Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2009 -00104
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 12/02/2009
Parcel: 2S 101 AC90000
Jurisdiction: Tigard
Site address: 7125 SW HAMPTON ST
Subdivision: Lot: 0
Project: Special Districts Association of Oregon
Project Description: Replace fire panel, add pull stations, and notification.
Owner: FEES
HAMPTON STREET BUILDING CONDO Description Date Amount
OWNERS OF ALL UNITS Permit Fee - COM 10/27/2009 $134.48
00000 Plan Review - Fire Life Safety - COM 10/27/2009 $53.79
PHONE: 12% State Surcharge - Building 10/27/2009 $16.14
Contractor:
SIGNALING SYSTEM SOLUTIONS
6816 NE HWY 99
VANCOUVER, WA 98665
PHONE: 360 - 694 -9199
FAX: 888- 511 -7734
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Height: ft
Stories: 2
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: No Alarm Type: Manual
Pull Station Required: No Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $204.41
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 6000
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 -0100. You may obtain a copy of the rules
or direct qu tions to OUNC by calling 503.246.6699 or 1.800.332.2344.
I �
Issued By: QV), y Q Q ,�� (� �t) Q ,� (� Permittee Signature:
J( `.J� 1( J�/� �
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.
��
Bulling Permit Application
Fire Protection System RECEIVED Foa 0i 11c. t� 1
CI of Tigard Received i� Permit No.: 71' , • a ii `J g Date/Bv: ,..- `
. . ° 13125 SW Hall Blvd., Tigard, OR 972 C T 2 7
2009 Plan Review 1/I
6 I� h Permit: Other ermt: /
Phone: 503.63 Fax: 503.598.1960 Date/Bv: _ COQ Go 7
Inspection Line: 503.639.4175 Date Read ® 0 See Pa e 2 for
T I G.. R U Int www.tigard- or.gov CITY OF TIGARD Notifi r Y th / / ' g
ppleme al Information
BUILDING DIVISION Agar 1 // / i , , ...4MigtV
TYPE OF WORK / ' EQUIRED ( I ATA 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
g iAddition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: - 11 2 5 5 h) \-k(-1 rat ( 2 T0 a_7 51 New dwelling area: square feet
City /State /ZIP: "—'; garz( Olt,. �'1 'Z Z3 - Garage /carport area: square feet
Suite/bldg. /apt. no.: V Project name: Si ec;hl 12i f , 0 . Gre r- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
St-,..) - 1 - ,2- . r1- Ave- ® 51,J )4 q r - r 7 L 4A - - ) S 1 - Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: . I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
)2eo,oue_AZeIacC i-Iehrl C'nc) l=: re 1 9,,,Ae.1 AV ,A)II ST � >o,L15 Valuation: $ 606'6 � -
6„j wo ; 1 G K A 776,3 pe.� L.,, -lur.Er r ez t - _/"1 (61— Existing building area: square feet
iu�-r- - i fet" Splc,' 12v9L.:rer,e ,,/s'- New building area: 0 square feet
VT PROPERTY OWNER ❑ TENANT Number of stories:
Name: .5,7QC i,t,( 0t - 3 r . U C Oreo v - Type of construction: / JUL e)1 .
Address: -14 Z5 *- I-{� r7 � , . fc 20° Occupancy groups: "13
l
City /State /ZIP: -I- � kr A Q (L '-'1 1 Z2 3 Existing:
Phone: 0 ) Lk 3 -- .2 3 1 _ Fax: ( ) New: ,4J 4
gI APPLICANT )23 CONTACT PERSON / NOTICE
Business name: S ;1 r_,H 1 ; „, 7 3 y � r ti u l �i r u, ✓5 ) tic _ All contractors and subcontractors are required to be
// licensed with the Oregon Construction Contractors Board
Contact name:
'7w L . _ 8'e. r Cf under ORS 701 and may be required to be licensed in the
Address: (-Ai* 1j6 A 5h jurisdiction in which work is being performed. If the
City /State /ZIP: U� OL („e9 � , applicant is exempt from licensing, the following reasons
{ 5 apply:
Phone: (3 - 1 p ) f y q i C l L1 I Fax:: (Ot ) // 1'.3 ( �
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
/ AJ
(Please rejerto fee schedule,
Business name:
S/� lhI �l 5.,51 �r'1 5,..1‘,7101,5,
6 6 , Permit fee:
Address: NG / 1w 9 1
State surcharge (12% of permit fee):
City /State /ZIP: \j /} A.JC. Li/4 c j ( f - - 6 6 S
FLS plan review (40% of permit fee):
Phone: q 6 ) 6 / -/ 0 1 1 C-7 I Fax: ( Ke 5 II - 11 3 ` - I (Due upon application.)
CCB lic.: ) - 1 3 )1 t-1 Total permit fees:
Amount received: 59) • -79
Authorized signature: /
/ This permit application expires if a permit is not obtained
Print name: Pc? v L. s /Lf e-, Date: id (.a G within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I:\ Building \Permiu&FPS- PermitApp.doc 10/01/09 440 -4613T(11 /02 /COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done: F' ' t Pr 0 1..) ( —
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
[Alteration ❑ 11+ heads: Plan review required.
SI Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: _ Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System `.
Hood Project Valuation: AM I $
C.) Fire Alarm •
Submittal shall Battery Calculations Yes
include: Individual Component Er* Yes
Cut Sheets
Fire Alarm Project Valuation: $ 6
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
: Users: paulsiefer :Downloads:FPS- PermitApp.doc 10/01/09 2
FUNDAMENTALS OF FIRE ALARM SYSTEMS
FES)-c)oq odk
JAN: 2`7 2
FIRE ALARM SYSTEM CITyOF BG p
EC F CO L � -DING DI V lS [ p,�
Name of protected property: e - ! �'� ST rl &'fs f-x s s c t !o , � � O r 4 o y�
Address: 2 J ?n J
Representative of protected property (name /phone): U 'en s S 6ti
Authority having jurisdiction:
Address /telephone number:
Organization name Iphone Representati nameIphone
Installer > / !I 61--111`", S7 S i e-rh S f d - worm 3 60 69 if 909 — gt ✓/ Se [ t ier-
Supplier
Service organization
Location of record (as- built•) drawings: A ÷ rA c•P
Location of operation and maintenance manuals: A—f F A c P
Location of test reports:
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 transmitted to location(s) off premises, list where received:
NFPA 72, Chapter 8 — Remote Station
Telephone numbers of the organization receiving alarm:
Alarm: S a n d- " b 1 5 ) 3 S2? )
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 alarm is retransmitted:
NFPA 72, Chapter 8 — Central Station
Prime contractor:
Central station location:
(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
)C 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, Chapter 9— 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 system as been install d in accorda c with the NFPA sta cjs as shown below, was inspected by
I £{/ / O� ( ,� t5�1` c on / /� 6 , includes the devices shown
in 5 and 6, and has been in service since .
1' NFPA 72, Chapters (circle all that apply)
NFPA 70, National Electrical •Code, Article 760
k Manufacturer's instructions
Other (specify):
Signed: / t 0/.414 Date: / /l - LA°
Organization: S 5 5 L ° '' e
3. Record of System 'Operation
Documentation in accordance with. Inspection Testing Form, Figure 10.6.2.3 ' attached
All operational features and functions of this system were tested by G, • date i /z// °
and found to be operating properly in accordance with the requirements of:
)C_ NFPA 72, Chapters . , . 9 10 1 , ircle all that apply)
)c NFPA 70, National Electrical Code, Article 760
X Manufacturer's instructions
Other (specify):
Signed: / r-- � 0 Date: f// Z //
Organization: -CC Cea p
4. Signaling Line Circuits
Quantity and class of signaling line circuits connected to system (see NFPA 72, Table 6.6.1):
Quantity: I Style: 15 Class: 6
(NFPA 72, 2 of 4)
FIGURE 4.5.2.1 • Continued
2002 Edition
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -
•
5. Alarm- Initiating Devices and 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
(a) Smoke detectors Ion Photo 1 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
(j) 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 appliance circuits connected to system (see NFPA 72, Table 6.7):
Quantity: Style: Class:
Types and quantities of notification appliances installed:
(a) Bells With Visible
(b) Speakers With Visible
(c) Horns With Visible C i
(d) Chimes With Visible
(e) Other: With Visible
(f) Visible appliances without audible:
9. System Power Supplies
(a) Fire Alarm Control Panel: Nominal voltage: 2 ° L Current rating:
Overcurrent protection: Type: Current rating:
Location: /" LI N. e oc -
(b) Secondary (standby):
Storage battery: Amp -hour rating: 74k
Calculated capacity to drive system, in hours: r ) 7 , 8
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:
i �� re/1 ( Z. /0
( si•ned) for install. ion co tractor /supplier (title) (date)
(signed) for alarm service company (title) (date)
(sign for central station (title) (date)
Up + impletio of the yst (s) satisfactory test(s) witnessed (if required by the authority having jurisdict' • n):
• J. e r j i t CG
( - d) (Ore . • e al nty ar "�' - lotion (title) — (date)
(NFPA 72, 4 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition