Permit (86) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00063
T f i;r1 It n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/04/2019
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9777 SW WASHINGTON SQUARE RD D09
Project: Hollister Co. Subdivision: None Lot: None
Project Description: Fire alarm permit:(15)notification 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: Hourly Building Rate 06/04/2019 $180.00
Hourly Building 12%State Surcharge 06/04/2019 $21.60
Type of Use: COM Permit Fee-COM 06/04/2019 $156.00
Class of Work: ALT Type of Const: IIB 12%State Surcharge-Building 06/04/2019 $18.72
Occupancy Grp: M Height: ft Plan Review-Fire Life Safety-COM 06/04/2019 $62.40
Stories: Info Process/Archiving-Lg$2.00(over 06/04/2019 $8.00
11x17)
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: Yes Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $446.72
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $7,710.00
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: ,ar'/ Permittee Signature: &C-
Call 503.639.4175 by7:00 a.m.for the next available inspection date. ��
P
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Applo.ed plans are required en the jab site at the time of each inspection.
Building Permit Application
Fire Protection System RECEIVED FOR OFFICE USE ONLY
Cityof Tigard Received
14 II g Date/By: + Permit No.: '"� ti L'"_ )-
13125 SW Hall Blvd.,Tigard,OR 972MAY 2 0 2019 S— l�i' L t
Plan Review
= Phone: 503.718.2439 Fax: 503.598.1960 Date/By: y NZi 9 Other Permit: t 1 `,stry"
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: /- Juris: ee Page 2 for` t�
.tigard or.gov BUILDING DIVISION . otified/Method:(.!� f //' 'RPS Supplemental Information
Internet: www DUILD Ci
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❑New construction ID 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
x QAIOt NSR ..".'y:''. !''..,:,!101,0*,.::
" ,0 : work indicated on this application.Is ; ., ll ilii
1-and 2-familydwellingValuation: $
LI El
AccessorybuildingNumber of bedrooms:
( ❑Multi-family iiVe
RI Master builder ❑Other: Number of bathrooms 1' K
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i .w �,7_4o r ^7AI
Total number of floors:
i
Jkb site address:9777 SW Washington Square Rd(9585 SW Wash Sq Rd) New dwelling area: square feet
Cfy/State/ZIP:Tigard,OR 97223 Garage/carport area: 'square feet
Suite/bldg./apt.no.:D09 Project name:WSQ Hollister Covered porch area: square feet
toss street/directions to job site: Deck area: square.feet].; ,
< Other structure area: � 5 squarefeet
-. ILII V� Q # d IIIMI"l I ii-' <.M T.
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
equipment,materials,labor,overhead,and the profit for the
i II � r.
SII
NIPIIIIjIIIII 11 11'.1 }''�Q][iiP s 4r lli :1 " work indicated on this application' ,
. .'�'' .�.<�..' Iaq r�.� :rr h I ... II I iI �v.�� ,� p moi`-
Tenant Improvement on Fire Alarm System at Washington Sq Mall store Hollister Valuation: $7,710.00
Audition of 15 notification devices Existing building area: square feet -
Electrical Permit#ELR 2019-00051 New building area: square feet
II II,;k `t. � ` � II I ; �p I !INumber of stories:
:,t i,. , `.w IIII I,IuIw I PII,III
. . --.
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: ��
,PPL! 1, ❑''''''''It ,PERSON GIP
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: . lI, NOTI
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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
City/State/ZIP:97006 applicant is exempt from licensing,the following reasons
amply:
-Phone:(503)207-1834 Fax: :(503)207-1834 `
E=mail:moses.frangopoulos@siemens.com
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` .. ;`Ii eae rafiejilgschei
, '-i4'.'.Business name:Siemens
i- 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 I Fax:(503)207-1834 (Due upon application submittal.)
CCB lic.:133041 '—.— 1 Total permit fees:
Amount received:
Authorized signature: --"!"_� �0-
This permit application expires if a permit is not obtained 1
opoulos Date:5/20/19 within 180 days after it has been accepted as complete. i
Print name:Moses Fr•
* Fee methndningy get by Tri-Cnnnty Building industry
Service Board.
1)Building\Permits\FPS-PermitApp_031016.doc 440-46131(11/02/COM/WEB) ; 1
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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Des` wl l tq be ne. u = ��II1Ntil •
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: 15
- E
® 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
sys tem
❑ 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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Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
Hood Project Valuation: I $
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Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: I $ 7,710.00
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Square Footage: Permit Fee: IMIhp11, "'"Ir
II RI,Vy ih� I4ryIIl�,IVy illih : 9 I�ry41pp1p
p:-.y I,11��III i , hi 4 ^d Llhiii pgWV, » - f JLwN r $ F -:`
Oto 2,000 $198.75 u1141,l �il11 IVIInIIIRr
2,001 to 3,600 $246.45
3,601 to 7 200 $310.05
> II�Id Ilu lilrl l s1 1 I ; r1 �i I s h a
7,201 and .reater $404.39
�I INil�lirl!If y Ihxa�%VIII VIII%�I IIyJII�� ��� h i,l�hl ��
Sprinkler Project Square Footage: sq. ft.
•py �1�IIMIO du'� rrw, � ,}4W',-tilll� II'P i',11 IN,n s•,.1R1 IIIrN,n e., h:�re Prbte+ tlon:."Pernnrr dee t-a" III III,: Wy -' _
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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.\,y,«i,)icity\Ciaugup oulu,.,\P3S Seiv PiujCLAJ(Ci a�1C,Huxl«)\Op�r,PwjC�ia\_M ,\262898 WSQ II 11 Lr\PIvf\Ptiriu�a\WSQ IIJIli,«�IZ..,��.���
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9777 SW WASHINGTON SQUARE RD D09,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00063
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor