Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2009 -00070
TiGA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/21/2009
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 830
Subdivision: LINCOLN TOWER Lot: 0
Project: Mortgage Express
Project Description: Installation of fire alarm system.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 permit Fee - COM 08/11/2009 $83.95
CALIFORNIA ST 49TH FL 12% State Surcharge - Building 08/11/2009 $10.07
PHONE: Plan Review - Fire Life Safety - COM 08/11/2009 $33.58
Houlry Building Rate 08/21/2009 $125.00
Contractor: Hourly Building 12% State Surcharge 08/21/2009 $15.00
CAPITOL ELECTRIC CO INC
11401 NE MARX STREET
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503 - 257 -7121
Type of Use: COM
Class of Work: FPS Type of Const: IB
Occupancy Grp: B Height: ft
Stories: 12
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 $267.60
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 4500
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
Utilit , otification . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or :irect questions to OU , alt :.0'.246.6699 or 1.800.332.2344.
I sued By: Permittee Signature:
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.
wu12T - t — 1 � tad ��
Building Permit Application
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Fire Protection System ��', ti� FOR.OFFICE USE ONLY
' City of Tigard \\,.. ® �q Date/By: p Q I Permit N °.: qO70
_ ' 13125 OR 97223 �� \ 13125 SW Hall Blvd., Ti � ` (. 7 7 /.5 a�9 —
Tigard, °‘ V G � l� Plan Rein' '� \ fl . � i :
' = N, = Phone: 503.639.4171 Fax: 503.598.1960 �
TI GARD Inspection Line: 503.639 C l� ��� \S
W Date /B : ing Date Read : p� 1 0 Other Permit.
10 See Page 2 for
Internet: www.tigard- or.gov
Q � 1 ti � Notified MethoH e29 A : p �/ � t t � Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ 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
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
❑ 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. (Lincoln Tower) New dwelling area: square feet
City/State /ZIP: Tigard., OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 830 Project name: Mortgage T.I. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:. COMMERCIAL - USE CHECKLIST
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
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Install Fire Alarm Notification Devices In Tenant Space Valuation: $4500
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Shorenstein Realty Services Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: Capitol Electric Company, Inc. (Please refer ta lee seliedu/e
Permit fee: 8 5 , 9-5
Address: 11401 NE Marx Street
Ci /State /ZIP: Portland OR 97220 State surcharge (12% of permit fee): I 0 • 07
ty FLS plan review (40% of permit fee): 2 '
Phone: (503) 255 - 9488 Fax: (503) 255 - 1966 (Due upon application.) d .4
CCB lie.: 48748 Total permit fees: 1 A -). 100
61,,,,
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: Dan Wilson Date: 8/5/09 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 03/23/06 440- 4613T( 11 /02 /COM /WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
I '
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, C 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 Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ $4,500
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): $ 4,500.00
Permit fee based on project valuation (see fee schedule): $ 83.95
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 10.07
FLS Plan Review (40% of permit fee): $ 33.58
TOTAL: $ 127.60
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.
U: \FA Jobs \z290667 -45 Mortgage Express, LincTwr -850, JUG 1 FPS - PermitApp.doc 2