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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT • f ~ W COMMUNITY DEVELOPMENT Permit #: FPS2011 -00117 � • Date Issued: 10/07/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Parcel: 1S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 1180 Project: NSKB, LLC Subdivision: METZGER, TOWN OF Lot: 9 Project Description: Fire alarm Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC 11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503 - 255 -9488 PHONE FAX: 503 - 257 -7121 FEES Description Date Amount Specifics: Permit Fee - COM 10/05/2011 $102 20 12% State Surcharge - Building 10/05/2011 $12 26 Type of Use: COM Plan Review - Fire Life Safety - COM 10/05/2011 $40 88 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg Sheet (over 10/05/2011 $12 00 Occupancy Grp: B Height: ft 11x17) Stories: 12 Info Process /Archiving - Sm Sheet (up to 10/05/2011 $3.50 11x17) 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 Reg: Yes Battery Calcs Provided: Yes Cut Sheets Required Yes Total $170 84 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation• $0 00 Residential Square Footage. 0 Fire Alarm Valuation $2,600.00 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 No ' • - 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 dire- questions to 0 b -. i • 503 232.1987 or 1 800.332 2344 Iss ed 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. i/ Building Permit Application Received ' USE ONLY Fire Protection System � FOR OFFICE Ci ty of Tigard r� I Date /B • /10,4121[ Permit No.. /Ma'/ O// 7 ' Irr '� 131 25 SW Hall Blvd., Tigard, 972 v Plan Review D Phone: 503 639.4171 Fax 598.1 60 1p11 Date /B . d . 1 O M Other Permtt 4U(s29, Pz TIGARD Inspection Line. 503.639.4175 OC Date Ready r tuns H See Page 2 for Internet: www Ttgard or.gov � Notified /Method• t �� i / i l /3 Supplemental Information TYPE OF WO REQUIRED DATA: 1- AND 2- FAMILY DWELLING ['New construction ❑ I' moniti 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. Valuation: $ ❑ 1- and 2- family dwelling ® Commercial/Industrial ❑ Accessory building Ill Multi-family Number of bedrooms. [1] Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address. 10260 SW Greenburg Rd. (Lincoln Tower) New dwelling area: square feet City /State /ZIP. Tigard., OR 97223 Garage /carport area square feet Suite/bldg /apt. no 1180 Project name: NSKB T.I. 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 Fire Alarm Notification Devices In Tenant Space Valuation: $$2,600.00 Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Shorenstein Realty Services Type of construction: Address: Occupancy groups: City /State /ZIP: Existing Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP applicant is exempt from licensing, the following reasons apply: Phone. ( ) Fax::( ) E -mail: CONTRACTOR BUILDING PERMIT FEES* Business name Capitol Electric Company, Inc. (Please refer to fee schedule Permit fee: Address 11401 NE Marx Street City /State /ZIP: Portland, OR 97220 State surcharge (12% of permit fee): FLS plan review (40% of permit fee): Phone: (503) 255 - 9488 Fax (503) 255 - 1966 (Due upon application.) CCB lie.: 48748 Total permit fees Authorized signature. Amount received: This permit application expires IT a permit is not obtained Print name: Dan Wilson Date: 9/30/11 within 180 days after it has been accepted as complete. * Fee methodology set by Trt- County Building Industry Service Board. 1 \Bui kiln \Pamirs \FPS- PemtitApp doe 03/23/06 440- 4613T( I I /02 /COM /WFn) 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: $ $2600 D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 3,601 to 7,200 $292.50 7,201 and greater $381.50 Sprinkler Project Square Footage: sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A, B & C above): $ 2,600.00 Permit fee based on project valuation (see fee schedule): $ 91.44 Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ 12.26 FLS Plan Review (40% of permit fee): $ 40.88 TOTAL: $ 155.34 Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NI CET level "3" technicians. U: \FA Jobs \zz111267 -45 NSKB (Soofi Law) Q LT- 1180 \1 FPS PenmtApp.doc 2 PERMIT FEE DOUBLES IF WORK HAS STARTED WITHOUT BENEFIT OF PERMIT •TO CALCULATE TOTAL FEE PERMIT FEE CALCULATION (REFER TO TABLE) $ 3,000.00 ROUNDED VALUATION $ 91.44 (BASE FEE FOR FIRST $ 2,000.00 OF VALUATION) + $10.76 ($ 10.76 PER $ 1,000.00 $102.20 BASE PERMIT FEE + $12.26 STATE SURCHARGE = 12% OF BASE PERMIT FEE + $40.88 PLAN REVIEW CHARGE = 40% OF BASE PERMIT FEE _ $155.34 TOTAL DUE FOR THIS PERMIT EXAMPLE TABLE EFFECTIVE ON ALL APPLICATIONS DATED ON OR AFTER 2009/10/01 TOTAL VALUATION OF WORK TO BE PERFORMED FEES $0 TO $500 $51.09 MINIMUM FEE $501 TO $2,000 $51.09 FOR THE FIRST $500, PLUS $2.69 FOR EACH ADDITIONAL $100 OR FRACTION THEREOF, TO AND INCLUDING $2,000. $2,001 TO $25,000 $91.44 FOR THE FIRST $2,000, PLUS $10.76 FOR EACH ADDITIONAL $1,000 OR FRACTION THEREOF, TO AND INCLUDING $25,000. $25,001 TO $50,000 $338.92 FOR THE FIRST $25,000, PLUS $8.06 FOR EACH ADDITIONAL $1,000 OR FRACTION THEREOF, TO AND INCLUDING $50,000. $50,001 TO $100,000 $540.42 FOR THE FIRST $50,000, PLUS $5.38 FOR EACH ADDITIONAL $1,000 OR FRACTION THEREOF, TO AND INCLUDING $100,000. $100,001 AND UP $809.42 FOR THE FIRST $100,000, PLUS $4.49 FOR EACH ADDITIONAL $1,000 OR FRACTION THEREOF. PLAN REVIEW CHARGES = 40% OF PERMIT FEE STATE SURCHARGE = 12% OF PERMIT FEE TO CALCULATE TOTAL FEE STEP 1: DETERMINE THE VALUE OF THE WORK STEP 2: CONVERT THE VALUE TO FEE USING TABLE STEP 3: ADD PLAN REVIEW & STATE SURCHARGES BY MULTIPLYING FEE BY 1.52 Capit ®I • Electric Co., Inc. RE CE IV ED September 30, 2011 BUI LD OFT N D IVISIp N Plans Examiner City of Tigard Building Services 13125 SW Hall Blvd. Tigard, OR 97223 Re: Tenant Fire Alarm System Additions NSKB, Suite 1180 @ Lincoln Tower 10260 SW Greenburg Road Tigard, OR 97223 Please find attached a building permit application, Tri- County Commercial Application Checklist, three sets of plans, calculations, and product submittals for the fire alarm tenant improvements at the address shown above. Occupancy Group: B The fire alarm system design includes the following: 1. Install (5) ADA synchronized fire alarm strobes in the tenant space per plans. 2. Install (1) strobe power supply. 3. We will pre -test the fire alarm devices prior to requesting a final fire alarm inspection. 4. Fire alarm equipment and design are provided by Simplex-Grinnell. Equipment installation and testing are provided by Capitol Electric Company. Please contact me if you have questions or comments. Respectfully, & 1/14 Dan Wilson Project Manager /Estimator. Fire /Life Safety Division Capitol Electric Company, Inc. (503) 255 -9488 dan @cepdx.com NICET Level IV, Fire Alarm Systems #104512 11401 NE Marx • Portland, Oregon 97220 -1041 • 503 - 255 -9488 • Fax 503 - 257 -7121 CCB# 48748 • www,capitolelectricco.com — vv1/ • 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 - O INFORMATION Name of property: L j hLa 1" 1 0 1 .V e 1 1 t1 I r ( M S ( c a) Sto: 4 - e I I KO Address: ( 0 7SD 5 rQ,ei bur 'Qd ri 9u �` I c72 Description of property: I3 LA- S L el€ SS Occupancy type: /3 Name of property representative: Address: Phone: Fax: E -mail: Authority having jurisdiction over this property: Phone: Fax: E -mail: • 2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION Installation contractor for this equipment: , (7rJ� ELCZ:r 2rr Address: /J ( iT7 I Nt- 44/4-9-_-)C A• �� f / 7? l� � "am/ / . O Phone: 4 ,2j. _ Fa x: :.S 3 ..2 z E -mail: Service organization for this equipment: 5 pie r, :n vl e /( Address: 6 3 0S Sb✓ /2o5P i./oo. S¢ La //e asM,/efa p12 9X3S Phone: S ? 1 3 F3 - 9 000 Fax: E -mail: Location of as -built drawings: 0,A — $ f fe Location of historical test reports: O" - 5 r r f� Location of system operation and maintenance manuals: CAA - $i F A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: Address: Phone: Fax: E -mail: Contract expires: Contract number: Frequency of routine inspections: 3. TYPE OF FIRE ALARM SYSTEM OR SERVICE NFPA 72 Chapter Reference of System Type: C4 ,g Name of organization receiving alarm signals with phone numbers (if applicable): Alarm: Phone: Supervisory: Phone: Trouble: Phone: Entity to which alarms are retransmitted: /VP, r 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: 4 igital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio ❑ 1 -way radio ❑ N/A • If Chapter 9, note the type of connection: 0 Local energy ' ❑ Shunt (N /A • 3.1 System Software • Operating system (executive) software revision level: I 2 Site- specific software revision date: 10 " Z -- / ( Revision completed by: ( r; ,� 4. SIGNALING LINE CIRCUITS • Characteristics of- signaling line circuits connected to this system (see NFPA 72, Table 6.6.1): - Quantity: /V//1- Style: Class: • 5. ALARM - INITIATING DEVICES AND CIRCUITS Characteristics of initiating device circuits connected to this system (see NFPA 72, Table 6.5): Quantity: Nbt Style: Class: 5.1 Manual initiating devices 5.1.1 Manual Pull Stations Number of manual pull stations: 0 Type of devices: ❑ Addressable ❑ Conventional 0 Coded ❑ Transmitter Id N/A • 5.2 Automatic Initiating Devices • 5.2.1 Area Smoke Detectors Number of smoke detectors: A Type of coverage: ❑ Complete area 0 Partial area ❑ Nonrequired partial area 14 N/A Type of devices: ❑ Addressable 0 Conventional ❑ Coded 0 Transmitter XN /A Type of smoke detector sensing technology: 0 Ionization ❑ Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: Type of coverage: • Type of devices: ❑ Addressable 0 Conventional ❑ Coded 0 Transmitter N/A Type of smoke detector sensing technology: 0 Ionization ❑ Photoelectric 5.2.3 Heat Detectors Number of heat detectors: • Type of coverage: . 0 Complete area ❑ Partial area ❑ Nonrequired partial area XN /A Type of devices: 0 Addressable ❑ Conventional ❑ Coded 0 Transmitter aN /A - 5.2.4 Sprinkler Watertlow Detectors Number of waterflow detectors: 6 Type of devices: 0 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 . ❑ Disabled ❑ 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 Number of valve supervisory switches: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter 4 N/A 6.2 Fire Pump Type of fire pump: ❑ Electrical ❑ Diesel Type of pump supervisory devices: ❑ Addressable ❑ Conventional 0 Coded ❑ Transmitter I'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 O Conventional ❑ Coded ❑ Transmitter X N/A ❑ Engine or control panel trouble ❑ Generator running O Selector switch not in auto 0 Low fuel Other: 7. ANNUNCIATORS 7.1 Annunciator 1 0 Local 0 Remote Type: ❑ Addressable 0 Directory 0 Graphic 0 N/A Location: 7.2 Annunciator 2 ❑ Local ❑ Remote Type: 0 Addressable ❑ Directory ❑ Graphic ❑ N/A Location: 7.3 Annunciator 3 ❑ Local ❑ Remote Type: 0 Addressable 0 Directory 0 Graphic 0 N/A Location: 8. ALARM NOTIFICATION DEVICES AND CIRCUITS 8.1 Emergency Voice Alarm Service TWA Number of single voice alarm channels: Number of multiple voice alarm channels: Number of speakers: Number of speaker zones: 8.2 Telephone Jacks N/A 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: I Style: Class: 13 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: 6 With visual device ' Horns: a With visual device: Chimes: 0 With visual device 0' Bells: With visual device: t Visual devices without audible devices: s 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 17.4 VAC Amps ZO Overcurrent protection: Type G i< l? reGke.' Amps Zv Location (of primary supply panelboard): I ' - Q (CL, .It4 . Disconnecting means location: 10.2 Secondary Power Location: NRC, PGtv,t.( Type: C 3 kfq-try Nominal voltage: I 7---vo Current rating: $ A- Number of standby batteries: Z- Amp hour rating: 7 Ali Location of emergency generator: Location of fuel storage: Calculated capacity of secondary power to drive the system In standby mode: q 14 r. In alarm mode: l r f^'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, but before conducting operational acceptance tests. The system has been installed in accordance with the following NFPA standards: (Note any or all that apply.) VNFPA 72 C IFPA 70, National Electrical Code, Article 760 Manufacturer's published instructions ❑ Other (please specify): System devi i ions from refe - ced NFPA standards: Signed: _ i // Printed name: �� 1 Date: � i C Organiz. air Cr�1 nI�1L �..L - ,c Title: ! Y�i •h. _ Phone: 7.2/. 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: ;ZgNFPA 72 1NFPA 70, National Electrical Code, Article 760 VManufacturer's published instructions ❑ Other (please specify): ❑ Documentation in accordance with Inspection and Testing Form (Figure 10.6.2.3) is attached Signed: N R 6 Printed name: 3t'i ay. J. a wI s,bV Date: 16— 6-1/ Organization: $ /Y/l "eIf' Title: C /Qct /cr ;c-S ?Pct.. Phone: 5 - 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.4 of 5) • FUNDAMENTALS OF FIRE ALARM SYSTEMS 13. CERTIFICATIONS AND APPROVALS 13.1 System Installation Contractor This system . specified er:•n has been installed and tested according to all NFP standards cited herein. Signed: �� I �- Printed name: 7 Date: vVl 1 ( Organiz. do - : T/_ El'f-O Title: __ _(' E,i_►_ Phone: 77/ crse16 ?-5 13.2 System Service Contractor This system as specified herein h s been installed and tested according to all NFPA standards cited herein. Signed: Printed name: /3 6 - Date: (0- ZC—I/ Organization: SffwfPle, r'n' C (I Title: electr tic fe e� r Phone: 5Z3 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 Authori Having Jurisdiction I have witn:: id a satisfactory acceptance test of this system and find it to be installed and operating properly in accord. • - •ith its ap . roved • • • • • specifications, its approved sequence of operations, and with all NFPA standard • . • herein. • Signed - � • ed name: OW 3X � T t t A . Date: A,- Z.9- /1 Organization: _ ` e L G A-,2� Title: cZINIca SPEtr 7Z 2'Y' 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)