Permit (156) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00021
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/04/2019
Tri. I:t: g Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9685 SW WASHINGTON SQUARE RD C07
Project: Casper Subdivision: None Lot: None
Project Description: Fire alarm. Adding(5)notification devices. Electrical permit ELR2019-00017.
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 03/04/2019 $145.24
12%State Surcharge-Building 03/04/2019 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 03/04/2019 $58.10
Class of Work: ALT Type of Const: Info Process/Archiving-Lg$2.00(over 03/04/2019 $4.00
Occupancy Grp: Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 03/04/2019 $0.50
11x17)
Hourly Building Rate 03/04/2019 $180.00
Commercial Sprinkler System: Hourly Building 12%State Surcharge 03/04/2019 $21.60
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required:
Total $426.87
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,035.00
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 952-001-0090. You may obtain a copy of the rules.-
or direct questions to OU by calling 3.232.1987 or 1.800.332.2344. -
Issued By: .ti ittee Signature: ,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
City of TigardA .{ Permit No.: ��U f
13125 SW HaII Blvd.,Tigard,OR 97223 ' v a
s Phone: 503.718.2439 Fax: 503.598.1960 Date Received: _ /Ace /1''
Inspection Line: 503.639.4175 ,j
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TIGAhl
Internet: www.tigard-or.gov , .�, By: , .4i. • � ,
FIRE ALARM SYSTEM AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(MAXIMUM OF 5 DEVICES WITHOUT PLANS)
Project Name: WSQ Casper Occupancy:
Job Address: 9685 SW Washington Square Rd Suite: C07 (WSQ Mail: 9585 SW Wash Sq)
Contractor: Siemens Phone: 503-352-8862
Valuation of work: $6,814.00
Type of System: (check one) ❑■Required ❑Non-required
(check one) EAutomatic ❑Manual ❑Both
Total number of devices added or moved under this permit process is 5 total per tenant space.
Number of Proposed Smoke/Heat Detectors: To be Added(max 5) /To be Relocated on.5)
Number of Proposed Manual Alarm Stations: To be Added(max 5) /To be Relocated(max 5)
Number of Proposed Notification Appliances: To be Added(max 5) 5 /To be Relocated on.5)
I, Moses Frangopoulos Oregon Construction Contractors Board No. 133
041
certify the following is true and defines the scope of work for this project:
a) All work complies with the current state-adopted NFPA-72 and the authority having jurisdiction.
b) All notification appliances are located in accordance with the current state-adopted NFPA-72.
c) Smoke/Heat detector spacing complies with current state-adopted NFPA-72 and the authority having
jurisdiction.
d) Exposed wiring will not be covered until inspected.
e) Final approval shall be subject to on-site tests and inspections.
f) Voltage drop is adequate to operate all appliances.
g) Battery supplies are capable of supporting the system modifications.
h) Compatibility of appliances and devices are in accordance with the FACP manufacturer's specifications.
In addition,I understand the following is required:
• Submit(3)copies of a sketch showing the area of work within the building's structure.
• Building fire protection system permit.
• Electrical permit.
• A copy of this document with a copy of the sketch attached shall be available for all inspections.
Signature: Date: 2/25/19
Print Name: Moses Frangopoulos
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