Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
II. COMMUNITY DEVELOPMENT Permit#: FPS2014-00143
T t GAR[5 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2014
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1170
Project: Ameriprise Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Add(3)new fire alarms.
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 08/28/2014 $112.96
12%State Surcharge-Building 08/28/2014 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 08/28/2014 $45.18
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 08/28/2014 $8.00
Occupancy Grp: Height: ft 11x17)
Stories: Hourly Building Rate 08/28/2014 $180.00
Hourly Building 12%State Surcharge 08/28/2014 $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:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $381.30
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,120.00
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: /621 40 0 - Permittee Signature:
s
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 REcEivED 1 I1h °I I Ic I I `,1 I1\1 1
ril City of Ti and Received -�G ' F'-
`, Tigard �p�d � {'�t Permit No.� p
13125 SW Hall Blvd.,Tigard,OR 9722�II Plan Review �i // /
Phone: 503.718.2439 Fax: 503.598.14x58 G 2 8 2014 Other permit i ,Q/�
Inspection Line: 503.639.4)75 Date Ready/By: Luria: See Page 2 for
Internet: www.tigard-or.gov CITY OF I U Notified/Method: Supplemental Information
BUILDING D n tOtA
TYPE OF"max REQUIRED DATA:I-AND 2-FAIMLY DWFILING
❑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 commtucnos work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial industrial
Valuation: $
❑Accessory building ❑Multi-family
Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB WE INFORMATION AND LOCATION Total number of floors:
Job site address:10260 SW GREENBURG RD New dwelling area: square feet
City/State/ZIP:TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:1170 Project name:AMERPRISE Covered porch area: square feet
Cross street/directions to job site:LINCOLN TOWER Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMESICIAIARM=oust
Subdivision: 1 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 (..._3 1 E� Valuation: $$3,120.00
J Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I El TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 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 PERMif FEER'
Business name:SAFE TECHNOLOGY GROUP INC. 6:*8
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: 9341.er Amount received:
This permit application expires if a permit is not obtained
Print name:JASON SWEET Date:8-27-14 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\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: $ 3120
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.
Fine Protection Permit Pees
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
City of Tigard Permit No.: , '°f AO/ y—Ol7/%_j
1114 " 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received:
Inspection Line: 503.639.4175
Internet: www.tigard-or.gov By:
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIOIRECEIVED
OR TENANT IMPROVEMENTS AUG 2 8 2014
(MAXIMUM OF 5 DEVICES WITHOUT PLANS) CITYOF WARD
BUILOttitsntincrov
Project Name: (','pr,`:5 e Occupancy: IS
Job Address: /Daub $(J Gr-e(n b(trl Ko/ Suite: 111,O
Contractor: -re 1-e C Gk n,o l a y (n " t . Phone: 3&o - I 9.9 - 2 13 v
Valuation of work: $ 3)�O
Type of System: (check one) ( equired ❑Non-required
(check one) ['Automatic ElManual ❑Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Manual Alarm Stations: To be Added(max5) /To be Relocated(max5)
Number of Proposed Notification Appliances: To be Added (max5) 3 /To be Relocated(max5)
I, ---3, S Oregon Construction Contractors Board No. I ?37 3
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
t) Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
In addition, I understand the following is required:
• Submit(3) copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• Electrical permit.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: L ��lN2 Date: 3 223 -1 t-I
Print Name: JGISC)V\
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