Permit (10) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 COMMUNITY DEVELOPMENT Permit#: FPS2016-00164
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/28/2016
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9624 SW WASHINGTON SQUARE RD G07
Project: Amazon Books Subdivision: None Lot: None
Project Description: Fire alarm-modification of existing system.
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 09/28/2016 $156.00
12%State Surcharge-Building 09/28/2016 $18.72
Type of Use: COM Plan Review-Fire Life Safety-COM 09/28/2016 $62.40
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 09/28/2016 $6.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Hourly Building Rate 09/28/2016 $180.00
Hourly Building 12%State Surcharge 09/28/2016 $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: No Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $444.72
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $7,352.00
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 Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-0' 0990. You may obtain a copy o the rules
or direct questions to OUNC by calling 503. . •: • \:10.332.234•. ✓
Issued By: ure:
Call 13.• 9.4175 by 7:00 a.m.for the next ava' .: - e.
This permit card shall be kept in a conspicuous place on the job site until completion of the proj-ct.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System RECEIVEFOR OFFICE USE ONLY
City of Tigard
Receive
: 9,a� � Permit No.: 60���(
a 13125 SW Hall Blvd.,Tigard,OR 97223
SEP �+A2 Za{�16 Plan Revie –mm
11111 ° Phone: 503.718.2439 Fax: 503.598.1960 Date/B w'd1 f4 I „Other Permit: �� --co
TI CARD Inspection Line: 503.639.4175 V I-rlf 1Tl +ate Reay . o �j Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY 1! . feed Method: / oZ D % Supplemental Information
DING DIMISI• , w IA , _.
' ar„ �� ` a, ri ^"h'ai��lfl r' ryy l"G IIV ,9y w +I , SMI t n i'll111111171i iVr w.. j„, ' t . Wr ,, n,, m^u. .i:,,,:
' rc ti- ' ht M r't 8t a d 4 1, v 1, Iil ll ® 1 i t i F `^ �G
'. I Iiigi, 't� ,�i'�i 9N 1 xlt — . , on J. �.xi,r 1m G. s r� s yr
0 New construction ❑Demolition Permit fees*are based the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
►1 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
"" �'°
MP,-"°"'°tilll'111'l�U l(J 11 11b��rkllo �
.„FlPoPi xi�l i f ¢ •` tC h&it
41�dN' ��C � r 1 �r,111"IlI' work indicated on this application.�
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other:
Number of bathrooms:
':r' �' a ly I y�' r a"5ee. t ° 1u #11V1y0. 11%. I�s
r' , ,,. 4, s 0 1 Total number of floors:
Job site address:. 89'SWV Washington Sq Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:G08 Project name:WSQ Amazon Books G08 Covered porch area: square feet
Cross street/directions tojob site:
1;4 '/ Deck area:
rf31fI 1 ; square feet
rtiv` g`i-0 4)
Other structure area: square feet
Q . f _ e 1" t r " Rp q�ih y1'u1j1"41( h -r11111i17 d,��pil�gt'1yq � Illy.w1. �,I 4Mi
�, y5-1c7
T S r�Z^ .;.tet Wrm .C '[M,.. t.ay h,IG*,,
Subdivision: a /� 1w,±-c)(:: $ of no.: c1,n.' Permit fees*are based on the value of the work performed.
Tax map/parcel no.: L t5f N Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
r ,'�, k4 yar�%' r h m h I';.yl III 41° 411 t m t^d#, u l VII
�� h s �', I°,utiaq, ,1 a°P�h 111,E ,� work indicated on this application.
Tenant Improvement on Fire System at Washington Sq Mall store,Amazon Books Valuation: $7,352.00
Existing building area: square feet
New building area: square feet
:ftr
I , ... i r'„,r,. ', 4. Number of stories:
Name:Roger Ott Type of construction:
Address:9585 SW Washington Square Rd Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existin
-- ._ g:
Phone:(503)352-8862 Fax:( ) New:
. ;ts1 (r ► G EO
Business name:Siemens All contractors and subo
cntractors are required to be
Contact name:Moses Frangopoulos licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:15201 NW Greenbrier Parkway,Suite A4 jurisdiction in which work is being performedIf the
City/State/ZIP:97006 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)207-1834 Fax: :(503)207-1834
E-mail:moses.frangopoulos@siemens.com
Ems,Ir k»� 2 _
a
5 "r.. '.. r ki;.. `,4-47,-''` r4ss,n_ irt~ 71 II.I ?t IPF+ 404#
dot tt,, t ki7 serefCX Permit fee:
Address:Moses Frangopoulos
State surcharge(12%of permit fee):
City/State/ZIP:15201 NW Greenbrier Parkway,Suite A4
FLS plan review(40%of permit fee):
Phone:(503)207-1834 Fax:(503) I 834 (Due upon application submittal.)
CCB lic.:133041 '"„ Total permit fees:
I
Amount received:
Authorized signature: Of
This permit application expires if a permit is not obtained
Print name:Moses Frangopo I Date:9/22/16 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
440-4613T(I I/02/COM/WEB)
I:\Building\Permits\FPS-PermitApp_031016.doc
City of Tigard: Fire
Pr- Qote
ction Permit Checklist
'''I''-'1'1.41'..
10011,r,,,,..:,-=,..;
"w d .P " , I:'1 al ' >-: 4rPage 2- Supplemental Information P oWkdtinlrinkler heads: 3.)1. Type for : 2.) Adio /asWµteraton nl top Additionn/alteration
only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices: 4
® Addition or ❑ 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 requited and
(3) sets of plans. (3) sets of plans.
'11'''':--
*nn
1"RIhya1Pt• °Additional description of work: : a _M'�:'.
vg
-. R1C : 4 � `" r
�s . 1clY ^�, s 1,1.047111'1,,,-7,-, lU ' ,.„14.1,,,h
I,'4,,,,,
r9 - llh II �m I ii0 �. is e1, . I 'II19 d +'a ,,„ K ,4 '� a kx1�1�V :,kti'+ �Y u . ,..' '47, 77
Ii 11 1II111iif y1n1 �i,; 4 0° s I110,.. ,110111 lrfr{lU/' AFi f . � 'Sprinkler TpeI * 11111' '''..ii''''''i
U '11'''''''t
'' '' e u V1 r4".4!-.411'$,1 II ' " ki ,;a:,,,nk - , II II 4101 IIII V Wet
❑"" DI1VIk ;w
111'1 Additional Stand.i.es
Information: .. EI Yes ❑ No
Hazard Grou.
Densi
Desi• Area
K. Factor
S. •i , - • - V. a .• $
6.-)v,. : ® • $ . i -'21'i'*.
• '4111* *'
i qn 'x-46 IV�Iu 9e, .i''i;; �"} v,. >''.•' '',�'��u O"l IIIcl,, ,' 'g',''M1d" ''..
&Al
Hood Pro•ect Valuation: $
i I F"7 ,:. 11 !Y I :;001,,i
� � � l �'IMIkll 111 I r xr�>�.�"Ti Iluf I I � „�Prkµ 11'1—
r. �: t j,,Ii IIyII1 pj110.11;,..:470,
I1IpI10.1,,11: w, , a414 4, i�� �1i�41'7 � 1 4,11 n
r ,, =aq. E t,' _ •�,. <'{V� ' ''" 1011111111,1111 11'11'1 j1�,1111�1,a1, N ' �IIII, °�fP I Ihhl
t
1a
,,.� �� �� = � � 'n� t�„„'a��,” ✓n���„'ridua41"IP 1V�u1!Iu9'I'IPIt1 'V�IdVI N,�uu� �' � ,a„a I{rItl1��'”ILL"
Submittal shall Batte Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
F �Fire Alarm Pro•ect Valuation: $
- �' �.v. .- > ;,s”, • 1";.:: 1~14 µ9P;411)114�If�y�p1” h1Ip���rNII I�1PII�111�1I I�YI'IPPI'I ylfll; = 1 ifl`ir,` - “1,,,,...,-.. . x. ”, IIN ,�,
tiw `< ;'y %S,� :,,W� ;`°r. � Ek 5� �'UWI 1� ,11'11,111 IIVI III�I 1wf P IIP1�11 Y�ll -y111pSr. h..Z. ,Lm '� IXI� �l,,,
r"a' .4� 11 1411 IIID P,III111111 Gy : a d 11,111111 PII -1 x.. '€„
" • „9 "1111141171"1111P11111
�.,� 1"� >n',I IIVI vl 1111 "III x::E 2', 4 m< "
x m�f t �.+ 4 ... I . $ . $telllh r1� VhV v pP VII III i111 " ,,.,1„ - p8n, .
-� N 1„A `"NII1I b m p 11'11 I„VI" 1 , '10;1'..1414111,114111110'04,11
•41:,._
111111 yl ' n"a SurF- • w ,.eJ u n Vli
_ S.uare Foota:e: Permit Fee: {Ii11a � kN'IBa�' `,IV111i1
1, ti, ��G I^�1Iy1��1i V 'Ill:', s-== �"' Y,�^"` m n asr t jw a m
0 to 2,000 $198.75rllllmi 1 Y14h41 91 y'h1 � j
1{111i1IN1 V�Iv{ „ w u 1Fk µ51r
•
2,001 to 3,600 $246.45 h11iI1p1Yt11 ,1 k1fi r "
r 11 III III III111j 1111 IIIIII II III 1�I +Jwv • ,'r,' ,,�'
3,601 to 7,200
$310.05 "111„IGI11,I, iPPi'11IIi1l111 Y1 r
t 111101111Il1111111 1 ' 111V1111111 ,r,R';,, 11N I111PIIIIuIIISol / sv'N� '
7,201 and : eater $404.39 ' `. ,., _,”"P"w luhu"' .P!!'!,all'11u11j'IItl6h'11111"11i11h""IIGIIhIII"INllr"1u+111101
Sprinkler Project Square Footage: sq. ft.
k 1111 fl 111 w_. r I 1 IYII Ill 11he1 II f r"I�ili�`�'.� uw�,1d11 Iy;�q P�q ul du�Iq NN 11 ?"� 1"1�1I II11 III P�s1 1d �lm,�l
e II„ 1 ,"IIp11 ti' yq, P''v"- 4 R 3 pIj�I lµ"i`'tkpVrP1 y 111111"III w+d kN1�1„NP
”d ',,,,,P,.1,�. 1,11 w 1" i .a ,, :5a ,,,n iul mlmiWPM'"1 n �wr,11111 ::sc11l h iu III : ,wwlu 1 n�I 1111 kµ44 u..a...�1ku' ti ti ..:q,
Pro'ect valuation subtotal see A,B &
Permit fee based on aro ect valuation see fee schedule : $
Permit fee based on s•uare foota•e. see D above : $
State Surchar•e 12% of.ermit fee : $
FLS Plan Review 40% of .ermit fee : $
TOTAL: $
D:\syncplicity\frangopoulosm\FSS Sery Projects(Charles Hughes)\Open Projects\_Moes\5200-WSQ\5200495167 WSQ Amazon Books\Permits\FPS_PermitApp.doc