Permit (221) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IN
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' COMMUNITY DEVELOPMENT Permit#: FPS2019-00101
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14!2019
T t(;;`I I3 g Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9561 SW WASHINGTON SQUARE RD B02
Project: Abercrombie Kids Subdivision: None Lot: None
Project Description: Fire alarm.Installing(8)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 08/14/2019 $180.00
Hourly Building 12%State Surcharge 08/14/2019 $21.60
Type of Use: COM Permit Fee-COM 08/14/2019 $156.00
Class of Work: ALT Type of Const: VB 12%State Surcharge-Building 08/14/2019 $18.72
Occupancy Grp: B Height: ft Plan Review-Fire Life Safety-COM 08/14/2019 $62.40
Stories: Info Process/Archiving-Lg$2.00(over 08/14/2019 $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
r Residential Square Footage: Il
Fire Alarm Valuation: $7,105.00
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 set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a .•py of the rules
or direct questions to 0 by calling 503. E.1987 or 1.;: 44
Issued By: 4T /, 7�,, / •-rmittee Signature: Al,
Call 503.639.4175 by 7:00 a.m.for the next available inspection
ll
This permit card shall be kept in a conspicuous place on the job site until co • • of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System ¢"c i« t ' ---? ` FOR OFFICE USE ONLY
ill Received ^���� ` /
City of Tigard p t�y Q Date/By: \'4\\\Ok S`T Permit No. y 'V�,(a�..rk
M 13125 SW Hall Blvd.,Tigard,OR 97223 1 L L-- 3 1 2019 Plan Review J (i�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: $ 7.. 1 1 Other Permit \A? `ACI-..V \
Inspection Line: 503.639.4175 t s .ly t i k silty a.; Da-Ready/By: //i aril 0 See Page 2 for
TiGitku p �el
Internet: www.tigard-or.gov @ I I I(it(-.. ti I i i a cz1 i4• ified/Meth.• �7/ ���00
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 ❑Other: equipment,materials,labor,overhead,and the profit for the
':i 7I,. =�, A . ' s ... . ..::.:.,; ,,'1.10041,0,111,!,i,,10..„,„.:: work indicated on this application.
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❑ I-and 2-family dwelling Z Commercial/industrial Valuation: $
CIAccessory building 0 Multi-family Number of bedrooms:
❑Master builder IDOther: Number of bathrooms:
6y04ILII ; . ` Total number of floors:
�t;�: . . ��0 '� �11tb"��tt1t1 ]tO�AIS LIJATI(1„ I,'M.
Job site address:9561 SW Washington Square Rd(9585 SW Wash Sq Rd) New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:j1.91-'5?- Project name:WSQ Abercrombie Kids Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet t '.
Other structure area: square feet
Subdivision: Lot no.:Tax map/
Permit fees*are based on the value of the work performed.
parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
' a III'' t l' D' RIPT,QN .1E*ORIS` work indicated on this application.
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Tenant Improvement on Fire Alarm System at Wash Sq Mall store Abercrombie Kids Valuation: $7,105.00
Addition of 8 notification devices Existing building area: square feet
Electrical Permit#ELR2019-00118 New building area: square feet
.<. =k6<w r VWk1. v, ti14111�kt �;.'« _-F.."4 ry ' 1"-LI N0Stle e III x�1161It .1 Number of stories:
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:
6 . .111.11,
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ness name:Siemens All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:Moses Frangopoulos 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 apply:
Phone•(5031 207_1S34 Fax •(503)2.07-1834 - — - — ;
E-mail: moses.frango s oulos�a siemens com
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a" d i ' ,:CONTRs1 q'O` ... p: 1 ,. �i .
� �:(, eat e ro ekedute . t ..,
Business name:Siemens Permit fee:
Address:Moses Frangopoulos
State surcharge(12%of permit fee):
City/State/ZIP: 15201 NW Greenbrier Parkwa ,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:
-00111b- 411, Amount received:
Authorized signature: r0 1IIII.IIIIIIP. _,,.., This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Moses Frangopo t Date:7/29/19 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-Perm6App 031016.doc 440-4613T(11/02/COM/WEB)
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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 devices:
❑ New system Number of sprinkler heads: Number of alarm devices: 8
® 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
0 11+heads: Plan review required and ® 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional des
cription of work:ork:
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Sprinkler Type �
❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes 0 No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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= te Irl' .. .E �h �:_.. ;, "fie
Hood Project Valuation: $
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Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: I $7,105.00
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Square Footage: Permit Fee: 11 r lSG &
�1° `� ��yI 5iuu
0 to 2,000 $198.75 i4 ulhl 119 �I 1l G4hr� ' � t "" i "
`2,001 to 3,600 $246.45 Il11ti , . 7
1 • 11 — $310.05
7,201 and greater $404.39 1 ' bn ma P rb , x. . - �
11 1 ”
.... 411+ 19w1 . 4.'1.111,1:M.14�9sw ', ...
l'..,,,,drl,^.,
Sprinkler Project Square Footage: sq.ft.
ru w w ;rfr laic 1R 'k `n IIyI �a % 111111 VIII 1i '''',.+111111111, €» _ { II
Project valuation subtotal (seeA,B &IC above): $ 1
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:\syncplicity\frangopoulosm\FSS Sere Projects(Charles Hughes)\Open Projects\_Moles\262898 WSQ Hollister\PM\Permits\WSQ Hollister Permit.doc