Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2011 -00015
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/08/2011
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Project: Two Lincoln Subdivision: LINCOLN CENTER/TWO LINCOLN 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: IIB Info Process /Archiving - Sm Sheet (up to 04/08/2011 $5.50
Occupancy Grp: B Height: ft 11x17)
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: 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 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 questi s to OUNC b calli 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 Application
Fire,Protection System RECEIVED FOR OFFICE I SF. O \1.1
City of Tigard
Date/B �� Per No.: r 95,4,, / ! � 4615- 4615- 13125 SW Hall Blvd., Tigard, OR 97223 FEB 1 Plan Review ►+
Phone: 503.718.2439 Fax: 503.598.1960 5 2 01 E DateB : 41 `jA_ Eb Other Permit:
TIGARD
Inspection Line: 503.639.4175 Date Ready : Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notifie ethod: / Supplemental Information
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max
REQUIRED DATA: 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
Z 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: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder 171 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10220 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: 2 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: 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.
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
® PROPERTY OWNER ❑ TENANT 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:
® APPLICANT ® CONTACT PERSON NOTICE
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*
Business name: Advantage Protection, Inc. (Please refer toeeschedale
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:
1 W ,
Authorized signature:
- Amount received: 05 . g�
This permit application expires if a permit is not obtained
Print name: .5.0,SCr \4c,..A\ Date: I (,l' k\ within 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)
•
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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 ❑ Dr<�
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 ��
� e ''
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_hall/departments /cd /docs /FPS- PennitApp.doc 02/01/g
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• FUNDAMENTTA1. S OF FIRE ALARM. SYSTEMS 72 –l3
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: 3 1,1 n 4451111
Address: 1 O? O SW 6 ree n 6‘ R
Description of property : ;1‘ e . �( 101 ■1ng
Occupancy type: property
1 Y1e SS j Gene red 0
Name of property representative: L h G Q/n Ce rT f / Z. L. L
Address: .f 6 (1ei►Q .S W & re e n 6 e. r3 Ro a o 1 1 J / c. 210
Phone: Fax: E -mail:
Authority having jurisdiction over this property: L s C t $ r;
Phone: Fax: E -mail:
2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION
Installation contractor fur this equipment: Ate►% O Y'l t Aq e. p t 4t CM 111 C
Address: 8 510 e S -C./ ,41 11 Plain MV I Valr1 GOV Vtr WA
Phone: 360' — SGTd Fax: 3 6 0 •• 6 96-1901E -mail:
Service organization for this equipment: (-S hind AS A • Cove.)
Address:
Phone: Fax: E -mail: .
Location of as -built drawings: N /A Location of historical test reports:
Location of system operation and maintenance manuals: ~ /4
A contract for test and inspection in accordance with NFPA standards is in effect as of 1'
Contracted testing company: ° VA
Address:
Phone: Fax: E -mail:
Contract expires: Contract number: Frequency of routine inspections:
3. TYPE OF FIRE ALARM SYSTEM OR SERVICE
NFPA 72 Chap.ter Reference of System Type: 11 Si G � ∎ O h '3 . 6. 3. S
Name of organization receiving alarm signals with phone numbers (if applicable):
Alarm: AOI VAnTwa VV a. Ned' k on I n .. Phone: 360 - 69S - SO Vek
Supervisory: Phone:
Trouble: Phone:
Entity to which alarms are retransmitted: h O h e. Phone:
Method of retransmission of alarms to that organization or location:
® 2007 National Fire Protection Association NFPA 72 (p. 1 of 5)
2007 Edition iris
72 —:i4 NAT70NAL FIRE ALARM IX)l)L
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:
0 Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio1 -way radio U N/A
If Chapter 9, note the type of connection: Local energy U Shunt 0 N/A
3.1 System Software N J
Operating system (executive) software revision level: /1
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 0 Conventional 0 Coded ❑ Transmitter 0 N/A
5.2 Automatic Initiating Devices
5.2.1 Area Smoke Detectors Number of smoke detectors:
Type of coverage: U Complete area 0 Partial area ❑ Nonrequired partial area U N/A
Type of devices: 0 Addressable ❑ Conventional 0 Coded U Transmitter 0 N/A
Type of smoke detector sensing technology: 0 Ionization 0 Photoelectric
5.2.2 Duct Smoke Detectors Number of duct smoke detectors:
Type of coverage:
Type of devices: 0 Addressable 0 Conventional ❑ Coded 0 Transmitter ❑ N/A
Type of smoke detector sensing technology: U Ionization ❑ Photoelectric
5.2.3 Heat Detectors Number of heat detectors:
Type of coverage: U Complete area 0 Partial area 0 Nonrequired partial area 0 N/A
Type of devices: 0 Addressable U Conventional 0 Coded 0 Transmitter 0 N/A
5.2.4 Sprinkler. Waterflow Detectors Number of waterflow detectors:
Type of devices 0 Addressable 0 Conventional O Coded 0 Transmitter 0 N/A
5.2.5 Alarm Verification Number of devices subject to alarm verification:
Alarm verification on this system is: ❑ Enabled ❑ Disabled ❑ Set for seconds
® 2007 National Fire Protection Association NFPA 72 (p. 2 of 5)
la 2007 Edition
• •
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -35
6. SUPERVISORY SIGNAL - INITIATING DEVICES AND CIRCUITS
6.1 Sprinkler System Number of valve supervisory switches:
Type of devices: 0 Addressable ❑ Conventional U Coded ❑ Transmitter 0 N/A
6.2 Fire Pump
Type of fire pump: ❑ Electric ❑ Diesel
Type of fire pump supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded 0 Transmitter 0 N/A
Fire Pump Functions Supervised
❑ Fire pump power ❑ Fire pump running ❑ Fire pump phase reversal ❑ Selector switch not in auto
O Engine or control panel trouble 0 Low fuel
Other:
6.3 Engine - Driven Generator
Type of generator supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter 0 N/A
0 Engine or control panel trouble 0 Generator running 0 Selector switch not in auto 0 Low fuel
Other:
7. ANNUNCIATORS
7.1 Annunciator 1 ❑ Local O Remote
Type: ❑ Addressable ❑ Directory ❑ Graphic O N/A Location:
7.2 Annunciator 2 U Local 0 Remote
Type: 0 Addressable ❑ Directory O Graphic ❑ N/A Location:
7.3 Annunciator 3 U Local ❑ Remote
Type: 0 Addressable 0 Directory 0 Graphic O 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: 0 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:
O 2007 National Are Protection Association NFPA 72 (p. 3 of 5)
2007 Edition °
•
• 72 -36 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: 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 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.)
X.NFPA 72 NFPA 70, National Electrical Code, Article 760
Manufacturer's published instructions ❑ Other (please specify):
System devi:' ' o , • ed NFPA standards:
_
Si • - � / Printed name: /1-7 J t Date: /I / 7/ 1/
Organiza on: 4 ' 60 j' A OL A CC ) Title: CA01 41.-C / Phone: ?60 5'09 )2G'0
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, National Electrical Code, Article 760
❑ Manufacturer's published instructions ❑ 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)
El 2007 Edition
' Ft:NDAMEN1ALS OF FIRE ALARM SYSTEMS 72 -37
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 • . • tai be monitored according to all NFPA standards cited herein.
Sign` . . � � Printed name: 2 / ` .. !NN Date: /1/7/ d Organization: itilltAAI FU Cc P/`-ol c;k e.N.Pritle: evihreopeLyas m6/2 Phone: .3 ' -, a4 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 Author / Having Jurisdiction
I have wi . • _ : ed a satisfactory a • • . :ice test of this system and find it to be installed and operating properly
in accord: . with its ap Ill v .lane and specifications, its approved sequence of operations, and with all NFPA
standar.. , -d herein.
Signe- � ��� � �� � Printed name:
CAP [RA2 ft/ ( c, I Date: //— !' V
Organization: 4�+ Al •, ' I 0 Title: eQ ic..� , #'.J' / A !Si 'hone: "I e 8 - -e-4'Yy
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® 2007 National Are Protection Association NFPA 72 (p. 5 01 5)
2007 Edition 51
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