Permit (43) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00010
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/30/2019
T I[_ k It D9 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9577 SW WASHINGTON SQUARE RD B07
Project: Morphe Subdivision: None Lot: None
Project Description: Fire alarm. Adding(7)notification devices&booster amp for TI. Electrical permit ELR2018-00237.
Contractor: SIEMENS INDUSTRY INC Owner: PPR WASHINGTON SQUARE LLC
15201 NW GREENBRIER PKWY PO BOX 847
SUITE A4 CARLSBAD, CA 92018
BEAVERTON, OR 97006
PHONE: 503-207-1839 PHONE:
FAX: 503-207-1901
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/30/2019 $209.80
12%State Surcharge-Building 01/30/2019 $25.18
Type of Use: COM Plan Review-Fire Life Safety-COM 01/30/2019 $83.92
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 01/30/2019 $6.00
Occupancy Grp: M Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 01/30/2019 $10.00
11x17)
Hourly Building Rate 01/30/2019 $180.00
Commercial Sprinkler System: Hourly Building 12%State Surcharge 01/30/2019 $21.60
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 Req: Yes
Battery Cates Provided: Yes Cut Sheets Required: Yes
Total $536.50
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $12,284.00
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 952-001-00•4
. You may .--- a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / 1r411,- - • e Signature:,a4"‘
Call 503.639.4175 by 7:00 a.m.for the next available inspection c.`e.
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
FirQ„Pr8"tection System RECEIVE FOR OFFICE USE ONLY
City of Tigard `� 3 2019 Date/By:Received �Ir��l i . ' e', ?01041 �
13125 SW Hall Blvd.,Tigard,OR 97223 JAN Plan Review ,gam /
m Phone: 503.718.2439 Fax: 503.598.1960 1-� � DateBy: / waC3-i 9 - J PIP' -,% /L(�`Q ,/7d2-1
T I GARD Inspection Line: 503.639.4175 CITY 01- ^ Date ReadyBy: i loris: ,. See Page 2 or
Internet: www.tigard-or.gov UILDIi�� ivilt7/j ifiieed//Metho • ij, C9 :/� Supplemental Information
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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
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
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r'Fa'a.6r a'r"'F 1 W l lk t� 1 p I y ,s dl§,,
work indicated on this application.
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Valuation: $
1-and 2-family dwelling ®Commercial/industrial
0 Accessory building 0 Multi-family Number of bedrooms: l
❑Master builder 0 Other:
Number of bathrooms:
1,� I 1 Ca t , . R� sl1�h oil., `� N � t ' t".11 l' Total number of floors:
Job site address:9577 SW Washington Square Rd(9585 SW Washingto) New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:B07 1 Project name:WSQ Morphe Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
4y�� y �j b'E
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06' �I�.<. �n.. . i ftlVIITT uun�. 4,•�'�: x.l ml
Subdivision: 1 Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:
` , equipment,ma erials,labor,overhead,and
the profit for the `
„IG
-''''''.'1,11;7.-..!;?....' 4 .i' t' 1 p d �E t xt ' tt 11f. • work indicated on this application.
-
Tenant Improvement on Fire Alarm System at Washington Sq Mall store Morphe Valuation: $12,284.00
Addition of 7 notification devices&booster Amp Existing building area: square feet
,»
New building area: square feet Permit#ELR 2018-00237 F f Sle: utiyl » ».,'I''," tai.�, r, , o Pr.awIIlI ' 413 i
Number of stories:
Name:Roger Ott Type of construction:
Address:9585 SW Washington Square Rd Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing:
Phone:(503)352-8862 Fax:( ) New:
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Business name:Siemens All contractors and subcontractors are required to be
Contact name:Moses Frangopoulos licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:15201 NW Greenbrier Parkway,Suite A4 jurisdiction in which work is being performed.If the
City/State/ZIP:97006 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)207-1834 I Fax::(503)207-1834
E-mail:moses.frangopoulos@siemens.com
sF?= , k " 4.0",.-MS...,.
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Business name:Siemens
Permit fee:
Address:Moses Frangopoulos
State surcharge(12%of permit fee):
City/State/ZIP:15201 NW Greenbrier Parkway,Suite A4 0
FLS plan review(40%of permit fee):
Phone:(503)207-1834 Fax:(503)207-1834 (Due upon application submittal.)
CCB lic.:133041 !/ (L Total permit fees:
i- a�A Amount received:
Authorized signature:
a�I�' This permit application expires if a permit is not obtained
Print name:Moses Frangopo;los Date:1/23/19 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(11/02/COM/WEB)
city of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
I=1 New system Number of sprinkler heads: Number of alarm devices: 2
J Addition or ❑ 1-10 heads: Affidavit required and ❑ 1 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:
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�.- ❑ Wet ❑ D
Additional Stand.is es
Information: 1:1Yes ❑ No
. ..
Hazard Grou.
Densi
Desi. Area
K. Factor
(..Al.I.
S. 'A . - .'- tVa • '. A: $
1r�16��A... �G Rk IA A��e .+u"A u1A� F .D�,�74 A AA t.�.va`- li11111u'I Irj11 a& 'e Al fd111... m 11... .�,,. g �r 1 "1:i'10i+,.,,::a4:
Hood Pro'ect Valuation: $
r=:: - : 1 u ryull'1 =s,r - r
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Submittal shall Batte Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Pro'ect Valuation: $ 12,284.00
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S•uare Foota.e: Permit Fee: p
0 to 2 000 $
198.75 11 �- � k'1111; t�r�v
2 001 to 3 600 $246.45 r �”"1" 1'1 � �
is r 1111 ryr 111
3,601 to 7,200 $310.05 lY ! ry M111;
`7,201 and treater $404.39
sq. ft.
Sprinkler Project Square Footage:
,11,1-ft
' 10:' _'lap-,."::... 4-4111':t
IIu✓°'i I1 C°14''''''''''4-''-'!'
A i pp.. a;� '-e,1,(47-7,7' . . " III .. ,:{ 11 Il ur
. I .s:: 7-1',11 m ' r ' 1 . .I no w. ...s ws ....>_ :Id,al IcSd'v.
Pro'ect valuation subtotal see A,B &C above : $
Permit fee based on .ro'ect valuation see fee schedule : $
Permit fee based on s•uare footage see Ds
above : $
State Surchar•e 12%of .ermit fee : $
FLS Plan Review 40% of s ermit fee : $
TOTAL: $
D:\syncplicity\frangopoulosm\FSS Sery Projects(Charles Hughes)\Open Projects\_Mods\255987 WSQ Morphe\PM\Permits\WSQ Morphe Permit.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9577 SW WASHINGTON SQUARE RD B07,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00010
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor