Permit 1 ,
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00476
A DEVELOPMENT SERVICES DATE ISSUED: 10/5/2005
I- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire alarm.
REISSUE: f' 6 F LOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: A 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:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 9,805.00
Owner: Contractor:
WASHINGTON SQUARE LLC OREGON ELECTRIC GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW O 5WASggHINGTON SQUARE RD PORTLAND, OR 97214
P hone' 03
Phone: 234 -1001
• 234 -9900
FEES Reg #: LIC 203
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surchan 9/16/2005 $16.50
[FLS] FLS PIn Rv 9/16/2005 $82.47
[BUILD] Permit Fee 9/16/2005 $205.15
Total $304.12
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 -246 699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: i ,/ / : • i
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.
0816 - 05 06:40AM FROM-Oregon Elect %a Was 5032313567 T -032 P.004/005 F -219
Building Permit Application FOR OFFICE USE ONLY •
Ci of Tigard ty [ p
Tl CE'r� 1 % it , n iaca7 / i �; 0 P__ AI —OO��
13125 S W Nall Blvd., Tigard, OR 97223 ' PL,n Rcvicw
/ rrri�,�.�ll .'r. — .01r J ilin Other Per nut:
phone: 503.639.4171 Fax: 503.598.1960 Date/8 ,
Inspection Line: 503.639.4175 ��� 1 6 2 0 / ,�- : 'i �± De Ready /By: el See Page 2 for
Internet; www.ci.ugard.or.us Notified/Method: Lf Supplemental inrormation
CITY OF
' TIGAgQ _
', . a pw -'
'+ �l�$10. :REQUmEDDATA:1 - AND2 FAMILY. .
[] New construction ❑ Demolition Permit fees* arc 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
:' a::: `' - ' `' ,,....,‘.,.,.•• -GORY .O CONS • .. -, " • - - r work indicated on this application.
❑ I- and 2- family dwelling ® Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder 0 Other: Number of bathrooms: •„ - JOB; SY , E. •A1 D LOCATION Total number of floors:
Job site ndd93 ejif W Washington Square Rd New dwelling area: square fcet
City /State/ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldgJapt. no.: T13 1 Project name: Pottery Barn Kids Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED.DATA: COMivleRCIAi..USE CI1LCKLLST' -
Subdivision: ` 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• Ooi + -<: • - - work indicated on this application.
Install fire alarm in new mall T.I. Valuation: $$9,805
Existing building area: square feet
New building area: 6,230 square feet
•••}.. 0 FkOPERIY OW1 ER ` • 1.-' . -- = ;TENANT - Number of stories: 1
Name: Washington Square L1.0 Type of construction:
Address: 9585 SW Washington Square Rd Occupancy groups:
City/Statc/ZIP: Tigard, OR 97223 Existing:
Phone: (503)234-9900 Fax: (503)535 -2620 New:
= 0.,APPL1411r , , - 1COLyarACT• PERSON . •,• 7...'..-f:-....':•'::...
� - • NOTICE, .' . .
Business name: Oregon Electric Group, Inc. All contractors and subcontractors are required to be
Contact name: Y.orti Martin licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1010 SE lI Ave. jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/Statc2IP: Portland, OR 97214 apply:
. Phone: (503) 234 -9900 Fax: : (503) 535 -620
E -mail: loni@oregon-electr1c.com
ti:;' .. !...•:,. ::CONTRACTOR. •*:.:- : • :. .
Business name: Oregon Electric Group, Inc.
oun
:'BNG'PEabgr FEES*:
Address: 1010 SE 11'" Ave.
Please refer to fee schedule.
City/State/71P: Portland, OR 97214
Fees due upon application 305.13
Phone: (503) 234 -9900 Fax: (503) 535 -2620
Amount received
CCB lie. : 203
Date received:
Authorized signature: T1ris permit application cxpir if a permit is not obtained wr f
within 150 days after it has been accepted as complete.
lam'
Print name: Loni Martin e,e , _ /.!.. - - Date: 9/15/05 * Fee methodology set by Tri - County Building Industry
" • - Service Board.
iAltvitdinp ■Vermi+.1[•TS- PermuArip.doc 12103 44U.461 1tI7lo?/COM/wnD)
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47 �
pb pi..l BMA-) S'Tmcl J a0hot ADD IT,c J
NFPA -72 Record of Completion C• S. wioDl fi coto-VADDS)
Name of Protected Property: JALif lb HMV SQ. 6uc sr Ajl it
Address: __91,11" VW to N• S 4 • V-Q, 1 Gri 97213
Rep. of Protected Prop. (name/phone): _21 r
Authority Having Jurisdiction: C t T'y o F -! 16q
Address/Phone Number: sal
1. Type(s) of System or Service
NFPA 72, Chapter 2 - Local
If Alarm is transmitted to I tion(s) off premises, list where received: /-1 lf f ^ F�wu M Oa+rb4/ t f(
Soo 836 6 69 /
❑ NFPA 72, Chapter 3 - Emergency Voice/Alarm Service
Quantity of voice/alarm channels:❑ Single:❑ Multiple: ❑
Quantity of speakers installed: Quantity of speaker zones:
Quantity of telephones or telephone jacks included in system:
❑ 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:
❑ NFPA 72, Chapter 4 - Central Station
❑ The Prime Contractor.
❑ Central Station Location:
Means of transmission of signals from the protected premises to the central station: M TACT
❑ McCulloh ❑° Multiplex ❑ One -Way Radio
Digital Alarm Communicator ❑ Two-Way Radio ❑ Others
❑ (a)
❑ (b)
System Location: 1)05 lb PolrE, 5104E m — ZND rLt( T $Locjj
Organization Name/Phone /
Representative Name/Phone
Installer
Supplier
Service Organization
Location of Record (As- Built) Drawings: OIN- 5 ire
• Location of Owners Manuals:
Location of Test Reports:
A contract, dated , for test and inspection in accordance with NFPA standard(s)
No(s). , dated , is in effect.
2. Record of System Installation
f I
(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 shown below, was inspected bye C .
on (h I � , includes the devices shown below and has been in service since JO/ ly/
Y NFPA 72, Chapters i 32- 4[' 5Q' 6B 70' (check all that apply)
❑ X NFPA 70, National Electrical Code, Article 760
El ' Instructions
❑ y O er ( ecify
Signed: Date: 444
Organization: tVO40 4 (f.„Ita)ee L 3 Record o f syste O
All operational features and functions of this system were tested by on
and found to be operating properly in accordance with the requirement of:
❑ NFPA 72, Chapters l Q' 3 la 4 5 I' 6 p' 7 12 (check all that apply)
❑ _ NFPA 70, National Electrical Code, Article 760
U Manutacturer's Instructions
(Peci
):
1 /
Oth r s
Signed: ' Date: IO f / -Z.0L1
Organization: f Eel f
4. Alarm- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
MANUAL
(a) Manual Statio Noncoded, Activating Transmitters
Coded
(b) Combination Manual Fire Alarm and Guard's Tour Coded Stations
AUTOMATIC
Coverage: Complete: ❑ Partial:
(a) 3 Smoke Detectors Ion 3 Photo �8V tc-sI 105 : 033, 1 :034 O 0
(b) Duct Detectors Ion Photo
(c) Heat Detectors FT RR FT/RR RC
(d) Sprinkler Watertlow Switches: Transmitters Noncoded, Activating Coded
(e) )( Other (list): - _ '5 - 12 -tr< • . _ - _ i , oii.Jt 0"-
C Supe''" -" J c.;� " r. "ating D. - “;^-s (:se is ".. '-:- - r- ' r;n ^c-1-4^-.)
'—
i l
GUARD'S TOUR
(a) _ Coded Stations
(b) Noncoded Stations, Activating Transmitters
(c) Compulsory Guard Tour System Comprised of Transmitter Stations and
iuiciiucdiaic Siaiiuiis
NOTE: Combination devices recorded under 4(b) and 5(a).
SPR INK [ .FR SVSTFM
(a) Coded Valve Supervisory Signaling Attachments
Valve Supervisory Switches, Activating Transmitters
(b) Building Temperature Points
(c) Site Water Temperature Points
(u) ww crawl Supply w'ru Points
Electric Fire Pump:
(e) Fire Pump Power
(f) Fire Pump Running
(g) Phase Reversal
Engine- Driven Fire Pump:
(h) Selector in auto Position
P'.__.__, n___, T__
1 l� LIl�l11G Of Control 16111.1 IIVYUIL
(j) Fire Pump Running
Engine - Driven G t
(k) Selector in Auto Position
11) Control Panel Trouble
(n) Engine Running
Other Supervisory Function(s) (specify):
6. Alarm Notification Appliances and Circuits A ��
Quantity of indicating appliance circuits seal the system: t G(A.s 5 $ 5711 I E
Types and quantities of alarm indicating appliances installed:
(a) Bells Inch
1 ap _ t— _ w �rfC
(c) Horns I II
(d) Chimes 60
(e) Other: � C
(f) 'L Visual Signals Type: S� ( with audible I w/o audible
(g) Local Annunciator
7. Signaling Line Circuits
Quantity and Style (see NFPA 72, Table 3- 6)signaling line circuits connected to system:
Quantity: Style:
8. System Power Supplies
(a) Primary (Main): Nominal Voltage: Current Rating:
Overcurrent Protection: Type: Current Rating:
Location:
(b) Secondary (Standby):
❑ Storage battery: Amp -Hour Rating
❑ Calculated capacity to drive system, in hours: 24 60
❑ Engine -driven generator dedicated to fire alarm system:
Location of fuel storage:
(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 AFPA 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) Operating System Software Revision Level(s):
(b) Application Software Revision Level(s): C 5(� v\ t 1. 01
(c) Revision Completed by: 1. 'J Pt,4 4C t
(name) (firm)
10. Comments: ''*
"
(signed) for Ce ral Stat on or arm ice Company " i " (title) / I f�// ate)
Frequency of routine tests and inspections, if other than in accordance with the refer nc�d 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)
CITY..OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00476
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/5/2005
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 �' W 1 L.
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 11
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY BARN KIDS •
DESCRIPTION: Fire alarm.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 -639 -8865
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 2349900
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time: . -
Code # Inspection Description Confirm # Contact # Message
998 Alarm final 020852 -02 503-793 -7'177 N
Corrections /Comments /Instructions:
•
1X____
-,:....--- i I; i L IN "11 ti I V ,
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIAL FEES ASSESSED
Inspector: Date: ( (f P #: (503) 718-