Permit r; _
" a
- CITY OF TIGARD
b-Arige PERMIT #: BUP2005 -00505
DATE BUILDING PERMIT
DEVELOPMENT SERVICES ISSUED: 10/11/2005
..� I ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
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: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 9,642.00
Owner: Contractor:
WASHINGTON SQUARE LLC OREGON ELECTRIC GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIR OR 97223
e:
Phone: 234 -1001
234 -9900
FEES Reg #: LIC 203
Description Date - Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surchan 9/29/2005 $16.50
[FLS] FLS Pin Rv 9/29/2005 $82.47
[BUILD] Permit Fee 9/29/2005 $206.16
Total $305.13
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 -669 or 1- 800 - 332 -2344.
Issued By: � d Permittee Signature: d"Y1 ,04 2. jl7L
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.
Fire Protection Zsct Id (1
Building Nrmit Application ho r rolt OFFICE USE ONLY
City of Tigard R EC E R eceived I i l
E _ Da te/B I Permit No.: / 1 2 0 5Q
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
IMMI
Phone: 503.639.4171 Fax 503.598 1960 � � i ` Date/B : � ly ;' D D Other Permit: - I �+ 'DO
Inspection Line: 503.639.4175 SEP 2 8 2 tJ� �- Date Read .1 ?! im H See Page 2 for o
Internet: www.ci tigard.or.us - Notified/Method' S u pplemental Information
(( C JJ�� ITY 'A O , r F _ TIIGARD
TYYPE W I 1 VISION 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.
ID 1- and 2- family dwelling ® Commercial/industrial Valuation: $
1:1 Accessory building 1:1 Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9329 SW Washington Square Rd New dwelling area: square feet
City /State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: T7 Project name: Sephora 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: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Install fire alarm in new mall T.I. Valuation: $$9,642.00
Existing building area: square fcct
New building area: 5,397 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Washington Square LLC Type of construction: 1\
Address: 9585 SW Washington Square Rd Occupancy groups: rn
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: ('503)234 -9900 Fax. (503)535 -2620 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Oregon Electric Group, Inc. All contractors and subcontractors are required to be
Contact name: Loni Martin licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1010 SE 11 Ave. jurisdiction in which work is being performed. If the
City /State/ZIP: Portland, OR 97214 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 234 -9900 Fax: : (503) 535-620
E-mail: loni@oregon-electric.com
CONTRACTOR
Business name: Oregon Electric Group, Inc. BUILDING PERMIT FEES*
Address: 1010 SE 11 Ave.
Please refer to fee schedule.
City /State/ZIP: Portland, OR 97214
Fees due upon application 305.13
Phone: (503) 234 -9900 Fax: (503) 535 -2620
Amount received
CCB lic.: 203
Date received:
Authorized signature- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name. Loni Martin Date: 9/27/05 * Fee methodology set by Tn- County Building Industry
Service Board.
\Butldmg\Pemuts'FPS- PemutApp doc 12/03 440- 4613T(11/02 /COM/WEB)
.
CITY OF TIGARD ;
BUILDING DIVISION PERMIT #: BUP200& -00506 I
13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 10111/2005
Phone: (503) 639- 4171 i t
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 38
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Fire alarm.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 2341001
Inspection Request Scheduled For: Date: 11/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
998 Alarm final 020468 -03 503- 793 -7177 N
orrections /Com ent /Instructions:
9._() tr -V . I k i b C (p -
4 p,,_ert,),c ,,_, o__Q,,,,, , 0,,,z4, s__.___i -4-,,
5 ,n ` 4 -c
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is ' Ss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED •
N.
Inspector: Date: ( 6 Phone #: (503) 718-
CITY -OF TIGARD .
BUILDING DIVISION PERMIT #: BUP2005-00605
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005
Phone: -(503) 639- 4171r�
• Inspection Requests (24 Hrs.): (503) 639 -4175 _,.. ^ 'I I..
INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 8
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA •
DESCRIPTION: Fire alarm.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 2341001
Inspection Request Scheduled For: Date: 11/4/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
998 Alarm final 020412 -04 603-793-7177 N
Corrections /Comments / Instructions:
•
• � i �►1
�i
•
❑ PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
c a5Apj
Inspector: Date: ij d (Y5 Phone #: (503) 718 -
•
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Certificate of Completion
Name of Protected Property: Washington Square Mall Expansion - SEPHORA
Address: _ 9585 SW Washington Square Road
Tigard, Oregon 97223 -4450
Rep. of Protected Prop. (name/phone): Roger Ott (503) 639 -8865
Authority Having Jurisdiction: City of Tigard
Address: 13125 SW Hall Blvd
Tigard, Oregon 97223
Phone Number: (503) 639 -4171
1. Type(s) of System or Service:
X NFPA 72, Chapter 3 - Local
If alarm is transmitted to location(s) off premise, list where received:
Honeywell Central Monitoring Station
X NFPA 72, Chapter 3 - Emergency Voice /Alarm Service
Quantity of voice /alarm channels: 1 Single: X Multiple:_
Quantity of speakers installed: 4 Quantity of speaker zones: 1
Quantity of telephones or telephone jacks included in system: None
NFPA 72, Chapter 4 - Auxiliary
Indicate type of connection:
Local energy, Shunt, Parallel telephone
Location and telephone number for receipt of signals:
•
NFPA 72, Chapter 4 - Remote Station
Alarm:
Supervisory:
NFPA 72, Chapter 4 - Proprietary
If alarms are retransmitted to public fire service communications center or others, indicate location
and telephone number of the organization receiving alarm:
Indicate how alarm is retransmitted:
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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:
McCulloh Multiplex One -Way Radio
Digital Alarm Communicator Two -Way Radio Others
Means of transmission of alarms to the public fire service communications center:
1.
2.
System Location:
Organization Name /Phone Representative Name /Phone
Installer Oregon Electric Group Scott Johnson
(503) 234 -9900 (503) 234 -9900
Supplier _ Siemens Building Technologies Ron Pulioff
(503) 234 -9995 (503) 234 -9995
Service Organization Siemens Building Technologies Service Department
(503) 234 -9995 (503) 234 -9995
Location of Record (As- Built) Drawings:
Security Office
Location of Owners Manuals:
Security Office
Location of Test Reports:
Security Office
A contract, dated 11/1/1999 for test and inspection in accordance with NFPA standard(s)
No.(s) NFPA 72 dated 2002 is in effect.
2. Certification of System Installation
(Fill 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 Scott Johnson on 11/02/2005 , includes the devices
listed below and has been in service since 11/03/2005
X NFPA 72, Chapters X 1 X 3_ 4 X 5 X 6 X 7
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's Instructions
Other (specify):
Signed: SGC. Date: I Ip-c1/05
Organization: l /+ ecit" El el
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3. Certification of System Operation
All operational features and functions of this system were tested by Jim Bramlage
on 11/03/2005 and found to be operating properly in accordance with the
requirements of:
X NFPA 72, Chapters X1 X3 _4 X5 X 6 X7
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's Instructions
Other (specify):
Signed: 13 Date: L 1, 65
Organization: Siemens Building Technologies
4. Alarm Initiating Devices and Circuits (Use blanks to indicate quantity of
devices.)
MANUAL
a) Manual Stations Noncoded, Activating Transmitters Coded
b) Combination Manual Fire Alarm and Guard's Tour Coded Stations
AUTOMATIC
Coverage: Complete Partial X
a) 8 Smoke Detectors: Ion 8 Photo
b) 3 Duct Detectors: Ion 3 Photo
c) Heat Detectors: FT RR _ FT /RR RC
d) Sprinkler Water Flow Switches: Noncoded, Activating
Transmitters Coded
e) Other (list):
5. Supervisory Signal Initiating Devices and Circuits (Use blanks to indicate
quantity of devices.)
GUARD'S TOUR
a) _ Coded Stations
b) 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 Supervisory Switches Activating Transmitters
b) Building Temperature Points
c) Site Water Temperature Points
d) _ Site Water Supply Level Points
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•
Electric Fire Pump:
e) Fire Pump Power
f) Fire Pump Running
g) Phase Reversal
Engine- Driven Fire Pump:
h) Selector in Auto Position
i) Engine or Control Panel Trouble
j) Fire Pump Running
Engine- Driven Generator:
k) Selector in Auto Position
I) Control Panel Trouble
m) Transfer Switches
n) Engine Running
Other Supervisory Function(s) (specify):
6. Alarm Notification Appliances and Circuits
Quantity of indicating appliance circuits connected to the system: 1
Types and quantities of alarm indicating appliances installed:
a) Bells Inch
Speakers
b) - Horns
c) Chimes
d) Other:
e) 6 Visual Signals Type: Speaker /strobes
4 with audible 2 w/o audible
f) Local Annunciator
7. Signaling Line Circuits:
Quantity and Style (See NFPA 72, Table 3-6.1) of signaling line circuits connected to system:
Quantity: 1 Style: Class B, Style 4
8. System Power Supplies
a) Primary (Main): Nominal Voltage: 120/1/60 Current Rating: 5 amp
Overcurrent Protection: Type: Circuit breaker Current Rating: 20 amp
Location: Panel HP4, circuits 40 & 42
b) Secondary (Standby):
X Storage Battery: Amp -Hour Rating 55 amp -hour
Calculated capacity to drive system, in hours: X 24 60
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
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c) Emergency or Standby System used as backup to Primary Power Supply, instead of using a
Secondary Power Supply:
Emergency System described in NFPA 70, Article 700
Legally Required Standby System described in NFPA 70, Article 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) X Operating System Software Revision Level(s): CSGM 17.01
b) X Application Software Revision Level(s): Revision 55
c) X Revision Completed by: Jim Bramlage Siemens Building Technologies
(name) (firm)
10. Comments:
(signed) for Central Station or Alarm Service Company (title) (date)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA
standard(s): None
System deviations from the referenced NFPA standard(s) are: None
(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)
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