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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 11 1 COMMUNITY DEVELOPMENT Permit #: FPS2011 -00017 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/08/2011 Parcel: 1 S135AB04500 Jurisdiction: Tigard Site address: 10250 SW GREENBURG RD Project: Four Lincoln Subdivision: LINCOLN BUILDING Lot: 0 Project Description: Installation of AES brand low voltage UL fire radio to monitor existing fire panel and existing equipment. For entire building. Contractor: ADVANTAGE PROTECTION INC Owner: LINCOLN CENTER LLC 8510 -C EAST MILL PLAIN BLVD BY SHORENSTEIN PROPERTIES LLC VANCOUVER, WA 98664 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 360 - 695 -5072 PHONE: FAX: 360 - 696 -2901 FEES Description Date Amount Specifics: Permit Fee - COM 04/08/2011 $64.54 12% State Surcharge - Building 04 /08/2011 $7.74 Type of Use: COM Plan Review - Fire Life Safety - COM 02/15/2011 $25.82 Class of Work: ALT Type of Const: 1IB Info Process /Archiving - Sm Sheet (up to 04/08/2011 $5.50 Occupancy Grp: B Height: ft 11x17) 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: Yes Alarm Type: Automatic Pull Station Required: Yes Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Yes Total $103.60 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $950.00 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 503.639.4175 by 7:00 a.m. for the next available inspection 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 Applicatior Fire Protection System FOR OFFICE USE ONLY /� n City of Tigard RECEIVE By . '5- �, „ Permit No.: �/� —� /7 • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 777 vw r Phone: 503.718.2439 Fax: 503.598.1960 Date /By: Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready /By: 2 Juns: H See Page 2 for Internet: www.tigard- or.gov Notified/Method: !// Supplemental Information 4 w /4Kc- -!'L, TYPE OF WORK O U I L ,t \ u j, i V I S I )Nt REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction El 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. El 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: 10250 SW GREENBURG ROAD New dwelling area: square feet City/State /ZIP: TIGARD /OREGON/97223 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 4 LINCOLN 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: 1 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. INSTALLATION OF AES BRAND LOW VOLTAGE UL FIRE RADIO TO MONITOR Valuation: $950 EXISTING FIRE PANEL AND EXISTING EQUIPMENT Existing building area: square feet New building area: square feet t bi,.r r Number of stories: Name: Lincoln Center, LLC Type of construction: Address: PO Box 541 Occupancy groups: City/State /ZIP: Arlington/ VA/ 22216 Existing: Phone: (503)619 -3100 Fax: ( ) New: ' � av�,- ,u. � r : " . Via: � r:.Y�d P � �¢ t � r�� ;. Business name: Advantage Protection, Inc. All contractors and subcontractors are required to be Contact name: Jason Keller licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 8510 -C East Mill Plain Blvd jurisdiction in which work is being performed. If the City/State /ZIP: Vancouver/ WA/ 98664 applicant is exempt from licensing, the following reasons apply: Phone: (360) 695 -5072 Fax: : (360) 696 -2901 E -mail: jasonkeller@advproinc.com CONTRACTOR BUILDING PERMIT FEES* (Please refer to.fediedule) Business name: Advantage Protection, Inc. Permit fee: Address: 8510 -C East Mill Plain BLvd State surcharge (12% of permit fee): City/State /ZIP: Vancouver/ WA/ 98664 FLS plan review (40% of permit fee): Phone: (360) 695 -5072 Fax: (360) 696 -2901 (Due upon application.) CCB lic.: 114312 Total permit fees: Authorized signature: ,' - Amount received: $ e2 i - This permit application expires if a permit is not obtained Print name: .- 0 ,.. so h Ke,V t. Date: /CI‘ / ` 1 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 02 /01/11 440- 4613T(11/02/COM /WEB) 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 I - 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: $ 950 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. http : / /www.tigard- or.gov /city_haIl/ departments /cd /does /FPS - PermitApp.doc o2 /41 /g PS ZO l(-- o o0/17 Sa.aa. FUNDAMENTALS S OF FIRE ALARM SYSTEMS 72 -33 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: L$ GOIYI Address: t6.1% SO SW 6rete.n6v Road S Description of property: d 4 f . e o Occupancy type: Q ( .11'ne // SS 60 In er« I d ifl 'L G L Name of property representative: •I n e obi Ge n'4e Address: i 0 • Co SW 6r,_ein 6u 14 cs C.� ,54e, 31 Phone: Fax: ~ S E-mail: Authority having jurisdiction over this property: C 9 ,/ o4 Pzar4 Phone: Fax: E-mail: 2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION Installation contractor for this equipment: AA vows)! ta 9 e. f o4 £ G .4- Oh - 11% G. w Address: 8 51t>� -t� FQS4 rt1i1 P�Air &/% t Vcir Govver WA Phone: 360 6q5-3074. Fax: 3 6 D " t17 96-1901E-mail: Service organization for this equipment: (f A WIC AS a 60VG) Address: Phone: Fax: E -mail: Location of as -built drawings: N /A / Location of historical test reports: Location of system operation and maintenance manuals: 'r A A contract for test and inspection in accordance with NFPA standards is in effect as of A Contracted testing company: N /i�l Address: Phone: Fax: E -mail: Contract expires: Contract number: Frequency of routine inspections: 3. TYPE OF FIRE ALARM SYSTEM OR SERVICE c NFPA 72 Chapter Reference of System Type: ^ P J4 G4 U O Y% $ II 6.3. S Name of organization receiving alarm signals with phone numbers (if applicable): Alarm: Ael Vekti4w8 PrATG GTI On I n .. Phone: 3 60 — 6 9.5— SO 71 Supervisory: V Phone: Trouble: Phone: Entity to which alarms are retransmitted: Y1 Oh G Phone: Method of retransmission of alarms to that organization or location: © 2007 National Fire Protection Association NFPA 72 (p. 1 of 5) 2007 Edition la 72-34 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: U Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio 1-way radio U N/A if Chapter 9, note the type of connection: Local energy U Shunt 0 N/A 3.1 System Software Operating system (executive) software revision level: N/A 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 U Coded ❑ Transmitter U N/A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: Type of coverage: LI Complete area U Partial area U Nonrequired partial area U N/A Type of devices: U Addressable ❑ Conventional U Coded ❑ Transmitter U N/A Type of smoke detector sensing technology: ❑ Ionization 0 Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: Type of coverage: Type of devices: U Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization 0 Photoelectric 5.2.3 Heat Detectors Number of heat detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area U N/A Type of devices: U Addressable U Conventional ❑ Coded 0 Transmitter 0 N/A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: Type of devices U Addressable U Conventional 0 Coded ❑ Transmitter ❑ N/A 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is: U Enabled U Disabled 0 Set for seconds © 2007 National Fire Protection Association NFPA 72 (p. 2 of 5) L3 2007 Edition FUNDAMIENTAI. S OF FIRE ALARM SYSTEMS 72 -3n 6. SUPERVISORY SIGNAL - INITIATING DEVICES AND CIRCUITS 6.1 Sprinkler System Number of valve supervisory switches: Type of devices: ❑ Addressable O Conventional U Coded U Transmitter O N/A 6.2 Fire Pump Type of lire pump: 0 Electric O Diesel Type of fire pump supervisory devices: ❑ Addressable O Conventional O Coded 0 Transmitter 0 N/A Fire Pump Functions Supervised ❑ Fire pump power O Fire pump running ❑ Fire pump phase reversal ❑ Selector switch not in auto O Engine or control panel trouble O Low fuel Other: 6.3 Engine- Driven Generator Type of generator supervisory devices: 0 Addressable ❑ Conventional ❑ Coded ❑ Transmitter O N/A U Engine or control panel trouble O Generator running 0 Selector switch not in auto O Low fuel Other: 7. ANNUNCIATORS 7.1 Annunciator 1 ❑ Local 0 Remote Type: O Addressable ❑ Directory ❑ Graphic 0 N/A Location: 7.2 Annunciator 2 ❑ Local ❑ Remote Type: ❑ Addressable O Directory U Graphic 0 N/A Location: 7.3 Annunciator 3 O Local ❑ Remote Type: U Addressable O Directory O 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 0 N/A 8.3 Nonvoice Audible System Characteristics of notification deuice circuits connected to this system (see NFPA 72, Table 6.5): Quantity: Style: Class: CO 2007 National Fire Protection Association NFPA 72 (p. 3 of 5) 2007 Edition f • 72 -31i NA JONA1. FIRE ALARM (;ODE 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: Other (describe): 9. EMERGENCY CONTROL FUNCTIONS ACTIVATED ❑ Hold -open door releasing devices 0 Smoke management or smoke control 0 Door unlocking ❑ Elevator recall Cl Other 10. SYSTEM POWER SUPPLY 10.1 Primary Power Nominal voltage Amps 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: X 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, National Electrical Code, Article 760 91C.Manufacturer's published instructions 0 Other (please specify): System devi: ".n . , u ed NFPA standards: C Si: , : Printed name: / J P(` Date: It f '7/1/ Organiza on: ,+41 ' J ► 'L't oN Title: C`AA pt O,M s ,144 Phone: ?6C.) ?e) 9— )2 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: D NFPA 72 0 NFPA 70, National Electrical Code, Article 760 O Manufacturer's published instructions 0 Other (please specify): ❑ Documentation in accordance with Inspection and Testing Form (Figure 10.6.2.3) is attached Signed: Printed name: Date: Organization: Title: Phone: C) 2007 National Fire Protection Association NFPA 72 (p. 4 of 5) { 2007 Edition FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 - 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: Printed name: Date: Organization: Title: Phone: 13.2 System Service Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: X 13.3 Central Station This system as - . • ct ftlii be monitored according to all NFPA standards cited herein. Sign . �� Printed name: /'oy ( , StieliA) Date: 11/7/ // Organization: if.../ VGA/ PUC C l p t'I"\-,i'itle: () Glk •UNS m16/2 Phone: 366 '90ei ' 72 4 6 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 Authorl aving Jurisdiction I have witn = _ • d a satisfactor > - • ..:.. • :. of this system and find it to be installed and operating properly in accorda , • with its appro ed plans and specifications, its approved sequence of operations, and with all NFPA standard / _ . herein. Signer / •■ 111111 _ Printed name: lf1PR4 Date: / p — I / Organization: - . /il Title:Z / Af&-. ( itl,S/ g- ) Kane: / f /O'?G" / y • 0 2007 National Fire Protection Association NFPA 72 (p. 5 of 5) 2007 Edition 111 / 1 umou1uO :apn1TTbuol ^ TT0J I3:92:TT L. 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