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Permit • CITX OF TIGARD BUILDING PERMIT 11111 111 PERMIT #: BUP2007 -00563 ° COMMUNITY DEVELOPMENT DATE ISSUED: 10/29/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09302 SW WASHINGTON SQUARE RD V05 ZONING: C - G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG PROJECT: LUCY Project Description: Fire alarm REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 2N : sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 78 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 2,910.00 Owner: Contractor: WASHINGTON SQ. LLC SIEMENS BUILDING TECHNOLOGIES 9585 SW WASHINGTON SQ. RD. 3025 SW CORBETT AVE. TIGARD, OR 97223 PORTLAND, OR 97201 Phone: Contact #: PRI 503- 944 -8160 FAX 503 - 234 -8030 Reg #: LIC 133041 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 10/25/2007 $69.65 [TAX] 8% State Surcha 10/25/2007 $5.57 [FLS] FLS Pln Rv 10/25/2007 $27.86 Total $103.08 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain a copy of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332 2344. f/ C�!� Issued By: ����,��� ,,.�Q . Permittee Signature: " Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application ation Fire Protection S stem i� EC FOR OFFICE USE ONLY City of Tigard o c T 2 5 2007 Rece e ived h,, P ermit No N 7.. oo51 n , 13125 SW Hall Blvd , Tigard, OR 97223 Plan Revl �7� Phone 503 639.4171 Fax 503 SS�$ ) ®F riGAR® DateBj &j�rfA� Inspection . •Y �� O ther Pe tt Ins Line 503 639 4175 �y 9A �1 Date Re. e 2 for TIGARD p BUILDING®9VlSION j B Internet www tigard -or gov Notts . e fo e 0. ® See Pa Supplemental Information TYPE OF WORK / . 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 CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: - JOB SITE INFORMATION AND LOCATION • Total number of floors: Job site address: 9 3 0 Z 5t.n) W o Aej ¢o-y, squ (t ,d • New dwelling area: square feet City /State /ZIP: I.; p a 02. 7 7 Z2 3 Garage /carport area: square feet Suite/bldg. /apt. no.: ff Project name: WA S(,t 1... 0cl , Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 1 Lot no.: Permit fees* are based on the value of the work performed. fax 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. e ` / L F- r \J I S ! t d'. R., A l annAw_\ G p Valuation: $ Z 5 0 Cook e el C orreo± F�eei p 10 ^'L `F' OCCv Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: 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:( ) Fax::( ) E -mail: ` CONTRACTOR BUILDING PERMIT FEES* Id J 7 l n0 7 (Please refer Permit schedule) Business name: 5 I Qx� b I IG ►/1 c� I Permit fee: Address: 3o 2 5 C o r ELI+ A J e P ii State surcharge (8% of permit fee): 5.57 City /State /ZIP: f ar-1- l _ o � r 7 7 Z © 1 FLS plan review (40% of permit fee): � /- Phone: ( 5e3) Z z3 ti . R 97 5 Fax: ( ) (Due upon application.) Or (p CCB lie.: 1 / Total permit fees: /O 2 g Authorized signature: Amount received: 3 signature: / T his permit application expires if a permit is not obtained Print name: R obe e t U Date: 1 0/ z s/0 . within 180 days after it has been accepted as complete. * Fee methodology set by Tri -County Building Industry Service Board. 1 \Budding\Permits\FPS- PermnApp doc 03/23/06 440 -4613T(I 1 /02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition El 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. El Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B; C or D as applicable): A.) Commercial Sprinkler • El Wet El Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.). _Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarni Submittal shall Battery Calculations Yes include: Individual Component va Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 3,601 to 7;200 $292.50 7,201 and greater $381.50 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 (8% of permit fee): $ FLS Plan Review (40% of permit fee): $ TOTAL: $ Plan requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. I \Building \Pernuts \FPS- PermitApp.doc 2 y.30j, w 6L� ..S' R.4' 1/5 U Po�o0 .7_ o-a5623 Certificate of Completion Name of Protected Property: MIA l 1,4 r; 1 D n( 5 u4a.C. PI A- I I Address: 9 585 - 51k) u.45 I♦►NGTo.> 5c,. Po nzv L ,- art y7 2 7 3 Rep. of Protected Prop. (name /phone): Authority Having Jurisdiction: C. I T •i 0 F - 71 G4rt-D Address: v2- I Z'S St.J ` v k, 'Q l.V l) T' (.-dn p Q/\ 1 7 2 2 Phone Number: sU- 63 cj `11 / 1. Type(s) of System or Service: 2 NFPA 72, Chapter 3 - Local # alarm is transmitted to location(s) off premise, list where received: A LArt_+vt cE&-fTrIA --. ST4 -1) on.) 5o3 96 8 33 8 7 NFPA 72, Chapter 3 - Emergency Voice /Alarm Service / Quantity of voice /alarm channels: Single: ✓ Multiple: Quantity of speakers installed: Quantity of speaker zones: C/4 5 Ti•' 4- Quantity of telephones or telephone ja s included in system: NFPA 72, Chapter 4 - Auxiliary \ Indicate type of connection: ) Y ' Local energy, Shunt, Parallel telephone Location and telephone number for receipt of signals: NFPA 72, Chapter 4 - Remote Station t i \ l Alarm; u Supervisory: N (PA 72, Chapter 4 - P , p Proprietary if alarms are retransmitted to public fire service communications center or others, indicate 1" ocation and telephone number of the organization receiving alarm: indicate how alarm is retransmitted: Updated: 6/10/2007 Page 1 T•I.FirotitAicr.\['rmmiecinninn Fnrmclmacfer "Dirt rmmn rin• a NFPA 72, Chapter 4 - Central Station The Prime Contractor: Central Station Location: Means of transmission of signals from the protected premise to the central station: McCuJloh Multiplex One -Way Radio X Digital Alarm Communicator Two -Way Radio Others Means of transmission of alarms to the public fire service communications /fO communications center: 2 p 1. i \ 51'aTl ) b1� — 5 94 7 2. System Location: S. c L, n. 0'1 0 F F i C Organization Name /Phone Representative Name /Phone installer TR,e. \L E t..ELTA (_ So %l S Supplier S'i iE M �ti 5 14 wi Cmic2E i i S03 Z34 9R9 > _ 5 23y 9' yyr - Service Organization _ Siam eN 9 "3 Sr >aq 4iiJ 5 23 4 9991 So 3 z_ 9945 - Location of Record (As- Built) Drawings: dAl- S► 1E Location of Owners Manuals: Or/ - S, T c Location of Test Reports: OP 51re S/EMEk.) A contract, dated _ for test and inspection in accordance with NFPA standard(s) No.(s) dated is in effect. 2. Certification of System Installation (Fin out after installation is complete and wiring checked for opens, shorts, ground faults, and improper branching, but prior to conducting operational acceptance tests.) This system has been installed in accordance with the NFPA standards as listed below, was inspected by _ 5A�n Ce lt/t r I 1 on /I/ i f,Jd7 , includes the devices listed below and has been in service since //),(/A f NFPA 72, Chapters L 1 4 4 V5 v 6 (circle all that apply) NFPA 70, Natrona/ Electrical Code, Article 780 y Man ,- cturer's Instructions Oth= • _ ' ); Signed: Date: /1 /6 Organization: £14--, Updated: 6/10/2007 Page 2 T•!F ralSAiarinrunmiaainn ➢nn Fnrrnclmactar tart torn rine , J, 3. Certification of System Operation All operational features and functions of this system were tested by 54-'1 R 2E I f on / /! /G,/6 7 and found to be operating properly in accordance with the requirements of. y NFPA 72, Chapters ✓1 3 5 f 6 7 (check all that apply) _ y NFPA 70, National Electrical Code, Article 760 y Manufacturer's Instructions Other (specify): Signed: �..■ - ;: Date: // j /G /G7 Organization: 5/ EM Ei✓" 4. Alarm Initiating Devices and Circuits (Use blanks to indicate quantity of (1.0V' es . -r ■ /tte vvtoDE \ MANUAL a) Manual Stations Noncoded, Activating Transmitters _ Coded b) Combination Manual Fire Alarm and Guard's Tour Coded Stations AUTOMATIC Coverage: Complete Partial a) C, Smoke Detectors: _ Ion _ Photo b) Duct Detectors: _ Ion Photo c) Heat Detectors: FT RR FT /RR RC d) _ Sprinkler Water Flow Switches: _ Noncoded, Activating ! Transmitters Coded e) Other (list):_ •7 EXi STird /. RKwu.1'EO I - y Ei,✓ 5. Supervisory Signal Initiating Devices and Circuits (Use blanks to indicate quantity of devices.) GUARD'S TOUR a ) _ Coded Stations 0� ) Noncoded Stations Activating Transmitters c) Compulsory Guard Tour System Comprised of Transmitter Stations and Intermediate Stations Note: Combination devices recorded under 4(b) and 5(a). SPRINKLER SYSTEM a) _ Coded Valve Supervisory Signaling Attachments Valve S Switches Activating Transmitters v ) Building Temperature Points c) Site Water Temperature Points d) _ Site Water Supply Level Points Updated: 6/10/2007 Page 3 T•1FiralAllicrlf tnrrsmiarinninn Frumalmaafor nazi rmmn rfnr^ . 6� Electric ire Pump: e) `re Pump Power f) MR t e Pump Running g) C hase Reversal Engine- Driven Fire Pump: h) Selector in Auto Position i) ► Re gine or Control Panel Trouble j) • ire Pump Running Engine- Driven Generator: ic) • e ector in Auto Position I) I1 ontrol Panel Trouble m) IJ - far Switches n) Engine Running Other Supervisory Function(s) (specify): A(r)1V E , r../ '?' -h 5 pl.° - 5 - 6 — c-t' 6. Alarm Notification Appliances and Circuits Quantity of indicating appliance circuits connected to the system: F ?<I 5 1 ki U Nl= Types and quantities of alarm indicating appliances installed: GIvl..CL)CT, a) _ Bells inch Speakers b) Horns c) Chimes d) Other e) Visual Signals Type: with audible w/o audible f) _ Local Annunciator 7. Signaling Line Circuits: — ST'l,v( r- ivZ(A-) Quantity and Style (See NFPA 72, Table 3-6.1) of signaling line circuits connected to system: Quantity: Style: 8. System Power Supplies a) Primary (Main): �ZLN' C ominai Voltage: MO \1L Current Rating: Z 44- Overcurrent Protection: Type: 1 & Current Rating: 2(_) Location: yet b) Secondary (Standby): ' I Storage Battery:21N Amp -Hour Rating c7 1t A" — Calculated capacity to drive system, in hours: 24 60 gine- driven generator dedicated to fire alarm system: ocation of fuel storage: Updated: 6/10/2007 Page 4 TAFirnAkEicr ftrammicainninn Frumslmrasicr rari rrumn rinr • a c) Emergency or Standby System used as backup to Primary Power Supply, instead of using a Secondary Power Supply: E mergency System described in NFPA 70, Arti cle 700 I emergency Re quired S tandb y Sy d in NFPA 70, Articl 701 Optional Standby System described in NFPA 70, Article 702, which also meets the performance requirements of Article 700 or 701 9. System Software a) _ Operating System Software Revision tevei(s): b) _ Application Software Revision Level(s): (-14-m c) Revision Completed by: .1 r re S, e3v (name) ' (firm) 10. Comments: 1.v • d1 u V�. - M� ► L t �. • 1 )E,v tLE5 wErl.‹._ rue Le, c4-1 Q ErL 0n u / 1. p6tJJ fr4ol6E A -1>D6l) 'MCA I6 (signed) for Central Station or Alarm Service Company (title) (da e) Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s): System deviations from the referenced NFPA standard(s) are: (signed) for Central Station or Alarm Service Company (title) (date) Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction: (signed) representative of the authority having jurisdiction (title) (date) �,. oi- l w, z 5U sys'3 S � Updated: 6/10/2007 Page 5 T• \Firn\Micr\f nmmiceinninn Ftarmclmactar tart rmmrs sitar . _. t COTY OF TOGA, MALI!ONG IOVOSOON I PERMIT #: - ,.., 13125 SW Hall Blvd., Tigard, OR 97223 � L. DATE ISSUED: 101111:01/ Phone: (503) 639 -4171 A �,� } Inspection Requests (24 Hrs.): (503) 639 -4175 ., „_. Alt. ,• G INSPECTION WORKSHEET FOR DATE: 3/1212CY)8 TIME: 7:00A a1 PAGE: 13 SITE ADDRESS: 0930) SW WASHINGTON SQUARE RD V05 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: I. UCY DESCRIPTION: TI OWNER: WASHINGTON SO. LLC, PHONE #: CONTRACTOR: FL.DE=R •.IOIWIF:; INC • PHONE #: 952 Inspection Request Scheduled For: Date: 3/1.2J201)3 Pour Tim-• 6 a Code # /spection Description Confirm # Contact # Mes 4 - qv . 2 r > 9 ' Final in,:pection 066574 -f)1 952 -297 -7611 Correctio s Comments /Instructions: /►- 5 14 1,45 - 06 %V? `-e P vv6 6. ig . 0 1 I: -IF. ,Se - - -12--c;i - e- 3 e - , A - L,e-,71 4c-vi .<_..A Sit_A"vviv._c-- 0- -- Pa-ir . ..., 1 C yvid . ( j i .( ' ' ,„,” ' ' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V1;1 ()( V Dated CO Phone #: (503) 718 - 7;\112-1 CITY OF TIGARD BUILDING DIVISION PERMIT #: 13UP2007.00563 t 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/29/200 Phone: (503) 639- 4171w�pt �► ,Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/16/2007 TIME: 7:01AM PAGE: 42 SITE ADDRESS: 09302 SW WASHINGTON SQUARE RD V05 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: LUCY • DESCRIPTION: Fire alarm OWNER: WASHINGTON SO. LLC, PHONE #: CONTRACTOR: SIEMENS BUILDING TECHNOLOGIES PHONE #: 503944 -616Q Inspection Request Scheduled For: Date: 11/16/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 998 Alarm final 059809-01 962- 297 -7611 N Corrections /Comments/ nstru tions: � 5 11 4 e 1.3 C c._(4-A kit, it fi,S‘t4 if9AL, 1 k/tA,,LN \iCc c,1% E6K 2617- eo Y- (II/Wa7)d< 1- Pr (Z(/•7 ❑ PASS ❑ PARTIAL APPROVAL , ❑ CANCEL ❑ NO ACCESS g FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED \ U ° Inspector: Date: 1 7 Phone #: (503) 718-