Permit (56) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
:I ■ .. COMMUNITY DEVELOPMENT Permit#: FPS2019-00007
Date Issued: 01/16/2019
T f c A R 17 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD
Project: Regus Lincoln Tower Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Adding and relocating(4)sprinkler heads on the 4th floor.
Contractor: WYATT FIRE PROTECTION INC. Owner: LINCOLN CENTER LLC
9095 SW BURNHAM BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97223 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/16/2019 $72.61
12%State Surcharge-Building 01/16/2019 $8.71
Type of Use: COM Plan Review-Fire Life Safety-COM 01/16/2019 $29.04
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 01/16/2019 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: .01 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $110.86
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,280.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
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 5 3.232.1987 or 1.800.332.2344.
Issued B
y:XPer ee 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.
Building Permit Application
Fire Protection System x F : FOR OFFICE USE ONLY
City of Tigard Received % la ,
III ■ 13125 SW Hall Blvd.,Tigard,OR 97223 JAN 1 2019
C Plan Review
to Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit:
T i(,:1 R D Inspection Line: 503.639.4175 CITY G, _;, Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov jiLD;rc, �i N Notified/Method: Supplemental Information
['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 ❑Other: equipment,materials,labor,overhead,and the profit for the
Jitzertmwasivivrarespwore wow work indicated on this application.
I=11-and 2-family dwelling ❑■ Commercial/industrial Valuation: $
111Accessory building ❑Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
vire4mgri1 N-Nrigiyfes` 1 11 t ';§ Total number of floors:
E. : . : __ a 1: ,:a. lei
Job site address:10260 SW Greenburg RD New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:4th floor Project name:Regus Lincoln Tower Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
C# i; I b 11k!m�latl gal 1.
Y n
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
skall �
kd► t t ! ,' worinicated on this application.
.Avpilt
Add and relocate fire sprinkler heads as required. Valuation: $1280
Existing building area: square feet
New building area: 0 square feet
i ` " t Ntiltnat Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ronin Campbell licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:( )503.684.2928 Fax: :( )503.684.9657
E-mail:r.campbell@wyattfire.com
- . WafteeleseitmomikakiekRIM .. .. ' t s lis , ,��1
Business name:Wyatt Fire Protection "" ''
Permit fee:
Address:9095 SW Burnham
City/State/ZIP:Tigard,OR 97223 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.)
CCB lic.:64077 Total permit fees:
Amount received:
Authorized signature: A A
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Ronin Campbell Date:1/16/19 *
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
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C' i #.�=,.sem � ..,�
,
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
ElNew system Number of sprinkler heads: 4 Number of alarm devices:
0 Addition or 0 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:
Pililigirigaalara*RMIZIWSZT*14P-41t3~.**StiftetaigaWWW4iirieftiOr-"?' _*40;44,4- c -
So rinkler T j.a Concealed ❑■ Wet ❑ D
Additional Stand i i.es
Information: EMEEMEINEOZ2 ❑■ Yes ❑ No
Hazard Grou. Light
Densi 0.1
Desi. Area 1500
K. Factor 5.6
S. '� .•- V, . 'os: $1280
Hood Pro'ect Valuation: $
,z may.
s
Submittal shall Batte Calculations El Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Pro•ect Valuation: $
_'�' # sae , . d 9 .,t . t i E A'k{ e a s
ravrzS•uare
t,a..
e: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45 14 YZ`+
3,601 to 7,200 $310.05
7,201 and eater $404.39 .,
Sprinkler Project Square Footage: sq.ft.
Pro.ect valuation subtotal see A,B & C above : $
Permit fee based on ero.ect valuation see fee schedule : $
Permit fee based on s.uare foota•e see D above : $
State Surchar•e 12% of sermit fee : $
FLS Plan Review 40% of.ermit fee : $
TOTAL: $
W:\Permits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc2
R1i1
CityofTigard L �. " F.-P(5).1)/z,
j , ,l
g Permit No.: l / S1,LO/Cf C2a22j7
' 13125 SW Ha11 Blvd.,Tigard,OR 97223 J �� "in
Phone: 503.718.2439 Fax: 503.598.1960 9liAl
Date Received: //&
Inspection Line: 503.639.4175 r
01),(;e4MS.X.,
I I�:3 AR I) Internet: www.tigard-or.gov q�e p`l,3, ) By: �.
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r� r ..a 4Yj I ', ) :..+L V
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Regus Lincoln Tower Occupancy:
Job Address: 10260 SW Greenburg RD Tigard, OR 97223 Type of Construction:
Suite: 4th floor
Contractor: Wyatt Fire Protection Phone: 503.684.2928
Number of Proposed or Altered Heads: 4
Type: Concealed Hazard: light Density: 0.1
1, Wyatt Fire Protection Oregon Construction Contractors Board No. 64077
certify the following is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
b) Positions of sprinkler heads relative to architectural features such as soffits,beams,partitions,walls, etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop (exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads(see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
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.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
e
Signature: Q)/(ld Date: 1/16/19
Print Name: Ronin Campbell
I:\Building\Forms\FireSprinlderAffidavit 071514.docx Page 1 of 1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10260 SW GREENBURG RD, TIGARD, March 14, 2019 at
OR, 97223 10:04:32 AM
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00007
Inspection Type: Inspector:
999 Sprinkler final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor