Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
• COMMUNITY DEVELOPMENT Permit #: FPS2010 -00013
T r GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/10/2010
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 500
Subdivision: LINCOLN TOWER Lot: 0
Project: Starbucks
Project Description: Add (1) pendent and (2) window sprinkler heads.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
Permit Fee COM 02/10/2010 $56.47
CALIFORNIA ST 49TH FL
12% State Surcharge - Building 02/10/2010 $6.78
PHONE:
Contractor.
AFP SYSTEMS INC
19435 SW 129TH
TUALATIN, OR 97062
PHONE: 503 - 692 -9284
FAX: 503 - 692 -1186
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $63.25
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation:
Residential Square Footage:
Fire Alarm Valuation:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. I work will be done in accordance with approved plans. This permit will expire If work is not started within 180 days of
issuan • if work is su • - ded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili I otification Center. Th. . e .. re set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or • ect questions to OUNC by < • ling 13. • .:699 or 1.800. 2.2344.
Is ued By: / ,P Permlttee Signature:
Call 503.639.4175 by 7:00 a.m. for an Inspection that busine y.
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 orrlc:f; test; ONLY
City of Tigard Received Data; • . to /0 _� 1 Permit No.: 'S.. 0 .. a co/
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
- Phone: 503.639.4171 Fax: 503.598.1960 Dawis • Other Permit: Al pap /e, ,- •,
. t - i i i \ i. 0 Inspection Line: 503.639.4175 Date Ready/By: /uric ® See Page 2 for
Internet: www.ligard- or.gov Notified/Method: Supplemental Information
....... ......:::: -.RE .:- :.: A ,,. 1 .,.:, 2- F MIL;Y?DWELUNG::::.
❑ 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
:.:: ;:<::-:: ::.::..,.:::•:-....::::...;:, .- _......-, _: work indicated on this application.
_ - _ rk'ndic app! c
Y F' R I : :; :y . i ., r: w�: "_;, ;:._.:
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�.: >:::.� CAT b CONST „UG?., ....:._ -._
❑ 1. and 2- family dwelling �6ommerciaUndusMal Valuation: S O OD
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
: =�; _i' Total number of floors:
Job site address:
- `J.OB`:SITE:_INFQRD3A,�ON” 'O 'A1'I ION: . ...::::. : ::::... : ..::• ' ;.:-
k� ��t
lor�(c S W �or1A.Ql+�.k1Wt,M It New dwelling area: square feet
...> ' ....:.,. _.... .
City / State/ZIP: "----1 m 2 Garage/carport area: square feet
Suite/bldgJapt. no.: I Project name: S roAlot riles 1b- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
-RE,QUIRED:, iA` 'Aa COMfMER040.1SE CHECKLIST
Subdivision: I 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
:. :: .
. and profit for the
.:.: :::.:.:: :: :: �:• ,:;<- ::-:. :c�:; �: '•::::' �;= ::,:-..::::::':: .::.,.; >.. r.. ^ .. _ _... - ,, . _ ..:.. . equipment, materi labor, overhead, an the ro 1
' ' =, = ; ,,,„ : work • indicated on this application.
ea
. - ..:_ .•: ,.. :_. bES F :WO It K•: - -. _ P
A ct.r. I Pi ! F �i , '. Valuation: S 7A
I Existing building area: e, c square feet
New building area: 200 square feet
- :_:;.'....:..;._ ....,p ..P.:;R.. Number of stories:
- ROE _ - : '�s= - -; 'I'E NA
Name: (j-j, Type of construction:
Address: 1 0.1GO S & d o.w . # g) '
w SbU Occupancy groups:
City /State/ZIP: 'TLq t9 & J Existing:
Phone: ( ) `� Fax: ( ) New:
Business name: A FP S All contractors
Business subcontractors are required to be ' L`
Contact name: cAi iv g .. ,„ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 19 4..1 S 1 keit ' Nue jurisdiction In which work is being performed. If the
City /State/ZIP: --r- t o applicant is exempt from licensing, the following reasons
apply:
Phone:( ) b - °12%' or ) (og2 -1I$-6
E -mail: JNM lA,`
C1
AF Y
CONT CTOR-:% • . itA. -1,�': °:�:BUIY:DIN :P i :
- - G E R 1 p
Business name: ' .. . ' r •'- re fe V o tee rc :d ;: :;.:.: c:'.%. :. -': > .'
Address: Permit fee: 5-6 Y 7:
City / State/Z1P: State surcharge (12% of pennit fee): 1, .7 g
I FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application)
CCB lie.: 1,,'� S `S 9 Total permit fees:
Authorized signature: 0- ZO Amount received: ( -C
This permit application expires if a permit Is not ohtaltled
I Print name: „AtyN. Ni iv I Date: ec - ' —ID 1 within 180 days after it has been accepted as complete.
I • Fee methodology set by Tri- County Building Industry
Service Board.
1ABultdinaiPermitnPPS- PermitApp.doe 01!13/06 440.4613T(11 /02/COM/WEB)
, .
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Deribe:viork to be.done: " • 1 . :.
1.) D New 2.) Modification to sprinkler heads only:
0 Addition I-4 -1O heads: No plan review required.
121- Alteration 0 11+ heads: Plan review required.
0 Repair
Number of sprinkler heads: 3
Additional descripti9n of w9rk:
A Atit et).4).--A udv.4(cru.
• • •:. . . .
Type . of.SySiern.(CoMPlete:A, , B, C or D as applicable): 1: -
-;.Commercial Sprinkler
131- W
et 0 Dry
Additional Standpipes
Information: Hazard Group
Density • 10
Design Area 1500
K. Factor 5,6
Sprinkler Project Valuation: $
B) Type! Hood Fire Suppression System
: •••.. ,••• '
Hood Project Valuation: I $
C) FireAlarin
. - . . -.•
..‘ , .‘ - •
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
SpriiikletAStarid AlOrie: : : • •:-."
, . „ . . . .
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
• ' • Fire Protection Permit Feel - ; •
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fcc schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
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