Permit (107) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 COMMUNITY DEVELOPMENT Permit#: FPS2019-00090
T I
(.1 A ii[3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/15/2019
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9459 SW WASHINGTON SQUARE RD A14
Project: Foot Locker Subdivision: None Lot: None
Project Description: Fire alarm. Adding(6)notification devices. Electrical permit ELR2019-00117.
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 07/15/2019 $145.24
12%State Surcharge-Building 07/15/2019 $17.43
Type of Use: COM Plan Review-Fire Life Safety-COM 07/15/2019 $58.10
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 07/15/2019 $6.00
Occupancy Grp: B Height: ft 11x17)
Stories: Hourly Building Rate 07/15/2019 $180.00
Hourly Building 12%State Surcharge 07/15/2019 $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: Yes Cut Sheets Required: Yes
Total $428.37
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,125.00
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 OUNC by calling 503.2 .1987 or 1.800.332.2344.
Issued By: Permittee Signature: •
CC( e-/r//?:?&. 71017
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.
1
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
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City of Tigard I " Date/B d 7 v`6 � i _ /V
14 ' a y:
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13125 SW Hall Blvd.,Tigard,OR 97223 n,, Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 E U L ti t Date/By: ..i)— ) / i6"' tt - �`l/_
Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
TLGARD p ,
Internet: www.tigard-or.gov • , •i N�ed/Method: ` � Supplemental Information
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❑New construction 0 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
I �t 11 Iu11'1tl i";' work indicated on this application.
e I t1" Eta tI1' .a Tim(� a. . 111�IInI��
1111 '
D I-and 2-family dwelling ®Commercial/industrial Valuation: $
Q Accessory building ❑Multi-family Number of bedrooms: ,r3,.
Master builder
f ❑Other:
Number of bathrooms:
w r. . I$ g:h 4s,.4s.e E la 1t . ,y1 1 1 . ill
Total number of floors:
„'b site address:
�b$S'S'VV Washington Square Rd New dwelling area: square feet. - I
_
misty/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet '
Suite/bldg./apt.no.:A14 Project name:WSQ Footlocker Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet,
Other structure area: square feet
(14R 1 4, i !`11'.. 1 ski JiiaNti.p.,!:,e, ,, ,, -„ :,,,,I ``,..
• 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 no: equipment,materials,labor,overhead,and the profit for the
: r ,9! ' work indicated on this application.
�, 1 �, � � IfES ' ICI'1sT F �'4'll�lt�: _ : -
Tenant Improvement on Fire Alarm System at Wash Sq Mall store Footlocker Valuation: $6,125.00
A'tdition of 6 notification devices, Existing building area: square feet
A Electrical Permit#ELR2019 00117 New building area: • square feet
. ."a r1 1myln s4 1 y11191 '
4 " r� i ..„14,,,,,„..,:11,,A14 1 + ,� ,',01'!'''',$:'...:.41,4.,,Q i Number of stories:
i`Y �`r +a � w, :1,t A,* WtalI111`�,.' "44 ,.... ,4101], �i:,:cr...
Name:Roger Ott Type of construction:
I Address:9585 SW Washington Square Rd Occupancy groups:
* City/State/ZIP:Tigard OR 97223 Existing:
v
Phone:(503)352-8862 Fax:( ) New:
'_rt 5 A 17 tcANT 11u° .4Q A r tS m E .,
.., .. _ i til : �,�: :: I+IQ' ;IGE Business name:Siemens All contractors and subcontractors are requiredd to be
Contact name:Moses Frangopoulos licensed with the Oregon Construction Contractors Board .
u .? under ORS 701 and may be required to be licensed in the
'A Address:15201 NW Greenbrier Parkway,Suite A4 jurisdiction in which work is being performed.If the
U City/State/ZIP:97006 applicant is exempt from licensing,the following reasons
'� 'r apply:
one:(503)207-1834 Fax: (503)207-1834
mail moses.frangopoulos@siemens.com
: 111 t s a :4 1 1 ( 6i a..ra r� ey �. ...-.:.,,H191:......4-..,..
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.AV1tl1°' , 1 w44 "":a W$01a'Y�I " 0u ,&- **4. * w114,1. !+ 4' ,x 1 I ® �#
1 .Jei e .
Business name:Siemens
Permit fee:
Address:Moses Frangopoulos
Fran o 0ul os
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)207-1834 (Due upon application submittal.)
CCB lic.:133041 Total permit fees:
i Amount received: '
Authorized signature: 'J
This permit application expires if a permit is not obtained I
within 180 days after it has been accepted as complete. .
t'rtnt name:Moses Fran:t poulos Date:7/8/19 ,
/ * Fee methodology set by Tri-County Building Industry.
i'=' Service Board.
: u lding\Permits\FPS-PermitApp_031016.doc 440-4613T(t 1/02/COM/WEB) a
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:
❑ New system Number of sprinkler heads: Number of alarm devices: 6
® 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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CYI p '"- kVVI IIau 1 - IIIpIN IN 1;'I II r �,,w r#' �' e I� q{��!11�11,'I I _ 9'
II 19r ..m r II X�V - III law .�._ �w I14. A'�n• _�,r;'w'"
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
i es
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
Hood Project Valuation: Iw�3
� I�,_ y"�� YIjIV!��I,I ��. drl��" ",,a^ .ilh�llllulll• I,11ru1�!Ih1
Submittal shall Battery Calculations ® Yes
include: Individual Component o
nent
Yes
Cut Sheets
Fire Alarm Project Valuation: I $ 6,125.00
•
F ,
pn ° fi ( a y$ ""e i1 ii ` Nr }NI IN'V°IyN �^ , r •
Square Footage: Permit Fee:
hill d'111 � I
IVIrN �Nu11NW � rj urgl lv d �r � III ; �"ky.•
0 to 2,000 $198.75
- I= 2,001 to-31300- 4246.45
_ , VIII
3,601 to 7,200 $310.05
IIuV,' 1 III x tra
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
�,�1�� '+p�gVllrt, NIT'r" rr! I.' .1@ Pxt1t _ ! C12'L IIIIJG' ',q II111 4NII^I�R�I% w1°11Iyp41y sN�11 ,
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 (12% of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $
ll:\syncplicity\frangopoulosm\FSS Sery Projects(Charles Hughes)\Open Projects\_Mos\267349 WSQ Footlocker\PM\Permits\WSQ Footlocker Perri-tit-doe:,.
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9459 SW WASHINGTON SQUARE RD A14,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00090
Inspection Type: Inspector:
998 Alarm Final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor