Permit ;, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 -00008
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/24/2012
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9532 SW WASHINGTON SQUARE RD H11
Project: The Body Shop Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: TI
Contractor: SIEMENS INDUSTRY INC Owner: PPR WASHINGTON SQUARE LLC
15201 NW GREENBRIER PKWY BY THOMSON PROPERTY TAX SERVICES
SUITE A4 ATTN HILARY RAYMOND
BEAVERTON, OR 97006 2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 234 -9995 PHONE:
FAX: 503 - 234 -8030
FEES
Description Date Amount
Specifics: Permit Fee - COM 01/24/2012 $112.96
12% State Surcharge - Building 01/24/2012 $13.56
Type of Use: COM Plan Review - Fire Life Safety - COM 01/24/2012 $45.18
Class of Work: ALT Type of Const: Info Process /Archiving - Lg $2.00 (over 01/24/2012 $4.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process /Archiving - Sm $0.50 (up to 01/24/2012 $5.00
11x17)
Houlry Building Rate 01/24/2012 $180.00
Commercial Sprinkler System: Hourly Building 12% State Surcharge 01/24/2012 $21.60
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 $382.30
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,673.00
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 , ow th- rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 -001 s i • /� ay obtain a copy of the rules
or direct questions to OU C by calling 503.232.1987 or 1.800.332.2344. '
Issued By: Permittee Signature: '`�
Call 503 .39 -411;l,y 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
V
Fire Protection System
�� FOR OFFICE USE ONLY
Received
City of Tigard •'�, Date/B : Perm No. i Ji I,. --ct,)e-
u 13125 SW Hall Blvd., Tigard, OR �i•? 't, �O V
Phone: 503.718.2439 Fax: 503.`t " a% �� c4I_�,? ` E iN
TIGARD Inspection Line: 503.639.4175 J` , \ � a 4 ■'ate Ready•?l' . See Page 2 for
Internet: www.tigard or.gov J .� Notified/Method: Supplemental Information
.:,'` `' 't - - . F PE >`'OF - a RK � RE " ' II2E : 1 °''AND:2= FAMILY DWEILINGx :,
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a ' -� � '",'t .;.. . � u
❑ New construction ❑ De n 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
•: -,, ,- -40:::::: 3K�l;:,- work indicated on this application.
°" �C _ ATEGOI2Y` °OF
•
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— 0 1 ^- and 2- family / dwelling ® Commercial /industrial Valuation: $
❑ Accessory building [1] Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
s,
I ,' , r . 5`' ,- r floors:
` =1- iNr Total number of floo
t:.
13�SITE' tVFORNIA'I'IO , >; A'PtD LOCATION., '' ' " ="
•,- ,�,� ". � �';,,' _..;fit: >- nz� -:; ..''-
Job site address: 9 W WASHINGTON SQUARE ROAD New dwelling area: square feet
City/State /ZIP: TIGARD, OR Garage /carport area: square feet
Suite/bldg. /apt. no.: STE GER II ft Project name: The Body Shop Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
WASHINGTON SQUARE MALL Other structure area: square feet
gREQUIRED >DATA
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
"` <: : : , ; ,;:.: .:, �v; -:_ ;;: and the profit materials, labor, overhead, a e ofit for the
r
� „Z: ••• DESCRIP'TiON r,QF WORK: , >. . °'- work indicated on this application.
- ..ra: :�uy' - � � r. - -3ti: ; „., ..[' � -I'- -<., - , - _ , -, .,. �.a:;��'� \ \: °, .. . -__ - - - - - -. _.. - ..- .d::aw
ADDITION OF SMOKE DETECTION IN RETAIL SPACE Valuation: 553,673.00
Existing building area: square feet
New building area: square feet
''-a®<PRORERTYW
' >'ONER t " -T `'` Number of stories:
Name: ROGER OTT Type of construction:
Address: 9585 SW WASHINGTON SQUARE ROAD Occupancy groups:
City /State /ZIP: TIGARD, OR Existing:
Phone: (503)639 -8860 Fax: ( ) New
LICAI :ONTAC, PE ON
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,_ -,, . �:., : :,..,. , r P_,,. ,.,,:. "wt� -= i •.'�4 ;�� . _ ..., . _,.._ s.. _ _ �, - �. NOTICE >y s r �,. ter' -*
Business name: SIEMENS INDUSTRY, INC. All contractors and subcontractors are required to be
Contact name: CHARLES HUGHES licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15201 GREENBRIER PARKWAY jurisdiction in which work is being performed. If the
City /State /ZIP: BEAVERTON, OR 97006 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 207 -1839 Fax: : (503) 207 -1901
E -mail: charles.hughes @siemens.com
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f,
Business name: SIEMENS INDUSTRY, INC. ;:T� ( Pl e nse_re u.to ee:�cltedute - �•
Permit tee:
Address: 15201 GREENBRIER PARKWAY
City /State /ZIP: BEAVERTON, OR 97006 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
A Phon -i f
e: (503) 207 -1839 Fax: (503) 207 -1901 (Due upon application.)
CCB tic.: 133041 Total p fees: Tf� 3o
Authorized signal , 1 Amount received: 3b
This permit application expires if a permi is not obtained
Print name: CHARL HUGHES Date: 01/24/2012 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
P \Building \Pe❑mns \FPS- PermaApp doc 02/01/11 440- 4613T( 1 1/02 /COM/WEB)