Permit FIRE PROTECTION SYSTEM PERMIT
liq CITY OF TIGARD
4 c . COMMUNITY DEVELOPMENT Permit #: FPS2010 -00026
t� Date Issued: 04/01/2010
IA Ab 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 500
Subdivision: LINCOLN TOWER Lot: 0
Project: Starbucks
Project Description: Install horns and strobes for TI.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee - COM 03/24/2010 $123.72
12% State Surcharge - Building 03/24/2010 $14.85
PHONE: Plan Review - Fire Life Safety - COM 03/24/2010 $49.49
Contractor:
SAFE TECHNOLOGY GROUP INC
6400 NE HWY 99 SUITE 375
VANCOUVER, WA 98665
PHONE: 360 - 699 -2130
FAX: 360- 719 -1527
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
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: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $188.06
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 4985
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
issuan - spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U ' y Notification Center. os- -s are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC • calling 50 .246.6699 or 1.800.332.2344.
Issued By: ‘ _ Permittee Signature:
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.
Building Permit Application Pacj_ C k - 1`'u,
Fire Protection System RECEIVE ' FO 'OFFIC U O NLY :4 �_ :
,r '{ " City of Tigard Dateiv d �., Permit No.: - O 6 - , r /
1 3125 S W Hall Blvd., Tigard, OR 97223 MAR 2
�� g 4 2 010 Plan Review ��
' :. Phone: 503.639.4171 Fax: 503.598.1960 Date/13 : / ® Other Permit:
1T l C'A R D Inspection Line: 503.639.4175 Date Ready :3 H See Page 2 for
I, ..
.... ..r_ _.
.:k Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: Supplemental Information
BUILDING DIVISIO
' • TYPE OF WORK, REQUIREDDATA:'1- AND 2=FAMILY DWELLING
❑ 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION
work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10260 SW Greenburg Road New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite /bldg. /apt. no.: 500 Project name: Starbucks Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
REQUIREDDATA: COMMERCIAL -USE CHECKLIST
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
DESCRIPTION OF WORK work indicated on this application.
Install Fire Alarm Horn/Strobes For Teant Improvement Valuation: $$4,985.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT • 0. CONTACT PERSON NOTICE
Business name: Safe Technology Group Inc. All contractors and subcontractors are required to be
Contact name: Jason Sweet licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6400 NE Hwy 99 Suite G375 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: Vancouver WA 98665
apply:
Phone: (360) 699 -2130 Fax: : (360) 719 -1527
E -mail: sales @safetechnology.net
CONTRACTOR . BUILDINGPERMIT FEES*
•
Business name: Safe Technology Group Inc. (Please refer ro .fie schedule)
.
Permit fee:
Address: 6400 NE Hwy 99 Suite G375
State surcharge (12% of permit fee):
City /State /ZIP: Vancouver WA 98665
FLS plan review (40% of permit fee):
Phone: (360) 699 - 2130 Fax: (360) 719 - 1527 (Due upon application.)
CCB tic.: 173731 Total permit fees:
Amount received: 18' O1,3
Authorized signature:
-.21 This permit application expires if a permit is not obtained
Print name: Adam Sweet Date: 3 -22 -10 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.doc 10/01/09 440- 46!3T(11 /02/COMIWEB)
1
FUNDAMENTALS OF FIRE ALARM SYSTEMS 115 2(40 (r)0 *-6 72 -
FIRE ALARM SYSTEM
RE ORD OF COMPLETION
Name of protected property: S a.0 • A
Address: 1 0 r 51• I o- ! t o I .) 2 S
Representative of protected property (name/p tone):
Authority having jurisdiction:
Address/telephone number:
c Organization name /phone Representative name /phone
Installer r J�- 1 `w`'
w�: a / ` 11, ist-c1
Supplier .11.t_,tC ( 1 t) 0 1
Service organization Sc- 14- t c h M ( nq r / (1 U )
Location of record (as-built) drawings: V Q 5
Location of operation and ma' tenance manuals: Sa 'k C.
Location of test reports: Sf
A contract for test and inspection in accordance with NFPA standard(s)
Contract No(s): Effective date: Expiration date:
• System Software
(a) Operating system (executive) software revision level(s):
(b) Site- specific software revision date:
(c) Revision completed by:.
(name) (firm)
1. Type(s) of System or Service
NFPA 72, Chapter 6 — Local
If alarm is to location(s) off premises, list where received:
NFPA 72, Chapter 8— Remote Station
Telephone numbers of the organization receiving alarm:
Alarm:
Supervisory:
Trouble:
If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone.
numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 8 — Proprietary
Telephone numbers of the organization receiving alarm:
Alarm:
Supervisory:
Trouble:
If alarms are retransmitted to. public fire service communications centers or others, indicate location and telephone
numbers of the organization receiving alarm:
Indicate how is retransmitted:
)` NFPA 72, Chapter 8 Central Station
Prirrie contractor: ".+ - 4_
Central station location: Dor itba 0 k
(NFPA 72, 1 of 4)
FIGURE 4.5.2.1 Record of Completion.
2002 Edition
72 - NATIONAL FIRE ALARM CODE
Means of transmission of signals from the protected premises 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:
(a).
(b)
System location:
NFPA 72, Chapter9 — Auxiliary
Indicate type of connection: Local energy Shunt Parallel telephone
Location of telephone number for receipt of signals:
2. Record of System Installation
(Fill out after installation is complete and wiring is checked for opens, shorts, ground faults, and improper branching,
but prior to conducting operational acceptance tests.)
This ys m as been installed in accordance with the NFPA s as shown below, was inspected by
) rt -5 on 7 ` / , includes the devices shown
in 5 and 6, and has been in service since
��// NFPA 72, Chapters 1 2 3 (4 5 6 7 9 10 11 (circle all that apply)
!K: NFPA 70, National Electrical Code, Article 760
Manufacturer's instructions
Other (specs ):
Signed: Date:
Organization: o-, ' 1 -e 0 1 es.
3. Record of System Operation 0 f
Documentation in accordance with Inspection Testing Form, Figure 1 2. is ttached
All operational features and functions of this system were tested by /� .5 date V- / - //0
and found to be operating properly in accordance with the requirements of:
NFPA 72, Chapters 1 2 3 4 5 6 7 8 9 0 1 (circle all that apply)
X NFPA 70, National Electrical Code, Article 760
X . Manufacturer's instructions
Other (speci ):
Signed:` v ti Date: / - 10
Organization: So- "C r s.0I i %of
4. Signaling Line Circuits
Quantity and class of signaling line circuits connected to system (see NFPA 72, Table 6.6.1):
Quantity: Style: Class:
(NFPA 72, 2 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -
5. Alarm- Initiating Devices Circuits
Quantity and class of initiating device, circuits (see NFPA 72, Table 6.5):
Quantity: Style: Class:
MANUAL
(a) Manual stations Noncoded Transmitters Coded Addressable
(b) Combination manual fire alarm, and guard's tour coded stations
AUTOMATIC
Coverage: Complete Partial
Selective Nonrequired
(a) Smoke detectors Ion Photo Addressable
(b) Duct detectors Ion Photo Addressable
(c) Heat detectors FT RR FT/RR RC Addressable
(d) Sprinkler waterflow indicators: Transmitters Noncoded Coded Addressable
(e) The alarm verification feature is disabled or enabled , changed from seconds to seconds.
(f) Other (list):
6. Supervisory Signal - Initiating Devices and Circuits (use blanks to indicate quantity of devices)
GUARD'S TOUR
(a) Coded stations
(b) Noncoded stations
(c) Compulsory guard's tour system comprised of transmitter stations and intermediate stations
Note:: Combination devices are recorded under 5(b), Manual, and 6(a), Guard's Tour.
SPRINKLER SYSTEM
Check if provided
(a) Valve supervisory switches,
(b) Building temperature points
(c) Site water temperature points
(d) Site water supply level points
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
(i). Fire pump running
ENGINE- DRIVEN GENERATOR:
(a) Selector in auto position
(b) Control panel trouble
(c) Transfer switches.
(d) Engine running
Other supervisory function(s) (specify):
(NFPA 72, 3 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition
72 -34 NATIONAL FIRE ALARM CODE
7. Annunciator(s)
Number: Type: Location:
8. Alarm Notification Appliances and Circuits
NFPA 72, Chapter 6 — Emergency Voice/Alarm Service
Quantity of voice /alarm channels: Single: Multiple:
Quantity of speakers installed: . Quantity of speaker zones:
Quantity of telephones or telephone jacks included in system:
•
Quantity and the class of notification a pliance circuits connected to sys ein (see NFPA 72, Table 6.7):
Quantity: . 2 Style: Class: i
Types and quantities of notification appliances installed:
(a) Bells With Visible
(b) Speakers With Visible •
(c) Horns With Visible
(d) Chimes With Visible
• (e) Other: Ci toe `j )7 With Visible 7 ,7
(f) Visible appliances without audible:,
9. System Power Supplies
(a) Fire Alarm Control Panel: Nomina oltag ) Current rating:
e
Overcurrent protection: Type: . I . Current rating: �7
Location: tit
(b) Secondary (standby): �7 r, / 44 /
Storage battery: oL Amp -hour rating: /
Calculated capacity to drive system, in hours: .R.
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency system used as backup to primary power supply:
Emergency system described in NFPA 70, Article 700:
10. Comments
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):
System deviations from the referenced NFPA standard(s) are:
‘-^-sk C reA-t4 /
tigo d) fo in allatio c actor /supplier (title) J (date)
(signed) for alarm service company (title) (date)
(signed) for central station (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)
(NFPA 72, 4 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition