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Permit � A FIRE PROTECTION SYSTEM PERMIT 711 .. CITY OF TIGARD x COMMUNITY DEVELOPMENT Permit #: FPS2010 00071 ," 71GA RI? 13125 SW Hall Blvd:, Tigard OR 97223 503.639.4171 Date Issued: 07/01/2010 Parcel: 2S101AD03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 200 Subdivision: TIGARD TRIANGLE CENTER Lot: 0 Project: CNA Insurance Project Description: Add /relocate (78) fire sprinkler heads for TI. • Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 Permit Fee COM 06/25/2010 $134.48 PORTLAND, OR 97224 12% State Surcharge - Building 06/25/2010 $16.14 PHONE: 503 - 624 -6300 Plan Review - Fire Life Safety - COM 06/25/2010 $53.79 Contractor: CROSSFIRE SPRINKLER CO 17400 SE 82ND DR CLACKAMAS, OR 97015 PHONE: 503 - 210 -5506 FAX: 503 - 210 -5538 Type of Use: COM Class of Work: ALT Type of Const: VB Occupancy Grp: B Height: ft Stories: 3 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: LT Density: 0 Design Area: 0 K Factor: 5.6 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: CO Sheets Required: Total $204.41 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: 5509 Residential Square Footage: 0 • Fire Alarm Valuation: 0 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 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. s Issued By: /' • - - ".ittee Signature: l� - LCcL' 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. • Application �A� ` � a - ^ h ' ` B .a Pt � - '' a s ' ; uild>tng Permit Application '� " . a 2 , t , , 1 - T , . ,,. .� �� ' h t� , fi t " \ ,\ q 4 q � q � NM \��r ,r� R1"`'T� 4 u) r1�1('g �a 2, q ,� , x , ... • D� t nav a g \ h c e tir i . k 1rH ry v k aC \ r N1 , v Flirt 11 P>rO Protection !System R e\ceW V � ^ N dt i FOR OFFICE USE ONLYu 0 q \ 10 d ; y 2 V 3 , i !: In ,.flmk= 04 =ix.,�`C�Y��A26',i� ;;A:1 Y�iSW,uuw=N.:. :�0 . _ �tii'idN�.` r•lftef��„Gr,�'Airl�,,Sd Ii rVp1�0. A " � M q C of Tigard �� ' �,` Date /B a (�(� ` yjA ertnttNo. P: 0 1,0. -LYXj 7 13125 SW Hall Blvd -, Tigard .OR 97223 � C�O Plan Review `4 Q 1 Ph e 50163 503.639.4175 5 3 :598.19601 0 l�la D %Read /B _, t Other Permit ,6uPaO(U- ' p C ' ll � + Y Y tuns Ea See Page 2 for n Internet: w,ww.tigard- or.gov �1V / /0 7 Supplemental Information Notified/Method: B �'-kiz1 i✓ L: 7"rn 1 i , 'I P� of WORK / `} - '''''/ � RIE QUIRED DATA .1 2 FAmatiwkLI.INC ❑ 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 forthe ' i work indicated on this application. '''4'''''''':- CAT G ORY e(iNSTRTTeT Ow _ - Valuation: 5 1 -.and 2-family dwelling ® u Commercial /indstrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder • 0, Other. Number of bathrooms: .' Sll?1'E ,,,: , iii 1NFORMATiUN AND EOtATIOIV , `' , a Total number of floors: ,,_.�..,, Job site address: 12909 SW 68 New dwelling area: square feet • City /State /ZIP: Portland, OR 97224 O&M- Garage /carport area: square feet Suite/bldg. /apt. no.: 200 Project nam, e: :Insurance Covered porch area: square feet Cross.street/directions to job site: Deck area: square feet Other'structure area: . square feet- ' `REQUIRED1UlTA COMMETt1ALSE C1iECKLIST = ' > 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 O c / rci - .: ..�, ... CRI IO , , ,to WORK work indicated on this application. Add/ Relocate Heads to maintain coverage around new'walls Valuation $$5,509.00 Existing building area: square feet • New building area: square feet i ` f® E C ANT PRUPERT,Y ^:OWNER � /y � � Number of stories: , Name: PacTrust Type of construction: Address: 15350 SW Sequoia Pkwy - Suite 300 .Occupancy groups: City /State /ZIP: Portland, OR 97224 Existing: ` Phone`. (503)624'6300 • Fax: ( ) New: • ❑ UN t1.PPL.ICANT € r n / Q CT T ` x %__° , s,� ..r , ,-, «a � ,,.r ...- .. �,. v , . .�� , � PERSON /. ' ' � ., ir )., , F , . r„', @ - '° k4 Businessinames' All contractors-and subcontractors are required to be Contactname`.` licensed withrthe Oregon Construction Contractors Board. under ORS 701 and may be required to be licensed in the Address:, jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ') Fax:: ( ) Email: E ' / / -/ y'E --y mac/ ,� , 1 ` r / CONTRACTUR, a ' BI3ILDING P RMIT ES* - (P,lease re er fee dhedu e / .eAAAAAAA .A Business Crossfire Sprinkler Company Permit fee: Address: :17400'SE 82 " Drive State surcharge (12% of permit fee): City /State /ZIP: Clackamas, OR 97015 0 FL,S plan review (40 %,of.permit fee): Phone "(503)'210 ;5506 Fax :: (51 • 538 (Due upon application.) CCB lie.: 174746 A u a Total permit fees: e Amount received: ( . ¥i Authorized Signature: ANT./ 1 --_ " 67 '_ This permit.application. expires if a permit is not obtained' Print Timothy A Bishop Date: 6/16/10 within 180 days after it has been accepted: as complete. * Fee methodology set. Tri Building Industry Service Board. I: \Buildpig \Permits \FPS- PermitApp.doc' 10/01/09 440- 4613T(1.1 /02 /COM/,WEB) City of Tigard: Fire Protection Permit Checklist `Page` 2: -. Supplemental Information • Descnbe wnrkto ;.'..° .. .; 1) ❑ New: 2:) Modification to sprinkler heads only: ❑ Addition ® 1 -1 0 heads: No plan review required. Alteration ® 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: 78 Additional description of work: yp o f S ys tem ( Complete A.; B C osr D as `applzcabre} }. CQt11t11etcia� Sp kl et.. i . /� / � Wet E. Dr Additional Standpipes Information: Hazard Group Light Density .10 Design Area 1500 K. Factor 5.6 Sprinkler Project Valuation: $ 5509.00 Hood Project Valuation: $ • C } Fir .an I �w Submittal:shall Battery Calculations ❑ Yes • include: Individual Component ❑ Yes Cut Sheets • Fire Alarm Project Valuation: $ xs D } R`esident1al Sprinkler /(Stand Ala a System} • Square Footage: P ermit Fee: y /c, 0 to2000 $198.75 2 , 001 to 3,600 $246.45 m\ 3, 601 to 7,200 $310.05 A PI* " Vii%.., . 7,201 and greater $404.39 Sprinkler Project Square Footage: sq.. ft. r. Fire'rptectatata�Pernatt 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. C • . \Documents and Settings \CAD \My Documents \Permits \tigard pemut.doc 10/01 /0 • • / S aUIU 0007 r 39037, • NATIONAL FIRE ALARM CODE 4 INSPECTION AND TESTING FORM �ecunty :Solutigns: N Stanley Integrated Security Solutions Date: 7/27/2009 Test Group # 390375 Time: 9:00 SERVICE ORGANIZATION PROPERTY NAME [OCCUPANT] Name: Stanley Integrated Security Solutions Name: Pactrust TTC 082 Address: 15495 SW Sequoia Pkwy #100, Portland, OR 97224 Address :. 12909 SW 68th Parkway Representative: Allan Goger Owner Contact: License No.: Electrical Contractor: 37•1054CLE Telephone: Telephone: 503 - 968 -3300' CCB #161567 MONITORING ENTITY APPROVING AGENCY Contact: Protection -Net Center [PNC, STANLEY] Contact: Telephone: 800 - 325 -9115 Telephone: Monitoring Account Ref. No.: 7245070343 TYPE TRANSMISSION SERVICE El Digital ❑ Weekly II Radio Frequency ❑ Monthly. ❑Cellular ❑ Bi- Monthly [60 days] ❑ Reverse Polarity ❑ McCulloh ❑ Multiplex WQuarterly Other [Specify]:` ❑ Semiannually — C Annually - _ • - -- - ❑ Other [Specify] CONTROL. UNIT Manufacturer: Honeywell Model No.: 2071 Circuit Class: B Number of Circuits: Software Revision: Last Date System had any service performed: Last Date that any Software. or Configuration was revised: • ALARM INITIATING DEVICES AND CIRCUIT INFORMATION Quantity of Quantity of Devices Installed Circuit Class Devices Tested Manual fire Alarm Boxes Ion Detectors Photo Detectors Duct Detectors Heat Detectors 4 B 4 Waterflow Switches 4 B 4 Supervisory Switches Other [Specify] Alarm verification feature is: ['enabled Edisabled not implemented NFPA 72 [p.1 of 4] 90375';; ALARM NOTIFICATION APPLIANCES AND CIRCUIT INFORMATION Quantity of Quantity of Devices Installed Circuit Class Devices Tested 2 B 2 Horn / Strobe combination units Horns Strobes • Chimes Bells Speakers Other [Specify] Number of alarm notification appliance circuits: Are circuits monitored for integrity? ElYes No SUPERVISORY SIGNAL - INITIATING DEVICES AND CIRCUIT INFORMATION Quantity of Quantity of Devices Installed Circuit Class Devices Tested N/A Building Temperature N/A Site Water Temperature N/A Site Water Level N/A Fire Pump Power N/A Fire Pump Running N/A Fire Pump in Auto position N/A Fire Pump or Pump Controller Trouble N/A Generator In Auto position N/A Generator or Controller Trouble N/A Generator Engine Run N/A Transfer Switch Actuation Other: • SIGNALING LINE CIRCUITS Signaling line circuits connected to system (see NFPA 72, Table 6.6.1] Quantity Class A • SYSTEM POWER SUPPLIES [a] Primary [Main]: Nominal Voltage: 120 VAC Amps 0.20 Overcurrent Protection, Type: BREAKER Amps 20 Location [of Primary Supply Panelboard] Electric room 1st floor Disconnecting Means Location: [b] Secondary Power [Standby]: 12VDC, NOMINAL Storage Battery: Amp -Hr. Rating 7.5 Calculated capacity [in Amp /hours] to operate system 24 hours Standby Current: ❑Engine- driven generator dedicated to Fire Alarm System Location of fuel storage: BATTERY TYPE: •Sealed Lead -Acid ❑Lead -Acid Wet Cell ❑Nickel- Cadmium ❑ Dry Cell ❑Other [Specify]: [c] Emergency or Standby system used as a backup to Primary power supply, instead of using a Secondary power supply: Emergency system described in NFPA_70, Article 700 Legally required standby described in NFPA 70, Article 701 Optional standby system described in NFPA 70, Article 702, which also meets the performance requirements of Article 700 or 701. NFPA 72 [p.2 of 4] • 8390 • EMERGENCY COMMUNICATIONS EQUIPMENT - Visual Functional Comments Phone Set ❑ ❑ Phone Jacks 0 0 Off- hooklndicator ❑ ❑ Amplifier[s] - ❑ ❑ - Tone Generator[s] ❑ ❑ Call -in Signal ❑ ❑ System Performance ❑ ❑ • COMBINATION SYSTEMS Device Simulated Visual Operation Operation Fire Extinguisher Monitoring Device / System ❑ ❑ ❑ Carbon Monoxide Detector / System ❑ ❑ ❑ [Specify] N/A ❑ ❑ ❑ INTERFACE EQUIPMENT [Specify] N/A ❑ ❑ ❑ [Specify] ❑ ❑ ❑ [Specify] ❑ ❑ ❑ SPECIAL HAZARD SYSTEMS • [Specify] N/A ❑ ❑ ❑ [Specify] ❑ ❑ ❑ [Specify] ❑ ❑ ❑ Special Procedures: Comments: SUPERVISING STATION MONITORING - Yes - - - No —Time - Comments Alarm Signal 0 ❑ Alarm Restoration 0 ❑ Trouble Signal 0 ❑ Supervisory Signal 0 ❑ Supervisory Signal Restore 0 ❑ NOTIFICATIONS: TESTING IS COMPLETE Yes No Who When Building Management 0 ❑ Nffraforra Monitoring Agency 0' ❑ PNC, Stanley [thru IVR interface] 0131=10 Building Occupants ❑ ❑ Other [Specify] ❑ ❑ The following did not operate correctly: System restored to normal operation: Date: 67/27/2009 Time: 10:00 THIS TESTING WAS PERFORMED IN ACCORDANCE WITH.APPLICABLE NFPA STANDARDS. Name of Ins estpr: Allan Go er Date: .a ,7%27/2009,r; Time: `,10:00 Signature: s, r ,, i ' 1 .r Name of Owner or Representative: Date: � , �: Time: Signature: • 2007 Edition N Fp © 2007 National Fire Protection Association NFPA 72 [p.4 of 4] 390375 PRIOR TO ANY TESTING NOTIFICATIONS ARE MADE Yes No Who: When: Monitoring Entity p ❑ PNC, STANLEY [through IVR interface] . Building Occupants p ❑ _' Building Management ❑ ❑ Other [Specify] ❑ ❑ AHJ Notified of any Impairments ❑ ❑ SYSTEM TESTS AND INSPECTIONS TYPE Visual Functional Comments Control. Unit p p Interface Equipment ❑ ❑ Lamps /LED's ❑ ❑ Fuses ❑ ❑ Primary Power Supply p p Trouble Signals p p Disconnect Switches ❑ ❑ Ground -fault Monitoring ❑ ❑ SECONDARY POWER Visual Functional Comments Battery Condition Load Voltage ❑ Discharge Test ❑ ❑ Charger Test ❑ Specific Gravity [wet cells only] ❑ TRANSIENT VOLTAGE SUPPRESSORS REMOTE ANNUNCIATORS p p NOTIFICATION APPLIANCES Audible p D Visible p p Speakers ❑ ❑ Voice Clarity ❑ INITIATING AND SUPERVISORY DEVICE TESTS AND INSPECTIONS Visual Functional Measured Location and S / N Device Type Check Test Factory Setting Setting Pass Fail W/F D D D ❑ Valves p p p LI ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Comments: NFPA 72 [p.3 of 4]