Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00358
4 DEVELOPMENT SERVICES DATE ISSUED: 9/2/2005
- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT OFFICE ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire alarm system for new retail addition.
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: 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:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 177,000.00
Owner: Contractor:
WASHINGTON SQUARE LLC OREGON ELECTIC CONSTRUCTION
BY THE MACERICH COMPANY 1010 SE 11TH
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIGARD, OR 97223
one: Phone: 503 - 234 -9900
FEES Reg #: LIC 203
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/29/2005 $1,044.60
[TAX] 8% State Surchari 7/29/2005 $83.57
[FLS] FLS Pln Rv 7/29/2005 $417.87
Total $1,546.04
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to 0 C by
calling 503 - 246 -669 r 1- 800 - 332 -2344.
Issued By: ) ,./.z4 ! Permittee Signature: ` LUGS
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
•
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
•
Approved plans are required on the job site at the time of each inspection.
Pe r.5 Saw Wac a*--sa
Fire Protection System S G •
Building Permit Application wK 146.7 FCC ll 01.1. 1 l ' i•: 0.1.\
City of Tigard = , j',` \! - 7 WV
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-, :. . _ \./ 1 ` Q Permit No. • i O� 3 5
13125 SW Hall Blvd., Tigard, OR 97223 V 1 Plan Revie '
Phone: 503.639.4171 Fax: 503,59$.1960 fIllrli u• r \3 '! . '• /g : k 6 4 + + . b5 Other Permit: W
Inspection L ine: 503.639.4175 , !. ( L ti,, J '� � Date R '!:".' ® See Page Z ror
Internet www.ci.tigard.or.us Notified/Method: �� . su pplemen tal Information Q
CITY OF i IG.AO y
• lIt (_i ll ikil4 dI► VCIRK REQUIRED DATA: 1- AND 2-FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. 4
Indicate the value (rounded to the nearest dollar) of all I1•
1:2 replacement ❑Other: equipment, materials, labor, overhead, and the profit for the �� •
. CATEGORY OF CONSTRUCTION
work indicated on this application. \:
El 1- and 2- family dwelling ttCommercial/industrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
■
❑ Master builder • ❑ Other. Number of bathrooms:
i
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: qyb5- c tr t New dwelling area: square feet `\
City / State/ZIP: 't, 5 . 4 n , . 04,4 4 t7 ZZ Garage/carport area: square feet
Suite/bldg./apt. no.: name: � N l MirTOIK SC1 .. Covered porch area: square feet
Cross street/directions to job site: 4 e 4 90 Deck area: square feet t
Q Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST \ M1
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax maplparcel 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. \
' STr41t.4. '�ll4. . A►L�►�.1ow. 1 P\ A1Cw Valuation: $ l 77 000 -- ,',
tA
tii4 AOLIs11 l01"'l Existing building area: square feet
New building area: �f Q00 square feet
lit PROPERTY OWNER I ❑ TENANT Number of stories: �"� Z.,
Name: U ut 11%ttprD t - , LLC_ Type of construction:
Address: '1585 SW t.41ASK TO/A S 'J.Aa.ft a i#D Occupancy groups:
IAA
City/State/ZIP: ^ y ,AKb . Ctu
024“ t '3 Existing:
Phone: ( ) J Fax: ( ) New:
fra APPLICANT a CONTACT PERSON NOTICE
Business name: Cv..c:or -t F..c..aCCh.t . C oK5 1 All contractors and subcontractors are required to be
Contact name: � f La, pe. ��� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: • 1 roc 0 Srt L ( &Oa jurisdiction in which work is being performed. If the
City/ State/ZIP: -rr� A t0 CDR-- Cr) 21 \ applicant is exempt from licensing, the following reasons
apply:
Phone: (5 Lbt.( Q400 I Fax:: ( ) 53Y- 2.765
E -mail: c.100 Y ( Oa' ACPC A — CtUtiC712.1Cr a C.Dt 1
CONTRACTOR
Business name: O(LrzErcipt F.1•4CGTri tf
BUILDING PERMIT FEES*
Address: 1O 10 SC L fit..► P Please refer to fee schedule
City/State/ZIP: ?r&T& t-t 21 Oa- R7 2
Fees due upon application / 5 .09
Phone: (03) j ( GoCt(%) Fax: ( * 7 I X35 17 b.S Amount received
CCB lic.: �d ( b
Date received:
Authorized signature k . This permit application expires If a permit Is not obtained
within 180 days after it has been accepted as complete.
I Print name: I 00‘? 01 air— I Date: ? / r e I • Fee methodology set by Tri -County Building Industry
■
1 ` v7
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 g Yes
include: Individual Component X Yes
Cut Sheets
Fire Alarm Project Valuation: $ 177,d00 •�—
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.
Project Valuation Subtotal (A, B & C): $ ( ?7 000
Permit fee based on valuation (see attached chart): $ logy —
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ $ 3..V—
FLS Plan Review 40% of Permit Fee: $ L41
TOTAL: $ I
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.ci.tigard.or.us/ city_ haU / departments /cd/docs/FPS- PermitApp.doc
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SUP2005.00358
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2/2005
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 _-
INSPECTION WORKSHEET FOR DATE: 11/22/2005 TIME: 7:02AM PAGE: 104
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: W • WIGIObN SQUARE EXPANSION)
DESCRIPTION: Fire alarm system for new retail addition.
