Permit (164) CITY OF TIGARDIN FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00062
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14/2019
Parcel: 1 S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 545
Project: Spec space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm.Adding(4)fire alarms for TI.
Contractor: OEG 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 05/14/2019 $123.72
12%State Surcharge-Building 05/14/2019 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 05/14/2019 $49.49
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 05/14/2019 $6.00
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: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Cates Provided: Cut Sheets Required:
Total $194.06
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $4,900.00
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: \,.........AiPermittee Signature: C..:„,—t.-
t,G 5 'h`...kr rP--\\
VVV 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 RECEIVE FOR OFFICE USE ONLY
City of Tigard Received
Permit No.
11 e 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 1 3 2019 DateB : Ci �� � '�
Plan Review `? `qt . ,\ . .
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permi.
T 1 G A R U Inspection Line: 503.639.4175 CITY OF TI GAR D Date Ready/By: funs. 0 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIO otified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
ID Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
I] 1-and 2-family dwelling Vf.Commercial/industrial
111Accessory building IDMulti-familyNumber of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION 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.: 545 Project name: 708097 VSP Suite 545 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
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
DESCRIPTION OF WORK. work indicated on this application.
Fire Alarm Valuation: $ 4,900.00
Existing building area: square feet 1800
New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name: Lincoln Center LLC Shorenstein Properties LLC Type of construction:
Address: 235 Montgomery St 16th Floor Occupancy groups:
City/State/ZIP: San Francisco,CA 94104 Existing:
Phone:( ) Fax:( )
New:
❑ APPLICANT 0 CONTACT PERSON
All contractors and subcontractors are required name: OEG,Inc. ed to be
Contact name: Mike Redman 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
City/State/ZIP: applicant is exempt from licensing,the following reasons
n Portland,OR 97214 apply:
Phone:( 503 )849-2597 Fax::( )
E-mail: laurel.semprevivogonzalez@oeg.us.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: :(P +se ekrro;/eeschedule/ '�
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 lic.: 203 Total permit fees:
comic, n� Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: within 180 days after it has been accepted as complete.
Laurel Semprevivo Date:05/10/19 * Fee methodology set by Tri-County Building Industry
Service Board.
-PermfApp_03i016.doc - 440-4613T(11/02TCOM/WEB)
f
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: 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
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 D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone 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: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2
RECEIVED
City of Tigard Permit No.: �r
• 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 13 2019i
I Phone: 503.718.2439 Fax: 503.598.1960 Date Received: l 1 �C
Inspection Line: 503.639.4175
TIGARD CITY OF TIGARD
Internet: www.tigard-or.gov BUILDING DIVISION BY: t^ 1 L
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: VSP Occupancy:
Job Address: 10220 SW GREENBURG RD Suite: 545
Contractor: OEG, INC Phone: 503-849-2597
Valuation of work: $4,900.00
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(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) 4 /To be Relocated(max 5)
I, 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: 5IJ1M//OVMM'l'V Date: 05-10-19
Print Name: Laurel A Semprevivo
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