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Permit CITY TIGARD BUILDING PERMIT PERMIT #: BUP2006 -00271 ,.,_ ,„, �.� DEVELOPMENT SERVICES DATE ISSUED: 9/18/2006 - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300 SITE ADDRESS: 09500 SW WASHINGTON SQUARE RD JCPEN 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: 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: $ 35,986.00 Owner: Contractor: WASHINGTON SQUARE LLC ADT SECURITY SERVICES INC BY THE MACERICH COMPANY 2815 SW 153RD DR 9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97006 TIGARD, OR 97223 Phone: Contact #: FAX 503 - 469 - 7110 PRI 503 - 469 -7100 Reg #: LIC 59944 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [TAX] 8% State Surcha 7/5/2006 $28.60 [FLS] FLS Pin Rv 7/5/2006 $143.38 [BUILD] Permit Fee 7/5/2006 $358.30 Total $530.28 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- 100. 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: ei 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 735-0 0/54 - �, Building Permit Application . ' FOR OFFICE USE ONLY Received City of Tigard Da y : , e, Permit No.: G — ?l 13125 SW Hall Blvd., Tigard, OR 97223 RECEI L,. Plan Revi 503.639.4171 Fax: 503.598.1960 pia, ` Date/B y: 7 / //d Other Permit: I' I Inspection Line: 503.639.4175 J U L 0 5 r ^ •I I. Date Ready/By: El See Page 2 for Internet: www.ci.tigard.or.us e. ethod: 7 �t/ �al > Supplemental Information CITY OF TIGARD b IV zQ BUILDING D ( �! I;�JQN ED TYPE OF WORK .: a , REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all I3dition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the } CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ I- and 2- family dwelling Commercial/industrial ❑ Accessory building El Multi-family Number of bedrooms: ❑ Masterruilder ❑ Other: Number of bathrooms: ^— 'WI"- `tOB SITE INFORMATION AND LOCATION . Total number of floors: Job site address 45 00 S t L'`) sk- $ 4 P I _ New dwelling area: square feet City/State /ZIP: r 9 col C) . C -- 2,.i 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: $ t; N.,1\ A C.,/ Covered porch area: square feet Cross street/directions to job ste: // Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST . . Subdivision: I 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 �� i � ` `r DESCRIPTION OF Pp G >;�,�, � O work indicated on this application. Valuation: $ -6 �P, T ) yOA. w` ii eye ••c A k 4...e -rc }..► t � Existing building area: square feet New building area: square feet ❑PR OPERTY OWNER ❑TENANT Number of stories: O � / Name: Type of construction: 2 Address: Occupancy groups: r/ ) City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: • ❑ APPLICANT ❑ CONTACT PERSON - NOTICE 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 /Z�: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR Business name: A sLVt � uy Lt S BUILDING PERMIT FEES* . Address: 4"1/4 sic I 5 - 811 be: tit.. Please refer to fee schedule. City/State /ZIP: Zem. ehoff %V rl ` Q `� Fees due upon application Phone: ( 5 0 . 4 ) _I ` o f _ "') 1 u Fax: (501 ) (4 T °') 11 l V Yf ! 09 Amount received CCB lic.: $ Date received: Authorized signature:# �/ - This permit application expires if a permit is not / obtained � � within 180 days after it has been accepted as complete. I Print name: 1-7.4-,,,k k '- o01/,_ Date: 7 - � C 4 * Fee methodology set by Tri-County Building Industry Service Board. i•\Buildmg \ Permits \FPS- PennitApp doc 12/03 440- 4613T(I1 /02/COM/WEB) A v City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information done: " . 1.) 1:1 New 2.) Modification to sprinkler heads only: 0 Addition 0 1-10 heads: No plan review required. 0 Alteration 0 11+ heads: Plan review required. 0 Repair Number of sprinkler heads: Additional description of work: • - Cotmercial Wet 0 Dry Additional Standpipes • Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ Hood Project Valuation: I $ �$ FireA1ahn , "'- '• Submittal shall Battery Calculations e Yes include: Individual Component E Yes Cut Sheets Fire Alarm Project Valuation: $ SS • ,t • „ -; - • 'f•-.1)45 Ke§idential SPrinkler:(Stand System) Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 3,601 to 7,200 $292.50 7,201 and greater $381.50 Sprinkler Project Square Footage: sq. ft. Project Valuation Subtotal (A, B & C): $ '17/94 Permit fee based on valuation (see attached chart): $ 33 ,3 0 . Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $ FLS Plan Review 40% of Permit Fee: $ I 1, 1 ,ZS TOTAL: $ rap , a% Plan review requires a completed application and 3 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. http://www.ct.tigard.onus/city_halUdepartments/cd/docs/FPS-PermitApp.doc 2 �e 6 - co o �. 7 j I 4a — FIRE ALARM SYSTEM +Eik k RECORD OF COMPLETION �3 ACT 720_ l .mod Name of protected property: J C KN/J d (si�a Address: 9 so was ri ^)o S W ?e*a Representative of protected property (name /phone): GNtifP ARA/ !03-56 7 - X1 03 Authority having jurisdiction: Address /telephone number: Organization name / phone Representative name / phone Installer: aaNA■CIJ GP -05CA / — 4 ,% IQi nSn Supplier: ADi Saz0 z- A.115 5.,) 153 %DQ4 Ark✓pt�.ir, Service Organization: So-Mr Location of Record (as- built) drawings: sA'''� Location of operation and maintenance manuals: SeoZiuk/..45i2 kin / ORE islirror - o - e6 0507/0 63% Location of test reports: sue_ ,&,M-e., Atirvoorde A contract for test and inspection in accordance with NFP st dard(s) Contract No(s): ,4- bi.■CGY Effective date: 28" 0 7 Expiration date: System Software (a) Operating system (executive) software revision level(s)/ (b) Site - specific software version date: (c) Revision completed by: /t (name) (firm) 1. Type(s) of System or Service }l NFPA 72, Chapter 6 -- Local � - If alarm is,ttransmitted to location(k) � � emises, list where received: /Q 3 ssovic Jo �<--88 wfJ t L IMF �NDP/ S J l 6,2,5 NFPA 72, Chapter 8 — Remote Station Telephone numbers of the organizatiouOing alarm: Alarm: ,W SS Supervisory: fri: 5 Trouble: 19 Si�Cc" l If alarms are retransmitted to public fire service communications centers or others. indicate location and telephone numbers of the organization receivi alarm: /4 - 4 0--- 3 azclie4vy c?-5 Avar Indicate how alarm is retransmitted: p /Gi ry,tL p /ALA° NFPA 72, Chapter 8 -- Proprietary Telephone Numbers of the organization receiving alarm: Alarm: Supervisory: Trouble: If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone numbers of the organization receiving alarm: Indicate how alarm is retransmitted: NFPA 72, Chapter 8 — Central Station Prime contractor: Central station location. Means of transmission of signals from the protected premises 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 communication center. (a) (b) System location: NFPA 72, Chaper 9 — Auxiliary Indicate type of connection: Local energy Shunt Parallel Telephone Location of telephone number for receipt of signals 2. Record of System Installation (Fill out after installation is complete and wiring is checked for opens, shorts, ground faults, and improper branching, but prior to conducting operational acceptance tests.) This system has been installed in accordance with the NFPA tandards as shown below, was inspected by y t,r4 Qi d) b � � on 3128/ , includes the devices shown in 5 and 6, and has been in service since 3/Z S' 67 . ✓NFPA 72, Chapters 1 I0,,10�0.i4et � ° i)ItI (circle all that apply) FPA 70, National Electrical Code, Article 760 /Manufacturer's Instructions Other (speci ): Signed: i Date: 3 2 b Organizaf • n: A :Ai _ i 59-4,--)c-, Ir 3. Reco d o System Operation Documentation in accordance with Inspection and Testing Form, Figure 7 -5.2. is attached . All operational features and functions of this system were tested by d.i'Q date '/1.g ef7 and found to be operating prop rly in accordance with the requirements of: NFPA 72, Chapters / r (circle all that apply) NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Other (.spec : / Signed: Date' 3 4 • Organizati• ' ... 5' • ' ort• I 4. Signaling Line Circuit Quantity and class signaling line circuits connected to system ( see NFPA 72. Table 3-6): Quanity: 1 Style: Class: �(2) } l 5. Alarm- Initiating Devices and Circuits Quantity and class of initiating devices (see NFPA 72, Table 3 -5): Quantity: Style: Class: MANUAL (a) Manual stations ,/ Noncoded Transmitters Coded Addressable (b) Combination manual fire alarm and guard's tour coded stations AUTOMATIC Coverage: Complete Partial Selective Nonrequired - \ _ 4 Ali (a) Smoke detectors: Ion / Photo Addressable 1 • (b) Duct detectors: Ion Photo Addressable `j (c) Heat detectors: FT RR FT /RR RC Addressable (d) Sprinkler waterflow indicators:Transmitter_ Noncoded Coded Addressable (e) The alarm verification feature is disabled or enabled , changed from seconds to sec (f) Other (list) © 1 / O eN g bJC - S O /3 6. Supervisory Signal Initiating Devices and Circuits (use blanks to indicate quantity of devices) GUARD'S TOUR (a) Coded stations (b) Noncoded stations (c) Compulsory guard's tour system comprised of transmitter stations and intermediate station Note: Combination devices are recorded under 5(b), Manual, and 6(a), Guard's Tour. SPRINK , ER SYSTEM Check if rovided (a) Valve supervisory switches (b) Building temperature points (c) Site water temperature points (d) Site water supply level points Ele y ;' fire pump: (e - - -. 2 , ire pump power ' j -. Fire pump running (g):;j Phase reversal Engine- driven fire pump: (h) _ Selector in auto position (i) Engine or control panel trouble (j) Fire pump running ENGINE - DRIVEN GENERATOR (a) Selector in auto position (b) Control panel trouble (c) Transfer switches (d) Engine Running Other supervisory function(s) (specify): 7. Annunciator(s) � �p�� Number. LI Type: (S eJ tr 4> i � - Location: rw 8. Alarm Notification Appliances and Circuits NFPA 72, Chapter 3 -- Emergency Voice /Alarm Service Quantity of voice /alarm channels: Single: Multiple: Quantity of speakers installed: Quantity of speaker zones: Quantity of telephones or telephone jacks included in system: 02 Quantity and the class of notification appliance circuits connected to system (see NFPA 72, Table 3 -7): Quantity : � Style: y Class: Types and quantities of notifcation appliances installed: (a) Bells With Visible (b) Speake r With Visible (c) Homs / 215�S �.aa�J With Visible (d) Chimes With Visible (e) Other: With Visible (f) Visible appliances without audible: 9. System Power Supplies ,,10 f (a) Fire Alarm Control Panel: Nominal Voltage: /N' h2b o Current rating: Overcurrent protection: Type: (/b-r16y46 ` • • Current rating: Location: .Pal,(PL&. R>., Wag, CL.EuI9vDE. (b) Secondary (standby): 7 � Storage battery: �?/� / /# /Z47 Amp hour rating: 4 7.. Calculated capacity drive system, in hours: Engine- driven generator dedicated to fire alarm system: Location of fuel storage: (c) Emergency system used as a backup to primary power supply: Emergency system described in NFPA 70, Article 700: 10. Comments Frequency of routine tests and inspections, if other than in accordance within the referenced NFPA standard(s): System deviations from the referenced NFPA standard(s) are: EMPFWArs jeG 6 7 (si ned) for inst. ati n c'ntractor /supplier (title) CA DAS# (required) NICET# Level (optional) (date (signed) for alarm' ervice company (title) CA DAS# (required) NICET# Level (optional) (date) (signed) for central station (title) CA DAS# (required) NICET# Level (optional) (date) Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdication): (signed) representative of the authority having jurisdiction (title) (date) Reprinted with permisson from the NFPA72® National fire Alarm Code ®, Copyright© 1999, National Fire Protection Association, Quincy, MA 02269 CAFAA - 3401 Pacific Ave, Ste 1C, Marina del Ray, CA, 90292 -7800 CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP200G -00271 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/18/2006 Phone: (503) 639 -4171 Aaao, Inspection Requests (24 Hrs.): (503) 639 -4175 ...'rill INSPECTION WORKSHEET FOR DATE: 3/29/2007 TIME: 7:00AM PAGE: 55 SITE ADDRESS: 09500 SW WASHINGTON SQUARE RD JCPEN CLASS OF WORK: . SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: JC PENNEY DESCRIPTION: Fire alarm OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: ADT SECURITY SERVICES INC PHONE #: 503-469-7100 Inspection Request Scheduled For: Date: 3/29/2007 Pour Time: Code # Inspection Description Confirm # - Mes - 998 Alarm final 045639 -02 503469.7217. go c IV v 044 Corr /Comments /Instructions: 1-- S:! W Keldreffr . • . oprz-__ / 7 ?) , • • - 77_7 ---- _ ed<._ e (c lely 1 ,3 . ,-- ...eX cr.- _• ;; AS P :: - TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS •;V' AIL rA °' L FOR INSPECTION II ADDITIONAL FEES ASSESSED ■ 2-Jl �J Inspector: \ Date: ✓ Phone #: (503) 718- AY_____± • , CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP2006- 00271 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/18/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 '"IL. INSPECTION WORKSHEET FOR DATE: 2/14/2007 TIME: 7 :01AM PAGE: 20 SITE ADDRESS: 09500 SW WASHINGTON SQUARE RD JCPEN CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: JC PENNEY DESCRIPTION: Fire alarm OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: ADT SECURITY SERVICES INC PHONE #: 503 - 469 - 7100 Inspection Request Scheduled For: Date: 2/74/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 998 Alarm final 043385-0/ 503 - 849 -5566 Y Corrections /Comments /Instructions: u L r oicYr ()Ott) U5 (G.t 09 it 72- (6 TOP-At ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL II CALL FOR I SPECTION ❑ ADDITIONAL FEES ASSESSED - Inspector: ,\ Date: ( ■ 410 Phone #: (503) 718- Z C3 •