Permit (178) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2018-00178
T I GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2018
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 500
Project: Bridgewell Resources Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm permit:Adding(1)fire alarm device. Affidavit submitted.
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-255-9488 PHONE: 503-412-4800
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/12/2018 $51.09
12%State Surcharge-Building 12/12/2018 $6.13
Type of Use: COM Plan Review-Fire Life Safety-COM 12/12/2018 $20.44
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 12/12/2018 $0.50
Occupancy Grp: Height: ft 11x17)
Stories: Hourly Building Rate 12/12/2018 $180.00
Hourly Building 12%State Surcharge 12/12/2018 $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: Cut Sheets Required:
Total $279.76
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $500.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: - -Permittee Signature:
503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application ,
,r
Fire Protection System roR si.()NI.)
City of Tigard r ?51`e,
1)t-k
Date/B : 42 3 la 447
Permit No.: 7
.11 13125 SW Hall Blvd.,Tigard,OR 97223 111 . Plan Review
: I Phone: 503.718.2439 Fax: 503.598.1?6k) Date/B : Other Permiti , . ).
[GARD Inspection Line: 503.639.4175 . • •-•!.• . •' Date Ready/By:
T
S
Internet: www.tigard-or.gov Notified/Method: Supplementalpelenagee'ienor
Supplemental
Information
TYPE OF WORK REQUIRED DATA.1 AND 2-FAMILY DWELLING
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY )F coNstioN work indicated on this application.
Valuation:
El 1-and 2-family dwelling Ej Commercial/industrial
o Number of bedrooms:
Accessory building 0 Multi-family
Number of bathrooms:
El Master builder 0 Other:
SITE INFORMATION ANDLOCATIO$ Total number of floors:
Job site address:10200 SW Greenburg Road (5Lincoln) New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:500 Project name:Bridgewell Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQTWB CIAL41SIICBE .1
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:
equipment,materials,labor,overhead,and the profit for the
ii0souilli:xv OF W ; ''••' work indicated on this application.
Valuation: $500
Install fire alarm devices per submitted plans.
Ernz-ty 4/-7 r/t-"/ Existing building area: square feet
New building area: square feet
,..‘ ta:FROPERTY OWNER TENANT Number of stories:
Name:Shorenstein Realty Services Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT 0 CONTACTPERSON NOUCE
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
applicant is exempt from licensing,the following reasons
City/State/ZIP:
apply:
Phone:( ) Fax::( )
E-mail:
CONTRACTOR BUILDING PEW!'FEES*
(Please refer to fee schedule)
Business name:Capitol Electric Company,Inc.
Permit fee:
Address:11401 NE Marx Street
State surcharge(12%of permit fee):
City/State/ZIP:Portland,OR 97220
FLS plan review(40%of permit fee):
Phone:(503)255-9488 Fax:(503)255-1966 (Due upon application submittal.)
CCB lic.:48748 Total permit fees: ' X71_
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Shane Tercek Date: 12/3/18
* Fee methodology set by Tri-County Building Industry
Service Board.
I\Building\Permits\FPS-PermitApp_031016 doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe work to be done:
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 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
0 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System Complete A,B,C or I) pp ca le : 4
, ' 1 m ereialSprinkler v:n ..e.' r t.=.
r.,
Sprinkler Type ❑ Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes ❑ No
Hazard Group
Density
Design Area
K.Factor
Sprinkler Project Valuation: $
5 Type I .° y Fire Suppression"System ..,
Hood Project Valuation: $
C.) Fire . :
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 500
13.) Residential Sprinkler(Stand. lone System) V;
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 Permit fgeS
Project valuation subtotal(see A,B&C above): $ 500
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:\Fire Alarm\FA Jobs\zz182325-45 Bridgewell FA @ L5-500\1 FPS_PermitApp 2017. 126.doc
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IICity of Tigard 'i_ '; ?-013 Permit No.: r-fi?z1/ -C)17g
• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960- Date Received: /,L/3 A r
Inspection Line: 503.639.4175
T(GARU
Internet: www.tigard-or.gov 'i-, By: `e), - 71,;,,,,e..1-7672, 4: ,�
ii
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: Bridgewell TI Occupancy: B
Job Address: 10200 SW Greenburg Road Suite: 500
Contractor: Capitol Electric Co., Inc. Phone: 503-255-9488
Valuation of work: $500
Type of System: (check one) ['Required ['Non-required
(check one) ❑Automatic ❑Manual ■❑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: 'c��"`��` �'" "� - Date: 12/3/18
Print Name: Shane Tercek
I:\Building\Forms\FireAlarmAffldavit071514.docx Page 1 of 1
Capitol
q..
Electric Co., Inc.
December 3,2018
Plans Examiner
City of Tigard
Building Services
13125 SW Hall Blvd.
Tigard, OR 97223
Re: Affidavit-Tenant Fire Alarm System Additions
Bridgewell, Suite 500 @ 5Lincoln
10200 SW Greenburg Road
Tigard, OR 97223
Please find attached a building permit application, a fire alarm affidavit, and a set of
plans, 11"x 17", for the fire alarm tenant improvements at the address shown above.
Occupancy Group: B
The fire alarm system design includes the following:
1. Install new ADA synchronized fire alarm notification devices in the tenant space
including(1) strobe.
2. We will pre-test the fire alarm devices prior to requesting a final fire alarm
inspection.
Please contact me if you have questions or comments.
Respectfully,
Shane Tercek
Project Manager/Estimator
Fire/Life Safety Division
Capitol Electric Company, Inc.
(503)262-0405 Direct
shane@cepdx.com
NICET Level III, Fire Alarm Systems#140599
11401 NE Marx Street - Portland.Oregon 97220-1041 - 503-255-9488 - Fax 503-257-7121
CC13#48748 - www.capitolelectricco.com
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10200 SW GREENBURG RD 500, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00178
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor