Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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.3 COMMUNITY DEVELOPMENT Permit #: FPS2009 -00074
Date Issued: 09/24/2009
T[GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Subdivision: Lot: 0
Project: Lincoln Two
Project Description: Core and shell replacement of existing fire alarm system.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee - COM 08/19/2009 $520.30
12% State Surcharge - Building 08/19/2009 $62.44
PHONE. Plan Review - Fire Life Safety - COM 08/19/2009 $208.12
Contractor:
SIMPLEXGRINNELL LP
6305 SW ROSEWOOD ST.
LAKE OSWEGO, OR 97035
PHONE: 503 - 683 -9000
FAX: 503- 675 -6521
Type of Use: COM
Class of Work: FPS Type of Const:
Occupancy Grp: 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: Yes Alarm Type: Automatic
Pull Station Required: Yes Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $790.86
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 81270
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 questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: 7
-- 4 ..1,
Call 503.639.4175 by 7:00 a.m. for an inspection th t u siness 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 a FOR OFFICEUSE ONLY
Cit of Ti and RECIcil Rec eived !� O �I ^
y g Date/By: 1 J 9 a Pcrnrit No.: �/� � C / V
" 13125 SW Hall Blvd., Tigard, OR 97223 g Plan Review Q /�� v -
Phone: 503.639.4171 Fax: 503.598.1960 AUG A 2009 Date/By: � l 1��1 Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready Q / /
luri ^ 0 See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD NotTi ethod: 704 0 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
, , ., ,:,_-„ �, ; ,r n .T,-R,•T,:.' °.,;,t work indicated on this application.
' " CA�TEGORI \ 'OF,: 'CONSTRUCTION a' -. .' ; ', -, „,...k.> 'z
El 1- and 2- family dwelling E Commercial /industrial Valuation: $
1=1 Accessory building 111 Multi-family Number of bedrooms:
111 Master builder 111 Other:
Number of bathrooms:
` • ; ;IF ': ' 'O "z B SIerlisIFOk∎;' 1WION :4 `- a,, ' -, Total number of floors:
Job site address: 1 ) 2'- o De • New dwelling area: square feet
City /State /ZIP: I OR --4-223 Garage /carport area: square feet
Suite /bldg. /apt. no.: Project name: u►^cD 2 / FAQ ,,_, Covered porch area: square feet
Cross street/directions to job site: ! Deck area: square feet
Other structure area: square feet
`'REQUIiii6Iiii GOMMERGIAL- .USE «CHECKLIST°
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Subdivision: I 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
< ri'.ii = f Vi i:
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. ,, '„` } z t ` a : ” ' work indicated on this application.
�,:• < <; ” '`x.y DESCRIPTION ,., OF`'• :W,ORIC;;c� ;, �.:1 �
1�2Av�> 92 E:= X. ■ SA 1 GJC—hrb� S't'C t
Valuation: �Q 2--4-
2��lGc e . ....) V`QW -',-e_ a C. V V � Existing building area: 1 square feet
S �S-• `� ae.Ai t ce l New building area: square feet
`:< i, ';` "' "re TEN ;,, : •' . Number of stories:
.� ► . , 11 ;',OWNER %`; ❑
Name: ')\.e l/ --eiu 2e_1. Se��ru ice .s Type of construction:
to Address: J C-1rP e e. Occupancy groups:
_
City /State /ZIP: --- Fi cl ry 'Z -2_Z Existing:
Phone: ( ) Fax:( ) New:
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Business name: S l• e--' C -j„ `p 11 All contractors and subcontractors are required to be
Contact name: /` 11 '' licensed with the Oregon Construction Contractors Board
3 h Qv` 't 4h ti P "C C"1 "`mss under ORS 701 and may be required to be licensed in the
Address: �3cps �- e . ,k C , jurisdiction in which work is being performed. If the
1 � � applicant is exempt from licensing, the following reasons
‘ ...... 1 4_12 C :::
City /State /ZIP: l Ce gn"OSS apply:
Phone: ( ).5)1083 ..- 1 Fax: : (5b3) 6 -- — ( S Z.I
E -mail: a i C v`tti � „ ' 1 D Q S�l l l m v\&eS t COvtti
�<.. NTRACTOR r �� ";�. %; ::�,,r, _,;.,.
.. r CO > ,, «: .., `:BUILDING'PERIVIIT' PO4. ,.,
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^;te, �„ e P er, °1o� eeaclre .:.. <_`� ;;; '_ ::' >"
Business name: e \34.v... (
` ,1��'� .� ` Permit fee: �� °
Address: Q
���� `�,��',„ State surcharge (12% of permit fee): _. qv-- City /State /ZIP: \ C �_ / , x p n - I c � " � � FLS plan review (40% of permit -' f / L `
Phone: (.,3 ) 42) l" Fax: (( 3) �- _ �� ( (Due upon ap• 'cati-;n.) 208
CCB lie.: 1([j G121 Total permit fee . � -- � / ,
A Amount received: �� . (7"
Authorized signature:
• , • This permit application expires if a permit is not obtained
Print name: ' � ' Date: B (7 . I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I: \Budding \Permits \FPS - PermitApp.doc 03/23/06 440- 4613T( I I /02 /COM /WEB)
.� • •
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
-done• .:::��
3' 1, xfFii..
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -1 0 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
•rikl'y�r
e = i e.
`'tner�talS ri .4
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❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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, "� :�� : ,,,...,.._ . ,� .�..„,, "�_...��: "�,�
Hood Project Valuation: $
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Fir :.Alarm
Submittal shall Battery Calculations IN Yes
include: Individual Component ki Yes
Cut Sheets
Fire Alarm Project Valuation: $
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d'e � � 111 .%`ti�x:�rl... .
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tiler Sta s
Square Footage: Permit Fee:
0 to 2,000 $187.50
2001 to 3,600 $232.50 7 10 , , ', `
3,601 to 7,200 $292.50 0'n. -,'
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
r. -.� i iW*otecti ' n`Pernit` Fees>
Project valuation subtotal (see A, B & C above): $ S t , Z.
Permit fee based on project valuation (see fee schedule): $ S
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ (02. `f`{
FLS Plan Review (40% of permit fee): $ j� . CL
TOTAL: $ - cam . 8C.,
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.
C. \llocuments and Settings \bgiannettino \My Documents \ Permits \City of'1'igard \IMPS- tn;•rmitApp.doc