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Permit (18) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit#: FPS2016-00090 T f Ga R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2016 Parcel: 151260000300 Jurisdiction: Tigard Site address: 9779 SW WASHINGTON SQUARE RD D11 Project: Champs Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S Project Description: Fire alarm-installation of fire alarm to code. 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 05/18/2016 $102.20 12%State Surcharge-Building 05/18/2016 $12.26 Type of Use: COM Plan Review-Fire Life Safety-COM 05/18/2016 $40.88 Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 05/18/2016 $4.00 Occupancy Grp: M Height: ft 11x17) Stories: 1 Hourly Building Rate 05/18/2016 $180.00 Hourly Building 12%State Surcharge 05/18/2016 $21.60 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: Automatic Pull Station Required: Smoke Detectors Req: Yes Battery Calcs Provided: No Cut Sheets Required: Yes Total $360.94 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $2,896.00 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 foils the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 Ye may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection d. . This permit card shall be kept in a conspicuous place on the job site until cod •letio of the project. Approved plans are required on the job site at the time of each spect•n. Building Permit Ap licatio � � Fire Protection System eFOR OFFICE USE ONLY City of Tigard MAY p 4 '/016 Receive Date/By:d A 6 Permit `6.y' 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re . "vv ti N . Phone: 503.718.2439 Fax: 503.598.196 kir t s < Qt) �� t ((,D (,„, Other Permit:0.4;90 Q �, e ;. DateBy: TI G A R D Inspection Line: 503.639.4175 {„�i t.` Date Ready :• Juris See Page 2 for Internet: www.tigard-or.gov T �� l�i�' Notified/Metlwd: �� f ^ Supplemental Information U'-) 1�a 1"15 �ua c- �.� .,"g `z ,a TYPE ©F WORK ® 'IGtIl2ED 71ATA 1 2 +li ING ❑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 CATI GORY OF CONSTRUCTION work indicated on this application. C:11-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑Accessory building ElMulti-familyNumber of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB.'SITE INFORMA.T)[ON AND LOCATION Total number of floors: Job site address:9779 SW Washington Square Rd. New dwelling area: square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.:Dl l Project name:Champs Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet BEI/FIRED,DA •A:COMMERCIAL-USE CHECKLIST 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 OF WORK work indicated on this application. Installation of fire alarm to code. Valuation: $2896.00 Existing building area: square feet New building area: square feet T' OPERTYuOWNER ® TENANT Number of stories: Name:Champs Type of construction: Address:9779 SW Washington Square Rd. Occupancy groups: City/State/ZIP:Tigard,OR 97223 Existing: Phone:( ) Fax:( ) New: PI'L T ® CONTACT PERSON ,NOTICE Business name:Siemens All contractors and subcontractors are required to be Contact name:CJ Volesky licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 15201 NW Greenbrier Pkwy,A4 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)896-9387 Fax: :(866)254-0669 E-mail:cj.volesky@siemens.com as x tac TOR ="ix BUILDING PERMIT FEES* Business name:Siemens (Please refertoferschedale)' Permit fee: Address: 15201 NW Greenbrier Pkwy,A4 State surcharge(12%of permit fee): City/State/ZIP:Beaverton,OR 97006 FLS plan review(40%of permit fee): Phone:(503)207-1900 Fax:( ) (Due upon application submittal.) CCB lic.:133041 Total permit fees: • Amount received: Authorized signature: This permit application expires if a permit is not obtained Print name:CJ Volesky Date:5/04/2016 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\FPS-Permit App_0715 t R`Auc./ 440-4613T(I I/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information ci'e�vorlta be done: 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: ElNew system Number of sprinkler heads: Number of alarm devices: 8 ® Addition or El 1-10 heads: Affidavit required and ® 1-5 devices: Affidavit required and Alteration (3) copies of sketch showing area (3) copies of sketch showing area to existing of work within building structure of work within building structure system ❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work: Some devices were removed and reinstalled after construction. We are going to test for proper operation. Type of;Syste n + ir�inplet =B,C or.D as applicable): "^ �6i '7 A,) Commercial Sprinkler ,z=T' s . ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.)'Type I- Hood Fire Suppression System ;r , Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ 2969.00 D. i e rdert i � p ntkl r„(Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 7,201 and greater $404.39 Sprinkler Project Square Footage: sq. ft. .' Fire Protection Permit Fees Project valuation subtotal (see A,B &C above): $ 2720.00 Permit fee based on project valuation (see fee schedule): $ Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ FLS Plan Review(40% of permit fee): $ TOTAL: $ D:\Users\voleskyc\]obs\WSQ\5200476903 WSQ-Champs\Permits\FPS_PermitApp.ddc Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 9779 SW WASHINGTON SQUARE RD D11, TIGARD, OR, 97223 Commercial - Fire Protection System 998 Alarm Final PASS - No C of O FPS2016-00090 Jeff Grove Violation Summary: Inspector Contractor