Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s COMMUNITY DEVELOPMENT Permit#: FPS2014-00006
Date Issued: 01/14/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB03400
Jurisdiction: TIGARD
Site address: 10260 SW GREENBURG RD 400
Project: Regus HQ Global Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Fire alarm
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/14/2014 $51.09
12%State Surcharge-Building 01/14/2014 $6 13
Type of Use: COM Plan Review-Fire Life Safety-COM 01/14/2014 $20.44
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 01/14/2014 $10.00
Occupancy Grp: B Height: ft 11x17)
Stories: 12 Info Process/Archiving-Sm$0.50(up to 01/14/2014 $5.00
11x17)
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 Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $92.66
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage 0
Fire Alarm Valuation $9.300.00
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 503232.1987 or 1.800.3.3223.44.
Issued By: Permittee Signature:
Call 503.6314175 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 RECEIVED FOR OFFICE USE ONLY
City Tigard Ti and Received Permit Nu..
Date/B : 'R
13125 SW Hall Blvd.,Tigard,OR 9724 N 0 6 2014 Plan Review Q
11 Phone: 503.718.2439 Fax: 503.598.1980' V Date/B : �) it thcrPermit:!du440 -60
TIGARD Inspection Line: 503.639.4175 Date Ready-7' )uns. ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1-AND 2-FAMILY DWELLING
❑Ncw 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 Valuation: s
®Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
leo JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address &•SW Greenburg Rd Tigard,OR(Lincoln Twr) New dwelling area: square feet
City/State/ZIP:97223 Garage/carport area: square feet
Suite/bldg./apt.no.:Ste 400 Project name:Regus 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 devices per plans Valuation: $9,300.00
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/Slate/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 rejrrrojeeschedvlrj
Permit fee: 169.99
Address: 11401 NE Marx Street
City/State/ZIP:Portland,OR 97220 State surcharge(12%of permit fee): 20.40
FLS plan review(40%of permit fee): 68.00
Phone:(530)255-9488 Fax:(503)255-1966 (Due upon application.)
CCB lie.:48748 Total permit fees: 258.38
Authorized signature:
Amount received: 275.88
This permit application expires if a permit is not obtained
Print name:Dan Wilson Date: 1/2/2014 1 within 180 days after it has been accepted as complete.
I Fee methodology set by Tri-County Building Industry
Service Board.
I:ouddingtPermiuTPS-PermilApp.doc Rev 01/092012 440-46131(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 S stem Com•lete A, B, C or D as a•plicable :
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standppes
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 (El Yes
Cut Sheets
Fire Alarm Project Valuation: $ 3,200.00
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): $ 9,300.00
Permit fee based on project valuation (see fee schedule): $ 169.99
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 20.40
FLS Plan Review(40% of permit fee): $ 68.00
TOTAL: $ 258.38
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
U:\FA Jobs\zz140081-45 Regus(g't LT-4xac\1 FPS-PemutApp.doc Rev 01/05/2012 2
PERMIT FEE DOUBLES IF WORK HAS STARTED WITHOUT BENEFIT OF PERMIT
-FO CALCULATE TOTAL FEE
PERMIT FEE CALCULATION (REFER TO TABLE)
$ 9,300.00 ROUNDED VALUATION
$ 91.44 (BASE FEE FOR FIRST $ 2,000.00 OF VALUATION)
+ $78.55 ($ 1 0.76 PER $ 1,000.00
$169.99 BASE PERMIT FEE
+ $20.40 STATE SURCHARGE = 12% OF BASE PERMIT FEE
+ $68.00 PLAN REVIEW CHARGE = 40% OF BASE PERMIT FEE
$258.38 TOTAL PERMIT FEES
+ $12.50 RECORDS RETENTION FEES
+ $5.00 MISC ADMIN FEE (MAILING)
_ $275.88 TOTAL DUE FOR THIS PERMIT
EXAMPLE
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10260 SW GREENBURG RD 400, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
2014-04-08 10:16:00
FPS2014-00006
PASS - No C of O
NFPA 72 completion report received
Violation Summary:
Inspector Contractor