Permit FIRE PROTECTION SYSTEM PERMIT
f 4 CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit #: FPS2010 -00045
Date Issued: 04/28/2010
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 350
Subdivision: LINCOLN TOWER Lot: 0
Project: Clean Net
Project Description: Fire alarm.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee - COM 04/28/2010 $102.20
12% State Surcharge - Building 04/28/2010 $12.26
PHONE: Plan Review - Fire Life Safety - COM 04/28/2010 $40.88
Houlry Building Rate 04/28/2010 $180.00
Contractor: Hourly Building 12% State Surcharge 04/28/2010 $21.60
SAFE TECHNOLOGY GROUP INC
6400 NE HWY 99 SUITE 375
VANCOUVER, WA 98665
PHONE: 360 - 699 -2130
FAX: 360- 719 -1527
Type of Use: COM
Class of Work: ALT Type of Const: IB
Occupancy Grp: B Height: ft
Stories: 12
Commercial Sprinkler Svstem:
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: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $356.94
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 2700
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 -0100. You may obtain a copy of the rules
or direct questi to OU aDer-4, NCbycalling 503.246.6699 or 1.800.332.2344.
Issued By: - _, Q 1 Permittee Signature: "` Call 503.639.4175 by 7:00 a.m. for an inspection that business day. ✓`^J
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 e /i6 Et 6 V 29 / v E Fire Protection System � t r012 n1 1 ICL`USE ONLI
T''117'''5-'''''-,. � m Receive f e) I r � �/_...) ;•/ %s
Date
City of Tigard APR .2 1.2010 B ° PermnNo.: ' D D -4O
�
71
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ► . �
® Phone: 503.639.4171 Fax: 503.598.1960 DateB : ��/�, d Other PermitE all . – , ; 4 I
CITY OF TIGARD
TI GA Ins ection Line: 503.639.417 D Read — See Pa e 2 for
p BUILDING DIVISIO y ho g
.1 . '? Internet: www.tigard or.gov I Notifie��ethod:y �� /d , .. i� Supplementallntormation
I
It4 W !__. �� , '020/0 -odO 2.
TYPE OF WORK _ ' ' Q IREDDATA: 1- AND 2 FAMILY DWELLING
❑ New construction ❑ Demolition Pe • es* 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
CATEGORY OF CONSTRUCTION work indicated on this application. •
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family
Number of bedrooms:
❑ Master builder ❑ Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10260 SW Greenburg Rd New dwelling area: square feet
City /State /ZIP: Tigard OR Garage /carport area: square feet
Suite/bldg. /apt. no.: 350 Project name: Clean Net Covered porch area: square feet
Cross street/directions to job site: Lincoln Tower Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE` CHECKLIST
Subdivision: 1 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
DESCRIPTION OF WORK . work indicated on this application.
Fire alarm
Valuation: $$2,700.00
Existing building area: 1320 square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT ' Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
g
Phone: ( ) Fax: ( ) New: B
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: Safe Technology Group Inc. All contractors and subcontractors are required to be
Contact name: Jason Sweet licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6400 NE Hwy 99 Suite G375 jurisdiction in which work is being performed. If the
City /State /ZIP: Vancouver WA 98665
applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 699 -2130 Fax: : (360) 719-1527
E -mail: sales @safetechnology.net
CONTRACTOR ' BUILDING PERMIT FEES*
.. , . (Please refer to fee schedule) .
Business name: Safe Technology Group Inc.
Permit fee:
Address: 6400 NE Hwy 99 Suite G375
State surcharge (12% of permit fee):
City/State/ZIP: Vancouver WA 98665 FLS plan review (40% of permit fee):
Phone: (360) 699 -2130 Fax: (360) 719 -1527 (Due upon application.)
CCB lic.: 173731 Total permit fees: /55 3/
0 „ Amount received:
r
Authorized signature: 1. J ` ( .�'
This permit application expires if a permit is not obtained
Print name: Jason Sweet Date: 4 -20 -10
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1:\Building\Permits \FPS- PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM/WEB)
I^J_r
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
® Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete - A, B, or D. as .applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire ,Suppression System -
Hood Project Valuation: $
C.) Fire Mann • _ •
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 2700.00
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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
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