Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2022-00123
Date Issued: 10/17/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9665 SW WASHINGTON SQUARE RD CO2
Project: Aritzia Subdivision: None Lot: None
Project Description: Fire alarm permit:Updating alarm notification and detection for TI.
Contractor: FRAHLER ELECTRIC COMPANY Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD BY MACERICH RET
TIGARD, OR 97223 PO BOX 4085
SANTA MONICA, CA 90411
PHONE: 503-639-4627 PHONE:
FAX: 503-639-4673
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/17/2022 $199.04
12%State Surcharge-Building 10/17/2022 $23.88
Type of Use: COM Plan Review-Fire Life Safety-COM 10/17/2022 $79.62
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 10/17/2022 $10.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1
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: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $312.54
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $11,162.00
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
Issued By: Permittee Signature:
77,9
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 5,10 ,-a-7,,A
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.
1 ?luilding Permit Application
Fire Protection System FOR OFFICE USE ONLY
EriCity of Tigard ■ , II'
13125 SW Hall Blvd.,Tigard,OR 97223 ECEIV.'�. eview ' /`/ ,
III Phone: 503.718.2439 Fax: 503.598.1960 (+Cn DateB : � a ' • Bill Other Permit: / � t ,�
T I GARD Inspection Line: 503.639 4175 J C 1 1 3 2p24 Date Ready/By:to YL/zn22. 'fT See Page 2 for
Internet: www,tigard-orgov CITY Notified/Method' Supplemental Information
, ' O.TIGARD
TYPE OF WORK DNtStQN REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTIONwork indicated on this application.
III1-and 2-family dwelling 0 Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
q f„t�� 677:OBUT TE INFORMATION AND LOCATION Total number of floors:
Job site address:9,aJ SW Washington Square Road New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg.apt.no.: Project name:WSQ Aritizia Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-LSE.CHECKLIST
Subdivision: I 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
DESCRIPTION OF WORK work indicated on this application.
Update fire alarm notification and detection due to a retail tenant improvement. Valuation: $11,162.00
Existing building area: square feet
New building area: square feet
❑] PROPERTY OWNER ❑ TENANT Number of stories:
Name.PPR WASHINGTON SQUARE LLC 'type of construction:
Address:PO BOX 4085 Occupancy groups:
City/State/ZIP: Existing:M
Phone:( ) Fax:( ) New:
❑i APPLICANT ❑ CONTACT PERSON NOTICE
Business name.Siemens Industry All contractors and subcontractors are required to be
Contact name:David Hemmer licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9755 SW Barnes Rd Suite 205 jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97225 applicant is exempt from licensing,the following reasons
apply:
Phone:( )971-864-4759 Fax: :( )
E-mail david.hemmer@siemens.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:JRA dba Frahler Electric (Please refer to fee schedule)
Permit fee: $199.04
Address:11860 SW Greenburg Road —
— — State surcharge(12%of permit fee): $23.89
City/State/ZIP:Tigard Oregon 97223 FLS plan review(40%of permit fee):
Phone:( )503-639-4673 I Fax:( ) (Due upon application submittal.) $79•62
David Hemmer
CCB lie.:197172 cepa.,«„epsp,.h,to Total permit fees: $302.55
Siei ,u lnJustries
•
Javidhemmerpsi men<c..
Amount received:
Authorized signatur
This permit application expires if a permit is not obtained—
Print name:David Hemme :9/8/2022 within 180 days after it has been accepted as complete.
' * Fee methodology set by Tri-County Building Industry
Service Board.
I.\BmIding,Permits\FPS-PermitApp_03 It I6.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
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 ❑ 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 0 6+ devices: Plan review requited and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑■ Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Mann Project Valuation: $11,162.00
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
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: $
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