The URL can be used to link to this page

Permit iii CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT *, Permit #: FPS2011 -00133 g na COMMUNITY DEVELOPMENT TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/18/2011 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 15350 SW SEQUOIA PKWY 320 Project: Professional Eye Care Subdivision: 1996 -048 PARTITION PLAT Lot: 2 Project Description: Relocating (2) horn strobes and installing (3) horn strobes to existing fire alarm system. Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACIFIC REALTY ASSOCIATES 15495 SW SEQUOIA PKWY STE 100 ATTN: N PIVEN PORTLAND, OR 97224 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 968 -3353 PHONE: 503 - 624 -6300 FAX: 503 - 968 -3398 FEES Description Date Amount Specifics: Permit Fee - COM 11/18/2011 $75.30 12% State Surcharge - Building 11/18/2011 $9.04 Type of Use: COM Plan Review - Fire Life Safety - COM 11/18/2011 $30.12 Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Sm Sheet (up to 11/18/2011 $2.50 Occupancy Grp: B Height: ft 11x17) Stories: 1 Info Process /Archiving - Lg Sheet (over 11/18/2011 $6.00 11x17) Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Unknown 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: Smoke Detectors Req: Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $122.96 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $1,400.00 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 -0091 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. I Issued By: Permittee Signature: % l 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. Bur ermit Application Fire Protection 3.—Xli V;04 . ''‘'" — i O FFICE USE ONLY AA City of Tigard * l � O \ � Re eiv d / Permit No.: U PI ° 13125 SW Hall Blvd., Tigard, OR 9722' '1 'd �� ` �� ,.._00/3 g Plan Rev / - Phone: 503.639.4171 Fax: 503.598.1960 �Q� t� 0 Date/B : S Other Permit: AL,, 4, . ((_ A I IGARD` Inspection Line: 503.639 \a � c ��I Date Rea.yBy: s See Page 2 for Internet: www.tigard- or.gov r! -(' Q t5 \��` Notified /Method: ' ./, /�=�� Supplemental Information r 4, - ., : s'" • , �, :, a dr *n a? ;a x ;',= , , M � {.fir " , m< �e , _.` ., � ...; v. TYPE OE ,VORK , µ o' 6 � ', ; & REQIJI DD_ AND 2- FA )<tLYbWELI IIN ., ❑ 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 f a , �.° ' •` a re � '3''';w33$3 work indicated on this application. CATEGOR O En €ONS * pp ❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: s _. �� , ; JOBS`SITI NFORMATION�ANiLOCA ' _ Total number of floors: �b ,.., QA,° xs .rn. - ,X1v 3 .k,_ d 0'0,C ,..a ' m Job site address: 15350 SW SEQUOIA PARKWAY New dwelling area: square feet City /State /ZIP: PORTLAND, OREGON 97224 Garage /carport area: square feet Suite/bldg. /apt. no...OD/320 Project name: PACTRUST SDPD..01�S B_ /4 Covered porch area: square feet Cross street/directions to job site: Z>/e.—.-' Deck area: square feet Other structure area: square feet REQ iCOMMERCIA US ECHE � C HI IS1- 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 A MA Air; . G , ES, N WORK , work indicated on this application. RELOCATE TWO HORN STROBES / INSTALL THREE HORN /STROBE TO Valuation: $$1,400.00 EXISTING FIRE SYSTEM Existing building area: square feet - New building area: square feet - ® PROP R Y OWNER' }' E1 O .; Number of stories: Name: PACIFIC REALITY ASSOCIATES Type of construction: Address: 15350 SW SEQUIOA PARKWAY Occupancy groups: City /State /ZIP: PORTLAND, OREGON 97224 Existing: Phone: ( ) Fax: ( ) New: , � ` .u. > - @ a , , : r y � ry gip; . Nt'-'b LICANT ,, l CONTACTIPERSON • . . sw NO E T , , • . Business name: STANLEY SECURITY SOLUTIONS All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact namEr.' ARVIPtu3CHER • �,„„ A. , i • under ORS 701 and may be required to be licensed in the Address: 15495 SW SEQUOIA PARKWAY �� jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City /State /ZIP: PORTLAND, OREGON 97224 apply: Phone: (503) ,e,2 7 _ mss' Fax: Fax: : (503) 968 -3398 E-mail: Z .. • - . •'- -. " CAN/4 541 ��7.4, —. '3 ?v '7`'= eUr� 9' " #' ., *�, F sss .,..6 s -F ± a r - m om ." r ` " S: CON CRA'"CTOR � s - -� 4 BU11iDIN 'ERMI EES . +;..- Z.= 1u . & s Aaw-:, _�; , .'. - .. - ,: i , �r ' 1 A r ate' e .. ) 1. ° -- `-, A g . _ _ � � r � ' .� (Plensesrefer�to.feeschedul - Business name: STANLEY SECURITY SOLUTIONS Permit fee: Address: 15495 SW SEQUOIA PARKWAY State surcharge (12% of permit fee): City /State /ZIP: PORTLAND, OREGON 97224 FLS plan review (40% of permit fee): Phone: (503)968 -3355 Fax: (503) 968 -3398 (Due upon application.) • CCB lie.: 161567 Total permit fees: Amount received: Authorized signature: c 0 `�' , D This permit application expires if a permit is not obtained Print name: GARY TAUSCHER lJ J Date: 11/07/2011 * within 180 days after it has been accepted as complete. Fee methodology set by Tri- County Building Industry Service Board. C\ Building \Permits\FPS- PermitApp.doc 03/23/06 440- 4613T(11 /02 /COMN✓EB) ffSZO)/ 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: Pacific Corporate Center Address: 15350 SW Sequoia Parkway, Suite 320 Description of property: Professional Eye Care Associates Occupancy type: Name of property representative: Dennis Pagni Address: 15350 SW Sequoia Parkway #300 Phone: 503 - 624 -6300 Fax: E -mail: Authority having jurisdiction over this property: City of Tigard Phone: 503 - 639 -4171 Fax: E -mail: 2. Fire Alarm System Installation, Service, and Testing Information Installation contractor for this equipment: Stanley Convergent Security Solutions Address: 15495 SW Sequoia Pkwy Ste. 100, Portland, OR 97224 Phone: 5039683300 Fax: 5039683397 E -mail: Service organization for this equipment: Stanley Convergent Security Solutions Address: 15495 SW Sequoia Pkwy Ste. 100, Portland, OR 97224 Phone: 5039683300 Fax: 5039683397 E -mail: Location of as -built drawings: Location of Historical Test Reports: Location of system operation and maintenance manuals: A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: Stanley Convergent Security Solutions • Address: 15495 SW Sequoia Pkwy Ste. 100, Portland, OR 97224 Phone: 5039683300 Fax: 5039683397 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: Name of organization receiving alarm signals with phone numbers (if applicable): Alarm: Stanley CSS Phone: 8778990001 Supervisory: Stanley CSS Phone: 8778990001 Trouble: Stanley CSS Phone: 8778990001 Entity to which alarms are retransmitted: Phone: Method of retransmission of alarms to that organization or location: NFPA 72, Fig. 4.5.2.1 (p. 1 of 5) Copyright e 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. If Chapter 8, note the means of transmission from the protected premises to the central station: ❑ Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio ❑ 1 -way radio ❑ N/A If Chapter 9, note the type of connection: ❑ Local energy ❑ Shunt ❑ N/A 3.1 System Software Operating system (executive) software revision level: 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 ❑ Coded ❑ Transmitter ❑ N/A • 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization ❑ Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: Type of coverage: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization ❑ Photoelectric • 5.2.3 Heat Detectors Number of heat detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: Type of devices: ❑ 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 6. Supervisory Signal Initiating Devices and Circuits 6.1 Sprinkler System Number of valve supervisory switches: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A NFPA 72, Fig. 4.5.2.1 (p. 2 of 5) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution 6.2 Fire Pump Type of fire pump: ❑ Electric ❑ Diesel Type of fire pump supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ 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 ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A ❑ Engine or control panel trouble ❑ Generator running ❑ Selector switch not in auto ❑ Low fuel Other: 7. Annunciators 7.1 Annunciator 1 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic ❑ N/A Location: 7.2 Annunciator 2 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic ❑ N/A Location: 7.3 Annunciator 3 ❑ Local ❑ Remote • Type: ❑ Addressable ❑ Directory ❑ 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 ❑ 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: -- - - - - -- -- - -- — - - - -- 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): NFPA 72, Fig. 4.5.2.1 (p. 3 of 5) Copyright 0 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. 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: 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 Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): System deviations from refe d NFP tandards: Signed: iv „ . Printed name: Tim Hungate Date: 12/20/2011 Organization: Sta ey CSS Title: Field Service Technician Phone: 503 - 968 -3300 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 Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): ❑ Documentation in accordance with Inspection and Testing Form (Figure 10.6.2.3 of NFPA 72 is attached Signed: Printed name: Tim Hungate Date: 12/20/2011 Organization: Stanley CSS Title: Field Service Technician Phone: 503 - 968 -3355 NFPA 72, Fig. 4.5.2.1 (p. 4 of 5) Copyright 0 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. 13. Certifications and Approvals 13.1 System Installation ontractor This syste eciff r erein has bel installed and tested according to all NFPA standards cited herein. Signed' Al Printed name: Tim Hungate Date: 12/20/2011 Organization: Stanley CSS Title: Field Service Technician Phone: 503 - 968 -3300 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: 12/20/2011 Organization: Stanley CSS Title: Field Service Technician Phone: 503 -968 -3300 13.3 Central Station This system ..reciffed herein will be monitored according to all NFPA standards cited herein. Signed: n o (1j k C Printed name: Gary Tauscher Date: 12/20/2011 Organization: Stan y CSS Title: Operations Manager Phone: 503 - 968 -3355 13.4 Property Representative I accept t4is f stem as hav been installed and tested to its specifications and II cited here Signed: k ft , .t v/,.�- Printed name: 5. and .kf Date: (2 � f Organization: VtA Y t t s Title: c ` Phone: s`g /�� © 60 / 13.5 Authority aving Jurisdiction / I have witnes j / a satisfactory acceptance test of this system and find it to be installed and operating properly in accordance with its app f d plans and specifications, its approved sequence of operations, and with all NFPA standards cite herein. Signed: / Printed name: et fI�j�L4 Date: /Z Z-4 1 / Organs . ion: j \ Title: Z02/....t, i ^f k. j /5/ Phone: NFPA 72, Fig. 4.5.2.1 (p. 5 of 5) Copyright ©2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution.