Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
a COMMUNITY DEVELOPMENT Permit#: FPS2017 00092
T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2017
Parcel: 1 S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 271
Project: Portland Autism Center Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm for TI: (6)devices.
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM 06/29/2017 $102.20
12%State Surcharge-Building 06/29/2017 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 06/29/2017 $40.88
Class of Work: ALT Type of Const: IIB Misc Administration Fee 06/29/2017 $5.00
Occupancy Grp: B Height: ft
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: Yes Cut Sheets Required: Yes
Total $160.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,450.00
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: _,..h. j Permittee Signature: _ 11°
`/eZ
75 ,1
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 ` EC) FOR OFFICE USE ONLY
City of Tigard BECEReceived Permit No.: r
�� DateBy % 1 C /—CJL7c.` a
13125 SW Hall Blvd.,Tigard,OR 97223 g 2011 Plan Re• -. - (
Phone: 503.718.2439 Fax: 503.598.1960 3UN Date/By: =� �%T Other Permit: t
Inspection Line: 503.639.4175 ir,III
12� t " era /for �/ 7
TI GARD p -\-)VIJS1O
tc'pkil� Date Rea: is . , Juris: See Page 2
Internet: www.tigard-or.gov G�" Y 1i ir `Notifiied/Methii. #S CJ/i7/� `4 Supplemental Information
- k a - - "-,44: A u " 9i ..' HTl1t':� '1."'-'
.r''''Vr 41Y2k - ' it E.O :a ! y :�'944949,4;99k,'" r 1 TA. aA 4 '`t =. lfla epi°" ' x «Nxno _ .-- . ol"Cu _ , . 7 :-._ ,m IGalemr,- _ '',j( �,, 9� s ,, . ,-A,
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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
;r 1ia "':l al "c' k�,',10;„11 apwork indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
ED Accessory building 0 Multi-family Number of bedrooms:
I:1Master builder 0 Other: Number of bathrooms:
;Ir °qi r cq ,.m v a�}�(Y1 t J<0 "2 :-*sF�
,� i, � SOB SIT ,1 , IATI01 i 1 E ATIy Total number of floors:
Job site address:10300 SW Greenburg Road (1Lincoln) New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:271 Project name:Portland Autism Center Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQ1. i
, ,o A -OO��R . .t'CITE W�
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
lir k -ill ' ' ,::''''i."*(}f- ��' - n� P6' work indicated on this application.
Install fire alarm devices per submitted plans. Valuation: $$2,450.00
Existing building area: square feet
New building area: square feet
,i' s q' ^4i ii ru ,, rbtvn, ,�i,y
.OPE ~ `a t 7'A'' ;1 ANT ,i i Number of stories:
Name:Shorenstein Realty Services Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
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�'�"� �t sw,. � �^rage. � 'fir
x i i APPL 7 M , t) ,7- ❑ t M"PER O � 7 4h"�Ih�7 �x'il" r% s ,N
a 71 .,A _ i it gy ` s, i 4 9fl h '{ `Fa.-- �",A
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax: :( )
E-mail:
` ' Pw 0 "� ��'''hili : - -Alio`-< -,:::-.,,,,,,:r4 Gr' ' ,4 iia �yi'�v��aiLua a
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ne
"I6 1 ,,,-cumNi IPk ase refer o ;' _..�'c" ~i%r;.a. z ° =moi
Business name:Capitol Electric Company,Inc.
Permit fee: 102.20
Address:11401 NE Marx Street
State surcharge(12%of permit fee): 12.26
City/State/ZIP:Portland,OR 97220 FLS plan review(40%of permit fee):
Phone:(503)255-9488 Fax:(503)255-1966 40.88
(Due upon application submittal.)
CCB lie.:48748 Total permit fees: 15534
S' ( -jam' Amount received:
Authorized signature: l
,,,A4This permit application expires if a permit is not obtained
Print name:Shane Tercek Date:6/15/17 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
A
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711:1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
ID New system Number of sprinkler heads: 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 /1 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
• i 1, CI • t' t 1 -r� ��, .. ors., ;� �: ,s a
..,., M ll- aC 't t Q :.' "' Bare."....- 'I --
E , Y , a® '0)Y1e � S• et ., ._. {Ili .IGhic. rea k r> b.1;!!!,,,A-7:4111',-; ii ....,..,04,447:.;.: '�QI`rte J71�s k..
)_b i - :..nia'�a °s'u� '� --s'.+, -1�ir.: .i�01Pt�-,= ,p"';�.' fi�ia :PI i�� �k"
S.rinkler Tp.e ❑ Wet E D
Additional Stand.i.es
Information: S.rinkler Su..1 Line ❑ Yes ❑ No
Hazard Grou.
Densi
Desi. Area
K. Factor
S.rinkler Pro'ect Valuation: $
r n�h ,, 1 , e=_ 1 rNk r '1. w� 1.� a � , r ' fi ,��S �
Hood Project Valuation: $
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 2450
li 4 ...-.F7k,1, a" "t i ,` ��paI�S � ` ia � ` „ .$ : � ,` ,°ii i"A ` -,h a ,cI [� t SP . Nsia° ,,& k-
e 01
S uare Foota e: '`
q g Permit Fee: '%)`-,7:-,": �, � 1 . �
0 to 2,000 $198.75 � ' '� '
2,001 to 3,600 $246.45 � �� �`" O
3,601 to 7,200 �� '
$310.05 .., kP ��kifiMa
7,201 and greater $404.39 �.� r-. 4 ,. .... •'4. `i; ' ,
Sprinkler Project Square Footage: sq. ft.
d 4,0�Nc,,,,,,,,„F
11 ,,,,T!,,,
Ute a PE' 4i. €6 U !I :'--2i...6„.;'",‘,.',-,-,„;., .. ,_ ,," I. , i t 6
a ..,ada -',,',, m - .-. --,---toz-.. .--�, s, hAli ..,
Project valuation subtotal (see A,B &C above): $ 2450
Permit fee based on project valuation (see fee schedule): $ 102.20
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 12.26
40.88
FLS Plan Review(40% of permit fee): $
TOTAL: $ 155.34
\\CE-VSBS11\RedirectedFolders\Dan\FA Jobs\zz170948-45 Portland Autism Ctr.,@ 2Linc-271\1 FPS_PermitApp 2017.0126.doc