Permit (48) 1114,
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I ' COMMUNITY DEVELOPMENT Permit#: FPS2018-00009
T f GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/22/2018
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 375
Project: Spec Space Subdivision: METZGER,TOWN OF
Project Description: Fire alarm:Adding(4)notification appliances.Affidavit submitted. Lot: 9
Contractor: CAPITOL ELECTRIC CO INC Owner:
11401 NE MARX STREET LINCOLN CENTER LLC
PORTLAND, OR 97220 BY SHORENSTEIN PROPERTIES LLC
235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Permit Fee-COM
02/22/2018 $86.06
12%State Surcharge-Building 02/22/2018 $10.33
Type of Use: COM Plan Review-Fire Life Safety-COM 02/22/2018
Class of Work: ALT Type of Const: $$0.50
Info Process/Archiving-Sm$0.50(up to 02/22/2018 $0.50
Occupancy Grp: Height: ft 11x17)
Stories: Hourly Building Rate 02/22/2018 $180.00
Hourly Building 12%State Surcharge 02/22/2018 $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 $332.91
Valuations:
S Required Items and Reports(Conditions)
prinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,800.00
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 503.639.4175 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 Systemii. i -
�� r FOR OFFICE USE ONLY
City of Tigard it 'V..- Received _
e 13125 SW Hall Blvd.,Tigard,OR 97223 DateB Permit No.: �f rr
_ CRAP / J. t
Phone: 503.718.2439 Fax: 503.598.1960 plan Review
age 2 for
T I G A R D Inspection Line: 503.639.4175 L D ; .. (� Date/B Other Permit:
Internet. www tlgard-or gov Date Ready/By:
Notified/Method: See
Supplemental_r, r ryi
0 New construction 1gic, wi, A W`,tyvt t-Rla E t Ar #AND 2 'AMILY %V LI II4C
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,
'° '' GATE ORY (I+�li ONSTR cTI i4A , ,;„ a ar t , work indicatedton thiserials,lapplicatonabor, ead,and the profit for the
0 l-and 2-family dwelling Valuation: $
®Commercial/industrial
❑Accessory building
0 Multi-family Number of bedrooms:
❑Master builder
0 Other Number of bathrooms:
'.'r.. i JOB-SITEu I?1 ORMATION''AND'LO ATI it �r , }Litt i4 Vt. Total number of floors:
Job siteIaddress:10260 SW Greenburg Road (Lincoln Tower) � �
New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223
Suite/bldg./apt.no.:375 Garage/carport area: square feet
Project names 1 „5 Fit
SO<,ljx....._ Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Othsctrea: urfeet
i1:,REQ tier tru
IR E,D DurerATaA� p � sq,i s ae f e;: ST
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
r �i+ pRh sO equipment,materials,labor,overhead,and the profit for the
work indicated on this a..lication.
Valuation: $$1,800.00
Install fire alarm devices per submitted plans.
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
Existing building area: square feet
New building area: square feet
" PROPER?y:OWNER44 ` i' � 4iQT 'At Ti i:c
txtt Number of stories:;r 0 % . r _ I "4 a it . , s
Name:Shorenstein Realty Services
Address: Type of construction:
City/State/ZIP: Occupancy groups:
Phone ( ) Existing:
Fax ( )
f' AP �u New
Business name: �r �� _ t
a, " r =r x It*y r a tt y 4 4' i;:
Contact name: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Address: under ORS 701 and maybe required to be licensed in the
jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
Phone:( ) apply:
Fax: :( )
Business name Capitol Electric Company,Inc. BUILb Ott#'I
Re r; i ' ,
P Y� � -i���" :r a 4-1414.40 Fleifsdr-ei•tb eas dude< % 1,4�c�"�.�ls: �,1
Address: 11401 NE Marx Street Permit fee:
86.06
City/State/ZIP:Portland,OR 97220 State surcharge(12%of permit fee): 10.33
Phone:(503)255-9488 Fax:(503)255-1966 FLS plan review(40%of permit fee):
t
CCB lic.:48748 Due u.on a..lication submittal. 34.42 0
Total permit fees: 1.11 i l i N
MEIN
Authorized signature: � _n`-� ,
`� Amount received:
Print name:Shane Tercek This permit application expires if a permit is not obtained
Date:02/21/18 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
1:\BuildingTermits\FPS-PermitApp_031016.doc Service Board.
440-4613T(1 I/02/COM/WEB) /
'1—)'1 VO (Aw +)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be�done; t' 4 N
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alt ryation only�to alarm devices:
0 New system Number of sprinkler heads:
Number of alarm devices: 4
® Addition or ❑ 1-10 heads: Affidavit uired and re
Alteration q ® 1-5 devices: Affidavit required and
(3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure
system of work within building structure
0 11+ heads: Plan review required and 0 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
7,1(Y04.of System,,(Complete.A,l", C
orDras;a II 6 I 'i li r ; 4 't'
g 444 ,i'-,,.--',1.4 r- 1e ' ,
44 44, .T_, "t ' ' h '4 44-44-4 P - u hp } 4Y � „5Y` 4*4 -' ii *I**, „Ib : A 4; A � d } 444 11444 r444-1444. s r 1i9 �44 4 A AT 4 ,` 4 4 ( 4 T , 1 5 " d4„A.) Com nercial Sprinkler ' 1 , ' 'i , r
4 744 4,4 4
r�Sprinkler Type ❑ Wet 0
ry
Additional Standpipes
Information: Sprinkler Supply Line
0 Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
0)'fiType°,I 'Hood;Fire Suppression System, 4 ., r A a- * 4'm , v r - i :4 e A
Hood Project Valuation: I $
: -f„ r-4 ,.� n �i „,l'-,-,',',' '' ' 4r?r Y 4 d 4` . '{ i 's jr'Y` i'''',',5,,,,'''''
C 'A't �` b r '4 a r ,,5” 50 54 i� r ,�, �. * �-* �` l� A a,�'�+�.:. i� h. "h, "Ti- c �"
44 ')' , arm A , '''''''111111'1i 4 N. 4 ' i 4 4 " �4 1' c, 4 *,"4444
4 e
44/4,1
- s-rr ' .� '- 4 � ` �"i �i ' ..i.�_ � ii r.'_,Y� r y r ' 1,� °'S w� j',11 t � 4 144 14 i 4 � 'p ' � A Y� d��� b �s.� � �,
rr 1 4 r`.. 1 7 rr 9 44 , 4 Yr U rr .1-�'4r S 4,114.144114414
4 1b >44 iY 41444144
144' >1t y f41411,41114',411,14
r 41
Submittal shall Battery Calculations � � '� 14 � ,F ` ' l� � m
include: ❑ Yes
Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: 1800
�' t 4i a� 4m iY xi r X4=4 51v w;-�, A IA t� t 44'"i4 ' 7 1 " -c l,. $
p� x 7 5; Y 'r. r,.0 rt :�* 4-sy 4 i Iu �A 1 47 S 4 "4 r-4i 4-1,- i-"G-4 w, r 7- A r r a
m t ,, 7 . :.,pr ip44- it( ,t tj Oir,o Sy34 �r a. y # u-*
� , � L :,r;« site it� � � G i �" k�� 4 '^4i� ���'F�r�r, �a � ��55144***,(� -���
' '! 4 .rr 4:;4 A Wt 4 r� 4.p:p4 4 4,r f444,44$ ' 7 4 a t kN 4 4*".' -,
4,44
Sauare Foota.e: a ' 1 � ' 4 = k 5 5? 4
0 to 2,000 Permit Fee:
YArrc � �"r �
$198.75 i f.
�rr� ,� � k1 '! s� r * � 5
2,001to3600 12 ] A` ",.„1 14' 4 ` � � , ,
$246.45 r t 1.14$$ A45,- 4� i i o 1 r
3,601 to 7,200 -,4155'454554-545,5 Pst � i � 4 1*,,l t,� a
7,201 and greater $310.05qr 1 ,; 00 ,Fl` 4 0 �4111
41
$404.39 44 4, tfr 44 414t' t'� ",
Sprinkler Project Square Footage: I
sq. t.
�
' 4, '!„'*4
re i 4 4," 4v1re: `otectkTOI.I"PeFIPIt Pe r it AA
w 'A ' 4,A 4 Y 4 X1��44 4`'
J - r 555 �, *"-I 'A ''1 4 �, "R-2','` �c X14 " >
Project valuation subtotal (see A, B & C above): $ 1800
Permit fee based on project valuation (see fee schedule): $ 86.06
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 10.33
FLS Plan Review(40% of permit fee): $ 34.42
TOTAL: $ 130.81
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INCity of Tigard FEBPermit No.: I='PSe7't 0 )e1
13125 SW Hall Blvd.,Tigard,OR 97223 D .. /iI i
Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 1/,?i/i V
Inspection Line: 503.639.4175 Cr e' ' 3Yty
TIGARD
Internet: WwW.tigard-or.gov r1 $ ; = y _..ite '
ii If DING L ''iSIO
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: LT 375 FA Occupancy:
Job Address: 10260 SW Greenburg Road Suite: 375
11
Contractor: Capitol Electric Co., Inc. Phone: 503-255-9488
Valuation of work: $ 1800
Type of System: (check one) QRequired ONon-required
(check one) ❑Automatic ❑Manual ElBoth
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) 4 /To be Relocated(max sI
I Shane Tercek Oregon Construction Contractors Board No. 48748
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.
l
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
i
Signature: ik,, Date: 2/21/18 I
Print Name: Shane Ter ek
I
s
I;\BuildingWorms\FireAlarmAttidavit_071514.docx Page I of!
I
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10260 SW GREENBURG RD 375, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00009
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor