Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2011 -00011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/11/2011
Parcel: 151 35AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREEN BURG RD 400
Project: Bridgewell Resources Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project Description: Relocating (10) sprinkler heads for TI.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 331 -0234 PHONE:
FAX: 503 - 331 -6907
FEES
Description Date Amount
Specifics: Permit Fee - COM 02/11/2011 $67.23
12% State Surcharge - Building 02/11/2011 $8.07
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard:
Density: .10 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $75.30
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,100.00
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 ex.ire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law require ou o follow the rules a ted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR • 2- 001 -0190. You may ob in copy of the rules
or direct questions to • NC by calling 503.232. • • .:.., ! 344.
Issued By: _Permittee Signat re /1 e „.z /
Call • •.4175 by 7:00 a.m. for the next availab ' • .ection 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 �
��N � FR•
OOFFICE,USE•ONL �
ii 1 C ity of Tigard � n
- 1 . 1 ��\\ DateB �
Plan Review 1/ / // n /37)-- /37)-- Permit No.: Fes 9 // cc
13125 SW Hall Blvd., Tigard, OR 97223 cc .'c3 �(2 Other Permit: � P /I — )
' Phone: 503.639.4171 Fax: 503.598.1960 G V f �,� v., DateBV: [ f �
T I GARD Inspection Line: 503.639.4175 OF' r ``,',(S pO [ Date Ready/By: tuns: El See Page 2 for
Internet: www.tigard or.gov CXXI ��O1V Notified/Method: 1J.—t, Supplemental Information
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❑ 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
, ' k � OF work in dicated on this application.
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'.- 'a _, CATEGORY :OF C. ONSTRUCTION . i � - �� ;,� , k .
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El 17 and 2- family dwelling ® Commercial /industrial Valuation: S
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ® Other: Number of bathrooms:
'.a_ =..;'” i.,,... r = : �.,
&> y ,, „x Y,_, ; u JOB SITE FOR,YIATION< ,I . 9CATION, <, -' k , :._ —,
°..�, »n ,, r,, >,i;...�,�'E ,,. >s ., ���' ° ..,:�a.�,� �a-a.` �a - h � �� s:� ..., ' ' s'�w, 4:» u Total number of floors:
Job site address: 10200 SW Greenburg New dwelling area: square feet
City /State /ZIP: Tigard, OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: 400 Project name: Bridgewell T.I. Covered porch area: square feet
Cross street/directions to job site: 5 Lincoln Deck area: square feet
Other structure area: square feet
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EED DAT A:rC011 MER'CIAL=TJSE
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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
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equipment, materials, labor, overhead, and the profit for the
; :1 ;� kti
',_ il laSCRIPTsiON 'OF 'WORK .� i9b -. so f =t _ a,e ,, » ,' ' � work indicated on this application.
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Relocate 10 fire sprinkler heads for new tenant wall layout Valuation: S t 1 W , s
Existing building area: square feet
McKinstry Job #9427 New building area: square feet
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„ , ;ROPERTI OWNER y *�< '�: ;, »;`� E� � T�ANT���� }� �� ��; Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
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T���. , ��``��I�� :��� NOTICE � ... �,�. .�
Business name: McKinstry Company, LLC All contractors and subcontractors are required to be
Contact name: Diane Parke licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 16790 NE Mason Street, Suite 100 jurisdiction in which work is being performed. If the
City/State/ZIP: Portland, OR 97230 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 331.0234 Fax: : (503) 331.6907
E -mail: dianep @mckinstry.com
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Business name: McKinstry Company, LLC < -li -;; ?_ - ° (Piease r "efer toyee<sch - ,;460". ':�;s '.,-
Permit fee:
Address: Same as applicant
State surcharge (12% of permit fee):
City/State/ZIP: FLS plan review (40% of permit fee):
Phone: ( ) ax: ( ) (Due upon application.)
CCB lie.: 172811 Total permit fees: 5 �✓
Authorized sign tur ,, fi'F/ al 4,Aka Amount received: - 7 5:
This permit application expires if a permit i not obtained
•
Print name: ) 6/ • c cZ Kew Date: 7/ within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits \FPS - PermitApp.doc 03 /23/06 440- 4613T(11/02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
escri "�'e' -. rkAt ;`lie�dorie: �,FU =�•' �;�. ,
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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: 10
Additional description of work:
4 a ,. `�_�' •��; =:: ...�,::. ..F :�"=', �:.y:ii ey. •�_'" t " �=3!j" `I� n�HP
'- 'T'ypenof`System (,Complete �'B .G =,or�D ; ;as,apphcable):��1 �' '� `:� 3�=
A `';COIT1merc t " al .e! Antler {5 j a i , 1k s��,'',^; a, lkkj a A ' a
� , ��e. � a';r �I�a�, � ���?�.;:s� -.. ��,�._ _._ _. e.>•.
® Wet ❑ Dry
Additional Standpipes 1
Information: Hazard Group light
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 1100.00
{ �a � - ' -_ � �i :_, 'e•=S �: �s' P."'fi�.xY aw:,, - � t .' ' H- � y =�" , a�,.
$B)£Typ I hoo F ire ;Supp re ssion • ; System; -x' -
IIood Project Valuation: $
C� Fire Alarmt 41. Z Y # a 4
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
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Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50 ,12-0%,44,4,t
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
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.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
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LEGEND 1120 NW Couch Street
Suite 300. Portland
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Fax: (5031 299.6273
I I EXISTING LIGHT FIXTURE TO REMAIN www.gbdarchitects.corn
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