: COM Plan Review-Fire Life Safety-COM 09/21/2016 $23.66
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 09/21/2016 $2.00
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: .10 Design Area: 1500
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 $91.92
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $800.00
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 questions to OUNC by calling 503 32 1c•7 or 1.800.332.2344.
Issued By: ` Permittee Signature: (.4Zz,./ff.}. ..40
Add
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
FOR OFFICE USE ONLY
r . City of Tigard RECEIV"i ived
13125 SW Hall Blvd.,Tigard,OR 97223 gate/BMiffi � PermitNo.:
/illk
Phone: 503.7182439 Fax: 503.598.1960
Plan Review r
Inspection Line: 503.639.4175Date/B : Other Permit: r
TIGARD P �� ,e ,-
Internet: www.tigard-or.gov + •r "" 2016 Date Ready/By: Mil 10 See Page 2 for
Notified/Method: Supplemental Information
4 ., : A �;TvPFWr. r
--,-,.l r16 RIS
,.r ..► w 1t1 Q 7IRl"D ?o,,,,,.4A,, 2,1i,.
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
I Addition/alteration/replacement Indicate the value(rounded to the nearest dollar)of all
❑Other
equipment,
* ' maik *rO l 4.66'6
ll t)#t' , work ndica indicated thiserials,lapplication.ead,and the profit for the
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
. OB*� 4RM I'ok � AT1<ON�555'5755;
Total number of floors:
Job site address:10200 SW Greenburg Road
New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223
Garage/carport area: square feet
Suite/bldg./apt.no.:365 I Project name;Vacancy Dren't65
t eLt-( Covered porch area: square feet
Cross street/directions to job site: V
Deck area: square feet
Other structure area: square feet
•
Subdivision: M�
DATA O4W us eft C
I 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 allM equipment,materials,labor,overhead,and the profit for the
,„ ,, . �*-"k � � 0 � ��, � work indicated on this application.
Add 1 sprinkler,relocate 3 sprinkers,and plug 2 sprinklers Valuation: $$800.00
Existing building area: square feet
New building area: square feet
,,. Number of stories:._ 7 _ , A v
Name:
Type of construction:
Address:
City/State/ZIP:
Occupancy groups:
Existing:
Phone:( )
Fax ( )
" rhid ' 1! 4 `; \' -- New:
�r
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
Phone:(503)318.2057 I apply:
Fax::( )
E-mail:tread@mckmstry co
,�� m `t Clt q � i�
ik
Business name:McKinstry Co. ."t fl serckm A d e1
Address:16790 NE Mason Street,Suite 100 Permit fee:
City/State/ZIP:Portland,OR 97230 State surcharge(12%of permit fee):
Phone:(503)331-0234 FLS plan review(40%of permit fee):
Fax:(503)331-6906 (Due upon application submittal)
CCB lic.:172811
Total permit fees:11(1 i"-'
Authorized signature: / Amount received:
l i This permit application expires if a permit is not obtained
Print name:Tria Day ( I Date:9/19/16 I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
I:\Building\Permits\FPS-PermitApp_071514.doc Service Board.
440-4613T(I I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
y Paae 2- Supplemental Information
,.E'SCtt�? W{�Lk t+ be dC3ne, \\ \\� •• E \ .
1.) Type of Work 2.) Addition/alteration onlyto sprinkler heads: 3.) Addition alteration onlyto alarm devices:
❑ 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
e o Syste (Compl to A, B, C 61,464„,,,,,.s ,' , .c fit �'
• e)
\CQ � r ial Spta��C�.,�et ' t �1 '
\
® Wet
❑ Dry
Additional Standpipes
Information: Hazard Group light
Density .10
Design Area 1500 sq ft
5.6
K.Factor
Sprinkler Project Valuation: $ 800
®,' \ I; Hood:F tp, + s ty "S., tetaa
Hood Project.Valuation: $
Submittal shall Battery Calculations El Yes
include: Individual Component EI Yes
Cut Sheets
Fire Alarm Project Valuation: $` � v
} ® e delttma S1tlet(S d A lone System) ./s
Square Footage: Permit Fee:
0 to 2,000 $198.7522; °
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.
�....: �'` a ction Pt:tmj Feed w
Project valuation subtotal (see A,B &C above): $
Permitfee 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: $
\\mckinstry\portland\Projects\N R\Russell Construction\108934 VSP-Ste 365,5-Linc2In\001 Mech Const\Permits\sprinkerpermit application\FPS-PemutApp.doc
City of TigardC Permit No.: 72-0/6,— Or✓I d l
13125 SW Hall Blvd.,Tigard,OR �-
Phone: 503.718.2439 Fax: 503.5':.1960 Date Received:
TIC:ARD Inspection Line: 503.639.4175
Internet: www.tigard-or.gov SEP 217_[�ryq 16 By: I/70 4 77e
FIRE SPRI l i to w I VIT FOR ALTERATIONS
ANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: VSP - Suite 365, 5-Lincoln Occupancy:
Job Address: 10200 SW Greenburg Rd, Tigard, OR 97223 Type of Construction:
Suite: 365
Contractor: Mckinstry Co. Phone: (503) 331-0234
Number of Proposed or Altered Heads: 6
Type: SSP Hazard: Light Density: .10/1500
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: Date: 9/19/16
Print Name: Tria Day
I:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1