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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT II Permit#: FPS2017-00162�� P COMMUNITY DEVELOPMENT 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2017 �f � Parcel: 1S126CC00100 Jurisdiction: Tigard Site address: 9700 SW WASHINGTON SQUARE RD Project: Nordstrom Subdivision: None Lot: None Project Description: Fire alarm permit:Adding(2)notification appliances,relocating(1)notification appliance,and relocating(1)smoke detector.Affidavit submitted. Contractor: WESTERN STATES FIRE PROTECTION Owner: PPR WASHINGTON SQUARE, LLC 17500 SW 65TH AVE C/O NORDSTROM LAKE OSWEGO, OR 97035 ATTN: TAX DEPT PO BOX 2229 SEATTLE,WA 98111 PHONE: 503-657-5155 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-COM 10/19/2017 $123.72 12%State Surcharge-Building 10/19/2017 $14.85 Type of Use: COM Plan Review-Fire Life Safety-COM 10/19/2017 $49.49 Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 10/19/2017 $2.00 Occupancy Grp: Height: ft 11x17) 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: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $190.06 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $4,300.00 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ---------7. / "" Permittee Signature: %T�`��" `�i ).......-19-6../4 (. Call 503.639.4175 by 7:00 a.m.for the next available inspection 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. Building Permit Application Fire Protection System FOR OFFICE USE()NEN Cityof Tigard8 1. Received ri g DateB : GI "1 Permit No.: ' 7 13125 SW Hall Blvd.,Tigard,OR 1 i ' = t iliN Plan Review Phone: 503.718.2439 Fax: 503. 60 C1-°'1 t°'1, Date/B : Other Permit �� r `� y; TI G A R D Inspection Line: 503.639.4175 v L �1 Date Ready/By: ;, See Page 2 for Internet: www.tigard-or.gov q.,'C', Notified/Method: EMI Supplemental Information V� A ' M9 TYPE OF 8 1S M � �'f „ REQUIRED DATA:1 AND 34FAN1iLY'lDb'4ELIC;ING ❑New construction Permit fees*are based on the value of the work performed. u Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION- ..° work indicated on this application. ❑ 1-and 2-family dwelling .Commercial/industrial Valuation: $ -,-t/ , ❑Accessory building 0 Multi-family Number of bedrooms: 0 Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION A,A;. Total number of floors: Job site address: 9"26 e S (,,J tt s[P, / r` ('en`tom A✓fir f New dwelling area: square feet ( City/State/ZIP: l i (,V.t ( O2 T 2Z-23 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: A4yri s 2 �4(PAry- LE Covered porch area: square feet Cross street/directions to job site: � /1 ( Deck area: square feet (,/v /'7 S L+ I'\ Fz; .--. St-="t. Other structure area: square feet J ! 'ILEQ p DATA ]COMMERCIAL-USE CH ' -IST °.' Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all '14. equipment,materials,labor,overhead,and the profit for the *.DESCRIPTION OF O work indicated on this application. .� / j Valuation: $ L1 3 cc. — Existing building area: square feet New building area: square feet PROPS WNER ' A,,, AA; O - , _ © TENANT rt, Number of stories: ki- Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: '' '44, 0 APPLICANT Of cpkirAcT PERSON Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed.If the City/State/ZIP: applicant is exempt from licensing,the following reasons apply: Phone:( ) Fax::( ) E-mail: ' CONTRACTOR2'4 ;*47' =, , 3UILNGI'ERMIT FEISS* Business name: toe 4� fL . J rc_S,)-(...xiet t" ,, (Plebse r to fee zhed:1e Address: /75-04 S LI 3 4.11-1 Permit fee: State surcharge(12%of permit fee): City/State/ZIP: N.- 05C-•^0 t' P.,, C 7617,� FLS plan review(40%of permit fee): Phone:(563) ye'7 c L7 5 Fax:( ) (Due upon application submittal.) CCB lic.: 6 6 y s 7 d Total permit fees: %ett). (j Authorized signature: ' >�, .� l Amount received: i This permit application expires if a permit is not obtained Print name: {/ It`//„1,,,,, r 'kLv."4— Date: Al --� y f within 180 days after it has been accepted as complete. Com` * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\FPS-PemutApp_031016.doc 440-4613T(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information Describe work to be done: F . 1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: El New system Number of sprinkler heads: Number of alarm devices: ❑ 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: Type of System(Complete A,B,C or D as applble) ) Commercial Sprttilder .ter � Sprinkler Type ❑ Wet ❑ Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ 8.) �'ype oo Fire Suppresstot ��yste� Hood Project Valuation: $ C) ,Fire Alarm . ,_ Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D ) Residential Spnnider( ee: Stand Alpe ystexn) Square Footage: Permit F 0 to 2,000 $198.75 t , 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 t.41 1,47, 7,201 and greater $404.39 . Sprinkler Project Square Footage: sq. ft. w_ Fie Protection Permit Fees_ <i 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: $ 2 I:\Building\Permits\FPS_PermitApp_031016.doc City of Tigard RECEIVEP Permi IN tNo.. � (7-6k)i a 13125 SW Hall Blvd.,Tigard,OR 97223 I� Phone: 503.718.2439 Fax: 503.598.1960} / Date Received: kit zi i TIGARD Inspection Line: 503.639.4175 OCT . u 201 _ Internet: www.tigard-or.gov By: ��� ary OF 1IGARD ' .� I r FIRE ALARAMRIUMMAraMiVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (MAXIMUM OF 5 DEVICES WITHOUT PLANS) Project Name: Nordstrom Occupancy: B Job Address: 9700 S.W. Washington Square Rd. Suite: Contractor: Western States Fire Protection Phone: 503-407-0279 Valuation of work: $4300.00 Type of System: (check one) •Required ❑Non-required (check one) ❑Automatic nManual ❑■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) 0 /To be Relocated(max 5) 1 Number of Proposed Manual Alarm Stations: To be Added(max 5) 0 /To be Relocated 0.5) 0 Number of Proposed Notification Appliances: To be Added(max 5) 2 /To be Relocated(max 5) 1 1, William T Stewart Oregon Construction Contractors Board No. 104570 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: • Submit(3)copies of a sketch showing the area of work within the building's structure. • Building fire protection system permit. • Electrical permit. • A copy of this document with a copy of the sketch attached shall be available for all inspections. William T Stewart Digitally signed by William T Stewart Signature: Date:2017.10.18 12:48:18-07'00' Date: 10-19-17 Print Name: William T Stewart I:\Building\Forms\FireAlarmAffidavit_071514.docx Page 1 of 1 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9700 SW WASHINGTON SQUARE RD, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Fire Protection System FPS2017-00162 Inspection Type: Inspector: 998 Alarm Final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor