Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11111 ' COMMUNITY DEVELOPMENT Permit#: FPS201500053
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/26/2015
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 417
Project: Cypress Semiconductor Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire sprinkler,relocate(2)heads&add(5)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 03/26/2015 $64.54
12%State Surcharge-Building 03/26/2015 $7.74
Type of Use: COM Plan Review-Fire Life Safety-COM 03/26/2015 $25.82
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 03/26/2015 $0.50
Occupancy Grp: Height: ft 11x17)
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 $98.60
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 strons . •UNC by calling 503.232.1987 or 1.800.332.2344.
Issued y: /e.041 Permittee Signature: .
1 I
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Call 503.639.4175 by 7:00 a.m.for the next available inspectio •. 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.
1111 City of Tigard Permit No.: ��6-;b/5-'DOO5 3
• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 3/X i/5'
I I, .,1,1, Inspection Line: 503.639.4175
Internet: www.tigard-or.gov By: 1 aGrc�>rtic--4�4
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: C■A c iec S X ç - - o —. Occupancy:
Job Address: \017_0 Sw (-1(4)e rI 1,..i -Es_ 42_0L. Type of Construction:
Suite: 1.4 1-
Contractor: M Ai n SA v (.0 . _ Phone: 5 Q3- 331 — 02,3i-4,
Number of Proposed or Altered Heads:
Type: V J-+ Hazard: l...i3v o- Density: • \Q
I, arN bok` v- Kh 2 Ci-t C4-C- Oregon Construction Contractors Board No. 1-17J5 1 t
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 Pr - Date: 312-u f !
Print Name: \l)y�t��, �1n Zf tA(,_C _
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard
Received /1 4;474,/ A
- DateDate/B : pL Permit No.: /5 ✓_( f
N 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 2 6 2015 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: `y u /� J'--" A
TI G A R D Inspection Line: 503.639.4175 CITY OF TtGARD Date Ready/By: Juris, ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
BULB[� (
TYPE OF WORK REQUIRED DATA:I-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:
❑Master builder ❑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 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:417 Project name:Cypress Expansion 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.
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 2 and add 5 sprinkler heads. Valuation: $1000
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Shorenstein Realty Services,LP Type of construction:
Address:10220 SW Greenburg Road,Suite 310 Occupancy groups:
City/State/ZIP:Portland,OR 97223 Existing:
Phone: (503)619-3100 Fax:( ) New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name:McKinstry Co. 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)331-0234 Fax::(503)331-6906
E-mail:antonijakvmckinstry.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:McKinstry Co. (PleruerefirferfetstJFdlule)
Permit fee:
Address: 16790 NE Mason Street,Suite 100
City/State/ZIP:Portland,OR 97230 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)331-0234 Fax:(503)331-6906 (Due upon application submittal.)
CCB lic.:172811 Total permit fees:
Amount received: 7g,fno
Authorized signature: 1
L This permit application expires if a permit is not obtained
Print name: n 1\�. Kit Date: 3 l2�I j within 180 days after it has been accepted as complete.
'v'` J / * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp_071514.doc 440.4613T(1 I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 7 Number of alarm devices:
❑ Addition or ® 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
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 Light
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 1000.00
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 $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: $
\\mc:ins try\portland\Projects\N-R\Russell Construction\101792 Cypress Expansion S .417\001 Construction\Permits\FPS-PermitApp.doc
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{ t r,� RSF INCLUDES OWNER'S LOAD FACTOR PER CURRENT BOMA STANDARDS. Cypress Semiconductor - Reflected Ceiling Plan. .
G �1 _ i ITEMS INDICATED BY HALF TONED LINES TO BE PROVIDED BY TENANT. Suite 41 7
, ‘i }/ SUITERHAS NOTTBEENCSITEONVERIDIE�ATED BY HALF TONED LINES ARE EXISTING. Approximately 11,339 RSF
_.. -; SITE OBSERVATION HAS OCCURRED AT AREAS OF WORK ONLY.
PANEL THICKNESSES ASSUMED TO BE 3"W AND LESS THAN 5'-9" AFF. Scale: 1 /16�� = 1 f-0�� (When Printed At 11x17)
FINAL FURNITURE PLANNING. COORDINATION AND INSTALLATION N.I.C. Issue Dates: Tenant Meeting Dates:
February 16, 2015 February 11,2015
Tenant Approval:
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211095221\3_DEYGN\SPACE PLANNING RCP-PLAN KJF 02/16/15 15:Ou 1.96.00