Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2014-00046
Date Issued: 03/20/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503 718 2439 parcel: 1 S135A604500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 212
Project: Miadonna Subdivision: 1991-055 PARTITION PLAT Lot: 1
Project Description: Fire alarm
Contractor: SAFE TECHNOLOGY GROUP INC Owner: LINCOLN CENTER LLC
6400 NE HWY 99 STE 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 03/20/2014 $102.20
12%State Surcharge-Building 03/20/2014 $12 26
Type of Use: COM Plan Review-Fire Life Safety- COM 03/20/2014 $40 88
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2 00(over 03/20/2014 $8 00
Occupancy Grp: B Height: ft 11x17)
Stories: Hourly Building Rate 03/20/2014 $180 00
Hourly Building 12%State Surcharge 03/20/2014 $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. Yes Alarm Type. Automatic
Pull Station Required Smoke Detectors Req:
Battery Calcs Provided. Yes Cut Sheets Required: Yes
Total $364.94
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation $0 00
Residential Square Footage: 0
Fire Alarm Valuation. $2,875 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 questiorys4eQUNC by calling 503.232 1987 or 1 800.332.2344.
Issued By: /JAI /�' Permittee Signature: (/V
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 1.()R OI I I( I I ' I ()\l
Received
City of Tigard Ie/B : �� Permit No.: r —L op
14 1 3125 SW Hall Blvd.,Tigard,oRECE Plan Revie. r ' /� '/
Phone: 503.718.2439 Fax: 503.598 Date/By: �� `:� •her Permit: �L{�'���7 G��7J IVED
Inspection Line: 503.639.4175 _ 4 2014 Date Ready :y: Juns ® See Page 2 for
Internet: www.tigardix.gov Notified/Method: }
4 ST, -- �� ARD �y�,_� / ` Supplemental Information
oeEf'-\s'1r ,177,0
TYPE II*1!WOW 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 ®Commercial/industrial
Valuation: S
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
`0,60 JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: W GREENBURG RI) New dwelling area: square feet
City/State/ZIP:TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no)655� Project name:MIADONNA Covered porch area: square feet
Cross street/directions to job site:LINCOLN 4 Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.
FIRE ALARM Valuation: S52875.00
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: B
Phone:( ) Far:( ) New: B
® 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 ref
owjusclsedw/i
Permit fee:
Address:6400 NE HWY 99 SUITE G375
State surcharge(12%of permit fee):
City/State/ZIP:VANCOUVER WA 98665
Phone:(360)699-2130 Fax:(360)719-1527 FLS plan review(Due of permit ion.)
(l�ue upon application.)
CCB lie.:173731 Total permit fees:
Authorized signature:
. Amount received:
This permit application expires if a permit is not obtained
Print name:JASON SWEET I Date:3-3-14 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1.Building\PermiteEPS-PermitApp doe 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 Batten Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 2875.00
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): $
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.
7_•\SAFE\Forms\Use these forms\Pemut Apps\Tigard\IPS-Perrnit App.doc 02/01/112
I
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
10250 SW GREENBURG RD 212, TIGARD, OR,
97223
Commercial - Fire Protection System
998 Alarm Final
2014-03-21 (null)
FPS2014-00046
PASS - No C of O
NFPA 72 completion report received
Violation Summary:
Inspector Contractor