Permit (176) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2018-00110
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2018
TIGARD 9 Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 416
Project: VSP Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm. Adding(1)devise for TI.
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 09/10/2018 $51.09
12%State Surcharge-Building 09/10/2018 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 09/10/2018 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 09/10/2018 $0.50
Occupancy Grp: Height: ft 11x17)
Stories: Hourly Building Rate 09/11/2018 $180.00
Hourly Building 12%State Surcharge 09/11/2018 $21.60
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $279.76
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $400.00
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: See17e . ms !mac Aa/ma y
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 L:SE OVI.IN '
City of Tigard } ,. Date/By:ed l f l(�/r , � i �j�t�[/(//!t�
�l 'emit No. .
Receiv
6liff
• 13125 SW Hall Blvd.,Tigard,OR 97223 "' Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date By: Other Permit:
1 1 c,A R I) Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/4hod: Supplemental Information
�4. .. ,, ,, , . /,'1,,,,),,,'",OF WORT ,.... . , r l # DDA w. .44 , "AMiLY f.* .v
❑New construction ❑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
4,43"w r TM work indicated on this application.
,"-'77.-","'
;7�"k2� ry 4/� �t44i � �Yl\�T1hVt.�.;'"mbR�� '�k
�. M... .�
1-and 2-familydwellingValuation: $
❑
®Commercial/industrial
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
ry�yt }' '" Total number of floors:
rte a.-, -§:u ,+41+ -.-k",.. „ .. ,6 :2-1_1' Oki:,.1 .1 ,W e"s'-$1,"
Job site address:10220 SW Greenburg Road (3Lincoln) New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:416 Project name:VSP Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
9 RED ATA:CO °..I RC;44-'41k,,,..,I{I IST',
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
- D s t to Of WORK , work indicated on this application.
Install fire alarm devices per submitted plans. Valuation: $400
Existing building area: square feet
New building area: square feet
P P II OWNER ❑ TEs Iie , Number of stories:
Name:Shorenstein Realty Services Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
� t
Q APPLICANT: - }it. 0 CONTACT PERSON _' NOTICE f, $ .,
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and maybe 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:
CONTRACTOR k`' BUILDING PERMIT PEES*
Business name:Capitol Electric Company,Inc. (Please rejerrojec'schaigte�
Permit fee: 51.09
Address:11401 NE Marx Street
State surcharge(12%of permit fee): 6.13
City/State/ZIP:Portland,OR 97220
FLS plan review(40%of permit fee): 20.44
Phone:(503)255-9488 Fax:(503)255-1966 (Due upon application submittal.)
CCB lic.:48748 Total permit fees: 77.66
Amount received:
Authorized signature: .a., _Q-
This permit application expires if a permit is not obtained
Print name:Shane Tercek Date:9/6/18 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 440-46131(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
etcr be wor to
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
0 New system Number of sprinkler heads: Number of alarm devices: 1
® 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:
$ + a'd`s {® # f .j4 t ``f:R � " r .�k +. , „ "1` ' � ,..
v
_ #�` w �, # • mac,.." V
f '
Sprinkler Type ❑ Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
I3 T e Hood FY a"Su re. sion S stemu
Hood Project Valuation: 1A$
5� �
C.) Fir s
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 400
1).) 21 Sprinkler(Stand Alone
Sytem)
Square Footage: Permit Fee:
0 to 2,000 $198.75
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.
Fire Protection Peitnit Fees,
Project valuation subtotal (see A,B&C above): $ 400
Permit fee based on project valuation (see fee schedule): $ 51.09
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $ 6.13
FLS Plan Review(40% of permit fee): $ 20.44
TOTAL: $ 77.66
Q:AFire Alarm\F'A Jobs\zz181871-45 VSP 416 @ 31,A1 FPS_PermitApp 2017.0126.doc 2
Julie Drinkwater
From: Shane Tercek <Shane@cepdx.com>
Sent: Thursday, September 06, 2018 8:35 AM
To: #Building Permit Technicians
Subject: FA Affidavit
Attachments: FA Affidavit.pdf; FA Submittal Plans.pdf; Permit Application, FA.pdf; Permit Application,
LE.pdf
Permit Specialist,
Please apply for a FA Affidavit with the following attachments and apply the off hours inspection fee to my payments.
Thanks,
Shane Tercek
Capitol Electric Co.,Inc.
11401 NE Marx St,Portland,OR 97220
T:(503)255-9488 I C:(503)516-2233 I D:503-262-0405
shane@cepdx.com I www.capitolelectricco.com
capitol
Cedric Co., Inc
"Celebrating over 30 years of excellence and innovation"
The information contained in this electronic mail transmission is intended by Capitol Electric Co.,Inc.for the use of the named individual or entity to which it is directed and may
contain information that is confidential or privileged.If you have received this mail transmission in error,please delete it from your system without copying or forwarding it,and
notify the sender of the error by reply e-mail or calling(503)255-9488 so that the senders'records can be corrected.Thank you.
1
City of Tigard Permit No.: F"Ps.A0/7- //O
13125 SW Hall Blvd.,Tigard,OR 97223 /
111 Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 12 i
Inspection Line: 503.639.4175
T:
At' g g y
Internet: www.ti and-or. ov B
kW:
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIO
OR TENANT IMPROVEMENTS SEP C 2018
(MAXIMUM OF 5 DEVICES WITHOUT PLANS) C.7 7)
BULL,,
Project Name: VSP 416 Occupancy: B
Job Address: 10220 SW Greenburg Road Suite: 416
Contractor: Capitol Electric Co., Inc. Phone: 503-255-9488
Valuation of work: $400
Type of System: (check one) ■❑Required [Non-required
(check one) ❑Automatic nManual ❑■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) 1 /To be Relocated(max 5)
I, Shane Tercek Oregon Construction Contractors Board No. 48748
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: ""''—�` �"�' Date: 09/06/18
Print Name: Shane Tercek
I:\Building\Fonns\FireAlarmAffidavit_071514.docx Page 1 of 1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10220 SW GREENBURG RD 416, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00110
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor