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Permit
4 CITY-OF TIGARD BUILDING PERMIT PERMIT #: ° y COMMUNITY DEVELOPMENT DATE ISSUED: 11/15/200 00574 7 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S12600-00400 SITE ADDRESS: 09800 SW WASHINGTON SQUARE RD SEARS ZONING: SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG PROJECT: SEARS Project Description: Fire alarm - replacing the FA/BA control 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: : sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: 2 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: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 29,714.00 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 [BUILD] Permit Fee 11/2/2007 $254.90 [TAX] 8% State Surcha 11/2/2007 $20.39 [FLS] FLS PIn Rv 11/2/2007 $101.96 Total $377.25 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 Bye �E3z� 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. - r, = 'teCrl , Building Permit pplication Fire Protection System RECEWE / FOR OFFICE USE ONLY `, City of Tigard D R D a e I ! 07 Permit No �( I i • 7 1 57S ° 13125 SW Hall Blvd., Tigard, OR 97223 N V — 2 2007 Plan Review / 11. , , 1111 C Phone: 503 639.4171 Fax. 503.598.1960 Date/B . .i ` �t Other Permit T 1 G A li D Inspection Line 503.639.4175 CITYOF f'GARD Date Read B ® I See Page 2 for Internet: www.tigard - or.gov BUI DINGD1VISJON Notifie. ethy. �l � ' .� I rr. - Sapplemental Y LiJ1tV�7 tvfa7t TYPE OF WORK ' 511 UIRED DATA: 1- • '1 2- FAMILY DWELLING ❑ New construction ❑ Demolition Pe 'it 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. ❑ I- and 2- family dwelling ❑ CommerciaUindustrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATIO AND LOCATION Total number of floors: Job site address:ACI ali(46/ / T AR._ New dwelling area: square feet City /State /ZIP: 77(.44e46 ok T7 ! Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Sp Q S Covered porch area: square feet Cross street/directions to job site: 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. fax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. 2.0 f / _ �. F » — 4 i n ' f -__ / Valuation $ �? 7 i( /1 -C=/ C�OitLIFa'O L� Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: SPS Type of construction: Address: Occupancy groups: 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 /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) I Fax:: ( ) E -mail: CONTRACTOR BUILDING PERMIT FEES* Business name: ig—/) r Se cii t«°� (Please reJerto fee schedule Address: 1 .2R/ 5— St) /!� 3 - i e, v � Permit fee: State surcharge (8% of permit fee): City/State /ZIP: a-eale leA/ ,O� L Q 7 o G j FLS plan review (40% of permit fee): Phone: 663 t.1 (4_ 7� / Z Fax: 6-03) 4-1 — 7,2-g/ (Due upon application.) CCB lic.: Total permit fees: I Authorized signature: mount received: V') 05 Bn . o 5 /2 This permit application expires if a permit is not obtained Print name: Date: / within 180 days after it has been accepted as complete. • Fee methodology set by Tri -County Building Industry Service Board. I \Budding'Permits\FPS- PermuApp doe 03/23/06 440-4613T(I I /02/COM/WEB) R City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads' only:, ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: 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 114es include: Individual Component ZfrIes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone 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. 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 (8% of permit fee): $ FLS Plan Review (40% of permit fee): $ TOTAL: $ Plan review requires a completed application and 2 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. I: \ Building \ Permits \FPS- PermitApp.doc 2 lec 614-e 2007 - 00c 72 -25 FUNDAMENTALS OF FIRE ALARM SYSTEMS Record of Completion Name of Protected Property Sears 1079 Address: 9800 SW Washington Square Rep. Of Protected Prop. (name/phone): Letty Devera 503- 624 -3431 Authority Having Jurisdiction: City of Tigard, Oregon Address /Phone Number: 13125 SW Hall Blvd Tigard, Oregon 97223 1. Type(s) of System Service: NFPA 72, Chapter 3 - Local If alarm is transmitted to location(s) off premise, list where received: ADT SECURITY SERVICES INC 14200 E. EXPOSITION, AURORA, CO 80012 NFPA 72, Chapter 3 - Emergency Voice /Alarm Service Quantity of speakers installed 0 Quantity of speaker zones: 0 Quantity of telephones or telephone jacks included in system: 0 NFPA 72, Chapter 4 - Auxiliary Indicate type of connection: Local energy, 0 Shunt, 0 Parallel telephone 0 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 service communications center or others, indicate location and telephone number of the •• • organization receiving alarm: ;•• Indicate how alarm is retransmitted: -' NFPA 72, Chapter 4 - Central Station • The Prime Contractor: ADT SECURITY SERVICES, INC Central Station Location: ADT SECURITY SERVICES, INC 14200 E. EXPOSITION, AURORA, CA CO 80012 Means of transmission of signals from the protected premise to the central station: McCulloh Multiplex One -Way Radio NI Digital Alarm Communicator Two -Way Radio Others Means of transmission of alarms to the public fire service communications center: (a) TELCO (b) TELCO System Location. Panel located in electrical closet on main floor behind passenger elevator, keypad by LP office Organization Name /Phone 1800- 453 -2247 Representative Duty Supervisor Installer ADT SECURITY SERVICES, INC 503- 469 -7110 KEN KRAUS 503 -469 -7212 Supplier ADT SECURITY SERVICES, INC 503 -469 -7110 KEN KRAUS 503 -469 -7212 Service Organization ADT SECURITY SERVICES, INC 1- 800 -428 -7124 KEN KRAUS 503 -469 -7212 Location of Record (As- Built) Drawings: ON SITE W /MANAGER Location of Owners Manuals. ON SITE W /MANAGER Location of Test Reports ADT SERVICING SSO AND THE CENTRAL MONITERING CENTER A Contract, dated , for test and inspection accordance with NFPA standard(s) No.(s) 72 ,dated , is in effect. Figure 1 -7.2.1 Certificate of Completion 1996 Edition 72 -26 NATIONAL FIRE ALARM CODE 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 has been installed in accordance with the NFPA standards as listed below, was inspected by Leland Slaughter on 1 -7 -2008 , includes the devices listed below and has been in service since 1 -7 -2008 NFPA 72, Chapters 1 03 ® © 0 (circle all that apply) NFPA 70, National Electrical Code, Article 760 • Manufacturer's Instructions Other (specify): Signed: Date: X 1 -11 -2008 Organization: ADT SECURITY SERVICES, INC 3 Certification of System Operations All operational features and functions of this system were tested by ADT SECURITY SERVICES, INC. on 1 -7 -2008 and Found to be operating properly in accordance with the requirements of. NFPA 72, Chapters 103 ® ® © ® (circle all that apply) • NFPA 70, National Electrical Code, Article 760 ▪ Manufacturer's Instructions Other (specify): NONE Signed: Date: 1 -11 -2008 Organization: ADT SECURITY SERVICES, INC 4 Alarm Initiating Devices and Circuits (Use blanks to indicated quantity of devices.) MANUAL a) Manual Stations Noncoded, Activating Transmitters Coded b) Combination Manual Fire Alarm and Guard's Tour Coded Stations AUTOMATIC Coverage: Complete: Partial: a) 8 Smokc Detectors Ion 8 Photo b) Duct Dctcctors Ion Photo c) Heat Detectors FT RR FT/RR RC d) 2 Sprinkler Water Flow Switches 2 Noncodcd, activating Transmitters Coded c) Other: (list) 5. Supervisory Signal Initiating Devices and Circuits (Use blanks to indicated quantity of devices.) GUARD'S TOUR a) Coded Stations b) Noncoded Stations Activating Transmitters c) Compulsory Guard Tour System Comprised of Transmitter Stations and Intermediate Stations Note Combination devices recorded under 4 (b) and 5(a). SPRINKLER SYSTEM a) Coded Valve Supervisory Signaling Attachments 9 Valve Supervisory Switches Activating Transmitters b) I Building Temperature c) Site Water Temperature Points d) Site Water Supply Level Points Electric Pump: e) Pump Running f) Controller Off (AC Loss) g) AC Phase Reversal Engine - Driven Fire Pump: h) Engine Running k) Engine trouble i) Controller Off I) Low Fuel .1) Controller Trouble m) Fuel Spill Engine — Driven Generator: n) Selector in Auto Position o) Control Panel Trouble p) Transfer Switches q) Engine Running Figure 1 -7.2.1 Record of Completion (continued) 1996 Edition 72 -27 FUNDAMENTAL OF FIRE ALARM SYSTEM Other Supervisory Function(s) (specify) Low temp device in store room next to sprinkler room 6. Alarm Notification Appliances and Circuits Types and Quantity of alarm indicating appliances installed: a) I Bells 12 Inch Speakers b) Horns c) Chimes d) Other: c) Visual Signals Type With audible without audible f) I Local Annunciator 7. Signaling Line Circuits: Quantity and Style (See NFPA 72, Table 3 -6.1) of signaling line circuits connected to system Quantity: Style: 8. System Power Supplies a) Primary (Main) Dual 16.5 vac xmrs Nominal Voltage: 16.5 vac Current Rating: 50va Overcurrent Protection: Type DEDICATED BREAKER Current Rating: 20 amp Location: Main floor electrical closet behind passenger elevator b) Secondary (Standby): Storage Battery: Amp Hour Rating. 4 (7 AH) Calculated capacity to drive system, in hours ) 24 60 Engine - driven generator dedicated to fire alarm system: c) Location of fuel storage: 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 71 Optional Standby 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): N/A b) Application Software Revision Level(s): N/A c) Revision Completed by N/A (name) (firm) 1 Comments Bosch 94I2GV2 combination Fire/Burglar Alarm Panel (Signed) for Central Station of Alarm Service Company Leland Slaughter Lead Installer 1-11-2008 Frequency of routine tests and Inspections, if other than in accordance with the referenced NFPA standard(s): NONE System deviations from the referenced NFPA standard(s) are: (Signed) for Central Station of Alarm Service Company (title) (date) Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction): X (Signed) representative of authority having jurisdiction (title) (date) Figure 1 -7.2.1 Record of Completion (continued). 1996 Edition CITY OF TIGARD BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 I DATE ISSUED: Phone: (503) 639-4171 A.40. (2AN1 OL; I Inspection Requests (24 Hrs.): (503) 639-4175 A ' 4 a/19n" klot t,_i itk t-a POT "r ePc vOn., INSPECTION WORKSHEET FOR DATE: VI it / cr TIME: PAGE: SITE ADDRESS: q crop 41,AI Wa,s\AA.,;(1/4/1,-. 5 &. CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message q6 Prt .c vyl 1,..‘ Coin s/Comments/Instructions: N fept - e). -- . Ve_Q•Letzt.I., out /),-/ isoks- Q-e/t/J-re \ . p 'ASS 0 PARTIAL APPROVAL . 111 CANCEL 0 NO ACCESS [1] FAIL 111 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: IN(/1 Date: V t/ Phone #: (503) 718- -Z)4 2A CITY OF TIGARD . . BUILDING DIVISION A PERMIT #: BUP2007 -00574 13125 SW Hall Blvd., Tigard, OR 97223 �� DATE ISSUED: 11 /V5/20O7 Phone: (503) 639 -4171 i Inspection Requests (24 Hrs.): (503) 639 -4175 ''I .. /� INSPECTION WORKSHEET FOR DATE: 1/11/2008 TIME: 7:01AM PAGE: 72 SITE ADDRESS: 09800 SW WASHINGTON SQUARE RD SEARS CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: SEARS DESCRIPTION (1:ire alarm1replacing the FA/BA control OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: ADT SECURITY SERVICES INC PHONE #: 503469.7'100 Inspection Request Scheduled For: Date: 1/11/2008 Pour Time Code # Inspection Description Confirm # Contact # Mes g 299 Final inspection 062876-01 503-572-6870 Y clili r W- ...t3.........4 Corrections/C mments /Instructions: �t 7. " 4/43) (6L' &. _ (1- J J — c?,-,„- is 4—a— V1..--- Pt _ E'7 t0Lt)-- . A - . 4 r- 5z V—' +A t V&.. -.e. ---1 t Z °,,3 sez . -- ovO . �)P''' i ( o C;) (sue- `�- / ' I,-- i x ;�4 14 L i I c i p t ( LI S C 1 t 'J p- r "71., . j ------ 1 I (-( Li) , f_-c_. Wr -A, ' ysJt PPt ` )z- ;v . - ` / PA = ` E, - ' RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS [1] F' IL 67 / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V )2-- Date: 03 Phone #: (503) 718- 2 'Y L ' 7