Permit (12) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00159
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2016
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1200
Project: VSP 1200 LT Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Adding(1)sprinkler and Removing(1)sprinkler. Affidavit submitted.
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 09/21/2016 $64.54
12%State Surcharge-Building 09/21/2016 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 09/21/2016 $25.82
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 $100.10
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $960.00
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 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.. 9.4175 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
IllCity of Tigard Received /�
q 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : Permit No.: / ' Si
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review , ,(
Date/B : Other Permit: ;i
Inspection Line: 503.639.4175 ,y , ' - ,
TIGARD pDate Ready/By: 0 See Page 2 for
Internet: www.tigard-or.gov SI14J1fj' TTIj Notified/Method:
+++ R Supplemental Information
� 4 ... � it :E;' Q D A, �E . , ittr� „
'El- emo
0 New construction tion Permit fees*are based on the value of the work performed.
1� 4>' y R. Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 51t r
equipment,materials,labor,overhead,and the profit for the
a � 6 ;,r' t work indicated on this application.
o 1-and 2-family dwelling ` ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
� tows 1N M T U11I A D O(A 9N 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.:1200 I Project name:VSP-Suite 1200,LT Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
. Q JtgERDATA§."A MMR 11. TJ I k C1 i
Subdivision: 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 all
` @: � 1 , „ F equipment,materials,labor,overhead,and the profit for the
,. - • • ,:• m.. 1I ��1 >r work indicated on this application.
Add l sprinkler and plug 1 sprinkler Valuation: $960
Existing building area: square feet
New building square q re feet
s
''' S P O t O
_ .. LflaP1Nit— Number of stories:
Name:
Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( )
New:
Business name:McKinstry Co. z e .
All contractors and subcontractors are required to be
Contact name:Tria Day licensed with the Oregon Construction Contractors Board
Address:16790 NE Mason Street,Suite 100 under ORS 701 and may be required to be licensed in the
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 Fax:: apply:
E-mail:triad@mckinstry.com
Business name:McKinstry Co. (Tiara,,, w-tofehrho,xt, n� _.w.,..
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 lie.:172811 Total permit fees: WO. i 0
Authorized signature: ,� Amount received:
This permit application expires if a permit is not obtained
Print name:Tria Day Date:9/19/16 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(11/02/COM/wEB)
City of Tigard: Fire Protection Permit Checklist
• Page 2- Supplemental Information
bsete c itia icfo * At A* , . • l
1.) Type of Work 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration onlyto alarm devices:
El New system Number of sprinkler heads: 2 Number of alarm devices:
® Addition or ® 1-10 heads: Affidavit required and
Alteration El1-5devices: Affidavit required and
Ato eei tin (3) copies of sketch showing area (3) copies of sketch showing area
s tem
g of work within building structure of work within building structure
❑ 11+heads: Plan review required and ❑ 6+devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work Add 1 sprinkler and plug 1 sprinkler
•W� c7P y'St PAWIPIp� �e 3 B/CM4 1J 4pp i bl ) `0
4 . ,J ..: .*
® Wet
Additional Standp ❑ Dry
Standpipes
Information: Hazard Group light
Density 10
Design Area 1500 sq ft
K.Factor 5.6
Sprinkler Project Valuation: I $ 960
Hood Project Valuation $
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
7 � C * .fig?"70
Square Footage: Permit Fee:
0 to 2,000 1 $198.75 3 -s
�
2,001 3,600to
$310.05 3,601 to 7,200 246.45
7,201 and greater $404.39 _ � W
Sprinkler Project Square Footage: I sq. ft.
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: $
\\mck instry\portland\Projects\N-R\Russell Construction\108933 VSP-Ste 1200,LT\201 Mech Const\Pemuts\sprinker permit application\FPS-PennitApp.doc
City of Tigard
13125 SW Hall Blvd.,Tigard,OR 97223EIVE
1ri]lt No.: —Pjvtulr� — 5O
,1,14 11 Phone: 503.7182439 Fax: 503.598.1960 + _ ate Received: Otit
i I GATtT� Inspection Line: 503.639.4175
Internet: www.tigard-or.gov By: #3r- 4' v
FIRE SPRINKI 1I1 , T FOR ALTERATIONS
0 'r;a b t l w' ' VEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: VSP - Suite 1200, Lincoln Tower Occupancy:
Job Address: 10260 SW Greenburg Road, Tigard, OR 97223 Type of Construction:
Suite: 1200
Contractor: Mckinstry Co. Phone: (503)331-0234
Number of Proposed or Altered Heads: 2
Type: SSP Hazard: Light Density: .10/1500 sq ft
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 ,
1:\Building\Forms\FireSprinklerAffidavit 071514.docx Page 1 of 1