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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT II _ llx:: COMMUNITY DEVELOPMENT Permit #: FPS2011 -00140 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011 TIGARD 13125 1S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 150 Project: Corvel Subdivision: METZGER, TOWN OF Lot: 9 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 11/30/2011 $145.24 12% State Surcharge - Building 11/30/2011 $17.43 Type of Use: COM Plan Review - Fire Life Safety - COM 11/16/2011 $58.10 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg Sheet (over 11/30/2011 $10.00 Occupancy Grp: B Height: ft 11x17) Stories: 6 Houlry Building Rate 11/30/2011 $180.00 Hourly Building 12% State Surcharge 11/30/2011 $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: Smoke Detectors Req: Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $432.37 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $6,189.00 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 1.800.332.2344. Issued By: P•rmitteeSignature: . i' Call 503.: • .y :00 a.m. for the next available inspectio= 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. 1 Building Permit Application yr F rtt711,1r: n ire Protection System ti " l FOR OFFICE USE ONLY ' City of Tigard 6 Received Permit No.: �/ ` g NOV N�V 1'D 2011 Date/By: / /to // > )95� /Thad //o q 13125 SW Hall Blvd., Tigard, OR 97223 Plan ReJ'- 11 Phone: 503.718.2439 Fax: 503.598.196 -1-y OF T GA D Date/ • �,,s (l (7 r f Other Permit:`4 / -,0,: ) 3 7 TIGARD Inspection Line: 503.639 p� i + i 9 ,, Date RearyBy: Juri H See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISION I:�I�fih Notified M // ethod: /I �,0-77- �� _' fC upplemental Information �V1Irn ,r Grit r...a I\n/ lh TYPE OF WORK 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: $ 171 Accessory building El Multi-family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 10200 SW GREEN BURG RD New dwelling area: square feet City /State /ZIP: TIGARD OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: 150 Project name: CORVEL Covered porch area: square feet Cross street/directions to job site: LINCOLN 5 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. FIRE ALARM Valuation: $$6,189.00 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 ❑ 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. (Please refer to fee schedule) 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): G Phone: (360) 699 -2130 Fax: (360) 719 -1527 (Due upon application.) 6 ° /� CCB lie.: 173731 Total permit fees. (7 ( 7 Authorized signature: Amount received: This permit application expires if a permit is not obtained Print name: JASON SWEET Date: j/, q _�l within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I \FPS- PermitApp.doc 02/01/11 440- 4613T(11 /02 /COM/WEB) 7 FPSZe•lko / yo 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: till C chi 5 5V/ re / ‘ // $ 0 Address: /O ,20O 5t G rctr 6 L r Rd rci O 9 72 Description of property: Off/CS Occupancy type: 8" 17 L/S I /1c 5' J V P Name of property representative: S/1 c1'G/l S' Te /�'t 47"y Sera /ct3 0 l.3 Address: / J S4) rccn b ti ; S Rd /��j/c, C /e ? 7zz3 Phone: 5 Z 2e 2 Fax: E -mail: Authority having jurisdiction over this property: (1 T r or T#/ Phone: Fax: E -mail: 2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION Installation contractor for this equipment: 4tfe- TC 4114010, / lsrc - f / IJC Address: 6H 00 N ' E ' fW y 99 6r G4 3 k)gn cc; VVA, '-A ?8 66 5 Phone: 3 7O b 2 0 Fax: 6 r/9 1577 E -mail: Service organization for this equipment: S/tsfikx Cr' 0 Se 1/ Address: 6 3 05 S w gO5Cv"L7Od 6T A I Itke. 05 .x5 0 , o, 97035' Phone: ' S O3 6G 3 9000 Fax: 3 675 65z1 E -mail: Location of as -built drawings: OLJ,aeR Lf Location of historical test reports: r` " Location of system operation and maintenance manuals: t' P.-a -P A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: Ai i Le.X ( /OM / 1 Address: i`tl ,f /4b0 Phone: Fax: E -mail: Contract expires: 011010‘J/ ontract num. •r: requency of routine inspec ions: 3. TYPE OF FIRE ALARM SYSTEM OR SERVICE NFPA 72 Chapter Reference of System Type: a Name of organiz tion receiving alarm signals with phone numbers (if applicable): Alarm: &W u- f irtiTC CT 10 n ACCT 5ZZ Phone: 09 / SZ 98 Supervisory: Phone: Trouble: 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: ❑ Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio X1 -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: 6 .05-,0/ �+ Site - specific software revision date: OZ I tIAe 7 9 Revision completed by: �'»lp� GI" °o it c I SIGNALING LINE CIRCUITS Characteristics of signaling line circuits connected to this system (see NFPA 72, Table 6.6.1): Quantity: 0 Style: Class: /ALARM INITIATING DEVICES AND CIRCUITS Characteristics of initiating device circuits connected to this system (see NFPA 72, Table 6.5): Quantity: Style: Class: 1 I Manual initiating devices 5.1.1 Manual Pull Stations Number of manual pull stations: 0 Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ¥N /A Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: Of Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area XN /A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter JXN /A Type of smoke detector sensing technology: ❑ Ionization ❑ Photoelectric 5gDuct Smoke Detectors Number of duct smoke detectors: Y Type of coverage: " Type of devices: ❑ Addressable CI �a�v Conventional ❑ Coded ❑ Transmitter /A Type of smoke detector sensing technology: Cl Ionization ❑ Photoelectric S Detectors Number of heat detectors: 0 Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area 10N /A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter J N/A 5.?/.4 Sprinkler Waterflow Detectors Number of waterflow detectors: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter AN /A 5.x .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 (Sprinkler Sprinkler System Number of valve supervisory switches: Type of devices: 0 Addressable 0 Conventional 0 Coded ❑ Transmitter JXN /A 6!t Fire Pump Type of fire pump: ❑ Electrical ❑ Diesel Type of pump supervisory devices: ❑ Addressable 0 Conventional ❑ Coded CI Transmitter , N/A Fire Pump Functions Supervised 0 Fire pump power ❑ Fire pump running ❑ Fire pump phase reversal ❑ Selector switch not in auto 0 Engine or control panel trouble ❑ Low fuel Other: 84 Engine Generator Type of generator supervisory devices: ❑ Addressable 0 Conventional ❑ Coded ❑ Transmitter XN /A 0 Engine or control panel trouble ❑ Generator running ❑ Selector switch not in auto 0 Low fuel Other: 4 NNUNCIATORS Y Til 7.1 Annunciator 1 ❑ Local ❑ Remote Type: ❑ Addressable 0 Directory ❑ Graphic XN /A Location: 7.2 Annunciator 2 ❑ Local ❑ Remote Type: ❑ Addressable 0 Directory ❑ Graphic J ' N /A Location: 7.3 Annunciator 3 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic 'N /A Location: e 8 (ALARM NOTIFICATION DEVICES AND CIRCUITS 8.1 Emergency Voice Alarm Service Number of single voice alarm channels: Number of multiple voice alarm channels: 0 Number of speakers: Number of speaker zones: i Telephone Jacks y,3T «? Number of telephone jacks installed: Number of telephone handsets stored on site: Type of telephone system installed: ❑ Electrically powered ❑ Sound powered J� N/A 8.3 Nonvoice Audible System \ Characteristics of notification device circuits connected to this system (see NFPA 72, Table 6.5): Quantity: 0 2, Style: / Class: B Reprinted with permission from NFPA 72, National Fire Alarm Code®, Copyright 02002, 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. 0 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 Install,d Bells: With visual device Horns: _( With visual device: Chimes: With visual device Bells: With visual device: Visual devices without audible devices: 9 Other (describe): 9. EMERGENCY CONTROL FUNCTIONS ACTIVATED g I5 Ti 11,1 ❑ Hold -open door releasing devices ❑ Smoke management or smoke control ❑ Door unlocking ❑ Elevator recall ❑ Other 10. SYSTEM POWER SUPPLY 10.1 Primary Power �j Nominal voltage /AO VAC Amps 6A' T'''''' Overcurrent protection: Type ()* (-I n e- 1 0 5 e- 5 Amps �� A Location (of primary supply panelboard): y F41 q LE /VI #) 9 Disconnecting means location: 5•4 /rS 4 ,, D A _. 10.2 Secondary Power 1�G pc�itel.. /trd Location: s P C- PA L 1 Type: OHrrcr\ Nominal voltage: / Zi Current rating: G' Z Number of standby batteries: 2-- Amp hour rating: CI ' 2 Location of emergency generator: Location of fuel storage: Calculated capacity of seco ary power to drive the system In standby mode: / a / (iUZ/1 -- In alarm mode: 5 A t f ' #4)4 Cm - 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, National Electrical Code, Art'cle 760 Manufacturer's published instructions Other (please specify): &Aunt, /pir. ('/S System deviation from referenced NFPA standards: Signe d: dlre Printed name: T Date: 12 2---1 ( Organization: Sj TediniSrD Title: I�/'�5; 6/0, Phone: 3Cs() S21 ' ?(. 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 Elec ical Code, Arti e 760 X Manufactur s published instructions Other (please specify):.J i ft5 S / r (//1 T5 ❑ Document accordance with Inspection and Testing Form ((Figure 10.6.2.3) is attached Signed: e-"---' Printed name: R - S wA TSk I Date: / Z/t /// Organization: S / iN l t . X f III Acil Title: 5 R lee-hike / N t'ti Phone: 4 0 3 4 '? 3 Reprinted with permission from ORA 72, National Fire Alarm Code®, Copyright 02002, 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 s cified herei has been installed and tested according to all NFPA standards cited herein. Signed: Printed name: Sa, e) 4 1 4.4 Date: / 2 ") -I/ Organization: S4 Jr. 14.6 y &r � / Title: PrL5i den -I" Phone: r3LJ-0 - 2.)30 13.2 Syste Service Contractor This system cified herein has been installed and tested according to all NFPA standards cited herein. / Signed: � Printed name: k ' SSA Tsk I Date: 1 z/ l / I O /i4 f fz-X ' f F!)Ac / TitleTetk I LEA / N ice r Phone: SG 3 L 3 / p 0O 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 witness d • atg acceptance test of this system and find it to be installed and operating properly in accord. ce • . approved plans and specifications, its approved sequence of operations, and with all NFPA standard cit:• P.. 1 Signed: � A � Printed name: ■r�) Date: r z / t Organization: Ci cI c Z G�7 Title: & d 1 L"Q x e: ifl �i j A15 oC•41nJLAT A 11 ,6.5 1 To D TAose. cr cv ir5 4 �,n lu (� b ec t.5 $ J ou/ I 1 Q� �T h�- c i c 4.v.) 0) 5 U 1 1 + Sim / La� p coje_cr#Qbo7 1 /O 1 . ` 1�- Se t cc- - i r We fc /4c.d�.- T 1¢h G XI 5T /'y CIS Reprinted with permission from NFPA 72, National Fire Alarm Code®, Copyright 02002, 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. 0 2007 National Fire Protection Association SG24 -2 -014 Rev. (10/07) (p.5 of 5)