Permit (133) 71 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
3
2 '' COMMUNITY DEVELOPMENT Permit#: FPS2018-00148
tGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/31/2018
T-
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9455 SW WASHINGTON SQUARE RD A15
Project: Stance Subdivision: None Lot: None
Project Description: Fire alarm. Addition of(4)speaker/strobes,(2)strobes,and(1)power supply. Contractor pulled permit for
electrical contractor online. ELR2018-00170.
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: 714-309-7220
FAX: 503-207-1901
FEES
Description Date Amount
Specifics: Hourly Building Rate 10/31/2018 $180.00
Hourly Building 12%State Surcharge 10/31/2018 $21.60
Type of Use: COM Permit Fee-COM 10/31/2018 $134.48
Class of Work: ALT Type of Const: VA 12%State Surcharge-Building 10/31/2018 $16.14
Occupancy Grp: B Height: ft Plan Review-Fire Life Safety-COM 10/31/2018 $53.79
Stories: Info Process/Archiving-Lg$2.00(over 10/31/2018 $6.00
11x17)
Info Process/Archiving-Sm$0.50(up to 10/31/2018 $10.00
Commercial Sprinkler System: 11x17)
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: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $422.01
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,797.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started • `, 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires yo to follow the rules adop -d by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001 1090. Y obtain : copy of the rules
or direct questions to OUNC by calling 503.232.1 . i f. •.4.
Issued By: > •• •••tee Signature: '/'
Ilri
Call503.639.4175 by 7:00 a.m.for the next available i -•ect on date.
This permit card shall be kept in a conspicuous place on the job site unti c• • • ion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection SystemEC l%SIT . FOR OFFICE USE ONLY'
City of Tigard Dateiv y (O if�/f / , 5',,Z,0_ii"0a IL/i
13125 SW Hall Blvd.,Tigard,OR 972 T 8 2018 Plan Review / ,
2 Phone: 503.718.2439 Fax: 503.59 DateB : ,0 '�_ "� • �' Ot ��' Pa I .GGrs�� ,
(�l i i i uris: 0 See Page 2 for
TI G A R D Inspection Line: 503.639.4175 Date Ready/By:
BUILDING p .otified/Method• 6i L/ Supplemental Information
Internet: www.
tigard or gov '��
,.: Pp IH•I,' Pu!PI!" i d i,llhi wil,u�i , 4 a "r' ;'Its tplilull" 11 "IIo �tlll1!! p�!'; tl `":"'I'V, s. Illi wa7rl kl q f +t,:
' ":P"q X11,114$ ' 1ia , Jllti it 11"[11 r'J ',✓��i .,7a ry 41iu11is crib !° 11 `tl B t 9 `� @ pit tl M i,1 "
❑New construction i."; ;. ,k iu llu r," "Ili I,i :' . pt aa> basedon t to then crest dollar)
Il
❑Demolition Permit fees* work performed.
Indicate the value(roundedollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
� �i u11i" ® w;" _work indicated on this application.
s`' , li,'t ;aa , It f,;* .... 111 .s W41' d,40i1Vi-2 ""t'. ^."i"IV:
t"..: l''',4''',. ;. *i 4.,4x'^ .:, L$.' ly,a ''64 . - w ".
Valuation: $
1J 1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms: 'Y
0 Accessory building 0 Multi-family �i
EV Master builder 0 Other:
Number of bathrooms: is
ll
� j11� tot 1 t"11 d ,,''',1,,,,,, r I tlilo11 ,1 Total number of floors:
fill site address:9455 SW Washington Square Rd(Mr :9
nl ll� ,
a11:9585 SW Wsq Rd) New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:A15 Project name:WSQ Stance Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
,�III p
, �€ E D 1I�� : ;!'�„a" k. n t. -ii,::t
.X11 �171�,�.
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 " w a.4; i w a.it" It sd �' r u"11[.11{ ibm ,Zi 1111ry"1°l:d .t rllI.. ' t.
1� j iii, x.•q�ia�u" a):4 44','1 r 1 .,',,,,,,,,$ $,b; n0111002:-I ., . l IV ,:iA a work indicated on this application. a..
Tenant Improvement on Fire Alarm System at Washington Sq Mall store Stance(A15)
i
Valuat
on: $5,797
ddition of 4 speaker/strobes,2 strobes and 1 Power Supply Existing building area: square feet
Electrical Permit#ELR2018-00170 New building area: square feet
f lalllu gr = ai
4142 7 e t 1;1111 ,,. „, I o 1 14 4"III 1,11r 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:
.s,,. 't " II .s cls .,i,. x«W °�:u81 Pt J "!1 � '111191'"4.,;::"rale AWP ^"1111„1.. r^1" 91 f',,,,,,,i5, w i!ut,, 1 4I ' °..s a a u qr.: >��d,,:
„"�'rr >r���� IGIi1 N., tl �;. : :. �,1„ I1 414„'::,,„',4-,- .7,„,, .: x1,,;,,:),,,:-;1",111114. .:” i� , '"�i I"lei"'ro lEf it � �� �' ��r��� ,"t,� ,��� �
Business 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
----4,: applicant is exempt from licensing,the following reasons
City/State/ZIP:97006 apply:
Phone:(503)207-1834 I Fax: :(503)207-1834
E-mail:moses.frangopoulos@siemens.com
a a4':',� t: pa� " .. »`w y..,, , .., 4:•: ., .•o-ia " ' rcF'✓" : , 'ryS` --,;,,It,,,,,,tla . 44 e t ,1,1 -" - a x 1 b"« t ; �1t �� ° ip� a vl , � � ' 1t � m
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Business 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 lic.:133041 _ Total permit fees:
// �* ".- . Amount received:
Authorized signature:
This permit application expires if a permit is not obtained ,=
Print name:Moses Fran:'TTT" Date:10/18/18 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 440-4613T(1 l/02/COM/WEB) 1
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City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm
o alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices: 7
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:
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Additional Stand.i.es
Information: . .. ❑ Yes ❑ No
Hazard Groue
Densi
Desi. Area
K. Factor
S.rinkler Pro'ect Valuation: $
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Submittal shall ® YesBatte Calculations
Individual Componentinclude:
,....
Cut Sheets
Fire Alarm Pro'ect Valuation: $ 5,797
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S•uare Foota.e: Permit Fee: 1 f III'1j0 �� 1 ,„I II 1,
'$.,1$41“$07,°,4",i1111$
� �III � 111111 „p u .
0 to 2 000
1198.75 ,,,,t rr�Il,'IIly�l�i1�
$ µ t,i1111�944„4p�l Vf r f 1 e i
2 001 to 3 600 IIp11IIaIAi
$246.45 4” ;1„•41 Y y!y l l ,f44,446-444,"'44'44;444V 2 h, Il +0
s /a145'1!44'1 u/,,ii/4/11l/ ' rl/4/0 u
3,601 to 7,200 l °II il 'lll
$310.05 ,-.4,44.--.410114,P :
4,-.144 111414 4,4
ti ihI1 ,, r,III IIIwIy1I,k
7,201 and treater $404.39 V.o a""`., IIIIuV! ��1 sq
• Sprinkler Project Square Footage: sq. ft.
M ren '.' 3; o"r' , a hN m II. e"4-448"1u,.."7,4144._4:1-4r ,, 11 «"r y'"j.lr 1 11191 II/r la
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"� 1 Ip
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Pro'ect valuation subtotal see As,B &e Ce above $
Permit fee based on .ro'ect valuation see fee schedule : $
Permit fee based on s.uare foota•e see D above : $
Surchar.e 12% of .ermit fee : $
FLState S Plan Review 40% of.ermit fee : $
TOTAL: $
D:\syncphcity\frangopoulosm\FSS Sery Projects(Charles Hughes)\Open Projects\_Mos\250614 WSQ Stance\PM\Permits\WSQ Stance Permit.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9455 SW WASHINGTON SQUARE RD A15,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2018-00148
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor