Permit (97) CITY OF TIGARD FIRE PROTECTION SYS
3. COMMUNITY DEVELOPMENT Permit#: FPS2018-00081TEMPERMIT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/09/2018
T I c� g Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1050
Project: VSP Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm permit:(11)new fire alarm devices.
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 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 08/09/2018 $102.20
12%State Surcharge-Building 08/09/2018 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 08/09/2018 $40.88
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 08/09/2018 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: Hourly Building Rate 08/09/2018 $180.00
Hourly Building 12%State Surcharge 08/09/2018 $21.60
Misc Administration Fee 08/09/2018 $5.00
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $367.94
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00 •
Residential Square Footage: 0
Fire Alarm Valuation: $2,400.00 ,
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 .UNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: p
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.
- Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard RE F P Date/Bea 7 i j, ; ,, Permit#: ile!)i�j�'--(1+'�f
71 y 13125 SW Hall Blvd.,Tigard,OR `, ``� Plan Review /'' �✓�+ !��
a Phone: 503.718.2439 Fax: 503.598.1960p Date/By: Related Permit#: / / �';,Z-}/10'--a1)37
Inspection Line: 503.639.4175 ii II 9 ]r3 1 d Ready Date/By: Surfs: 0 See Page 2 for
TIGARD Internet: www.tigard-or.gov ''u�- Notified/Method: Supplemental Information
aww�. r �444 ' .:2....,...„11 i Wi� s:'.t �..,m.� a 4,4424414 .,'----'..'M
' 4daiq 'V;,1u1 � ..��� ���W*wK, :s
�� ,. . L .
0 New construction ®Addition/4300A n ' ' 1
Please check all that apply(submit 2 sets of plans w/items checked)
E]Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
M'lllii
li i.�IK�I ;. ,....... ::. :00* , eo1 *11..*t1b15" ' ;,` ''13:`-;14 exceeds 10,000 amps at 150 volts or ❑Floating buildings.
O 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations, buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
,- «y ','rlil09 _:i. "O lr's k ` D tlll g 6 H 4... ❑Emergency system. larger separately derived
Job#: Job site address: SW GreenburgRoad ❑A 0HP o of oew motor load of system.
100HP or more. ❑"A" "E" "1-2" "1-3"
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
y g ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: 1050 Project name:VSP 1050 ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: IT .. $ 1 ; .I
Description „_, I Qty Each Total 1
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#
Ea.add'l 500 sq.ft.or portion 33.92 1
'i,* C=RIp ,i. ., ':":04.010•078#070j0:,!
_ RIP'`IO ,CIF':,.- bR 0N PhI V-l iLimited energy,residential
75.00 2
Install fire alarm circuit in suite 1050
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
. }; ,» Renewable Energy ❑ See Page 2
,V.Y E'ER• ''_ .. --�* ' d,ligi Services or feeders installation,alteration,and/or relocation
Name:Shorenstein Realty Services 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax: ( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
T.ICAM1 IyMM Mll '+ 'O ACT; M' 'I„I Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: : ( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
n, Ilii, _,°ialu�mO C , . a .11'.I III, ,o�liVwli ., ,. Pump or irrigation circle 67.84 2
Business name:Capitol Electric Company,Inc. Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ® See Page 2 75.00 2
Address: 11401 NE Marx Street panel,alteration,or extension.
City/State/ZIP:Portland,OR 97220 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)255-9488 Fax:(503)255-9488 Investigation(1 hr min) 90.00/hr
Email:shane@cepdx.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 48748 Electrical Lic.: 26-496C Suprv.Lie.: 3132-S specifically listed('/hr min)
n:.,'...!..'.::','..„:44;': -iEi+ IUCAL PERI4 I.F1
Suprv.Electrician signature,required: -„,,xzyi...e__ yh'IAA Subtotal: 75.00
Print name: DARRELL MCNEEL Date: 7/5/18 ❑Plan Review Required(25%of pennit fee):
�--� ���,(y� State surcharge(12%of permit fee): 9.00
Authorized signature: ` / � ”"`" `. TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: DARRELL MCNEEL Date: 7/5/18 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(I1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
. ..
Description Qty. r Each Total 1
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is
charged at an hourly(I hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
., on pT x ! �I'"„�IlllpPi;il allylts
sQect tc to 'h r mm)
a, I�r .. !, . . u��l'I�'� Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC PermitApp_ELR_ERE.doc Rev 06/17/2015
- N
TIGARD
City of Tigard
September 17, 2018
Capitol Electric Company Inc.
111401 NE Marx Street
Portland, OR 97220
Re: Permit No. FPS2018-00081
Dear Applicant:
The City of Tigard has processed a refund for overpayment of permit fees on the above
referenced permit for the following:
Site Address: 10260 SW Greenburg Rd, #1050
Project Name: VSP
Job No.: N/A
Refund: ® Check#229732 in the amount of$21.60.
❑ Credit card"return"receipt in the amount of$
❑ Trust account"deposit"receipt in the amount of$
Notes: Refund overpayment of hourly inspection fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
<:(2)9,47(7-.F,c_—
Dianna Howse
Building Division Services Coordinator
Enc.
I:\Building\RefundgicgliSfriz&ortMeN eipT 5 1 gon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
City of Tigard
T[G A R D Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the l�eque rt for permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Capitol Electric Co Inc DATE: 9/10/2018
11401 NE Marx Street
Portland, OR 97220 REQUESTED BY: Dianna Howse
TRANSACTION INFORMATION:
Receipt#: 419194 Case#: FPS2018-00081
Date: 8/29/2018 Address/Parcel: 10260 SW Greenburg Rd, 1050
Pay Method: CreditCard Project Name: VSP
EXPLANATION: Refund overpayment of hourly inspection fee.
amrlyzunTAMFAMFfiVi' t,
,
Cash Over100-0000-48001 $21.60
TOTAL REFUND: $21.60
APPROVALS: SIS DATE:
If under$5,000 Professional Staff t��_
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract ReviewwBoard
114N�..'� ,. z?w �' .. w * M.7. :1,0(1"414:0'i 'Case Refund Processed: Date: 1 Lf /z /y `�..
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10260 SW GREENBURG RD 1050, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00081
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor