Permit (78) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
' ." 2. COMMUNITY DEVELOPMENT Permit#: FPS2017-00131
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/13/2017
TIGARD Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9632 SW WASHINGTON SQUARE RD G09
Project: Bath&Body Works Subdivision: None Lot: None
Project Description: Fire alarm-modification of(6)alarm devices.
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 09/13/2017 $134.48
12%State Surcharge-Building 09/13/2017 $16.14
Type of Use: COM Plan Review-Fire Life Safety-COM 09/13/2017 $53.79
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 09/13/2017 $6.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 09/13/2017 $14.00
11x17)
Hourly Building Rate 09/13/2017 $180.00
Commercial Sprinkler System: Hourly Building 12%State Surcharge 09/13/2017 $21.60
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: Yes Smoke Detectors Req: No
Battery Gales Provided: Yes Cut Sheets Required: Yes
Total $426.01
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,968.00
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 952-001-0091. You may obtain"copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: /`/6 /
�/ Permittee Signature: '
/""iii
..
Call 503.639.4175 by 7:00 a.m.for the next available inspec o•ate. ' id
This permit card shall be kept in a conspicuous place on the job site unti completion of • pr. •ct.
Approved plans are required on the job site at the time of ea i inspe •• .
Builth' n2 Permit Applicata a ,,,,,-,-•77E .,r TIN
Fir Protection Systel'ImIN r' FOR OFFICE USE ONLY
City of Tigard l i 2 i Date/By:Received 1 /7 / fSo7O/ 0013/
71 Permit No.: i
'I 13125 SW Hall Blvd.,Tigard,OR 97221 Plan Review �`
Phone: 503.718.2439 Fax: 503.59$503.59849.00.i; Date/By: / Other Permit: Tvl7_L1?yid9_-
i, ', Off" IC .R
TIGARD Inspection Line: 503.639.4175 t: gA' Date Ready : (��-` Iuris: I ® See Page 2 for
Internet: www.tigard-or.gov T i t Notified/Metho. R` U Supplemental Information
ry S4 a dui
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",.t� ' �II i �°�ul��� ,l - t#1 "° $ ' k l �'�I� REQtb ..!, ^,TA 1 „ Al l'� aWEI G�,.
+. ,l .. trim ..~fir.- ?:.x :,,. .r`3v^ib -e ., ,i., -. �'. ' ., ^ `„.. .: . wli� . , '
❑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
I - work indicated on this application.
�,.:f ~tet f „.rTEQ U- + ,� 7"R1 IUN .� "
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
0 Accessory building CIMulti-family❑Master builder ❑Other: Number of bathrooms:
i h�4 3, + 'QR I A "LO} T m 11III:1 " Total number of floors:
^ ., r o.. . , iMw n , . ..KK. i'''''''''''''''''
- I'+�5 -m *4.7. .»W .�. VIII Ii
Job site address:9632 SW Wash Square Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:G09 Project name:WSQ Bath and Body Works Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
QUI b DATI t'Vit) tIA E CHEC I'LIST
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
„r. „'','-:;., „I I, .44'4.';'il..I'1 4 work indicated on this application.
Tenant Improvement on Fire System at Washington Sq Mall store, Valuation: $5,968.00 ,
Bath and Body Works. Existing building area: square feet
New building area: square feet I
�* `, pR a� * (1 ER 7 ii Number of stories:
Name:Roger Ott Type of construction:
Address:9585 SW Washington Square Rd Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing:
Phone:(503)352-8862 Fax:( ) New:
0Ap0�hT �u ^ ,'O1STACT PU' t
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Business name:Siemens All contractors and subcontractors are required to be
licensed
r on Construction Contractors Board
e
Contact name:Moses Frangopoulos
with the Oregon
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 performed.If the
City/State/ZIP:97006 applicant is exempt from licensing,the following reasons
apply:
y:
Phone:(503)207-1834 Fax: :(503)207-1900 4G ..e.d/}
/
E-mail:moses.frangopoulos@siemens.com ,
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... #'e�s�refer t'a.1e sch` urea .. . .,...
Business name:Siemens
Permit fee:
Address:Moses Frangopoulos o
State surcharge(12%of permit fee):
k
City/State/ZIP: 15201 NW Greenbrier Parkway,Suite A4
y y FLS plan review(40%of permit fee):
Phone:(503)207-1834 I Fax:(503)207-1900 (Due upon application submittal.)
CCB lic.:133041 Total permit fees:
l_!,._ Amount received:
Authorized signature: -
� ” This permit application expires if a permit is not obtained
Date:8/16/17 within 180 days after it has been accepted as complete. ;
Print name:Moses Fran:i i oulos * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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De'451 tibe w ,to <d� III _.: ':
..
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices: 6
® 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 required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
I?lltk h d ": 4 orapp�
r �ttr
Cbroa� natrud�er j
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes El No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
ymr��l d 1u IINI�
•
fir) # Hotsd re�JI� p s
Hood Project Valuation: $
i:� II IIII.
"'a 14 YVS ,& 1.°'.•I 11"I lu litlz
Ilikr�rr , r+ I�II�j+�� I
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C� . �ret.A + (i 'F IIII prllllllldl y g X V F "ld"
✓�, lug ulmv111.INll r .r
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $
il4'I r u41,�u�llu il11�N Iw7 +n Irx III 1hIP rrlllllil^ "� a „', IIII 0 - Iifill+Illlry I;,, '
Iµkb"y�,�M n k f7, lh�f rl�l ow�:I�k.0 N�w l�s� $z yl�l,il Ip I141I Iia ro F,
D. a;;R�S, +en• er tand o a System)
Square Footage: Permit Fee:II s
g II (IIIIw IM1aYd'wGll, ^e � �< r t !r„M
_ 0 to 2,000 $198.75 "III" 16111 x ra.� ;1I rl ' s
■
2,001 to 3,600 $246.45 gpN11HIw �t w r rr r r M fi�I N III Ihp VI R - '�' �rp3 ip 11 S4 � �l 1IIII �
I �r�l�I III IIII IN r �s � , t 1�"{jy III�IJ}r ; � pl!Iu1i IIII .
3,601 to 7,200 $310.05 mu�wI1161dIlIIII'I p ,� �I°Ilpl6lb a
7,201 and greater $404.39 . xlrrllll!d”,e, rlld ly I'I
Sprinkler Project Square Footage: sq. ft.
FIknn, III
�hrotectibn POsrnt dee' r ;
Project valuation subtotal (see A,B & C above): $
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:\syncplicity\frangopoulosm\FSS Sery Projects(Charles Hughes)\Open Projects\_Moies\220858 WSQ Bath and Body Works\PM\Permits\FPS_PermitApp.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9632 SW WASHINGTON SQUARE RD G09,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00131
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor