Permit (61) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
114 ` Permit#: FPS2019-00026
■ COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/25/2019
g Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 571
Project: Trellborg Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm-notification 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: 503-412-4800
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/25/2019 $134.48
12%State Surcharge-Building 03/25/2019 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 03/25/2019 $53.79
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 03/25/2019 $8.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 03/25/2019 $4.00
11x17)
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 $216.41
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
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 503.23 1987 -r 1.800.332.2344.
Issued By: �� ,, / Permittee Signature: ("<2.1.tij /
lc)
Call 503.639.4175 o 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 USE ONE)"
City of Tigard Received,
Date/B /y y Permit Not y//y--ax)a�W
.� 13125 SW Hall Blvd.,Tigard,OR 972 Plan Revi w G _ �T'
S Phone: 503.718.2439 Fax: 503.598.1 6 ELI Date/By: 0 / / Other Perm• 44 /9-'6;1003
1 G A R D Inspection Line: 503.639.4175 FEB 2 6 2019 Date Ready/By: / `/!. ris: See Page 2 for
Internet: www tigard-or gov N.ified/Method: / �,I //��� Supplemental Information
Uf/
ms ,
IjINGOVISION � REQ" 1 "351 !
T� i
0 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
T r CAI � work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
EtAccessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
,Zt.,•g'' SITE'INFORMJO I,AND O l i,4, Total number of floors:
Job site address:10220 SW Greenberg Rd. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:571 Project name:Trelleborgs Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
e COM eVSE CHS K#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
t9 1 rONOF work indicated on this application.
Fire Alarm-Notification Devices Valuation: $$5,230.00
Existing building area: square feet
New building area: square feet
1 OPEC OWNER,S7kk .: ' ,., ...r ,
� NA,1VT � Number of stories:
Name:Trelleborg Type of construction:
Address:10220 SW Greenberg Rd Suite 571 Occupancy groups:
City/State/ZIP:Tigrd,OR 97223 Existing:
Phone:( ) Fax:( ) New:
"AP'LICANT El CONT ` " I
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
CONTRACTOR BUILDINGPERMIT
Business name:Point Monitor Corp. (Please refer to feesche$ale
Permit fee:
Address:5863 Lakeview Blvd#100
State surcharge(12%of permit fee):
City/State/ZIP:Lake Oswego,OR 97035
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal.)
CCB lic.:135901 Total permit fees:
Authorized signature Amount received:
This permit applicationnexexpires if a permit is not obtained
Print name:Ben Breit Date:2/26/19 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:ABudding\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
• City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
e$CuLue AVV►al., 0-v,F., , .xo-.. ~• � C«s, t ��`^�' P�§:�,# 4. r. �*.`.�..tr;.x,
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:
® 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: Fire Alarm Notification Devices
' 1.0; , cele •� OS$# •
4o easlee ,* t
5t: . * ''' ;' '� •••' ate, r v, : ` t ,,;
y„
A.) Commercial Sprinkler.;x 7,,7 ,
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B:) Type I-:Hood Fire SuppresSiOn System
Hood Project Valuation: $
s; n
m
'" " �,....,. ;�: €'� "�'"_ w .... ° , Oxy,.£ �"xw .~���: '. ,��
C:) Fire Alarm +, 4
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 5,230
I ) Residential sprinkler(Stan4 Moue System)
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 Fees
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: $
C:\Users\bwilliams\Desktop\PERMIT FOILI\IS\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 571 , TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00026
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor