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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT q s -` - . 111 COMMUNITY DEVELOPMENT Permit #: FPS2010 -00082 T E G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/03/2010 Parcel: 1S135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD 410 Subdivision: LINCOLN CENTER/TWO LINCOLN Lot: 0 Project: EXTERRO Project Description: Fire alarm TI Owner: FEES LINCOLN CENTER LLC Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee - COM 08/03/2010 $77.99 CALIFORNIA ST 49TH FL 12% State Surcharge - Building 08/03/2010 $9.36 PHONE: Plan Review - Fire Life Safety - COM 08/03/2010 $31.20 Contractor: CHRISTENSON ELECTRIC INC 111 SW COLUMBIA ST, STE 480 PORTLAND, OR 97201 PHONE: 503 - 419 -3300 FAX: 503 - 419 -3695 Type of Use: COM Class of Work: ALT Type of Const: IIB Occupancy Grp: B Height: ft Stories: 5 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 $118.55 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: 0 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..pec' =Ity Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if wok is r of st rted within 180 days of Niles issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the adopted by the Oregon Utility • rcation- enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. ou rray obtain a copy of the rules or ect questions to • - C b • : ing 503.246.6699 or 1.800.332.2344. I sued By: ; • // 4/ / Permittee Signature: j/P47 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 CE A .. ,-kt- . ..,.....:•,"4-,-.,.e1.•(; -.. . :.,... , ,F,,, - • — Fire Protection System RE • -4::q;• tINEYt*,..MA,4"... - 7.:--f , ' . "' . ' .•::::;',....:,' City of Tigard AUG ©3 2310 Received r" : /6 Date/By: . yr Pemnt No.: P p41/0',0408-- 1- , Tigard, 71 125 SW Hall Blvd. Tigard OR 97223 Plan Revie% P • / "....: Phone: 503.639.4171 Fax: 503.598.1960, Date/By: AP" 5/f 10 Other Permit: TIGARD Inspection Line: 503.639.4175 ulTY OF TIGARD Date Rea. , : . Juris: 0 See Page 2 for ,,:,•, Internet: www.tigard BUILDING DIVISION Notified/Method: Supplemental Information . . ' .. ......:::'...: ':'' ';'.' - ' " '''' . '":' : !-:' j ';.,--,,:'-:,,-'''' - ','' - - - •• - - RiQii.IR:E DID D New construction [1] Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all [S] Addition/alteration/replacement III Other: equipment, materials, labor, overhead, and the profit for the ,„,.,, . ,..,,,,, f ,..,.. ::: :•:,. : -,,..• ,.-_,,*:-: ... . —: ,,',,. -; ': • •,• , •,.- ::• _ ,:-% :.:,?-, 1;' , iri 4 ,: •;.'. . ' ' ...: , , , , ,.- work indicated on this application. !-::••:•:::;.,:.::.=;,,.,::,_.> .,',,: cATTPqRyj.0 IN:, : ,, • .• -::: Valuation: $ III 1- and 2-family dwelling -t3,Commercial/industrial Number of bedrooms: ID Accessory building 0 Multi-family 0 Master builder [S] Other: Number of bathrooms: •:- , . , ':. , .L :.: .. ... . . .. .. .. . . .. . ...... . : JOB .SITE;INFPRMATIoTi ,ANDj-A:TIO,Nir,•:::,:; --, ,-..,. : : • . Total number of floors: Job site address: 5,\k) cry '(3 New dwelling area: square feet City/State/ZIP: I , ire , Garage/carport area: square feet Suite/bldg./apt. no.L Project nam • E...,$\ El.p cureers , Covered porch area: square feet Cross street/directions to job site: ‘ e ,, Deck area: square feet .903 HA —NA& Other structure area: square feet REQUIRED tiAtAzi,'COMI012.CIO8E•tiftGiOAS*'-:::l 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'' s '.4 ,` 4: -,' :.,' .'' ,.,',- ,'", - ' " • , - -. ' ,' work indicated on this application. • ..... ', it fi ILiVr. ■ .44 0t , WA E.M : ' tt.// -..r Valuation: $ ---sk)-1 'D0,59 Li Existing building area: square feet New building area: square feet .;'''; '....: 410PBR'Jir.-bWN:Bttr:Y:'' :' ::•.•':. :',' :. - :.,' ' I Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone: ( ) Fax: ( ) Nev • - . - '•-• • i 0: •• :,-, ..--,': •,- .,-:• ::::. • - • '• • ::- ' ,• - . - . • ' : ' •-•:- :,! ,• '''• ' ' , --• ! -- '..:..., , •-• .• ' ;.-,- ! NOTICE Business name: ' , ll 1 - ,\ ,., 1 \ : ,. All contractors and subcontractors are required to be Contact name: licensed with the 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 applicant is exempt from licensing, the following reasons City/State/ZIP: apply: Phone: ( ) Fax: E-mail: . „ . .. . . • ,.,,,,..,. • • -.,,. , -, • •• . . '• - CONTRACTOR :-..'.:' . • . • • . . BUILDING PERMIT FEES!' . ..' •• ,- :,' .' ". • - - . _ ,,,.. , . •• . , . , , (Please'rgfer to . .f&;!j'ehlfyle .. : ., : ''';." Business name: CA..k?_kSTet, S,0 CA....C-Criit.1c c..7 e. Pemnt fee: - 7 - 2 . i I Address: „ e _ ot , . .,„ . . . Li -,-D q , 3 , State surcharge (12% of permit fee): City/State/ZIP: 0 9 . 11 ... f tt\s 0 t 0 a_ • s k FLS plan review (40% of permit fee): Phone: ( 5 ) 4 I 0 - 3-2, ....,00 Fax: (:> 5 Ltk 9 - 33 3' (Due upon application.) <- S I I 2 ? ) CCB lic.: 95 s Total permit fees: nim / / , , 41 Amount received: Authonzed signa This permit application expires if a permit is not obtained 1 . Print name: ga, tier Bt?..%)et•-)€-: I Date: / ,i • within 180 days after it has been accepted as complete. * Fce methodolo2y set by TT i-County Building Industry Ser..' iCc! Boa' d. I: \BaildingTermits FPS-Po doc 10'01/09 140-,6! 7 ' 9:'(.0011\VEB City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only. ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ 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 T - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm 'Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ J It 1 1 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. G \Documents and Settings \BBruene.CHRISTENSON\Local Settings\ TemporaryInterget Files \ Content.Outlook\ YWODX2WD \ City of Tigard Fire Alarm.doc 10/01/09 III C ° Building Division - Over- The - Counter (OTC) Building Permit T i c ii o Check List Description of Project: GENERAL INFORMATION Class of Work:* /j -r Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* COM First floor: N: S: Type of Construction: Second floor: E: W: Occupancy Group: Third floor: Openings Protected Y /N ?: Occupancy Load: -- Total sq ft.: N: S: Stories: Note: Combine total floor area for , E: E:, Height: all floors above third floor and Roof Construction: Floor Load: add to the third floor s ft. Fire Retardant: Basement Basement: Area Separation Rated: Mezzanine: Garage: Occu. Separation Rated: REQUIRED . Fire sprinkler: ceE Handicap access: Smoke detector: Protected corridors: Fire alarm: Parking spaces ( #): • Notes: Total Valuation: $ (� INSPECTIONS BEES DUE Footing/foundation Firewall $ Permit Fee Post /beam structural Smoke detector $ State Surcharge Shear wall Misc. inspection $ ' 1 ,2Q Plan Review Fee Masonry Approach /sidewalk $ FLS Plan Review Fee Framing $ Additional Permit Fee Insulation Sprinkler rough -in $ Additional Plan Review Fee Gyp board Fire alarm $ Metro Construction Excise Tax Suspended ceiling Sprinkler final $ School Construction Excise Tax Final inspection $ Misc. Fee $ Hourly Rate Fee $` Hourly Rate State Surcharge $ Other: $ f (8 ,5 ------ Total Fees Due . *OPTIONS: TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK ACS =accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo; FND = foundation; FPS =' fire ,protection system; NEW = new OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = • repair. I: \Building \Forms \OTC - BUP.doc 08/19/08 ° r/05 ,20 2. FIRE ALARM SYSTEM RECORD OF COMPLETION To be completed by the system installation contractor at the time of system acceptance and approval. 1. PROTECTED PROPERTY INFORMATION Name of property: (o)ej Z Address: �DL20 SC C r c.� \ ✓rc �1. 'rc O O. 572Z �u�f>~ - C{!d Description of property: 0 4 .< C3 1 c1 c, J Occupancy type: 12 " G "„ Name of property representative: St, �r<., g e .\■ at 0%1 Address: ( 02°U Sw G ^cC.-1 srT ' 4. 4 0 e7. ci 2 Phone: Fax: E -mail: Authority having jurisdiction over this property: Phone: Fax: E -mail: 2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION Installation contractor for this equipment: C trr S o._ -c 2[ c_ The_ Address: • .Lx • — ' 3 Phone: : Fax: S o 3 / i ct — ff 3.:? E -mail: Co C1n x ts"T e ni S., LA Co v Service organization for this equipment: S r‘A f ('c nf7 R Address: 3 ��� S G1 (Lel et,uc,�;Z /� t C ( fit 0 ., We f a 6 �1 • '7 S Phone: S�' k 3 $ Fax: E -mail: Location of as -built drawings: Location of historical test reports: Location of system operation and maintenance manuals: A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: Address: Phone: Fax: E -mail: Contract expires: Contract number: Frequency of routine inspections: 3. TYPE OF FIRE ALARM SYSTEM OR SERVICE NFPA 72 Chapter Reference of System Type: S 17A �'� Name of organization receiving alarm signals with phone numbers (if applicable): n Alarm: .-y (r < C r .rte. I I Phone: 8 9g C ' 7F� e Supervisory: I ' Phone: 1/ Trouble: / ( Phone: Entity to which alarms are retransmitted: Phone: Method of retransmission of alarms to that organization or location: Reprinted with permission from NFPA 72, National Fire Alarm Code®, Copyright ©2002, National Fire Protection Association, Quincy, MA 02169. This reprinted material is not the complete and official position of the National Fire Protection Association on the referenced subject which is represented only by the standard in its entirety. © 2007 National Fire Protection Association SG24 -2 -014 Rev. (10/07) (p.1 of 5) NATIONAL FIRE ALARM CODE 3. TYPE OF FIRE ALARM SYSTEM OR SERVICE (continued) If Chapter 8, note the means of transmission from the protected premises to the central station: igital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio ❑ 1 -way radio ❑ N/A If Chapter 9, note the type of connection: ❑ Local energy ❑ Shunt 0 N/A 3.1 System Software Operating system (executive) software revision level: N//3 Site - specific software revision date: Revision completed by: 4. SIGNALING LINE CIRCUITS Characteristics of signaling line circuits connected to this system (see NFPA 72, Table 6.6.1): Quantity: Style: Class: 5. ALARM - INITIATING DEVICES AND CIRCUITS Characteristics of initiating device circuits connected to this system (see NFPA 72, Table 6.5): Quantity: Style: Class: 5.1 Manual initiating devices 5.1.1 Manual Pull Stations Number of manual pull stations: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter /A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area XN /A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter N /A Type of smoke detector sensing technology: ❑ Ionization Cl Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: Type of coverage: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter N /A Type of smoke detector sensing technology: ❑ Ionization Cl Photoelectric 5.2.3 Heat Detectors Number of eat detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area STN /A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter N/A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter J/A 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is: ❑ Enabled Disabled Cl Set for seconds Reprinted with permission from NFPA 72, National Fire Alarm Code®, Copyright ©2002, National Fire Protection Association, Quincy, MA 02169. This reprinted material is not the complete and official position of the National Fire Protection Association on the referenced subject which is represented only by the standard in its entirety. © 2007 National Fire Protection Association SG24 -2 -014 Rev. (10/07) (p.2 of 5) • FUNDAMENTALS OF FIRE ALARM SYSTEMS 6. SUPERVISORY SIGNAL - INITIATING DEVICES AND CIRCUITS 6.1 Sprinkler System Number of valve supervisory switches: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter /A 6.2 Fire Pump Type of fire pump: ❑ Electrical ❑ Diesel Type of pump supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter 4JA Fire Pump Functions Supervised ❑ Fire pump power ❑ Fire pump running ❑ Fire pump phase reversal ❑ Selector switch not in auto ❑ Engine or control panel trouble ❑ Low fuel Other: 6.3 Engine- Driven Generator Type of generator supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A ❑ Engine or control panel trouble ❑ Generator running ❑ Selector switch not in auto ❑ Low fuel Other: 7. ANNUNCIATORS 7.1 Annunciator 1 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic AN /A Location: • 7.2 Annunciator 2 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic 1-4,/A Location: 7.3 Annunciator 3 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic ,N/A Location: 8. ALARM NOTIFICATION DEVICES AND CIRCUITS 8.1 Emergency Voice Alarm Service Number of single voice alarm channels: ( Number of multiple voice alarm channels: Number of speakers: Number of speaker zones: 8.2 Telephone Jacks Number of telephone jacks installed: Number of telephone handsets stored on site: Type of telephone system installed: ❑ Electrically powered ❑ Sound powered ❑ N/A 8.3 Nonvoice Audible System Characteristics of notification device circuits connected to this system (see NFPA 72, Table 6.5): Quantity: i Style: Class: Reprinted with permission from NFPA 72, National Fire Alarm Code®, Copyright ©2002, National Fire Protection Association, Quincy, MA 02169. This reprinted material is not the complete and official position of the National Fire Protection Association on the referenced subject which is represented only by the standard in its entirety. © 2007 National Fire Protection Association SG24 -2 -014 Rev. (10/07) (p.3 of 5) NATIONAL FIRE ALARM CODE 8. ALARM NOTIFICATION DEVICES AND CIRCUITS (continued) 8.4 Types and Quantities of Nonvoice Notification Appliances Installed Bells: With visual device Horns: With visual device: Chimes: With visual device Bells: With visual device: Visual devices without audible devices: 1 Other (describe): 9. EMERGENCY CONTROL FUNCTIONS ACTIVATED ❑ Hold -open door releasing devices ❑ Smoke management or smoke control ❑ Door unlocking ❑ Elevator recall ❑ Other 10. SYSTEM POWER SUPPLY 10.1 Primary Power Nominal voltage t 2c, cir4-c._ Amps g-'" rIve, Overcurrent protection: Type grcAke,- Amps 7_r ei.pi Location (of primary supply panelboard): Disconnecting means location: 10.2 Secondary Power . Location: Type: Nominal voltage: 2`", le_ Current rating: S' ft n• n Number of standby batteries: - Z Amp hour rating: 32 Location of emergency generator: Location of fuel storage: Calculated capacity of secondary power to drive the system In standby mode: 2 q 6.,r; In alarm mode: s ---- 11. RECORD OF SYSTEM INSTALLATION Fill out after all installation is complete and wiring has been checked for opens, shorts, ground faults, and improper branching, but before conducting operational acceptance tests. The system has been installed in accordance with the following NFPA standards: (Note any or all that apply.) ❑ NFPA 72 Cl NFPA 70, National Electrical Code, Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): System dev ' from referenced NFPA standards: Signed: �� � Printed name: �Ue 7 K S_ z.✓th �•�Date: � I) c �t 4 Organization: 1 ir s kS e 6 Le 12.i c Title: S e_ �..,; i L - re-cf., Phone: S:a3 / 4 i y -:33 00 12. RECORD OF SYSTEM OPERATION All operational features and functions of this system were tested by or in the presence of the signer shown below, on the date shown below, and were found to be operating properly in accordance with the requirements of: N FPA 72 NFPA 70, National Electrical Code, Article 760 anufacturer's published instructions ❑ Other (please specify): ,latTs,,o cument o in a rdanc wit spection and Testing Form (Figure 10.6.2.3) is attached Signed: Printed name: Om (pi- VtG 2 ,- Date: 2c' /0 Organization: i Title: 'Tt p Phone: S 7 j 4 Reprinted with permission from NFPA 72, National Fire Alarm Code ®, Copyright ©2002, National Fire - Protection Association, Quincy, MA 02169. This reprinted material is not the complete and official position of the National Fire Protection Association on the referenced subject which is represented only by the standard in its entirety. © 2007 National Fire Protection Association SG24 -2 -014 Rev. (10/07) (p.4 of 5) ° ., • FUNDAMENTALS OF FIRE ALARM SYSTEMS 13. CERTIFICATIONS AND APPROVALS 13.1 System Installation Contractor This system pectlte`d herein has been installed and tested according to all NFPA standards cited herein. Cr� Signed: T Printed name: '¢i d -y S. Ke vt vt z3 Date: 9.�r� / Organization: V`C� T c t�< < ►t Exec ir'1t t:_ , Title: S=mot c-e-_ "r t dL.. Phone: __co-R/ 4 ( — 13.2 System Service Contractor This system . r s.e ierei as been installed and tested according to all NFPA standards cited herein. Signed: Jid.� Printed name: / She' Jr Date: 1 S - ' 20 • I V Organiza ion: S M ple/ r • n eNQ Title: + 1✓cL' aP Phone: 7 °an •It 13.3 Central Station This system as specified herein will be monitored according to all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: 13.4 Property Representative I accept this system as having been installed and tested to its specifications and all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: 13.5 Authority Having Jurisdiction I have witnessed a satisfactory acceptance test of this system and find it to be installed and operating properly in accordance with its approved plans and specifications, its approved sequence of operations, and with all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: ' 5 G A C Reprinted with permission from NFPA 72, National Fire Alarm Code®, Copyright ©2002, National Fire Protection Association, Quincy, MA 02169. This reprinted material is not the complete and official position of the National Fire Protection Association on the referenced subject which is represented only by the standard in its entirety. . © 2007 National Fire Protection Association SG24 -2 -014 Rev. (10/07) (p.5 of 5)