Permit (63) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
2'' COMMUNITY DEVELOPMENTIN
Permit#: FPS2019-00081
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/20/2019
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 700
Project: Road Scholar Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire Alarm.Adding and relocating notification devices for TI.
Contractor: POINT MONITOR CORPORATION Owner: LINCOLN CENTER LLC
5863 LAKEVIEW BLVD STE 100 BY SHORENSTEIN PROPERTIES LLC
LAKE OSWEGO, OR 97035 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Hourly Building Rate 06/20/2019 $180.00
Hourly Building 12%State Surcharge 06/20/2019 $21.60
Type of Use: COM Permit Fee-COM 06/20/2019 $123.72
Class of Work: ALT Type of Const: VA 12%State Surcharge-Building 06/20/2019 $14.85
Occupancy Grp: B Height: ft Plan Review-Fire Life Safety-COM 06/20/2019 $49.49
Stories: Info Process/Archiving-Lg$2.00(over 06/20/2019 $6.00
11x17)
Info Process/Archiving-Sm$0.50(up to 06/20/2019 $5.50
Commercial Sprinkler System: 11x17)
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: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $401.16
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $4,806.00
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 503.232.198 . .:00. •.2344. n
Issued By: g...4„..,rt..r.,, ' ermi nature. 4 �/II/
9{21-1/
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 System FOR OFFICE USE ONE\'
City of Tigard Received
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Permit No.:Fe�� t t' C
`'WSA
111 13125 SW Hall Blvd.,Tigard,OR 97223RECEIVE• U
Date/By: l,lPlan Review
111Phone: 503.718.2439 Fax: 503.598.196 Date/By: G'oC, j / Other Permit3t.„\AG1
Inspection Line: 503.639.4175 A Juris: ® See Page 2 forTlGARU JUNJL01Note ed/Method: ` /Internet: www.tigard-or.gov i..
Supplemental Information
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- .. �r'i��t .,4r3►Y"a�'f � i 6 E`�' i` a"- 'F li � I y
❑New construction ❑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
G+(IItY` aau work indicated on this application.
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
14"400$ITE'110 1ATION ANI} LOCATION Total number of floors:
Job site address:10200 SW Greenburg Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:700 Project name:Road Scholar-Lincoln 5 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
UJBED B A*cOMM RCIAL-A§CtilECKUS ` '.
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
" " 0700 y I ON 0 tit-V.110 tit-V.110work indicated on this application.
FIRE ALARM Valuation: $$4,806.00
Existing building area: square feet
New building area: square feet
":7;11-4-
►® ! ! Number of stories:
Name:Road Scholar-Lincoln 5 Type of construction:
Address:10200 SW Greenburg Rd.,Suite 700 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( )
New:
5 ,r M1.11,ICA"NT4. L3� T r t . 1,41
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
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Business name:Point Monitor Corp. "`' refer
Permit fee:
Address:5863 Lakeview Blvd#100
State surcharge(12%of permit fee):
City/State/ZIP:Lake Oswego,OR 97035
FLS plan review(40%of permit fee):
Phone:(503)627-0100 Fax:( ) (Due upon application submittal.)
CCB lie.:135901 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name:Ben Breit Date:6/4/19 within 180 days after it has been accepted as complete.
* Fee methodology set-by-Tu-County-Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-46131(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
the�vo kto one;
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices:
® Addition or El 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies ofi 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: Fire Alarm Notification 'Devices
l yS�L4+ 0 ® 'f i y a yr 1 z ;44,117;i:
« f=;-4.gi aI it �l def„mx,t:,,--,,,,,, x s x
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes El No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
}
. J %,, ,i� �I ... ' . � ! �. .ct Valuation: �;,$ „
Hood Project
fuy ,E ..,.,..„..„„,„----4,:&,.-r,-.
�w3r, Y r tv`� ' "#' .a „ ,� a w� *'�w'
Submittal shall Battery Calculations �/ Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 4,806
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,,,,...„..„..f„.,„, , , „ :: ,„...,,,,... ,k.:',!1,,„,;41:14,4fC-y '$--,"
S t [ct.. P* e� `w1'i r✓FE m _ t a : • k 4.
Square Footage: Permit Fee: g ;
0 to 2,000 $198.75 :, m - , s
u
$246.45
2,001 to 3,600
3,601 to 7,200 $310.05
7,201 and greater $404.39 � s < '� 4w h i r
Sprinkler Project Square Footage: sq. ft.
t ,f.:
Fire .n:'.s a
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\bwilliams\Desktop\PERMIT FORMS\Fire permit-city of tigard.doc 2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
10200 SW GREENBURG RD 700, TIGARD, July 26, 2019 at 9:07:39 AM
OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00081
Inspection Type: Inspector:
998 Alarm Final Chip Barnett
Result:
PASS - NoCofO
Comments:
NFPA 72 completion report received
Violation Summary:
Inspector Contractor