Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 s COMMUNITY DEVELOPMENT Permit#: FPS2014-00028
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/18/2014
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Project: Lincoln Three Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Restroom and shower facility addition in common area on first floor.Relocate(7)fire sprinkler heads.
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 02/18/2014 $64.54
12%State Surcharge-Building 02/18/2014 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 02/18/2014 $25.82
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 $98.10
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,000.00
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 questions to OUNC by calling 503.232,1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspe tion date.
This permit card shall be kept in a conspicuous place on the job site until • • etion of the roject.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System OFFICE USE ONLY
Received
INCity of Tigard Date/B : �� Permit No.. /s, ,/y.,
..-.. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 FEB 1 S 2014 Date/B : Other Permit: dap/3—QQ /
T I GARD Inspection Line: 503.639.4175 Date Ready/By: )uric: la See Page 2 for
Internet: www.tigard-or.gov CITY Notified/Method:TIGARD Notified/Method: Supplemental Information
TYPE OF WORK MIRED 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.
❑ 1-and 2-family dwelling Valuation: $ O, cr
y g ®Commercial/industrial
1=1 Accessory building El 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: 10220 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97233 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:3 Lincoln Shower Room Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED D VIA:CO\I\IERCIAL-l'SE CIIECKLIS"F
Subdivision: 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
DESCRIPTION OF !WORK work indicated on this application.
Relocate 7 existing heads into the new hard lid ceiling. Valuation: $
Existing building area: square feet
1lcKinstr■ Job#71374 New building area: square feet
_ ❑ PROPERTY OWNER ® TENANT Number of stories:
Name:3 Lincoln Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( 1 I Fav:( 1 New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name:McKinstry Company,LLC All contractors and subcontractors are required to be
Contact name:Antonija Krizanac licensed with the Oregon Construction Contractors Board
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:(503)278-3971 Fax::(503)331.6906
E-mail:antonijakCmckinstr■.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:McKinstry Company,LLC (Please re(ertafaartheule)
Permit fee:
Address:Same as applicant
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.:172811 Total permit fees:
Authorized signatu •
Amount received: $9
— This permit application expires if a permit is not obtained
Print name:Antonija Krizanac Date: 2
/ / // within 180 days after it has been accepted as complete.
t * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Buitding\Pnmits\FPS-PermitApp.doc 03/23/06 440.4613T(i1/02/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 0 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 vi 4
Density I I`Z
Design Area 1 S S •
K.Factor rj_ to
Sprinkler Project Valuation: $ 1000
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): $ 1000
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.
\\mclanstry\portland\Construction\Projects\705 OR SPG Hard Girds\2014\71374 3 IIncoln Shower Room\Pecmit\71374-FP Permit Application.doc
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD, TIGARD, OR,
97223
Commercial - Fire Protection System
999 Sprinkler Final
PASS - No C of O
April 29, 2014 at 9:42:59 AM
FPS2014-00028
Chip Barnett
Violation Summary:
Inspector Contractor