Permit „ CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'” 1 / ' -- COMMUNITY DEVELOPMENT Permit #: FPS2013 -00105
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/01 /2013
Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 320
Project: Springwater Wealth Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Fire alarm modification
Contractor: SAFE TECHNOLOGY GROUP INC Owner: LINCOLN CENTER LLC
6400 NE HWY 99 SUITE G375 BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98665 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360- 699 -2130 PHONE:
FAX: 360 -719 -1527
FEES
Description Date Amount
Specifics: Permit Fee - COM 08/01/2013 $83.37
12% State Surcharge - Building 08/01/2013 $10.00
Type of Use: COM Plan Review - Fire Life Safety - COM 08/01/2013 $33.35
Class of Work: ALT Type of Const: Info Process /Archiving - Lg $2.00 (over 08/01/2013 $8.00
Occupancy Grp: Height: ft 11x17)
Stories: Houlry Building Rate 08/01/2013 $180.00
Hourly Building 12% State Surcharge 08/01/2013 $21.60
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 $336.32
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,655.00
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 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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: i ) n Permittee Signature p ,,,,42 Call 503.639.4175 by 7:00 a.m. for the next available inspection 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
tiii Fire Protection System RECEIVED I O R OFFI('l1 1 SF ,-,N,„ Cit of Tigard A \ L jL, 1 �/ Received � r0 �
City Date r i Perm No. GPS �d/ 3
13125 S W Hall Blv T igard, OR 97 (' Plan Review
Phone: 503.718.243 Fa x: 5 03.59. 6� 1 2013 Date/B : OtherPermlt.��j��� —LY' /p
Inspection Line: ligard 503.639.4175
CITY O� G pD Date Ready/By: Juris: 13 See Page 2 for
Internet: www.or.gov ► 1 �VC11\L Notified/Method: Supplemental Information
BUILDING DIVISION
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.
❑ I- and 2- family dwelling ® CommerciaVindustrial Valuation: $
11 Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10200 SW GREENBURG RD New dwelling area: square feet
City/State /ZIP: TIGARD OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 320 Project name: SPRINGWATER WEALTH 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.
FIRE ALARM Valuation: $$1,655.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
0 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*
Business name: SAFE TECHNOLOGY GROUP INC. (Please reerwjeeschedule)
Permit fee:
Address: 6400 NE HWY 99 SUITE G375
City/State /ZIP: VANCOUVER WA 98665 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (360) 699 -2130 Fax: (360) 719 -1527 (Due upon application.)
CCB lic.: 173731 Total permit fees:
Authorized signature: $LAj•el-- Amount received:
This permit application expires if a permit is not obtained
Print name: JASON SWEET Date: 7 -31 -13 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 02/01/11 440- 4613T(11 /02/COM/WEB)
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, 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: $ 1655
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.
Z: \SAFE \Forms \Use these forms \Permit Apps \Tigard \FPS - PermitApp.doc 02/01/112