Permit (188) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2017-00107
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/20/2017
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 250
Project: Keyence Corportation Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm-modification of(8)devices for TI
Contractor: POINT MONITOR CORPORATION Owner: LINCOLN CENTER LLC
5863 LAKEVIEW BLVD STE 100 BY SHORENSTEIN PROPERTIES LLC
LAKE OSWEGO, OR 97035 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Permit Fee-COM 07/20/2017 $102.20
12%State Surcharge-Building 07/20/2017 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 07/20/2017 $40.88
Class of Work: ALT Type of Const: Info Process/Archiving-Sm$0.50(up to 07/20/2017 $3.00
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: Yes Alarm Type: Automatic
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required: Yes
Total $158.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,200.00
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
ordirec estions . •UNC b -- ling 503.232.1987 or 1.800.332.2344.
Issu By: Permittee Signature04.4illai
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 Anyone ` F
.* rCEIVE1)
Fire Protection System FOR OFFICE USE ONL\
City of,Tigard Received
`J 3 2017 Date'By: 7
,/� /7 � PermitNo.: 05,96/7-06/07
13125 SW Hall Blvd.,Tigard,OR Plan Review"
11 Phone: 503.718.2439 Fax: 503.598.19 0 -020'1 Other Permit:Au,�>/7_06/ 8,
Date/By: �C
„I(i a tt l) Inspection Line: 503.639.417 + )By: Juris
P �� ,� ��Gi��� Date Read -�, /404106 1 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
311ILNING DIVISION -7/9e. f c
0 New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
pu A ._ I or a a F,-co _ UCT4444ii7 . ' .,. . - work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrialm Valuation: $
❑Accessory building ElMulti-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
O 1 li a TOt -a* T.QN 11 Total number of floors:
om
Job site address:10300 SW Greenburg Rd.#250 New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:250 1 Project name:Keyence Corp. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
4:-iialik s a 1l1 , :1:4 1ST.
Subdivision: f Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded the nearest dollar)of all
Tax map/parcel no (
equipment,materials,labor,overhead,and the profit for the
,, .U .1,14:6-10C _ � work indicated on this application.
Fire alarm notification devices Valuation: $2200
Existing building area: square feet
New building area: square feet
I a d 1t a w ..a A., M Number of stories:
Name:Keyence Corp.-One Lincoln#250 Type of construction:
Address:10300 SW Greenburg Rd.#250 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax ( )
New:
►, t ) .AC 'EoN` ^
„p ` I u : ar-
Business name:Point Monitor Corp. All contractors and subcontractors are required to be
Contact name:Brooke Williams licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5863 Lakeview Blvd#100 jurisdiction in which work is being performed.If the
City/State/ZIP:Lake Oswego,OR 97035 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)627-0100 Fax::( )
E-mail:bwilliams@pointmonitor.com
Business name:Same as above fiast:ieJertm rsekedu[eif - -
Permit fee:
Address:
State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB tic,:135901 Total permit fees: ,,,,yy
V
Authorized signature: —
Amount received: `l � .3
_..� This permit,application expires if a permit is not obtained
Print name:Ben Breit Date:7/18/17 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_031016.doc 440-4613T(I I i02iCOM'WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
-a oO
�Air7 ;J
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
0 New system Number of sprinkler heads: Number of alarm devices:
® Addition or 0 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:
�a R 'st. e! C 1 + liteca
F
Sprinkler Type 0 Wet 0 Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group
Density
Design Area
K.Factor
Sprinkler Project Valuation: I $
BAR $ R $—! ' re RIi " .
Hood Project Valuation: $
.. iLlt;ILJLIL.,
Submittal shall Battery Calculations � 1. Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: I $
sz ® aA r7 R qtiide ems. _
IOW
Square Footage: Permit Fee: mm
0 to 2,000 $198.75ris
2,001 to 3,600 $246.45F-
3,601 to 7,200 $310.05
7,201 and greater $404.39 741*
Sprinkler Project Square Footage: sq.ft.
�� a iiir FireiPr4 tect10 Permit 111 W PWN p mo
"4;7
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: $
C:\Uses\bwilliams\Desktop\PERMIT FORMS\Fire permit-city of tigard.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10300 SW GREENBURG RD 250, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00107
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor