Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IIIi. COMMUNITY DEVELOPMENT Permit#: FPS2018 00023
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/09/2018
T f t�' .t�"I`� g Parcel: 1S 135AB01004
Jurisdiction:
Site address: 10220 SW GREENBURG RD 600
Project: Hull and Company Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm permit:(8)alarm devices.
Contractor: POINT MONITOR CORPORATION Owner: LINCOLN CENTER LLC
5863 LAKEVIEW BLVD STE 100 BY SHORENSTEIN PROPERTIES LLC
LAKE OSWEGO, OR 97035 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/03/2018 $134.48
12%State Surcharge-Building 04/03/2018 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 04/03/2018 $53.79
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 04/03/2018 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 04/03/2018 $4.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: No Sprinkler Type:
Standpipe Required: No Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type: Automatic
Pull Station Required: No Smoke Detectors Req: Yes
Battery Cates Provided: Yes Cut Sheets Required: Yes
Total $214.41
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,841.00
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 952-00 '090. You ma obtain copy of the rules
or direct questions to OUNC by calling 503.232.1987 .:... - 'b / /
Issued By: Z.
rmittee Signature: r
Ca 5.4175 by 7:00 a.m.for the next available insp-''tion 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
Firc,Protection System FOR OFFICE LSE ONL\
City Tigard Received
d y
Date/By: U
0371-..'
Other Permit ���
� 1/Permit No.: Js2
6
131SW Hall Blvd.,Tigard,OR 97223 Plan Riew
Phone: 503.718.2439 Fax: 503.598.1960 ba�/By
Inspection Line: 503.639.4175IcAKD ate
Ready/By: ,f,„ Juris: See Page 2 for
Internet: www.tigard-or.gov Not ed/Method: ( ®5/g j 4 I Supplemental Information
t' .1
TYPE c k $ t s �k 'e t f.3 a IATA. AlF111;11,1
❑New construction ❑Delnolifton .; Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement El 04 r;' ;''q equipment,materials,labor,overhead,and the profit for the
4 {
'� � •J ��t t o �, t I �;, , ��; work indicated on this application.
... c urn eda. s i,
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
' la it I t 6B 011";^', `' G r
,..... cTotal number of floors:
Job site address:10220 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:600 Project name:Lincoln 2-Hull&Co. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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
It t a : t e ~ 4 n+ I work indicated on this application.
Fire Alarm Notification Devices Valuation: $5,841
Existing building area: square feet
New building area: square feet
�, .
.. . . ' ,t.�� �s �. .. '� e � �sr t� � � Number of stories:
Name:Lincoln 2-Hull&Co. Type of construction:
Address:10220 SW Greenburg Road Suite 600 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( ) New:
�� „1
',
Business name:Point Monitor Corp. All contractors and subcontractors are required to be
Contact name:Brooke Williams licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5863 Lakeview Blvd#100 jurisdiction in which work is being performed.If the
City/State/ZIP:Lake Oswego,OR 97035 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)627-0100 Fax: :( )
E-mail:bwilliams@pointmonitor.com
t] �e-v , �,x "y za; 1 9`I *' ,*
Business name:Point Monitor Corp. `
.. r 'e'er wJ .. r
Permit fee:
Address:5863 Lakeview Blvd#100
State surcharge(12%of permit fee):
City/State/ZIP:Lake Oswego,OR 97035
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal.)
CCB lic.:135901 Total permit fees:
Authorized signature: r Amount received:
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:3/26/18 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_031016.doc 440-4613T(I 1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1' "A' - _-� . ; - � „ -:a: .E: a y„v
- — - ars-�: , ..,, �;.
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: Number of alarm devices: 8
® 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
El 11+ heads: Plan review required and ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work: Fire Alarm Notification Devices
w;. x �, e �z •
• `"4.�r e • 1 .
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P F i3- e„ n ti
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R1 71^1`' ? . .. ''aikt ua"'44 '. --."
S.rinklerTp.e El Wet ❑ D
Additional Stand.i.es
Information: IMEEZIMIE=M1 El Yes ❑ No
Hazard Grou.
Densi
Desi• Area
K. Factor
S•rinkler Pro Sect Valuation: $
044. `.mo � t
Hood Pro'ect Valuation: $
• rmok" XS n- sem, •
'"'-W4*. ,....... .,. put e x x. r" l
Submittal shall Batte Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Pro Sect Valuation: $ 5,841
.. �,,�* y4'.i ] • z r Ft``?t"
}3 r'k gap.. ; r r,wy � r.E • ptq
t vrE • � u f v { 1
S.uare Foota.e: Permit Fee:
0 to 2
$198.75
000F��`
• a -:
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05 •
'
7,201 and treater $404.39 ` ' r
Sprinkler Project Square Footage: sq. ft.
Fire Piotetioli Perfnit
Pro'ect valuation subtotal see A,B &C above : $
Permit fee based on sro'ect valuation see fee schedule : $
Permit fee based on ssuare foota•e see D above : $
State Surchar•e 12% of permit fee : $
FLS Plan Review 40% of permit fee : $
TOTAL: $
C:\Users\bwilliams\Desktop\PERMIT FORMS\Fire permit-city of tigard.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10220 SW GREENBURG RD 600, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00023
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor