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Permit
S . 1 ; CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 1 ' COMMUNITY DEVELOPMENT Permit #: FPS2011 -00096 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/09/2011 Parcel: 1S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 610 Project: New York Life Subdivision: METZGER, TOWN OF Lot: PTS 7 -8 Project Description: Fire alarm Contractor: SAFE TECHNOLOGY GROUP INC Owner: LINCOLN CENTER LLC 6400 NE HWY 99 SUITE G375 BY SHORENSTEIN PROPERTIES LLC VANCOUVER, WA 98665 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 360 - 699 -2130 PHONE: FAX: 360- 719 -1527 FEES Description Date Amount Specifics: Permit Fee - COM 07/26/2011 $156.00 12% State Surcharge - Building 07/26/2011 $18.72 Type of Use: COM Plan Review - Fire Life Safety - COM 07/26/2011 $62.40 Class of Work: ALT Type of Const: IB Info Process /Archiving - Lg Sheet (over 08/09/2011 $10.00 Occupancy Grp: B Height: ft 11x17) Stories: 12 Houlry Building Rate 08/09/2011 $180.00 Hourly Building 12% State Surcharge 08/09/2011 $21.60 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: Yes Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $448.72 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $7,265.00 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 ^ if • •rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utilit otification C- ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or •• rect questions to O■ NC • a - . 503.232.1987 or 1.800.332.2344. i I - sued By: ` I / � 4 ' ,ct,/ f{ PermitteeSignature: JC 4111111111110111111111111111 - - Call 503.639.4175 by 7:00 a.m. for the next available inspec •• n date. This permit card shall be kept in a conspicuous place on the job site u • it completion of the project. Approved plans are required on the job site at the tim: of each inspection. Building Permit Application j Fire Protection System H I 1.1 FOR OFFICE USE ONLY City of Tigard 2 Date/B 7 4 / Permit No.: lig ° 13125 SW Hall Blvd„ Tigard, OR 97223 JUL � % � rA5egev/ of q ! , ,, 0 g Z� 1 Pl an Review �, Other Permit: P 503.639.4171 Fax: 503.598.1960 Date/B : �. /� TI G A RD Inspection Line: 503.639.4175 CITY �L Gl� d OF ! '°"� TI Date Ready T . ions. El ms. Page 2 for Internet: www.tigard or.gov �Jt�1.J Notified/Method: 4 � it Supplemental Information ' G DiVf I i r V " ;T u ' r TYPE ,OF WORK .r; REQUIREDDATA:"1- AND'2- FAMILY DWELLING, ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. x � Indicate the value (rounded to the nearest dollar) of all 1 ® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION,' work indicated on this application. dwelling Valuation: $ ❑ 1- and 2-family g ® Commercial/indusVial ❑ 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: 10260 SW Greenburg Rd New dwelling area: square feet City /State /ZIP: Tigard OR 97223 Garage /carport area: square feet • • Suite/bldg. /apt. no.: 610 Project name: New York Life Covered porch area: square feet • Cross street/directions to job site: Lincoln Tower 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 ,r ;, ": - . work indicated on this application. Fire alarm Valuation: $57,265.00 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: B Phone: ( ) Fax: ( ) New: B • ® APPLICANT .0 :CONTACT 'PERSON - ' . • . . NOTICE Business name: Safe Technology Group Inc. . All contractors and subcontractors are required to be Contact name: Jason Sweet licensed with the Oregon Construction Contractors Board . under ORS 701 and may be required to be licensed in the Address: 6400 NE Hwy 99 Suite G375 jurisdiction in which work is being performed. If the . City /State /ZIP: Vancouver WA 98665 applicant is exempt from licensing, the following reasons apply: Phone: (360) 699 -2130 Fax: : (360) 719 -1527 E -mail: sales @safetechnology.net CONTRACTOR BUILDING PERMIT FEES* . . . Business name: Safe Technology Group Inc. (Pleaserejermjeeschedule ,: Permit fee: Address: 6400 NE Hwy 99 Suite G375 State surcharge (12% of permit fee): City /State /ZIP: Vancouver WA 98665 FLS plan review (40% of permit fee): Phone: (360) 699 -2130 Fax: (360) 719 -1527 (Due upon application.) CCB lic.: 173731 Total permit fees: Authorized signature: 0,5j/L Amount received: 37• I This permit application expires if a permit is not.obtained Print name: Jason Sweet Date: 7 -26 -11 within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry • Service Board. ' I:\Building\Permils\FPS- PermitApp.doc 10/01/09 440- 4613T(I1/02 /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: $ j C.) Fire Alarm . Submittal shall Battery Calculations 12 Yes include: Individual Component 12 Yes Cut Sheets Fire Alarm Project Valuation: $ a L'5 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. \ \ Safeserver \ d$ \ SAFE \ Forms \ Use these forms \Permit Apps \ Tigard \FPS- PemutApp.ctbc 10/01/09 .sz01( 1 —c_D° ° 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 CAC L 1 T-Q 11 Address: [ 0 2 �O SC's) G c c_e_o `` 33.4 -3 �C\ I "C I hA. 6 T 22-3 Description of property: I Occupancy type: g- Bvs 1 IICss G rC' U k ::, • Name of property representative: R..) JSQ I\ ` Q r tcrto r' S ` k c 1 s e/ r C_.1 Address: 0 22-0 SW, '' f e_IA � W c— s A I l f}rA O F q 2_2. _. Phone: Fax: E -mail: Authority having jurisdiction over this property: •TLsiet Phone: Fax: E -mail: 2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFO M ATION Installation contractor for this equipment: Slk� %€C h no (05 ) Y'Cty P I' c � Address: 7 , F Ow1 ( le% Svc G # 3 \i l bAcoJV t. P.._ ' A ( IS-US - Phone: 3lp4) - 6 t 7- Z/ 3 Fax: E -mail: Service organization for this equipment: 6 / p 1-exGr t �1 A Z I' Address: 6305" �. U • 5e- fi (p OS50 �1 p 1O Phone: 'S 6'f - S WOO Fax: E-mail: 4 S 675 65 Location of as -built drawings: OWNS.. Location of historical test reports: O,.J A. Location of system operation and maintenance manuals: C.)W 0-e-- P A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: \ l I pts4( r - r I nF Q_1I Address: PtDASL l' Itic''1e. Phone: Fax: E -mail: Contract expires: ki,P-Ar i Contract number: Frequency of routine inspections: ✓ 1 - AnnVpt- 3. TYPE OF FIRE ALARM SYSTEM OR SERVICE NFPA 72 Chapter Reference of System Type: Name of organizati receiving alarm signals with phone numbers (if applicable): �� Alarm: / 1 1 VI%nT foMTecTler) Phone: 3 Z ?5 ?B Supervisory: Phone: Trouble: f c _ I • cZ 2-1- 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: 0 Digital alarm communicator ❑ McCulloh ❑ Multiplex X2 -way radio 0 1 -way radio ❑ N/A If Chapter 9, note the type of connection: ❑ Local energy ❑ Shunt XN /A 3.1 System Software Operating system (executive) software revision level: / Z' 05 Site - specific software revision date: - -q - / / Revision completed by: c(01 GCI AN l 4. SIGNALING LINE CIRCUITS t x \ STI nq 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 E x\ STI N,3 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 EX 13TI i\ � Number of manual pull stations: WEIPM Type of devices: ❑ Addressable ❑ Conventional 0 Coded ❑ Transmitter 0 N/A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: l \ e.Cn3 ��[[ Type of coverage: 0 Complete area jlJ�Partial area 0 Nonrequired partial area 0 N/A Type of devices: Addressable ❑ Conventional 0 Coded ❑ Transmitter 0 N/A Type of smoke detector sensing technology: ❑ Ionization Photoelectric 5.2.2 Duct Smoke Detectors E 1ST n � Number of duct smoke detectors: `— Type of coverage: x Type of devices: ❑ Addressable ❑ Conventional 0 Coded ❑ Transmitter 0 N/A Type of smoke detector sensing technology: 0 Ionization 0 Photoelectric 5.2.3 Heat Detectors ey 13TI A5 Number of heat detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area 0 N/A Type of devices: ❑ Addressable ❑ Conventional 0 Coded ❑ Transmitter ❑ N/A 5.2.4 Sprinkler Waterflow Detectors . X 151115 Number of waterflow detectors: Type of devices: 0 Addressable ❑ Conventional ❑ Coded ❑ Transmitter 0 N/A 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is: ❑ Enabled Disabled 0 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 f X 15TH 1‘ Number of valve supervisory switches: Type of devices: ❑ Addressable 0 Conventional ❑ Coded ❑ Transmitter ❑ N/A 6.2 Fire Pump - wri A Type of fire pump: ❑ Electrical 0 Diesel Type of pump supervisory devices: ❑ Addressable 0 Conventional ❑ Coded ❑ Transmitter ❑ 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 ❑ Low fuel Other: 6.3 Engine Driven Generator X16-1 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 E al l sT( 7.1 Annunciator 1 ❑ Local ❑ Remote Type: 0 Addressable ❑ Directory 0 Graphic ❑ N/A Location: 7.2 Annunciator 2 0 Local ❑ Remote — Type: 0 Addressable ❑ Directory ❑ Graphic ❑ N/A Location: 13 Annunciator 3 ❑ Local ❑ Remote • Type: 0 Addressable ❑ Directory 0 Graphic ❑ N/A Location: 8. ALARM NOTIFICATION DEVICES AND CIRCUITS 8.1 Emergency Voice Alarm Service L )(1ST( nO Number of single voice alarm channels: — Number of multiple voice alarm channels: Number of speakers: ° Number of speaker zones: 8.2 Telephone Jacks . x S T I r J G Number of telephone jacks installed: Number of telephone handsets stored on site: Type of telephone system installed: i � ❑ Electrically powered ❑ Sound powered ❑ N/A 8.3 Nonvoice Audible System V' 1 Sv Pri - Characteristics of notification device circuits connected to this system (see NFPA 72, Table 6.5): Quantity: 2_. Style: Li 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 ( 0 Other (describe): 9. EMERGENCY CONTROL FUNCTIONS ACTIVATED E 5r rC3 ❑ Hold -open door releasing devices ❑ Smoke management or smoke control ❑ Door unlocking ❑ Elevator recall ❑ Other 10. SYSTEM POWER SUPPLY ¶ L\ e c Fe � n eL 10.1 Primary Power 11�� Nominal voltage 12 0'v P` Amps Overcurrent protection: Type 1J t.-( I' e- Am s Location (of primary supply panelboard): cca s_14 cTlf1 -. rV . • Disconnecting means location: cc- kne_L -- .3L 4 3 10.2 Seco d ry Power Location: '�� 11 €1- Type: 1 Nominal voltage: 1 Zy Current rating: 1 2— Number of standby batteries: .2— Amp hour rating: Location of emergency generator: E)( I57 ( ''`3 Location of fuel storage: ex 1 .5T( i Calculated capacity of seco ary power o drive the system In standby mode: 02 In alarm mode: COOU T 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, hut 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 ,'Manufacturer's published instructions ❑ Other (please specify): System deviations from referenced NFPA standards: '' p Signed: c�G'` Printed name: `J � t'Y- Date: SS S '7 — Orga ation: �YZ 1�'c'r ✓t ofro5j & z , yO Title: t/ Q G Phone: 560 6 y 9 ' 2 / 3 6 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 Ele •rical Code, Article 760 ,Manufactur' 's s blished instructions XOther (please specify): 0.W I rk)S Sped fIC f}-n n s ❑ Documen'at n accordance with Inspection and Testing Fo Figure 10.6.2.3) is attached I • Signed: .`� Printed name: � 1 P1 Date: Organization: I V 7C ('t I nZ l Title: T ch LEA Il (« 3 W33 9000 Reprinted with permission from NF 'A 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 as specified herein has been installed and tested according to all NFPA standards cited herein. Signed: ,s..3 Printed name: 7:€,,J< 2 Date: 5 .as Organiza ion: 54 free 4 L it e (eel) Title: 'T.e-i".—. Phone: 344 13.2 System Service Contractor This syste .. s ified herein has been installed and tested acco ing o all NFPA standards cited herein. Signed: ,•." Printed name: 14T5iC % Date: ?'' ! I Organization: ' ( M l/) ' $. , " -- 1 i AR <. 1 \ Title: 1"cG.L i 14 k eeT LEA Phone: 503 6433 / b 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 wit :.sed a satisfactory acceptance test of this system and find it to be installed and operating properly in accord. , ., with its a.. eyed pla. • . a pecifications, its approved sequence of operations, and with all NFPA standards c • , d herein. 1 _ Signed: 4_ raw � ` Printed name: 04 le N.(i Lt Date: /z6 iii Organization: e-- o — r1 Title: ZJtt ,^l &\ hone: pT1 I ..-Tir c (&LRT I(eS T d�'- — P G 1 VA �Plnrzt\ t �e� . SeSS - 6s - ot P � b 'It co( IA `%du -'cam SUIT 6001 1■,eQ(ce4 + Orc‘.di Ts Ek e 4' ' `a a-r'. 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)