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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 1 114 COMMUNITY DEVELOPMENT Permit #: FPS2011 -00005 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011 Parcel: 2S113AB00101 Jurisdiction: TIGARD Site address: 16101 SW 72ND AVE 130 Project: Siemens Subdivision: PACTRUST BUSINESS CENTER Lot: 0 Project Description: Installing (4) horn strobes and (2) strobes to existing fire alarm. Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACIFIC REALTY ASSOCIATES 15495 SW SEQUOIA PKWY STE 100 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PORTLAND, OR 97224 PHONE: 503 - 968 -3353 PHONE: 503 - 624 -6300 FAX: 503 - 968 -3398 FEES Description Date Amount Specifics: Permit Fee - COM 01/11/2011 $69.92 12% State Surcharge - Building 01/11/2011 $8.39 Type of Use: COM Plan Review - Fire Life Safety - COM 01/11/2011 $27.97 Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg Sheet (over 01/11/2011 $6.00 Occupancy Grp: B Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Yes Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $112.28 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $1 ,200.00 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 s ification b-nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or d' ect questions to O ► . • • al ' - , 503.232.1987 or 1.800.332.2344. ` ( Is- ed By: k a /�• Permittee ' - � IL mar Call 503.639.4175 by 7:00 a.m. for the next availabl ' pection 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. Building Permit Application Fire Protection System FOR OFFICE USE ONLY e City of Tigard � � Rec Date/B ived : Permit No.: l ig 1 ' 13125 SW Hall Blvd., Tigard, OR 972 . Plan ReviCW•• I . Phone: 503.639.4171 Fax: 503.5' :11 Date/By: - 7 H Other Permit: f 110 _ Li l ' I t.:1 It l� Inspection Line: 503.639.4175 Date Rea. • :y: Jun:: H See Page 2 for Internet: www.tigard- or.govt < - Notified/Method: 1U' Supplemental Information TYPE OF W01% REQUIRED DATA 1- AND 2-FAMILY DWELLING ❑ New construction ❑ 1)tion 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: $ El Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 16101 SW 72 AVE, SUITE 130 New dwelling area: square feet City/State /ZIP: PORTLAND, OREGON 97224 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: SIEMENS REAL ESTATE Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA 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 FOUR HORN STROBES AND TWO STROBES TO EXISTING FIRE Valuation: $$1,200.00 SYSTEM BOOSTER Existing building area: square feet New building area: 3512 square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: PACIFIC REALITY ASSOCIATES Type of construction: Address: 15350 SW SEQUIOA PARKWAY Occupancy groups: City/State /ZIP: PORTLAND, OREGON 97224 Existing: Phone: ( ) Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: STANLEY SECURITY SOLUTIONS All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: GARY TAUSCHER under ORS 701 and may be required to be licensed in the Address: 15495 SW SEQUOIA PARKWAY jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/State /ZIP: PORTLAND, OREGON 97224 apply: Phone: (503) 968 -3355 Fax: : (503) 968 -3398 E -mail: GTAUSCHER @STANLEYWORKS.COM CONTRACTOR rx r`" BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: STANLEY SECURITY SOLUTIONS Permit fee: Address: 15495 SW SEQUOIA PARKWAY State surcharge (12% of permit fee): City/State/ZIP: PORTLAND, OREGON 97224 FLS plan review (40% of permit fee): Phone: (503) 968 -3355 Fax: (503) 968 -3398 lX (Due upon application.) Total permit fees: i(), ) D CCB lic.: 161567 ilP Amount received: .)-- / )t Authorized signature: This permit application expires if a permi is not obtained �'�� � within 180 days after it has been accepted as complete. Print name: GARY TAUSCHER ' Date: 01/11/20110 * Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \Permits\FPS- PermitApp.doe 03/23/06 440- 4613T(11/02 /COM/WEB) v CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT ''7 COMMUNITY DEVELOPMENT Permit #: FPS2011 -00005 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011 Parcel: 2S 113AB00101 Jurisdiction: TIGARD Site address: 16101 SW 72ND AVE 130 Project: Siemens Subdivision: PACTRUST BUSINESS CENTER Lot: 0 Project Description: Installing (4) horn strobes and (2) strobes to existing fire alarm. Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACIFIC REALTY ASSOCIATES 15495 SW SEQUOIA PKWY STE 100 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PORTLAND, OR 97224 PHONE: 503 - 968 -3353 PHONE: 503 - 624 -6300 FAX: 503 - 968 -3398 FEES Description Date Amount Specifics: Permit Fee - COM 01/11/2011 $69.92 12% State Surcharge - Building 01/11/2011 $8.39 Type of Use: COM Plan Review - Fire Life Safety - COM 01/11/2011 $27.97 Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg Sheet (over 01/11/2011 $6.00 Occupancy Grp: B Height: ft 11x17) Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Yes Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $112.28 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $1,200.00 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 503.232.1987 or 1.800.332.2344. Issued By: ( Permittee Signature: Call 50 • .4175 by 7:00 a.m. for the next availab nspe ' n 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. r 1 14 Building Division Over- The - Counter (OTC) Building Permit TIGARD Check List Description of Project: 1,,C-( GENERAL INFORMATION Class of Work:* 4 Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* '\ 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: _ _ "� No te: 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 ITEMS Fire sprinkler: (?( Handicap access: Smoke detector: Protected corridors: Fire alarm: 1 Parking spaces ( #): Notes: Total Valuation: $ ( INSPECTIONS FEES DUE Footing/ foundation Firewall $ `` ° 6-2 " - 12---- - Fee Post /beam structural Smoke detector $ � �C . ' f Ir. `5t1 State Surcharge Shear wall Misc. inspection $ a 1 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 $ 1 ,cy Other: )4 HVc $ ,, Total Fees Due _jj,7: I G1 *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 2.--" 50 , ^� �--F~°=v — �� ^ ^ �� \'[ ~~ ~~c90S 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: Oregon Business Park, Bldg A,PnTnn, Address: 16101 Gvv7u Suite ro ____ Description of property: Siement Real Estate Occupancy type: • Name of property representative: Dennis Pagni Address: 15350 SW Sequoia Parkway #300 Phone: 5O3-824'03OO Fuu� E-mail: Authority having jurisdiction ove this property: City of Tigard Phone: 503-639-4171 Fax: E-mail: 2. Fire Alarm System Installation, Service, and Testing Information Installation contractor for this equipment: Stanley Convergent Solutions Address: 15 SW Sequ i Ste. 100, Portland, OR 9 Phone: 5039683300 5039683397 E-mail: | Security Solutions Stanley Convergent nv�H��� @duUo �� _____�____________________ Add,uus: 15495 SW Sequoia Pkwy Ste. 100, Portland, OR 97224 Phone: 5039683300 Fax: 5039683397 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: Stanley Convergent Security Solutions Address: uo 1s4n*uvvuoq� Pkwy s��un.Pomanu.ony7oo4 Phone: 5039683300 Fax: 5039683397 E-mail: Contract expires: � Cvntnmtnumhuc Frequency of routine inspections: 3. Type of Fire Alarm System or Service NFPA 72v, Chapter Reference of System Type: Name of organization receiving alarm signals with phone numbers (if applicable): Alarm: Stanley CSS Phone: 87789e0001 Supervisory: Stanley CSS Phone: 8778990001 Trouble: Stanley CSS Phone: 877e990001 ____�__ Entity to which alarms are retransmitted: Phone: Method of retransmission of alarms to that organization or location: NFPA 72, Fig. 4.5.2.1 (p. 1 of 5) Copyright © 2009 National Fire Protection Association This form may be copied for individual use other than for resale. it may not be copied for commercial sale or distribution. • If Chapter 8, note the means of transmission from the protected premises to the central station: ❑ Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio ❑ 1 -way radio ❑ N/A If Chapter 9, note the type of connection: El Local energy ❑ Shunt ❑ N/A 3.1 System Software Operating system (executive) software revision level: 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 ❑ N/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 ❑ N/A Type of devices: El Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization ❑ 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 ❑ Photoelectric 5.2.3 Heat Detectors Number of heat detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ❑ Addressable ❑ Conventional El Coded El Transmitter ❑ N/A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: Type of devices: ❑ Addressable - ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A • 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is: ❑ Enabled El Disabled ❑ Set for seconds 6. Supervisory Signal Initiating Devices and Circuits 6.1 Sprinkler System Number of valve supervisory switches: Type of devices: ❑ Addressable El Conventional ❑ Coded ❑ Transmitter ❑ N/A NFPA 72, Fig. 4.5.2.1 (p. 2 of 5) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. • 6.2 Fire Pump • Type of fire pump: ❑ Electric ❑ Diesel Type of fire pump supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 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 ❑ N/A Location: 7.2 Annunciator 2 ❑ Local ❑ Remote • Type: ❑ Addressable ❑ Directory ❑ Graphic ❑ N/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: Style: / /✓ . Class: 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: a- Other (describe): NFPA 72, Fig. 4.5.2.1 (p. 3 of 5) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution „ • 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: Overcurrent protection: Type: _ Amps Location (of primary supply panelboard): Disconnecting means location: 10.2 Secondary Power Location: Type: Nominal voltage: Current rating: Number of standby batteries: Amp hour rating: Location of emergency generator: Location of fuel storage: Calculated capacity of secondary power to drive the system In standby mode: In alarm mode: 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`”' ® NFPA 70"', Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): System deviations from referenced NFPA standards: Signed: 2-7'1 Printed name: / 1.i °!r Date: -,2 — Organization: Stanley CSS Title: Fiels Service Technician Phone: 503 - 968 -3300 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: ❑ NFPA 72` ❑ NFPA 70 ® , Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): ❑ Documentation in accor nce with Inspection and Testing Form (Figure 10.6.2.3 of NFPA 72'"') is attached aDate: Signed: �� /� __- Printed name: �,vi Organization: _ Stanley CSS Title: Field Service Technician Phone: 503-968-3355 NFPA 72, Fig. 4.5.2.1 (p. 4 of 5) Copyright 0 2009 National Fire Protection Association This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. 13. Certifications and Approvals 13.1 System Installation Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. • Signed: __..---- ` ; 4 Printed name: 7:441: _ Date: Organization: Stanley CSS Title: Fiels Service Technician Phone: 503 - 968 -3300 13.2 System Service Contractor This system as speci herein h s been installed and tested according to all NFPA standards cited herein. Signed: / Printed name: l , (-�y..i4t, Date: ----)-- _GJ • Organization: Stanley CSS Title: Field Service Technician Phone: 503 - 968 -3300 13.3 Central Station This syste specified herein will be mo 'tored according to all NFPA standards cited herein. Signed: Vilji 1 L ,,_10,._k_ii Printed name: Gary Tauscher Date: Organization: Stan y CSS Title: Operations Manager Phone: 503- 968 -3355 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 Authori , aving Jurisdiction I have witne. ••d a sa ' . acceptance test of this system and find it to be installed and operating properly in accordance with its ap • 7 ed plans.•. pecifica . • • - approved sequence of operations, and with all NFPA standards cited herein. Signed: AMP � Printed name: Gi _ Date: Z_•-2._.-ii Organization: ` m itle: Phone: NFPA 72, Fig. 4.5.2.1 (p. 5 of 5) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution.