Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2010 -00025
T GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/23/2010
F
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW Greenburg RD 1250
Subdivision: LINCOLN TOWER Lot: 0
Project: Reinisch & McKenzie
Project Description: Add (3) pendents and relocate (5) pendents.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee - COM 03/23/2010 $80.68
12% State Surcharge - Building 03/23/2010 $9.68
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: B Height: ft
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $90.36
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 0
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, spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit otification Center. ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or erect questions to OUN • g 503.246.6699 or 1.800.332.2344.
slued By: / / i,1 � < Permittee Signature: A
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 RFC r> FOR O1 FICE USE ONLY . . ,
Cl of Tigard Received
P ermit No.:
� g Date : a r A►_ 5 , . . — 060a
o 13125 SW Hall Blvd., Tigard, OR 97223 fl /l; \, p t.; Plan Review / pa� O
C Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit: 1
Ins Lithe: 503.639.4175 L . i Date Ready/By: 0 See Page 2 for
Internet: www.tigard -or.gov t u¢
I 1 l'r\ K t7 ' , ,
,'■ Notified/Method! Supplemental Information
BUILD I)
- I)' V ial 01).1
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAb11LY DWELLING
❑ New construction ❑ Demolition Penult fees* are based on the value of the work perfonned.
Indicate the value (rounded to the nearest dollar) of all
0- 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 Jommercialrndustrial Valuation: S
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
. JOB SITE INFORMATION AND LOOCATION Total number of floors:
Job site address: 1049,6 0 6 k.f?" K r New dwelling area: square feet
City /State /ZIP: n OR y� Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 (D I Project name: R Q 1lM R� , ('Y) U Covered porch area: square feet
Cross street/directions to job site: 6(„ ,(,0 ' t Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: l Lot no.: Pennit fees* are based on the value of the work perfonned.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
• (n�
.,111 3 ++ DESCRIPTION OF WORK d work indicated on this application.
OL/A.A Pt) M.PADA n 5 J f
— K -IIIVT k k j� 41w(A Valuation: S 4,00 , 00
Existing building area: j() 0 square feet
New building area: 02 00 0 square feet
❑ PROPERTY OWNER , . I ®, TENANT Number of stories: j b
Name: IP\IAJ 1 - I 10. Type of construction:
Address: ' 0
(0 1.'t,b �r St 1 ILO Occupancy groups:
City /Slate /ZIP:1-n ad �f 0 K Existing: y---
Phone: ( ) Fax: ( ) New:
ki APPLICANT. - -0 CONTACT ;PERSON NOTICE .
Business name: A EP SrtN,- -. dNA All contractors and subcontractors are required to be
Contact name: J licensed with the Oregon Construction Contractors Board
tv. IJI under ORS 701 and may be required to be licensed in the
ry
Address:
°� t f -55 S , I a9 , L jurisdiction in which work is being performed. tithe
City/State/ZIP: applicant is exempt from licensing, the following reasons
t0At_ton - i✓ OJ apply:
Phone: ( 56 ,92 �` Fa. -x: (5b3) 1. 9 2 --1 I 9 C.
E -mail: 31."..� IC}Fp 5y5. Cot^'
CONTRACTOR BUILDING PERMIT FEES*
- (Please refer fofee schedule) /
Business manna: Pennit fee: 0 . (Ob
Address:
City /State/ZIP: State surcharge (12% of pennit fee): C?' 6g
FLS plan review (40/oof permit fee):
Phone: ( ) Fax: ( ) (Due upon application)
CCB lic.: 175 3 t-k Total permit fees: 0 •
Authorized signature: Amount received: ( 3/0
This permit application expires If a permit Is not obtained
Print name: Date: 3 4Z'Z. l0 1 within 180 days after It has been accepted as complete.
�° " t ✓ t • Fee methodology set by Tri- County Building Industry
Service Board.
1: tauitdingTermitsffS •PermitApp.doc 03/23/06 440•4613T(1)/02/COMWEB)
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.
0 Repair
Number of sprinkler heads: C A
Addition. 1 description of work:
frt
Type of System (Complete A, B, C or D as applicable
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group ( ` r Lt 6 tt
Density . 10
Design Area 150 O
K. Factor 5, 6
Sprinkler Project Valuation: $ /Wp
B.) Type ]( - Hood Fire Suppression System
Hood Project Valuation: 1 $
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 $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 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. Plata review fees are required at submittal.
I: \Building \Permits \FPS - Permit 1pp.doc 06 /25/08 2