Permit (179) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2018-00180
Date Issued: 12/19/2018
T f A D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 125
Project: VSP Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm permit:(2)horn strobes and(1)strobe. Affidavit submitted.
Contractor: ON ELECTRIC GROUP INC Owner: LINCOLN CENTER LLC
1709 SE 3RD AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97124 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-234-9900 PHONE: 503-412-4800
FAX: 503-234-1001
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/19/2018 $123.72
12%State Surcharge-Building 12/19/2018 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 12/19/2018 $49.49
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 12/19/2018 $2.00
Occupancy Grp: Height: ft 11x17)
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:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required: No
Total $190.06
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $4,500.00
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:
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.
70 7Z0 5- 7
Building Permit Application
Fire Protection System , . -../-4„.. A,N°3 FOR OFFICE USE ONLY ..•
•
•
City of Tigard AL)\ .kuc")‘,\ --.1. , Received
, ie
11 . 13125 SW Hall Blvd.,Tigar4,ofV/7223
‘,?'' Date/B : '
Plan Review /1 ICIIMINIM
° I. Phone: 503.718.2439 Fax: 50r598.1M — Date/13 : Other Permit: ', -„,. r '"'
Inspection Line: 503.639.417513.3 NOoatteifiRedimeadyeThyod:: IMI til See Page 2 for
Supplemental Information
TIGARD
Internet: www.tigard-orgov
. .: ., ., , ,,
ita .
TYPE ., Mt ' '''REQUIRED DATAt 1-AND 2-FAMILY DWIELLIN:q.,;',.,;;;,,i,
El New construction El Demolition Permit fees*are based on the value of the work performed. i
Indicate the value(rounded to the nearest dollar)of all
IE Addition/alteration/replacement 0 Other; equipment,materials,labor,overhead,and the profit for the
rOPRekilidtiii:ii*,:,ONsritutTioN‘ . . . ' . . . work indicated on this application.
.,-,,,...,.., .„,.....,.„.-.t,...;R,' '''' '-''.?' ''
Valuation: S
0 1-and 2-family dwelling El Commercial/industrial .:
0 Accessory building 0 Multi-family Number of bedrooms: .,
LI Master builder 0 Other: Number of bathrooms:
JOiiif-ii:iioiticiti iiiii4lii1:66AilOi%r=,',,,, ,::-s :, ,',,,::- , Total number of floors;
Job site address: 10220 SW Greenburg Rd New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg/apt,no.: 125 Project name: 707657 VSP Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
tA'k00t*:1 r,00:*;g:°:*f:lg'Wt*:t*qOt''':,
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
REsOmpTioN*op WORK ,, , work indicated on this 4pplication.
Fire Alarm Devices Valuation: s 4500
Existing building area: square feet 1800
New building area: square feet
IRI(:?:1'ROPERTY OWNER .'...': ,1;N,1..;,i..i..;',;1$:,,,;r,,,f.',E1.'TENANT. -: ,,.. . - Number of stories: I
Name: Shorenstein Real Estate Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( / New:
.. ... . . . .... .... ... .., .
t:y;,0iiicArd -777::--1,- ; igrtONTACT.,PERSON,, "--,. — - ,' , ' , ' ' -
' Y-,',''.',,, ' ' ' NOTICE
Business name: OEG, Inc. All contractors and subcontractors are required to be
Contact name: Laurel-Admin//Mike-Project Manager licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1709 SE 3rd Ave jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: Portland, OR 97214
apply:
Phone:( 503) 234-9900 Fax::(503 ) 234-1001
E-mail:laurel.semprevivogonzalez@oeg.us.com .,
0;;IT*Ti',Iiisl,'.''''- -',',' '::::' 7:.,,,i,-: ' ,:':: ::::',-', l3p14p.,,INGPERWTITES,.. -""'.'"- -
Business name: OEG, Inc.
Permit fee:
Address: 1709 SE 3rd Ave
State surcharge(12%of permit fee):
City/State/ZIP: Portland, OR 97214 FLS plan review(40%of permit fee):
Phone:(503 )234-9900 Fax:(503) 234-1001 (Due upon application submittal)
CCB lie.: 203 Total permit fees: /74:# )(0
Amount received:
Authorized signature:
116
i ,0 /
This permit application expires if a permit is not obtained
Print name: Laurel emprovivo Date: 12/13/18 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
Is\BuildinglPermits\FPS-PermitApp_031016.doc 440.4613T(I 1/02/COM/WEB)
. 4
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:
❑ New system Number of sprinkler heads: Number of alarm devices: 3
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
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,orD as ap licable) ty i c "
A.) Come efcial
Sprinkler Type ❑ Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation $
B.) 'ype I ligod'"Fire"Suppression System i a:f
Hood Project Valuation: $
w � �
//�� ��iii�,� � '.. ,`d".� R i. t Pau �` r' '' d�����u�� r�•�e;���gv4��4b1 ll�r (�,,i t x�iu�F.�"
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $ 4,500.00
D j Residential Sprinkler(Stand Atone System) s r f2 h �, r
as �n " rz ".
Square Footage: Permit Fee:
9 g
0 to 2,000 $198.75
2,001 to 3,600 $246.45 401111,3ISEggiPEOPERM111111111
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
G v,Vit,. Fire'.Protec`t on Permit Fees S lr",a,tli s iij
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: $
1:\Building\Permits\PPS_YermitApP 031016.doc 2
Branden Taggart
From: Branden Taggart
Sent: Tuesday, December 18, 2018 5:04 PM
To: 'Semprevivo Gonzalez, Laurel'
Cc: #Building Permit Technicians
Subject: VSP Fire Alarm Permit: FPS2018-00180 - 10220 SW Greenburg Rd Suite 125
Attachments: Branden Taggart.vcf
Hi Laurel,
Your permit for VSP has been created and is ready for payment. The balance due is$190.06, and you can pay the fees
online now through our website: https://aca.accela.com/TIGARD/Default.aspx. To pay the fees online,click on the
Building tab, enter the permit number in the Record Number field (FPS2018-00180), and click Search. Please let us know
when the fees have been paid, and we will email you the permit paperwork.
Thank you,
Mandan Taggart
q City of Tigard
M6 ; Senior Permit Technician
<w Community Development
TIGARD
13125 SW Hatt Blvd
Tigard,OR 97223
(503)718-2449
brandent@tigard-or.gov
1
Branden Taggart
From: Branden Taggart
Sent: Wednesday, December 12, 2018 10:17 AM
To: 'Semprevivo Gonzalez, Laurel'
Cc: #Building Permit Technicians
Subject: VSP Fire Alarm Permit Submittal: 10220 SW Greenburg Rd Suite 125
Attachments: Branden Taggart.vcf; FPS_PermitApp_031016.pdf
Hi Laurel,
The courier delivered your submittal for VSP a second time, and again you were missing the Fire Protection System
application. We do not accept incomplete submittals, but I made an exception this time. If you can email a completed
Fire Protection System application to us, we will process your permit within 2-3 business days. I have attached the
permit application above for you. To reiterate our fire alarm affidavit permit requirements, we will need the following:
• (1) Completed Fire Protection System permit application (front and back).
• (1) Completed Fire Alarm Affidavit.
• (3) copies of a floor plan showing the area of work.
• Note: No cut sheets are required.
Also,you are welcome to email the applications and plans to us in the future. If you have questions, please let me know.
Thank you,
Branden Taggart
s City of Tigard
IN Senior Permit Technician
1 �°' Community Development
13125 SW Hail Blvd
Tigard,OR 97223
(513)718-2449
brandent tigard-or.gay
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
1
OEG, Inc.
1709 SE 3rd Ave
Portland, Oregon 97214(503)234-9900
TRANSMITTAL
Date: 12/12/2018
To: City of Tigard
Attn: Building Permits RE: Lincoln Center VSP Suite 125 3L
13125 SW Hall Blvd Fire Alarm Devices
Tigard, OR 97223
Herewithin (X)
Under Separate Cover ( )
Direct ( )
Good morning!
Here is the plan review and application that we discussed. Whenever payment is required, I will pay it ASAP.
Thank you!
laurel.semprevivogonzalez(cr�oeq.us.com
These Items are being sent:
( ) For your immediate action, keep us advised of action taken
(X) For you to process
( ) For your inspection and approval
( ) For your General Information and File
( ) For your Approval or Corrections
( ) For you to correct if required, &return conforming copies to us
( ) Please advise if additional copies are required after Approval is rec'd
( ) Please return copies to us with approval or correction notations
( ) For you to submit a proposal upon work indicated as being changed
( ) (Approved)(Disapproved) By As noted
Please contact us promptly if there is a problem or question Very Truly Yours,
Laurel Semprevivo Gonzalez
OEG, INC.
City of Tigard RECEIVE No.: /----,95-iiiF-o `eo
;� ,1 13125 SW Hall Blvd.,Tigard,OR 97223
1 Phone: 503.718.2439 Fax: 503.598.1960 Date Received: % r/7
f;
Inspection Line: 503.639.4175 I t` �t—�s+
1f t;.n R n Internet: www.tigard-or.gov L By: gfi 7-)0.4
CITY() ",t
FIRE ALARIVM:ht�� 4 iii DAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: VSP Suite 125 Occupancy:
Job Address: 10220 SW Greenburg Rd Suite: 125
Contractor: OEG, Inc Phone: 503-849-2597
Valuation of work: $2,400.00
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 0.5)
Number of Proposed Manual Alarm Stations: To be Added 0.5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added 0.5) 3 /To be Relocated(max 5)
(2) horn strobes, (1) strobe
I, OEG, Inc. Oregon Construction Contractors Board No. 203
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: AWL,
I Date: 12/11/18
Print Name: Laurel A. Semprevivo
I:\Building\Forms\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 125, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00180
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor