Permit CITY OF TIGARDIN FIRE PROTECTION SYSTEM PERMIT
2: COMMUNITY DEVELOPMENT Permit#: FPS2018-00126
RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2018
T F �"'` g Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 417
Project: Cypress Subdivision: METZGER,TOWN OF Lot: 9
Project Description: New Inergen clean agent suppression system in server room.
Contractor: SUPPRESSION SYSTEMS INC Owner: LINCOLN CENTER LLC
4417 PACIFIC HWY EAST BY SHORENSTEIN PROPERTIES LLC
TACOMA,WA 98424 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 253-926-3300 PHONE:
FAX: 253-926-3306
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/02/2018 $263.60
12%State Surcharge-Building 10/02/2018 $31.63
Type of Use: COM Plan Review-Fire Life Safety-COM 10/02/2018 $105.44
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 10/02/2018 $25.00
Occupancy Grp: H-5 Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Unknown
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 $425.67
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
t
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
1 Fire Protection System FOR OFFICE USE ONLY
City of Tigard { Received // ^//i ' ^ �*_/,0 /-
yk Date Re vJ� I Pernrh�i �O !� ��tD
III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1
_ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ��4 — ) Oth����,x__60( 7,
T I G A RD Inspection Line: 503.639.4175 Date Ready/By: �' loris: { ® See Page 2 for
www.tigard-or.gov `Notified hod: / /
Supplemental Information
..PA,zsem' b� -0-42*,;',, y... y �,, ,\ «�� �/ �L .
` Nsa x . W(?1t1t� 'A: 11 I a I) I 1 L DW) NG
❑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
�,� SCA II; V"i �y work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ElMulti-familyNumber of bedrooms:
❑Master builder ElOther: Number of bathrooms:
A` 'CN TI01e ` lfic101d ; Total number of floors:J 1 N Ta
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 Semiconductor Covered porch area: square feet
Cross street/directions to job site:SW Washington Square Road Deck area: square feet
Other structure area: square feet
�9 ,QU1DED'► . . " '''',2;•,•l
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.M
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the\
r g D ONo Wt yr
work indicated on this application.
New Inergen clean agent suppression system in server room. Valuation: $$17,500.00
Existing building area: square feet
New building area: square feet
01' : ►a ")ENj Number of stories:
Name:Cypress Semiconductor Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
®i' � I
•NA P '' at
E
Business name:Same as contractor(below) All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) I Fax::( )
E-mail:nathan@suppression.com
. . o f i O
Business name:Suppression Systems,Inc.
Permit fee:
Address:7715 NE 33rd Drie,Suite E
City/State/ZIP:Portland,Oregon 97211 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503)961-5865 Fax:( ) (Due upon application submittal.)
CCB lic.:132701 Total permit fees:
Authorized signature:
-- Amount received:
This permit application expires if a permit is not obtained
Print name:Nathan Scherneck Date:9/17/18 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 1/02/COM/WEB)
1
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1.)— ll
Type of Work: 2. Addition alteration only to sprinkler heads: 3.) Ad
Yl' ) / clition/alteration only to alarm devices:
® New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or ❑ 1 10 heads: Affidavit required and El 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:
;;Dirivi app
'TyfiSy � (Ccap�+ te A C e � �' ; ,�\
A.) •` mea1�Speer
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
e ire Six+ ssiQ cern
Hood Project Valuation: ':'-'-$‘,,..'",',i,- ,,,&:•,,1,1-,'„, •. ,,,,.:,,- :,,,i,
.,,°. - ., a - ..a,; ..• ,., \:..ani ....... ;�a� ..
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $
�,) #'nli tatl� Sys, z
Square Footage: Permit Fee: /".‘,,,-( .,; ,.,,\\
0 to 2 000 �� ' �, \��
$198.75
2,001 to 3,600 $246.45
3601 to7200 $310.05
--
73:260011
201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
, .F 'n./ _i,, -i x�, .,,,,, • � � Fri
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:\Users\SSI-PDX-001\Google Drive 2\Jobs\2018\1861-Cypress Semiconductor\SUBMITTALS AND PERMITS\PPS_PermitApp.doc