OWNER: WASHINGTON SQUARE LLC. PHONE #:
CONTRACTOR: OREGON ELECTIC CONSTRUCTION PHONE #: 503234 -9900
Inspection Request Scheduled For: Date: 11/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 022131 -01 503703.3804 N
Corrections/Comments/Instructions:
I II il
1
I
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL . ❑ CALL F R INSPECTION ❑ ADDITI NAL ES ASSESSED
Inspector: 41 \, Date: t 7 6 / Phone #: (503) 718-
• � ,
•
CITYOF�TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00358
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2/2005
Phone: (503) 639 -4171 II
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 10/28/2005 TIME: 7:18AM PAGE: 62
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WASHINGTON SQUARE EXPANSION
DESCRIPTION: Fire alar stem for new retail addition.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: OREGON ELECTIC CONSTRUCTION PHONE #: 503- 2349900
Inspection Request Scheduled For: Date: 10/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
998 Alarm final 019701 -01 503 - 793 -7177 N
Corrections /Comments /Instructions:
' 0)
`-' fl V-- e7-r-cm-ord .
– Fbows A Tocri(4,w- (Slik' -
4naid S (333 P(1U(T-- 40% 'w l c6-- •
s -T LL- t V E
2 tie e_Er-__s cur
eE ft.C_- op To /1—
, .
❑ PASS [ ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
' tri,.4
Inspector: / Date: itw. Phone #: (503) 718 -
c7 oz' 358
Certificate of Completion
Name of Protected Property: Washington Square Mall Expansion
Address: 9585 SW Washington Square Road
Tigard, Oregon 97223 -4450
Rep. of Protected Prop. (name /phone): Roger Ott (503) 639 -8865
Authority Having Jurisdiction: City of Tigard
Address: 13125 SW Hall Blvd
Tigard, Oregon 97223
Phone Number: (503) 639 -4171
1. Type(s) of System or Service:
X NFPA 72, Chapter 3 - Local
If alarm is transmitted to location(s) off premise, list where received:
Honeywell Central Monitoring Station
X NFPA 72, Chapter 3 - Emergency Voice /Alarm Service
Quantity of voice /alarm channels: 1 Single: X Multiple:
Quantity of speakers installed: 45 Quantity of speaker zones: 1
Quantity of telephones or telephone jacks included in system: None
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 Oregon Electric Group Scott Johnson
(503) 234 -9900 (503) 234 -9900
Supplier Siemens Building Technologies Ron Pulioff
(503) 234 -9995 (503) 234 -9995
Service Organization Siemens Building Technologies Service Department
(503) 234 -9995 (503) 234 -9995
Location of Record (As- Built) Drawings:
Security Office
Location of Owners Manuals:
Security Office
Location of Test Reports:
Security Office
A contract, dated 11/1/1999 for test and inspection in accordance with NFPA standard(s)
No.(s) NFPA 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 has been installed in accordance with the NFPA standards as listed below, was
inspected by Scott Johnson on 10/26/2005 , includes the devices
listed below and has been in service since 10/27/2005
X NFPA 72, Chapters X 1 X 3 4 X 5 X 6 X 7
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's Instructions
Other (specify): I
Signed: `�� Date: 1)/3O,r
Organization: C'rpcicv, C'echerc.
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3. Certification of System Operation
All operational features and functions of this system were tested by Ron Pulioff
on 10/27/2005 and found to be operating properly in accordance with the
requirements of:
X NFPA 72, Chapters X1 X3 _4 X5 X 6 X7
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's Instructions
Other (specify):_
Signed: 9 rA.v.'07.2— Date: 1 (,/3/65
Organization: Siemens Building Technologies
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
Coverage: Complete Partial X
a) 39 Smoke Detectors: Ion 39 Photo
b) 8 Duct Detectors: Ion 8 Photo
c) 2 Heat Detectors: FT 2 RR FT /RR RC
d) 8 Sprinkler Water Flow Switches: Noncoded, Activating
Transmitters Coded
e) Other (list):
5. Supervisory Signal Initiating Devices and Circuits (Use blanks to indicate
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) 12 Coded Valve Supervisory Signaling Attachments
Valve Supervisory Switches Activating Transmitters
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) Phase Reversal
Engine- Driven Fire Pump:
h) Selector in Auto Position
i) Engine or Control Panel Trouble
j) Fire Pump Running
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: 12
Types and quantities of alarm indicating appliances installed:
a) Bells Inch
Speakers
b) Horns
c) Chimes
d) Other:
e) 50 Visual Signals Type: Speaker /strobes
45 with audible 5 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: 8 Style: Class B, Style 4
8. System Power Supplies
a) Primary (Main): Nominal Voltage: 120/1/60 Current Rating: 5 amp
Overcurrent Protection: Type: Circuit breaker Current Rating: 20 amp
Location: Panel HP4, circuits 40 & 42
b) Secondary (Standby):
X Storage Battery: Amp -Hour Rating 55 amp -hour
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) X Operating System Software Revision Level(s):_ CSGM 17.01
b) X Application Software Revision Level(s): Revision 55
c) X Revision Completed by: Jim Bramlage Siemens Building Technologies
(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): None
System deviations from the referenced NFPA standard(s) are: None
(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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