Permit (3) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
it. COMMUNITY DEVELOPMENT Permit#: FPS2019 00149
Date Issued: 12/18/2019
T 1G Aft L7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD
Project: Washington Square Subdivision: None Lot: None
Project Description: Migration of current MXL system panels to XLS system. Electrical permit ELR2019-00187.
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: 503-639-8865
FAX: 503-207-1901
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/18/2019 $1,451.49
12%State Surcharge-Building 12/18/2019 $174.18
Type of Use: COM Plan Review-Fire Life Safety-COM 12/18/2019 $580.60
Class of Work: ALT Type of Const: Other Info Process/Archiving-Lg$2.00(over 12/18/2019 $50.00
Occupancy Grp: M Height: 33 ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 12/18/2019 $50.50
11x17)
Hourly Building Rate 12/18/2019 $180.00
Commercial Sprinkler System: Hourly Building 12%State Surcharge 12/18/2019 $21.60
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 $2,508.37
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $242,153.00
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- des are set fo'• in OAR 952-001-0010 through OAR 952-001-0190. You may obtain a copy of the rules
or direct questions to OUNC by 4lli 50 32.1987 f." 1.800. . .2344.
Issued By: io,
/ / Permittee Signature: 1/
!� Call 503.639.417. by 7:00 a.m.for the next available inspection .
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 '4•1 �.d , , FOR OFFICE USE ONLYcy �)
City of Tigard ?�19
Date/By:Received Flu' L / G I , '''' ,)'(/)/ 1 ' Oa g?
I ° 13125 SW Hall Blvd.,Tigard,OR 972`23' Plan Revie 4
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: J Z f r Other Permit:
Inspection Line:
Ins 503.639.4175 !;,,JI i c,y i I,j(,r;-4i Date Read /B ) j V hats: See Page 2 for
TIGARD p1
Internet: www.tigard-or.gov ,: r{'? „ q- ted Me Y.:`r �� , I 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
�Il' 11 �1 i ,fi161 work indicated on this application.
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Valuation: $
❑„1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
❑Accessory building 0 Multi-family
0 Master builder ❑Other:
Number of bathrooms: -r. "'a
11 9 .' Q4,.%".. Ii V',4'11111,1111['0-,.. ', ,,, 1 ,,. Total number of floors:
4 fob siteiladdress:9585 SW Washington Sq l lryl o .._ �. PI@oll 1�111i91wu1 IIS
911 rtll 4 0$ 1
New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square Ilret”
Suite/bldg./apt.no.: Project name:WSQ MXL Migration Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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`Subdivision: I 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
* Ix :!.. 1 ullpl +L work indicated on this application.
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Valuation: $242,153.00
Migration of current MXL System Panels to XLS system.
.N Electrical Permit#:ELR2019-00187 Existing building area: square feet
New building area: square feet
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Name:Maria Halstead Type of construction:
ppp�
Address:9585 SW Washington Sq Occupancy groups:
U
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:(503)639.8865 Fax:( ) New:
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11/4 Business name:Siemens All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
S+ Contact name:Moses Frangopoulos under ORS 701 and may be required to be licensed in the
1 Address:15201 NW Greenbrier Parkway,Ste A4 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:Beaverton,OR 97006 apply:
Phone:(503)207.1834 Fax: :( )
.,E-mail:moses.frangopoulos@siemens.com
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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:
® Addition or ❑ 1-10 heads: Affidavit required and ❑ 1 5 devices: Affidavit required and y
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: No devices-Just panel swaps from MXL to XLS panels.
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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: $
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Hood Project Valuaton: $
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Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 242,153.00
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Square Footage: N; �I 411 J C911N
Permit Fee: I��a 1 i �I�P71r1�1 a" 11 1 � ;1611 ,. �
q4 I
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0 to 2 000 $198.75 pmlul 1IIfVk ! ul & 1
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2 001 to 3 600 $246.45 p� 9 II a 1 .'q..,,,---,7,111..Y..2,4[1.,'.';.'111',:...,,,'11.41,,,,:IB1X '41'01'.".I1l itl
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3 601 to 7 200 $310.05 �I 1 w ;1
7,201 and greater $404.39 �rh i111,,,,!,[4, �a '111 1 1 II19h,1 Q1.: 1 « „ ,h . NII,
N'Is .ap ,..of m1P. ,. iu
Sprinkler Project Square Footage: sq. ft.
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Project valuation subtotal (see A,B & Cc above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on uare footage (see D above): $
State Surcsqharge (12% of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $
D:\syncplicity\frangopoulosm\FSS Svc Projects(Charles Hughes)\Moses\262061 WSQIXL Migration\PM\Permits\WSQ XLS Permit App,doc