Permit ,, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
! - COMMUNITY DEVELOPMENT Permit #: FPS2011 -00084
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/29/2011
Parcel: 2S 101 DC00200
Jurisdiction: Tigard
Site address: 13535 SW 72ND AVE 200
Project: Optilink Subdivision: 72ND AVE OFFICE BUILDING Lot:
Project Description: Fire alarm.
Contractor: POINT MONITOR CORP Owner: PNWP LLC #2
7869 SW NIMBUS AVE • BY PACIFIC NW PROP LTD PTNSP
BEAVERTON, OR 97008 PO BOX 2206
BEAVERTON, OR 97075
PHONE: 503 - 627 -0100 PHONE:
FAX: 503 - 627 -0110
FEES
Description Date Amount
Specifics: Permit Fee - COM 06/29/2011 $80.68
12% State Surcharge - Building 06/29/2011 $9.68
Type of Use: COM Plan Review - Fire Life Safety - COM 06/29/2011 $32.27
Class of Work: ALT Type of Const: Info Process /Archiving - Sm Sheet (up to 06/29/2011 $5.00
Occupancy Grp: Height: ft 11x17)
Stories:
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: No Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $127.63
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $1,522.00
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.: 44.
Issued By: ittee Signature: ,/
Call 5e irrrf 75 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 0 FOR OFFICE USE ONLY
City of Tigard 11.%.\\ Recei )4,11
Date /B ved 1a Permit No.: ----.0. r
= a .� pi., I/
13125 SW Hall Blvd., Tigard, OR 9 9 Plan R eview
Phone: 503.718.2439 Fax: 503.598.1960 `\� V �` Date /B : '" % Other Permit:
T t G A R D Inspection Line: 503.639 ,\) G �G 40 , ` Date Ready ®
Internet: www.tigard- or.gov o 1 � � Notified /Method: Supplemental Page 2 for lnformation
C.1
TYPE OF WO 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
® 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:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13535 SW 72 Avenue New dwelling area: square feet
City/State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Suite 20t) Project name: Retisliotreguite 200 i ivvii 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.
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.
Install additional notification in an existing Fire Alarm system. Valuation: $$1,522.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: Point Monitor Corporation All contractors and subcontractors are required to be
Contact name: Steve Bruns licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7869 SW Nimbus Ave. jurisdiction in which work is being performed. If the
City/State /ZIP: Beaverton, OR 97008 applicant is exempt from licensing, the following reasons
. apply:
Phone: (503) 626 - 0100 Fax: : (503) 627
E - mail: SBruns @PointMonitor.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: Point Monitor Corporation (Please refer to fee schedule)
Permit fee:
Address: 7869 SW Nimbus Ave.
City/State /ZIP: Beaverton, OR 97008 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 627 - 0100 Fax: (503) 627 - 0110 (Due upon application.)
CCB lie.: 135901 (430/// I Total permit fee i�7 �3
Authorized signature:
Amount received:
'e This permit application expires if a permit is not obtained
Print name: Steven M. Bruns Date: 6/28/11 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board. 4 L \ Building \Permits \FPS- PermitApp.doc 02 /01 /II 440- 4613T(11/02 /COM/WEB) 4 t i 1 c
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 El 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: $ 1522
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: $ 131.63
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
\ \Rodan \shared \Projects - Current \Reduction of Suite 200 \SUBMIT "PALS \FPS- Permi01pp.doc 02/01/11
. .. , Fp5zo 1 / -c_)c)08,e
FIRE ALARM SYSTEM
RECORD OF COMPLETION
,
Name of protected property: 7 2 N � filke c2 A00/(4/
Address: 1 7 5' 6 5k/ 7r.-- Av-e. Say -"c 7ZP
Representative of protected property (nai a /phone): ieetzrec, iii-' ® -'4r
Authority having jurisdiction: -773 arcs
Address /telephone number:
1. Type(s) of System or Service
NFPA 72, Chapter 3 — Local
If alarm is transmitted to location(s) off premises, list where received:
NFPA 72, Chapter 3 — Emergency Voice /Alarm Service
Quantity of voice /alarm channels: Single: Multiple:
Quantity of speakers installed: Quantity of speaker zones:
■ Quantity of telephones or telephone jacks included in system:
NFPA 72, Chapter 6 — Auxiliary
Indicate type of connection:
Local energy Shunt Parallel telephone
Location of telephone number for receipt of signals:
NFPA 72, Chapter 5 — Remote Station
Alarm:
Supervisory:
NFPA 72, Chapter 5 — Proprietary
If alarms are retransmitted to public fire service communications centers or others, indicate location and
telephone numbers of the organization receiving alarm:
I /Indicate how alarm is retransmitted:
v NFPA 72, Chapter 5 — Central Station
Prime contractor:
Central station location:
4 ,A-1 Means of transmission of signals from the protected premises to the central station:
y►^ McCulloh Multiplex One -way radio
I;
r
Digital alarm communicator Two -way radio Others
Means of transmission of alarms to the public fire servic$ communications center:
(a)
(b)
System location:
(NFPA Record of Completion 1 of 4)
•
Organization name /phone Representative name /phone
Installer 4,i N/a, i CO Z- - v l cro
Supplier
/1 /i
Service organization
Location of record (as- built) drawings:
Location of owners manuals:
Location of test reports:
A contract, dated , for test and inspection in accordance with NFPA standard(s)
No(s). , dated , is in effect.
2. Record of System Installation
(Fill out after installation is complete and wiring checked for opens, shorts, ground faults, and improper
branching, but prior to conducting operational acceptance tests.)
This system has � been ipstalled in acco dance with the NFPA standards as shown below, was inspected
by . /P.N Mi - it on _�7 I , includes the devices shown below, and has been in service
7 7 FPA 72, Chapters 1 2 3 4 5 6 7 (circle all that apply)
FPA 70, National Electrical Code, Article 760
Manufacturer's instructions
Other ecify):
Signed: i t� Date: r 9 �A
Organization: A-ML
3. Record of System Operation
All operational features and functions of this system were tested by on ,
an ound to be operating properly in accordance with the requirements of:
NFPA 72, Chapters 1 2 3 4 5 6_ ccle all that apply)
� NFPA 70, National Electrical Code, Article 760
Manufacturer's instructions
_ Othe3
Signed: ��- Date:
Organization:
4. Alarm- Initiating Devices and Circuits
Quantity and class of initiating device circuits (see NFPA 72, Table 3 -5) Quantity: Style: Class:
MANUAL
(a) Manual stations Noncoded, activating Transmitters Coded
(b) Combination manual fire alarm and guard's tour coded stations
AUTOMATIC
Coverage: Complete: Partial:
(a) Smoke detectors Ion Photo
(b) Duct detectors Ion Photo
(c) Heat detectors FT RR FT/RR RC
(NFPA Record of Completion 2 of 4)
(d) Sprinkler waterflow switches: Transmitters Noncoded, activating Coded
(e) Other (list):
5. Supervisory Signal- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
GUARD'S TOUR
(a) Coded stations
(b) Noncoded stations, activating transmitters
(c) Compulsory guard tour system comprised of transmitter stations and
intermediate stations
Note: Combination devices are recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) Coded valve supervisory signaling attachments
Value supervisory switches, activating transmitters
(b) Building temperature points
(c) Site water temperature points
(d) Site water supply level points
Electric fire pump:
(e) Fire pump power
(f) Fire pump running
(g) Phase reversal
Engine - driven fire pump:
(h) Selector in auto position
(i) Engine or control panel trouble
(j) Fire pump running
Engine - driven generator:
(k) Selector in auto position
(1) Control panel trouble
(m) Transfer switches
(n) Engine running
Other supervisory function(s) (specify):
6. Alarm Notification Appliances and Circuits
Quantity and class (see NFPA 72, Table 3 -7) of notification appliance circuits connected to the system:
Types and quantities of notification appliances installed: Quantity: Style: Class:
(a) Bells Inch
(b) Speakers
(c) Horns
(d) Chimes
(e) Other:
(NFPA Record of Completion 3 of 4)
• v r
(f) Visual signals Type: i 71 -
9 with audible w/o audible
(g) - Local annunciator
7. Signaling Line Circuits
Quantity and class (see NFPA 72, Table 3 - 6) of signaling line circuits connected to system:
Quantity: Style: Class:
8. System Power Supplies
(a) Primary (main): Nominal voltage: Current rating:
Overcurrent protection: Type: Current rating:
Location:
(b) Secondary (standby):
I I Storage battery: Amp -hour rating:
Calculated capacity to drive system, in hours: 24 60
Engine -driven generator dedicated to fire alarm system:
' ✓ Location of fuel storage:
(c) Emergency or standby system used as backup to primary power supply, instead of using a secondary
power supply:
Emergency system described in NFPA 70, Article 700
Legally required standby system 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
9. System Software
(a) Operating system software revision level(s):
(b) Application software revision level(s):
(c) Revision completed by:
(name) (firm)
10. Comments:
(signed) for central station or alarm service company or installation contractor /supplier (title) (date)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):
System deviations from the referenced NFPA standard(s) are:
(si or central station or alarm service company or installation contractor /supplier (title) (date)
Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
(signed) representative of the authority having jurisdiction (title) (date)
(NFPA Record of Completion 4 of 4)