Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00477
A ik DEVELOPMENT SERVICES DATE ISSUED: 10/5/2005
- '�I I- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09367 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire Alarm.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 140 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 8,859.00
Owner: Contractor:
WASHINGTON SQUARE LLC DRYER ELECTRIC
BY THE MACERICH COMPANY PO BOX 86369
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97286
i'none c g 503 8865
Phone: 503 - 287 -6164
FEES Reg #: LIC 153466
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/16/2005 $129.70
[TAX] 8% State Surchari 9/16/2005 $10.38
[FLS] FLS Pln Rv 9/16/2005 $51.88
Total $191.96
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 than 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: ,/6i�zz iJj Permittee Signature:
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
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.
Fire Protection System 920 5w I gC:A e ( OP- C''' - �
Building Permit App ,= - % VED • F012 OFFICE USE ONLI
City ot t Dat / J V �f 7 Permit N ' '. 1 1
13125 SW Hall Blvd., Tigard, OR 97223 � `� Plan Review , a� �
Other Permit
Phone: 503.639.4171 Fax: 503.598.1960 SE e°� ����'dr,,, s � I Date/B • r.
Inspection Line: 503.639 4175 e I . Date Ready/By. June ® See Page 2 for ` Q
Internet. www.ct.tigard or.us GITY OF TIGAR'' Notified/Method 1lif Supplemental Information v
.
BUN 'DING DIVISION N
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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
NI Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
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F ti Ti.' ,. , p,• ,{„ ,,' „• work indicated on this application
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❑ 1- and 2- family dwelling A Commercial /industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
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Job site a d d r e s s : I '� siiJ W A fl b ib r) S �,u E f�J) New dwelling area: square feet
City /State /ZiP: I i fte/p 0e, q-)2_2 5 Garage/carport area: square feet
Suite/bldg. /apt. no : S Project name: W So k ) 0 yyvP Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
it,
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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
4 ,r t ;i. ,, aa t1 4 � k . �„ yrj w,, equipment, materials, labor, overhead, and the profit for the
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i i ,,: ,Y,tn - . g ' ; ” tr DESCRIPTION�� �W. ,ca '• r+ ,! _�_fs � ::1 �.' . ' ,; work indicated on this application.
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Valuation: S .2 r ' j q .06
i
1 - ' j i ,v► C f ri k Existing building area: engo square feet
' `�, New building area: square feet
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, t• s I II ` P r ° i "` -ti N umber of stories:
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Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
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Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
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Business name: e 1:4 -7.;u t �r'd s rk7 # iM�i+rr•' n y ,• r
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Address: - PO 1 $(03
JfJ q Please refer to fee schedule.
City /State /ZiP: r L ct D Fees due upon application /9 /i -`"'JJ
Phone: (56 ) a 7.... (DI (PLl 1 Fax: (50?.) ) g•—e— 10 (4, / `
/( r Amount received
CCB lie.: )c:))Li 1,b l 14 t O
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Kt�� 0) et&O`r” Date: q /'c{ 1 Dc-- * Fee methodology set by Tri- County Building Industry
J Service Board.
1 U3urlding\Permits'.FPS- PermitApp doc 12)03 440-46 I 3T( I I /02/COM/WEB)
'4 . • ��- oe `{7 >
Certificate of Completion
Name of Protected Property: v..IAS I-% I INIC -1 TUN S6z u.AR£ MA LL,
Sf wILt..IAM.S- 50NOM APT, IT L0
Address: I gw WASH tNiGTDN 50.up ' p..D .
TIGARD a OR
Rep. of Protected Prop. (name /phone): ROGER OTT J S 03 G39 . P, 8 G 5
Authority Having Jurisdiction: C I T Y OF 7 I G ARP
Address: 1312.9 Sv.l h1ALL BLvD
TIGARD , OR 91223
Phone Number: So3 _ G3 -'1 111
1. Type(s) of System or Service:
NFPA 72, Chapter 3 - Local
If alarm is transmitted to location(s) off premise, list where received:
NnNE^( vJCLL_
X NFPA 72, Chapter 3 - Emergency Voice /Alarm Service
Quantity of voice /alarm channels: 1 Single x Multiple:
Quantity of speakers installed: 6 Quantity of speaker zones: L
Quantity of telephones or telephone jacks included in system: 0
NFPA 72, Chapter 4 - Auxiliary
Indicate type of connection:
Local energy, Shunt, Parallel telephone
Location and telephone number for receipt of signals:
NFPA 72, Chapter 4 - Remote Station
Alarm:
Supervisory:
NFPA 72, Chapter 4 - Proprietary
If alarms are retransmitted to public fire service communications center or others, indicate location
and telephone number of the organization receiving alarm:
Indicate how alarm is retransmitted:
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NFPA 72, Chapter 4 - Central Station
The Prime Contractor:
Central Station Location:
Means of transmission of signals from the protected premise to the central station:
McCulloh Multiplex One -Way Radio
Digital Alarm Communicator Two -Way Radio Others
Means of transmission of alarms to the public fire service communications center:
1.
2.
System Location:
Organization Name /Phone Representative Name /Phone
Installer
Supplier
Service Organization _
Location of Record (As- Built) Drawings:
SrcuRIT`I oFF IGE
Location of Owners Manuals:
SEC URIT`4 OFFICE
Location of Test Reports:
SEc ■.&RiN O1i (CC
A contract, dated 1 1 / t! 99 for test and inspection in accordance with NFPA standard(s)
No.(s) 72. dated 2002 is in effect.
2. Certification of System Installation
(Fill out after installation is complete and wiring checked for opens, shorts, ground faults, and
improper branching, but prior to conducting operational acceptance tests.)
This system h s en t i ccor ance with the NFPA standards as listed below, was
inspected b ,C C F on I I / 1 6 , .1 , includes the devices
listed belol
if
has been in service since t t / r 1 fob
X NFPA 72, Chapters El 34 5 6 T ircle all that apply)
X NFPA 70, National Electrical Code, Article 760
Man facturer' nstr tion
Oth (spe
Signed: ,CE Date: 11 /I Q /OS
Organization: 0SE C ri'-( E LECTR iC_
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3. Certification of System Operation
All operational features and functions of this system were tested by J I M 6 RAM LAG E
on I VI (s>, 1', IV, /OS and found to be operating properly in accordance with the
requirements of.
NFPA 72, Chapters __3 4 5 6 7) (check all that apply)
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's Instructions
Other (specify):
Signed: Of OAC "`
G0g— Date: I 1/18 /US
Organization: SIEMENS Bul►LDING iTc t- TEC V-INC>LOG 1ES 11.1C
4. Alarm Initiating Devices and Circuits (Use blanks to indicate quantity of
devices.)
MANUAL
a) Manual Stations Noncoded, Activating Transmitters Coded
b) Combination Manual Fire Alarm and Guard's Tour Coded Stations
AUTOMATIC
Covera e: Complete >G Partial
a) Smoke Detectors: Ion X Photo
b) 3 Duct Detectors. Ion X Photo
c) _ Heat Detectors: FT RR FT /RR RC
d) Sprinkler Water Flow Switches: Noncoded, Activating
Transmitters Coded
e) E Other(list): ELEv/Q6Q REr ALl Rf W■15 2, 1. ANSUL MONITOR_
5. Supervisory Signal Initiating Devices and Circuits (Use blanks to indicate
quantity of devices.)
GUARD'S TOUR
a) Coded ns
b) - Noncoded Sta i s Activating Transmitters
c) Compulsory Guard r System Comprised of Transmitter Stations
and Intermediate -tions
Note: Combination devices recorded un. - 4(b) and 5(a).
SPRINKLER SYSTEM ,q
a) Coded Valve Supervisory Signaling Attachments
Valve Supervisory Switches Activating Transmi
b) Building Temperature Points
c) Site Water Temperature Points
d) Site Water Supply Level Points
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Electric Fire Pump:
e) Fire Pump Power
f) Fire Pump Running
g) ' ∎ ase Reversal
Engine- Driven Fire • . 4 p:
h) Selector in Au : •osition
i) Engine or Control • = i el Trouble
j) Fire Pump Running ti
Engine- Driven Generator:
k) Selector in Auto Position
I) Control Panel Trouble
m) Transfer Switches
n) Engine Running
Other Supervisory Function(s) (specify):
6. Alarm Notification Appliances and Circuits
Quantity of indicating appliance circuits connected to the system:
Types and quantities of alarm indicating appliances installed:
a) Bells Inch
Speakers
b) Horns
c) Chimes
d) Other:
e) $ Visual Signals Type: STti20 c SPEAKER -/s rROBE
with audible Z, w/o audible
f) Local Annunciator
7. Signaling Line Circuits:
Quantity and Style (See NFPA 72, Table 3 -6.1) of signaling line circuits connected to system.
Quantity: L Style: C LA S5 R
8. System Power Supplies
a) Primary (Main). Nominal Voltage: 12 O V AC Current Rating: 2.0 a
Overcurrent Protection: Type: RRt-p+1LER- Current Rating: T, a
Location: PA NI L 1-11' y (C KT 4 O )
b) Secondary (Standby):
X Storage Battery: Amp -Hour Rating 55 ak
Calculated capacity to drive system, in hours: X 24 60
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
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c) Emergency or Standby System used as backup to Primary Power Supply, instead of using a
Secondary Power Supply:
Emergency System described in NFPA 70, Article 700
Legally Required Standby System described in NFPA 70, Article 701
Optional Standby System described in NFPA 70, Article 702, which also meets the
performance requirements of Article 700 or 701
9. System Software
a) Operating System Software Revision Level(s): 20 'OH
b) Application Software Revision Level(s): 01-
c) Revision Completed by: .11tH RRPnALAG� SIEMENS
(name) (firm)
10. Comments:
(signed) for Central Station or Alarm Service Company (title) (date)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA
standard(s):
System deviations from the referenced NFPA standard(s) are:
(signed) for Central Station or Alarm Service Company (title) (date)
Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having
jurisdiction:
(signed) representative of the authority having jurisdiction (title) (date)
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ZC`S- C�`c���r
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 y�yi' �
Inspection Requests (24 Hrs.): (503) 639 -4175 — ^'I �I
INSPECTION WORKSHEET FOR DATE: I (A a ) os . TIME: PAGE:
SITE ADDRESS: x'3 SC4.3 WA- SQ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: Lti «t 1 A 1 A4S g bruit
OWNER: PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
9eis AL wt Fifes
Corrections /Comments /Instructions:
•
•
f •
•
�`�PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
lA
Inspector: Date: ` �� 105 #: (503) 718-
CIT Y- Of TIGARD 66( P
BUILDING DIVISION PERMIT #: 4 4065 — 1417
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171r � '
Inspection Requests (24 Hrs.): (503) 639 -4175 ° L.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: I 3 c 7 id (T, w • R-0 i CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: lA
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: / / — 1 7 - Q5 Pour Time:
Code # Inspection Description Confirm # Contact # Message
02- 9 ? 1 .---,/,-ti—_,t C ;iz...e M c—a-v--- q fs
Corrections/Comments/Instructions:
- Cu Erz=b IOC Certw-c:r7 c
,..
..
. .
....-
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Nitij Date: Phone #: (503) 718-