Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s. COMMUNITY DEVELOPMENT Permit#: FPS2014-00061
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/09/2014
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9767 SW WASHINGTON SQUARE RD D07
Project: AMERICAN EAGLE OUTFITTERS Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Fire Alarm-addition of(5)notification appliances
Contractor: SIEMENS INDUSTRY INC Owner: PPR WASHINGTON SQUARE LLC
15201 NW GREENBRIER PKWY PO BOX 847
SUITE A4 CARLSBAD, CA 92018
BEAVERTON,OR 97006
PHONE 503-207-1839 PHONE:
FAX: 503-207-1901
FEES
Description Date Amount
Specifics: Permit Fee-COM 04/09/2014 $112.96
12%State Surcharge-Building 04/09/2014 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 04/09/2014 $45.18
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
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:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $171.70
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,929.00
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 ification Ce Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or ect questions to OUNC .lin. 503.232.1987 or 1.800.332.2344.
I ued By: Permittee Signature:
k .01 ■
Call 503.639.4175 by 7:00 a.m.for the next available inspe on 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.
z
04/08/2014 05:55 FAX 0 0 2/0 0 4
Building Permit ApplicationEc evED
Fire Protection System FOR OFFICE USE ONLY
INI
• City of Tigard
13125 SW Hall Blvd.,Tigard,OR 97223
APR 8 201,!
! Phone: 503.718.2439 Fax: 5°159CtROF TIGARD RpeatcciDeivcd; viniiminiffi permit NO., pt.:50./..000th
Plan Review
Datc/B : Other Permit: . ,.., jo/;--er 0 .•
Inspection Line: 503.639.4175 Thi iii r„ Date Ready/By: Juris. El Sc Page 2 for
T I GA RD
Internet: www.tigard-or.gov DulLuING Illvisloy Notilied/MetImd: Supplemental Information
'' '•,•!:::':;';': '''!.::•::.:‘:1.::i. '...''. i • .:!
TYPE,oi;Iii6Rk 3...:1:;,..';::,:Ii:;;!:. . ! REQUIRED DATA:.1-AND 2-FAM1LY DWELLENG':k
El New construction 0 Demolition Permit fees*are based on the value of the work performed, -
Indicate the value(rounded to the nearest dollar)of all
El Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
• ...,". • • ' •.-,..... !....- . ...- .., ,.......:1 - ,-.•,,
CATEGORY OF CONSTRUCIVN ..1. •-.' • work indicated on this application.
' ' ' -',''': ''',.,'•- : .' ' ' , •
Valuation: S0.00
El 1-and 2-family dwelling tEl CornmerciaVindustrial
Number of bedrooms:
['Accessory building Ei Multi-family
0 Master builder Li Other: Number of bathrooms:
. .. • .: .
JOB SITE INFORMATION AND .:.:',.'-•• '':-.• - ,-,::!,.', Total number of floors:
Job site address:9767 SW WASHINGTON SQUARE ROAD New dwelling area: square feet
City/State/ZIP:TIGARD,OR Garage/carport area: square feet
Suite/bldg./apt.no.:STE D07 Project name:American Eagle Outfitters Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
WASHINGTON SQUARE MALL
Other structure area: square feet
4QP11410:• ., li*46544E4*0 *:.;.*OlOST.;: ::
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
fax map/parcel no.:
. . equipment,materials,labor,overhead,and the profit for the
:" , .. , • ' •: .•-, DESCRIPTION OF WORK ' . , ' ,' ' ., :.: ' work indicated on this application.
ADDITION OF NOTIFICATION IN RETAIL SPACE(PUBLIC ACCESS SPACE Valuation: $53,929.00
ONLY)
Existing building area: square feet
New building area: square feet
Number of stories:
'-,,g.•:!1'.014.i.0.* *i :. ''' ''. .::li:.;■". ih::; 'Fti:'!.(f*4 !1:1:1:":*'11#1:!i;;:j:•'
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:
APPLICANT NT7 . : ,• . :,. E'., ' - •LT.;t0i,kki..:PEFs0.4i:!:::;1:4:::!:11:1'!.; !.i1! TV..;ii■in:i!!!;:i!, INOTICE.., ,!.,','‘
Business name:SIEMENS INDUSTRY,INC. All contractors and subcontractors are required to be
licensed with the Oregon Constriction Contractors Board
Contact name:CHARLES HUGHES _ 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
applicant is exempt from licensing,the following reasons
City/State/ZIP:BEAVERTON,OR 97006 apply:
Phone:(503)207-1839 Fax::(503)207-1901
E-mail:charles.hughesgslemens.com
CONTRACTOR ' i. 'i : ' .: - ".1 • IWH,PrN0gE,RwygEs,-...., :::::::•::;:;.!::i!::..
. . . .., • , 1.,,],1:. 1.:,:- ..(71.ii.iiiirezrieilitiiiii;fe)nl:i .,: ,::';I:E5:-::13:.
Business name:SIEMENS INDUSTRY,INC.
Permit fee:
•
Address: 15201 GREENBRIER PARKWAY
State surcharge(12%of permit fee):
City/State/ZIP:BEAVERTON,OR 97006 FLS plan review(40%of permit fee):
Phone:(503)207-1839 Fax:(503)207-1901 (Due upon application.)
Total permit fees:
CCB lie.:133041
Amount received: - /7/, 7)
Authorized signature: 4 lik This permit application expires if a permit is not obtained
-qur' W within 180 days after it has been accepted as complete.
Print name:CHARLES HUGHES Date:04/08/2013 * Fee methodology set by Tri-County Building Industry
Service Board.
IABuildingWernuts\FPS-PermitApp.doc 02/01/II 440-4613T(l 1/02/CONNWEB)
04/08/2014 05:55 FAX Q001/004
City of Tigard EECEI v Permit No.: /95 dU/Y' V /
13125 SW Hall Blvd. Tigard
I Phone: 503.718.2439 Fax: 503.598.1960 Date Received: 4/Nig
t I G A K ll
Inspection Line: 503.639.4175 APR g 2014 ^
Internet: www.tigard-or.gov By:
CITYOF ri : •
FIRE ALA;. a ,FFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: WSQ Mall—American Eagle Outfitters Occupancy: B
Job Address: 9767 SW Washington Square Road Suite: D07
Contractor: Siemens Industry,Inc. Phone: 503-803-7125
Valuation of work: $3929.00
Type of System: (check one) Required [Non-required
(check one) ['Automatic ['Manual Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max 5) /To be Relocated(..x5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(m.xs)
Number of Proposed Notification Appliances: To be Added(max 5) 5 /To be Relocated 0.5)
I, Charles Hughes Oregon Construction Contractors Board No. 133041
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
f) Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
In addition,I understand the following is required:
• A sketch attached to this document and the building permit showing the area of work within the
building's structure,
• A copy of this document shall be available for the authority having jurisdiction,and
• Electric. p:r 't.
•Signature: ift Date: 04/08/2014
Print Name: Charles Hughes
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WASHINGTON SQUARE MALL
9767 SW WASHINGTON SQUARE ROAD
TIGARD,OREGON
AMERICAN OUTFITTERS SUITE D07
1st FLOOR FIRE ALARM PLAN