Permit iiii , CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
. '- COMMUNITY DEVELOPMENT Permit#: FPS2019-00067
T[ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2019
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9345 SW WASHINGTON SQUARE RD T13
Project: Altar'd State Subdivision: None Lot: None
Project Description: Fire Alarm. Installing(11)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: 865-288-7700
FAX: 503-207-1901
FEES
Description Date Amount
Specifics: Hourly Building Rate 06/13/2019 $180.00
Hourly Building 12%State Surcharge 06/13/2019 $21.60
Type of Use: COM Permit Fee-COM 06/13/2019
$166.76
Class of Work: ALT Type of Const: VA 12%State Surcharge-Building 06/13/2019 $20.01
Occupancy Grp: M Height: ft Plan Review-Fire Life Safety-COM 06/13/2019 $66.70
Stories: Info Process/Archiving-Sm$0.50(up to 06/13/2019 $12.50
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 $467.57
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $8,571.00
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-+090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.3 - --- ---7
Issued B _... ....-___...7...--
Y- ���� ittee Signature: .�
r /
Call 503..39.4175 by 7:00 a.m.for the next available inspec •n date
This permit card shall be keot in a conspicuous place on the job site until completion of the prnjer_t
Approved plans are required on the job site at the time of each inspection.
1
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Building Permit Application ., -
Fire Protection System �`� FOR OFFICE USE ONLY
of Tigard MA( 2 9 2019 Received
Permit No..}.- 1\1/4-%.r.,„
City g Date/By: tit"?'14� (•. )-T• 1�J� \ .1il
13125 SW Hall Blvd.,Tigard,OR 97223 y-•�, Plan Review
III
_ Phone: 503.718.2439 Fax: 503.598.19601 i t kir I i -�' )�) Other Permit k? ,_ �uk
DS Date/By:
TIGARD Inspection Line: 503.639.4175 tit �� � I � � Date Ready/By: Az Juris: H See Page 2 for
Internet: www.tigard-or.gov tawotified/Method: `Ill Supplemental Information
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❑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 0 Other: equipment,materials,labor,overhead,and the profit for the
�& x rI Iill '0 Mt" `ilk(}, co a IIII �IIII�iI�'IIIIII work indicated on this application.
�F�`; �+ql, ..,. ,' �� xxLl�l�hl I+Nxe .� I IW14 .. .„ .1 I , :I i I��,I wII �I I
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
AccessorybuildingNumber of bedrooms: yi-',,`
ci 0 Multi-family
Master builder ❑Other: Number of bathrooms: "
" sErl, FO .��I TtO � ,'IIIIIII�II Total number of floors: --
site address:9345 SW Square ton S
g q re Rd(9585 SW Wash Sq Rd) New dwelling area: square feet - ----
L.ty/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet_`° `
Suite/bldg./apt.no.:T13 Project name:WSQ Altar'd State Covered porch area: square feet
-Gross street/directions to job site: Deck area: square feet. i
Other structure area: square feet
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Q V%RZP M ,:COMMi1R i S-UU I+c""rti '
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 they,,,...:,
',-.''',..:::`,. , 1-i,-,,..;.'.'.,.,4,-,;40),4::. 010t6.; it pN (fi Q 1 _ work indicated on this application.
Tenant Improvement on Fire Alarm System at Wash Sq Mall store Altar'd State Valuation: $$8,571.00
-/fddition of 11 notification devices,power supply and booster Amp(+relay) Existing building area: square feet
Electrical Permit#ELR2019-00064 New building area: square feet
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Number of stories:
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Name:Roger Ott Type of construction:
Address:9585 SW Washington Square Rd Occupancy groups:
City/State/ZIP:Tigard OR 97223Existing:
_
Phone:(503)352-8862 Fax ( )
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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
applicant is exempt from licensing,the following reasons
City/State/ZIP:97006
is”} apply:
P tine:(503)207-1834 Fax: :(503)207-1834
_E-mail: moses.frangopoulos@siemens.com
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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 I Fax:(503)207-1834 (Due upon application submittal.)
CCB lic.:133041 / Total permit fees:
Authorized signature: f� M�, Amount received:
�_� This permit application expires if a permit is not obtained
Ptint name:Moses Frangopoulos Date:5/29/19 within 180 days after it has been accepted as complete. I
* PPP methndningy sot by Tri-Cpnnty Bvilding ie vygtty }
t Service Board.
IIapuilding\Permits\FPS-PermitApp_031016.doc 440-4613T(I l/02/COM/WEB) ----1,
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City of Tigard: Fire Protection Permit Checklist
• Page 2- Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
I=1 New system Number of sprinkler heads: Number of alarm devices: 11
® 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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❑ Wet ❑ Dry v wl , q,.'.'—' Sprinkler Type
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes 1:1 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
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aV ' ,, PeValuation: $ ,• ]� oN �� Hooroj
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C.) ir atm: 111 III 11j1 IIII.R -` 111Pi11 '!I,IIi a - ,w ; .
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Submittal shall Battery Calculations ® Yes
® Yes
include: Individual Component
Cut Sheets
Fire Alarm Project Valuation: I $ 8,571.00
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ry �I' cul '' Ila qh III l
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Square Footage: Permit Fee: „1 9
0 to 2,000 $198.75 x . '" 1rr1+11''III'
k�
2 001 to 3 600 246.45
,r,= � 111111111111k . �+
3,601 to 7,200 $310.05 „k r .
w pu1d��lq r 011,111`{ �,` `-, a',r p1,Jd
7,201 and greater $404.39 ' l'{�111'1141 d li .l u,r,1,�y1;11 'tl ;' ^1
Sprinkler Project Square Footage:• sq. ft.
:-.711.,;7.,":",,111,M1,,,'I _ ,)�,Isl I1 ,, .huh;' , ire Protection�4rmit ee 'I a Illl
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: $
LAT,. .u..lucD.\wp.epGeky\Eaeg„pe,lo.,...\�666,ry I\e�cct.(C1...1,,,II,,L,,)\OF,..11 i,. ,\_Mal,,\262190 WSQ Aka.1 Stam At
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9345 SW WASHINGTON SQUARE RD T13,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00067
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor