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Permit (46) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 14-1 COMMUNITY DEVELOPMENT Permit#: FPS2018-00045 13125 SW Hall Blvd.,Ti Date Issued: 05/08/2018 TiC Ai< and OR 97223 503.718.2439.i7 9 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9315 SW WASHINGTON SQUARE RD T03 Project: Lovesac Subdivision: None Lot: None Project Description: Fire alarm permit:Adding(1)device and relocating(4)devices for TI. 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 05/08/2018 $123.72 12%State Surcharge-Building 05/08/2018 $14.85 Type of Use: COM Plan Review-Fire Life Safety-COM 05/08/2018 $49.49 Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 05/08/2018 $8.00 Occupancy Grp: Height: ft 11x17) Stories: Hourly Building Rate 05/08/2018 $180.00 Hourly Building 12%State Surcharge 05/08/2018 $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: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: No Cut Sheets Required: Total $397.66 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $4,983.00 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 952-001-009Q. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. fl Issued By: - ✓l - Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspec '. d. 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 FIECEIVEDFOR OFFICE USE ONLY City of Tigard Q 2n1U Received Rjr� Permit No.: iiil pit VIDLt),.. 13125 SW Hall Blvd.,Tigard,OR 97223,,, Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit �Q /r-- n TIGARD Inspection Line: 503.639.4175 CITY OF TI%. f(I. Date Ready/By: Juris: 0 Sete"Page 2 for (�� Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information .., . er 1 I r,�t R§,41,,,, i uilli;,6k � i � 1ryNa � �RJeDAT , � Wt ' ,® G ,x „„,;',1,11074!"3+, 4 �dr ..a . ) Itl .`;” 0r„ryfI, ,.. Iyl "' l.l , . y . � �.. Permit fes*uarre based.on the the work performed.New construction 0 Demolition Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the 19u SP I ,56.4•ina :r t� ,ti I I r "r .i�Q. II pIIIUI�01 „. work indicated on this application. 5 ® SIM PP �- ,a,�'- ..".ala _ d lu�� �art's<' � -4,:4101.,::. a. .�`. I .�I 3 .. K '-9---7.9.�, .�,,: ' LI 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑Accessory building E]Multi-family Number of bedrooms: o Master builder ID Other: Number of bathrooms: r h a 1 �i"l��t "e .ryl n #,m;'"4' d l dI v 41 'r : #. a„wi r. „ �� t l Total number of floors: i .r V��I` TIO a., hlaq IIL?t . _.. . ,., , Job site address:9315 SW Washington Square Rd (9585 SW Wash Sq) New dwelling area: square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.:T03 Project name:WSQ Lovesac Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area • : square p�t feet eet : 6irilTAafi1r » iEe LI 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 r ,�� equipment,materials,labor,overhead,and the profit for the i �ld��l ��II( �I .m i a ltI,t a `II k`(1 ,"101, , .+ �, ," � , r 111::' . r I. : work indicated on this application. r . . w Tenant Improvement on Fire Alarm System at Washington Sq Mall store"Lovesac" Valuation: $$4,983.00 Existing building area: square feet New building area: square feet allr ` ®� S ,...,...0,11:01.., .....„, dha lilryh ►r 1 i . '>.` � Number of stories: d'MI til:., e= fir ,, Pu' ,`, „III ^,iIl .wio,-- "v; 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: 11 AI r ti 1�V ';., d {lllf pl© t r.�BASmA:: 1 ... a . .r. ii r 10 T: It ':t`«, c 19N,...-. �' . as s ,iIlil,,,! ,:.„,,:.;,,, ,P11,11,,....,,,,,,,,It4 �ryl� V I"y '�,,, name:Siemens All contractors and subcontractors 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 performed.If 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 „,.,„„,„„,,,,,i,,,, _. I, l„. ,' m S t' „ � �iii L' t � ` .4 --,;-'11T:] .':.'6.''''', ;-'11 . ::,t;.:.',,,,.... �t � LD, � �JXe1 '',? s '41,4I h' .VI 11 . 15ew ..7Ae. . I,- .- .e . „ ` .. ,VI (Phseie1 .94.0schedBusiness name:Siemens 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)207-1834 (Due upon application submittal.) CCB lie.:133041 Total permit fees: Authorized signature: i� ��.`--i Amount received: This permit application expires if a permit is not obtained Print name:Moses -' p Frang o a ' Date:5/8/18 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613 T(1 I/02/COM/WEB) w ` City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information ® � • :Q b+ 1� o" 'iGP h,r'+ ' IC"'_ w14:110j11!1,1!1:111!,0"II�III " ps` — '��u , x,., - �Vw ron '' ell,Ar 1 """+�^ ' 10 1101 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: 5 ® 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 El 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and (3) sets of plans. (3) sets of plans. Additional description of work: rear➢!�� '" � y � „t GI '8'�& � II"� III NII " 7 lel IIj�tl11 i�'1��alr `"> , yld a ti. 1' -. , _j �., `L< awooa 1:1 reel r "1 IIMI4 Yr�w a ure.5,, ,dl °,444.fsti l .. �r�^� `.,�� �' ��.�: -- :;-. :��T, a ° ','"r �1!,,,„,IJ lllllrm?rn°7lulld Ve!I�h!Illln Ipp V'llll��°' lk:`',a l�h rP4J,'4, .:;: ylrl;�_ � � '-•:� �,^ r �II��� �:` 1� iGl I. I ul,Il lull R l�ldd„q,I.. _ . .F 7llll1%'I��WdI ld�ti�IVI Ilya d ? * ;. GIYI l �aIINe st I P i7ey''Iw,IIIIjjICw11 ilk �1 h 4+ti dl�j k v £, M 1 ��y P111 � Bl _ .__• e Sprinkler Type El Wet El Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes El No Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: I $ 4 Ie l, i 110111 IV� OFF' ^I fume `r pp,x sio .,Syste Ee '',1 slPII Hood Project Valuation: I $ w..:” `..' ,44=:Z._ uy- ar ” �' ;,Il lVreula II y ,rl;l,yl�,!I.II�Vll;l „l�d4r�lNlllaud1�ul0llll . jl:a, _Y„»_1il;lr•e�1 I -4_ ,'4 rj ukp { " p,„r art44^°pk e� " ''''''t-"4'44""''''''.4$4444,,4'...4."!;4t4" da1 � l! xtn-�;xPlI 4 r ,2 . ' ". µs.t„ ; ' _ y4w1 nd1„"r, ,4��� P1I +" S '3- - 6lN�I l r`I �� I4". Submittal shall Battery Calculations El Yes include: Individual Component ® Yes Cut Sheets Fire Alarm Project Valuation: $ 4,684.00 Irk P dP � rl�hq '�"�"' �•,�$ °- '' ^E,rll vw P°lljl"1 Vjr!de r rt'a"'mm"a"� - 's� �' ry ., u Ik IP _'_� m rlu IIfiJ 1 �djlfl� t?.. 1 { ,,' r "14 G�l1 Illy) Iiol!,'`0:44,' G { `sl n 'l 11� r fp 11a`j "rsf' Ilggl l qll ' ', , rP mq aa, V � :,.W` ;019I6! ^ r` ' :1.1110, � �Prlul lful� y.;_ Square Footage: Permit Fee: �Illllli'd, 111 yl illllllhil •, , + 1 1 dy ,a , , + eII1; III �r 0 to 2,000 $198.75 « tF Ill del lh � 6d�,,�II�re+Gu�, 2,001 to 3,600 $246.451 ly �4;IV16111 3,601 to 7,200 $310.05';°j 7,201 and greater $404.39 Sprinkler Project Square Footage: sq. ft. my �PIl�j1u Y"r w 40,F . 1t1 t, a0,41,1,;� ee dl� Vl uPV�� 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 permit f o e Surcharg (12% fee): $ FLS Plan Review(40% of permit fee): $ TOTAL: $ D:\syncplicity\frangopoulosm\FSS Sery Projects(Charles Hughes)\Open Projects\_Mods\5200613183 WSQ-Lovesac\PM\Permits\FPS_PermitApp.doc RECEIVED MAY 8 2018 City of Tigard CITY OF TIGARD Permit No.: f'/5/ZOIX'001/S- -'1 13125 SW Hall Blvd.,Tigard,OR 9721 ftfnt 'lVG DIVISInl�ate Received: �� �`� Phone: 503.718.2439 Fax: 503.598.1 6 TIGARD Inspection Line: 503.639.4175 Internet: www.tigard-or.gov By: //41; , ' FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS OR TENANT IMPROVEMENTS (MAXIMUM OF 5 DEVICES WITHOUT PLANS) Project Name: WSQ Lovesac T03 Occupancy: Lovesac Job Address: 9315 SW Washington Square Rd Suite: 103 Contractor: Siemens Phone: Valuation of work: $4,983.00 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(max 5) Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(max 5) Number of Proposed Notification Appliances: To be Added(max 5) 4 /To be Relocated(max 5) 1 I, Moses Frangopoulos 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: • 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. Signature: Date: 5/8/18 Print Name: Moses Frangopoulos 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: 9315 SW WASHINGTON SQUARE RD T03, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Fire Protection System FPS2018-00045 Inspection Type: Inspector: 998 Alarm Final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor