Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
"! s COMMUNITY DEVELOPMENT Permit#: FPS2014-00158
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2014
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 245
Project: PMC Sierra Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinklers,relocate(2)heads and add(3)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 10/02/2014 $53.78
12%State Surcharge-Building 10/02/2014 $6.45
Type of Use: COM Plan Review-Fire Life Safety-COM 10/02/2014 $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: $600.00
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• - • : •UNC 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 inspecti e.
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 Qhaa4 raft D FOR OFFICE USE ONLY
Received I ��
City of Tigard ! Permit No.: si
• 13125 SW Hall Blvd.,Tigard,OR 97223 2014 Date/By: C � f/LS�G/ _i /
II g Plan Review Q
Phone: 503.639.4171 Fax: 503.598.1960 E 1 D81e/B : Other Permit: [he����-�o A
T 1 G A R D Inspection Line: 503.639.4175 • Date Ready/By: Juris: See Page 2 for
tO 1 Internet: www.ti ard-or. ov n 9,`" 1? 1YIN Notifed/Method: Su PP lementalInformation
TYPE OF"WORK 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.
❑ 1-and 2-family dwelling ®Commercial/industrial
Valuation: ! ___
❑Accessory building ❑Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10220 SW Greenburg Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97233 Garage/carport area: square feet
Suite/bldg./apt.no.:245 Project name:PMC Sierra 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.
Valuation: $ ( (X).(31)
Relocate two(2)and add three(F)fire sprinkler heads.
Existing building area: square feet
McKinstry Job#71570 New building area: square feet
❑ PROPERTY OWNER TENANT Number of stories:
Name:PMC Sierra Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fa.x:( ) 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)331.6907
E-mail:antonijak@mckinstry.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:McKinstry Company,LLC (Please refer rojea cliedule)
Permit fee:
Address:Same as applicant
State surcharge(12%of permit fee):
City/State/ZIP: FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.:172811 Total permit fees:
Authorized signature=—�
Amount received:
This permit application expires if a pertnit is not obtained
Print name:Antonija Krizanac Date: i 1 I f 1 Lf within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I.\Building\Permits\FPS-PermitApp.doc 03/23/06 440-4613T(11/02/COMJWEB)
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 El 11+heads: Plan review required.
❑
Repair
Number of sprinkler heads: 5
Additional description of work
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
(Xi Wet ❑ Dry
Additional Standpipes _
Information: Hazard Group Light
Density ,
Design Area S(370
K.Factor 5.6
Sprinkler Project Valuation: $ 600
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: $
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.
\\Mckinstry\ponland\Construction\Projects\705 OR SPG Hard Cards\2014\71570 PVC Sierra-Suite 245,3L\Permits\FiteProtection-PennitApp.doc
L
City of Tigard Permit No.: /P5 aO/41i /
II 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received:
,�I� Inspection Line: 503.639.4175 'n
Internet: www.tigard-or.gov By: CD �Y1ti0-
FIRE SPRINKLER AFFIDAVIT FOR ALTERATION
OR TENANT IMPROVEMENTS ECEIVED
(1 to 10 SPRINKLER HEADS WITHOUT PLANS) OCT 2 2014
CITY OF f4GARD
Q 1S(W!S1(W
Project Name: ' ASL i e f Occupancy: J
Job Address: t 02:7-0 S. D (-�i e�,.,b,,�r�1�� Type of Construction:
Suite: Z`-tS
Contractor: n.\ Cr . Phone: S U 3 2 -3`1-1
Number of Proposed or Altered Heads: .cj
Type: \A.r_ • Hazard: LA-r Density: .
I, NC's '/ \h Oregon Construction Contractors Board No. , I-7_61
certify the following is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
b) Positions of sprinkler heads relative to architectural features such as soffits, beams, partitions, walls, etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop (exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads(see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
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.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: i■ IA Date: lt, 2,1 I
Print Name: keN ,∎ c—
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