Permit .111 CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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I. ' COMMUNITY DEVELOPMENT Permit#: FPS2019-00159
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/16/2020
Parcel: 1 S126BC01500
Jurisdiction: Tigard
Site address: 9000 SW WASHINGTON SQUARE RD
Project: Embassy Suites Subdivision: None Lot: None
Project Description: Fire alarm. Replacing(500)devices for TI.
Contractor: SIEMENS INDUSTRY INC Owner: WASHINGTON SQUARE PROP INVESTMEN
15201 NW GREENBRIER PKWY BY PARKVIEW INTERNATIONAL
SUITE A4 ATTN MUELLER, PAULA&HARRINGTON
BEAVERTON, OR 97006 152 W 57TH ST 58TH FL
NEW YORK, NY 10019
PHONE: 503-207-1839 PHONE:
FAX: 503-207-1901
FEES
Description Date Amount
Specifics: Permit Fee-COM 03/27/2020 $939.63
12%State Surcharge-Building 03/27/2020 $112.76
Type of Use: COM Plan Review-Fire Life Safety-COM 03/27/2020 $375.85
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 03/27/2020 $44.00
Occupancy Grp: R-2 Height: ft 11x17)
Stories: 5 Info Process/Archiving-Sm$0.50(up to 03/27/2020 $126.00
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 Reg: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $1,598.24
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $128,716.00
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.
/1 / 4
Issued By: Permittee Signature: (/a.-f�_ (/ /7
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Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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 r • FOR OFFICE USE ONLY
City of Tigard l D e va l . l�7 l7� r1 Pe /S'�"j
II • 13125 SW Hall Blvd.,Tigard,OR 97223 , .'. ' `' Plan Review �y
M Phone: 503.718.2439 Fax 503.598 1960 rr1 ' , i-' IT:, `,>' Date/By: J a'�Li 1 Other Permit:
T I G A R D Inspection Line: 503.639.4175 !Date ReadyBy: / Jnris: la See Page 2 for
"Internet: www.tigard-or,gov '"" otified/Me od:10-�—(//1 Supplemental Information
TYPE Of WORK E UIR I> W R Q ED DATA: -AND 2-FAMILY DWELLING
❑ New construction 0 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
CATEGORY OF CONSTRUCTION work indicated on this application.
dwellin Valuation: $
❑ I-and 2-family g ® Commercial/industrial
❑Accessory building ID Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9000 S.W Washington Square Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet -
Suite/bldg./apt.no.: Project name:Embassy Suites Migration Covered porch area: square feet
Cross street/directions to job site:SW Washington Square rd and Allen Deck area: , square feet i `
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
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
1IDESCRIPTION OF WORK work indicated on this application.
Tenant Improvement replace fire system in building 86. Valuation: $$128,716.00
Existing building area: square feet
•
,-- New building area: square feet
'b 1, ® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Hilton Hotels Type of construction:
NA Address:9000 SW Washington Square Rd Occupancy groups:
4 City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( ) New:
4 ® APPLICANT
Business name: 0 CONTACT PERSON NOT1446,4,4
Siemens Industry Inc. All contractors and subcontractors are required to be
Contact name:Sean Martin licensed with the Oregon Construction Contractors Board
3ziunder ORS 701 and may be required to be licensed in the
` Address:15201 NW Greenbrier Pkwy jurisdiction in which work is being performed.If the
\ applicant is exempt from licensing,the following reasons
� City/State/ZIP:Beaverton,OR 97006
apply: _
v Phone:(503)207-1900 Fax::( )
E-mail:seanmartin@siemens.com
__
CONTRACTOR BUILDING PERMIT FEES*
Meuse refer to fee schedule)
Business name:Siemens Industry Inc
Permit fee:
Address: 15201 NW Greenbrier Pkwy
4 State surcharge(12%of permit fee):
of City/State/ZIP:Beaverton,OR 9700
FLS plan review(40%of permit fee):
$ Phone:(503)207-1900 Fax:( ) (Due upon application submittal) _
CCB lie.:133041
Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained •
Print name:Sean Martin Date: 12/17/2019 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board. .
J:1Building\Permits\FPS-PermitApp_031016.doc 440-4613T(I1/02/COM/WEB)
1 PS
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City of Tigard: Fire Protection Permit Checklist s'
Page 2- Supplemental Information
Describe workto be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
g' ❑ New system Number of sprinkler heads: Number of alarm devices: 500
Y
ElAddition or ❑ 1-10 heads: Affidavit required and El1-5 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: Replace the fire alarm system in building 86.New panel,power supply, beam
detectors and speakers.
Type of System (Complete A, B, C orb as applicable):
A.) Commercial Sprinkler
S rinkler T e El Wet ❑ D -
Additional Standpipes
Information: Sprinkler Supply Line El Yes El No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm •
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 128,716.00
D.) Residential Sprinkler (Stand Alone System) �°
' Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
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): $
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