Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11 COMMUNITY DEVELOPMENT Permit#: FPS2013-00112
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2013
Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 320
Project: Springwater Wealth Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Add(2)fire sprinkler heads and relocate(1)head 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 08/07/2013 $53.78
12%State Surcharge-Building 08/07/2013 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 08/07/2013 $21.51
Class of Work: ALT 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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $81.74
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $550.00
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 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 que • ns UNC by calling 503.232.1987 or 1.800.332.2344. ^,,,�)r M/17,<-
Issued By: ( Permittee Signature: 11 /14 {' b.
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
Fire Protection System FOR OFFICE USE ONLY
Received p q
City of Tigard RECEIVE
p� Re eiv : 0 I•, Permit No.:r,5 4,7413"�/7•
13125 SW Hall Blvd.,Tigard,OR 97223 j Y�;D Plan Review
0 Phone: 503.639.4171 Fax: 503.598.1960 Date/B Other Permit: �do�3 /�
T t G n RD Inspection Line: 503.639.4175 q��G Date Ready/By: Juris• ® See Page 2 for
Internet: www.tigard-or.gov Tv 'r7 2013 Notified/Method: Supplemental Information
TYPE OF kQ�C1tI�` ®F 1 j4,"'w REQUIRED DATA:I-AND 2-FAMILY DWELLING
1NG Permit fees*are based on the value of the work performed.
❑New construction
El Demolition� ISjoM P
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.
1:1 1-and 2-family dwelling • ®Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 1:1 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10200 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97233 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.
Add(2)sprinkler heads and relocate(1)to accommodate a new glass relite entry Valuation: $$550.00
Existing building area: 1056 square feet
McKinstry Job#71177 New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name:Springwater Wealth Type of construction: 2-B
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name:McKinstry Company,LLC All contractors and subcontractors are required to be
Contact name: alma }h a M a e� licensed with the Oregon Construction Contractors Board
h 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:(J)331 - 0-23f Fax::(503)331.6907
E-mail: saivain Ina. M c Ihs Fry .C on
CONTRACTOR BUILDING PERMIT FEES*
Business name:McKinstry Company,LLC (Please refer ro fee sehedute1
Permit fee: 5?)-7 g
Address:Same as applicant
State surcharge(12%of permit fee): l/
r2 45
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.) A I r 57
CCB lie.:172811 Total permit fees:
��� fit/44"--' Amount received: �i
Authorized signature:
This permit application expires if a permit is not obtained
Print name: sa Al fin H44, M a,d_., Date: os/Q t!`- within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
IABuilding 03/23/06 440-46 I 3T(I I/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: $
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. 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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