Permit (165) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2017-00016
-F tGAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/21/2017
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 530
Project: SVN Imbrie Realty Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Adding(2)and relocating(2)fire alarm notification appliances for TI.
Contractor: SAFE TECHNOLOGY GROUP INC Owner: LINCOLN CENTER LLC
6400 NE HWY 99 STE G375 BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98665 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 360-699-2130 PHONE:
FAX: 360-719-1527
FEES
Description Date Amount
Specifics: Permit Fee-COM 02/21/2017 $134.48
12%State Surcharge-Building 02/21/2017 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 02/21/2017 $53.79
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 02/21/2017 $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 $204.91
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,360.00
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. 75 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.
' 'Hui ding Permit Application
Fire Protection System - FOR OFFICE I NE OyL1
City of Tigard ' ,\a .?a Received AWAIII
-111 ✓ ,�' Date/B ,_ t l)' Permit No.: �; j. 1
13125 SW Hall Blvd.,Tigard,OR 97 �b Plan Review �l ".
Phone: 503.718.2439 Fax: 503.59 li, �0 Date/B : Other Permit I` �� 1 .,^�_0'
Inspection Line: 503.639.4175 .,,,:',.-7,." late Rea B
TIGARD
,,,, Ready/By' H See Page2for
Internet: www.tigard-or.gov V`C .asotified/Method: IIMI Supplemental Information
v
TYPE OF WOIKt REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑MITolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 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 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10260 SW GREENBERG RD New dwelling area: square feet
City/State/ZIP:TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:530 Project name:SVN IMBRIE Covered porch area: square feet
Cross street/directions to job site:LINCOLN TOWER 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.
FIRE ALARM Valuation: $55,360.00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address:
Occupancy groups:
City/State/ZIP: Existing: B
Phone:( ) Fax:( )
New: B
Eil 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 STE 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 reertojeesrhetlute)
Address:6400 NE HWY 99 STE G375 Permit fee:
City/State/ZIP:VANCOUVER WA 98665 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(360)699-2130 Fax:(3.60)719-1527 (Due upon application submittal.)
CCB lic.:173731 Total permit fees: ,../
g./
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:JASON SWEET Date:2/20/2017 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board. ,,
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City Tigard:Ti ard: 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:
1:1 New system Number of sprinkler heads: Number of alarm devices: -t
❑ Addition or ❑ 1-10 heads: Affidavit required and 4 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 El 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
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alann
Submittal shall Battery Calculations ® Yes
include: Individual Component /1 Yes
Cut Sheets
Fire Alarm Project Valuation: $ 5360
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: $
Z:\Forms\Pemut Apps-Inspection forms\Tigard\FPS-PermitApp.doc 2
City of Tigard r 0 Permit No.: ,L?clf)/
13125 SW Hall Blvd.,Tigard,OR 97223 7`�
Phone: 503.718.2439 Fax: 503.598.1961 gr h Date Received: :42 Lia
T 1 G:A K U Inspection Line: 503.639.4175
Internet: www.tigard-or.gov FEB 2 1 2:0
16 By: igd /crsv f
FIRE ALARM q.0.-tot :AFFrOAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: SVN IMBRIE Occupancy: B
Job Address: 10260 SW GREENBURG RD TIGRAD OR 97223 Suite: 530
Contractor: SAFE TECHNOLOGY GROUP INC. Phone: 360-699-2130
Valuation of work: $5360
Type of System: (check one) ®Required ONon-required
(check one) DAutomatic :Manual :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(max 5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) Z /To be Relocated(max 5) 2_
I,JASON SWEET Oregon Construction Contractors Board No. 173731
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.
f) 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: Date: 2/20/2017
Print Name: JASON SWEET
I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10260 SW GREENBURG RD 530, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00016
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor