Permit (167) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00056
T i( A u f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/29/2019
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9631 SW WASHINGTON SQUARE RD FC03
Project: Ruby Thai Kitchen Subdivision: None Lot: None
Project Description: Fire alarm:Adding(1)monitoring relay for hood suppression system.
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 04/29/2019 $123.72
12%State Surcharge-Building 04/29/2019 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 04/29/2019 $49.49
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 04/29/2019 $1.50
Occupancy Grp: Height: ft 11x17)
Stories: Hourly Building Rate 04/29/2019 $180.00
Hourly Building 12%State Surcharge 04/29/2019 $21.60
Commercial Sprinkler System:
- 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 Calcs Provided: Cut Sheets Required: Yes
Total $391.16
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $4,637.00
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,._follo'wthe rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009 nay obtain . opy of the rules
or direct questions to OUNC by calling 503.232 1987 or 1.800. ,2.2344.
Issued By: - / Permittee Signature: ± 1111.
pr
Call 503.639.4175 by 7:00 a.m.for the next available inspection 4111111
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
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard Received
t/
13125 SW Hall Blvd.,Tigard,OR 9722Y 21 aB: � /I > P,—Vac-7,-
Plan
Review
-•1 e )elf ,� Other Permit
Phone: 503.718.2439 439 Fax: 503.5 Date/By: turfs: ® See Page 2 for
TIGARD Inspection Line: 503.639.4175 taj `0� TibtARD DateReadyBy: ; I g
Internet: www.tigard-or.gov '-JU!1.D!NG DIVISION Notified/Method:/M / /II`'i Supplemental Information
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❑New construction D 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
,, I 11I , ��� I 1 y su ^
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work indicated on this application.cation.
IC" w II t 01,.. .d 1r T INV I I11 atri^ Valuation: $
0 1-and 2-family dwelling ®Commercial/industrial Number of bedrooms:
0 Accessory building 0 Multi-family
i
Master builderNumber of bathrooms: s
0 Other:
aIP '" r� ", * Total number of floors:
., IIIPN N :. "�3 nitlm ,e . ®,.» W"g .. ����I�'ll�� 19�iNIINIi ,,:
.0,1,,b site address:9631 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.:FC-3. Project name:' RubyThai pl Malt,/ Covered porch area: square feet'
Cross street/directions to job site: Deck area: square feet. _.
-Ruby Thai store name is being changed to Bombay Walla Other structure area: square feet
QI,i' T w1 N .4ST.
Subdivision: 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
map/parcel no.,:, ! Ii
equipment,materials,labor,overhead,and the,profit for the
a ;` 4tk sMGy ;1 d N 40„ SN „, , ,. work indicated on this application.1 � a : I e 1
,
• Tenant Improvement on Fire Alarm System at Washington Sq Mall store Ruby Thai/ Valuation: $4,637
Bonbay Walla. Addition of 1 monitoring relay for hoods. Existing building area: square feet
Electrical Permit# ELR2019-00075 New building area: square feet -
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1."►I v ii ~ " ' +R, � r N"'i Ila Ar i II4ilp.,... Number of stories:
Name pger-6tr ' 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 apply: is exempt from licensing,the following reasons
pp y:
Phone:(503)207-1834 Fax::(503)207-1834
-E-mail:moses.frangopoulos@siemens.com I
N iM FI l 7+r7C' 'r -C. 6 c dF "ad 'Irh... itilliNo ',.'nIININ1„h . SII pxffh z g r k 'm44 .
,: (.. se,lefetita eelschedu
Business name:Siemens
Permit fee:
Address:Moses Frangopoulos °
State surcharge(12%of permit fee):
City/State/ZIP:15201 NW Greenbrier Parkway,Suite A4 FLS plan review(40%of permit fee):
Phone:(503)207-1834 Fax:(503)207-183',,. (Due upon application submittal.)
CCB lie.:133041 Total permit fees:
•
I
�� .---- Amount received:
Authorized signature:
` This permit application expires if a permit is not obtained
.� within 180 days after it has been accepted as complete.
Print name:Moses Fran l p ou Date:4/24/19
* Fee methodology set by Tri-County Building Industry 1
Service Board.
1:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T01/02/COM/WEB) ---.i
i
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9631 SW WASHINGTON SQUARE RD FC03,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00056
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9631 SW WASHINGTON SQUARE RD FC03,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00056
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor