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Permit
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT a COMMUNITY DEVELOPMENT Permit #: FPS2012 -00052 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/13/2012 Parcel: 1 S 135AB01003 Jurisdiction: Tigard Site address: 10300 SW GREENBURG RD 360 Project: DiLorenzo & Company Subdivision: METZGER, TOWN OF Lot: 9 Project Description: Fire alarm for TI. 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: 503 - 619 -3200 FAX: 360 - 719 -1527 FEES Description Date Amount Specifics: Permit Fee - COM 04/05/2012 $83.37 12% State Surcharge - Building 04 /05/2012 $10.00 Type of Use: COM Plan Review - Fire Life Safety - COM 04/05/2012 $33.35 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 04/05/2012 $10.00 Occupancy Grp: B Height: ft 11x17) Stories: 6 Houlry Building Rate 04/05/2012 $180.00 Hourly Building 12% State Surcharge 04 /05/2012 $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 $338.32 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $1,685.00 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 = / - "gneture Call 503.63' a.m. for the next available inspe date / This permit card shall be kept in a conspicuous place on the Job site til completion of the project. Approved plans are required on the job site at the time of each Inspection. Building Permit Application Fire Protection System Foil OFFICE USE tt Received City of Tigard �,1 Date/B : __ ©. Permit No = <t/ _ , IN • 13125 SW Hall Blvd., Tigard, OR 9722, `O \ t° Plan Review 1n i� I • her Penner. , fa, 3 Phone: 503.718.2439 Fax: 503.598.196b Date/B : I I_IPA � . i ► I , /0 L i . TI l li D Inspection Line: 503.639.4175 ‘'%.1. e t ^;' r ate Ready : . , �r� kris: % See Page 2 for GA Internet: www.tigard - or.gov ® ��`� � 'y \ ‘',,\ • otifte,/ ethod if 1/4"; �� S Information '‘Z 1 2F_W2 F il2 .. - TYPE OF WORK v\ \\ ...fr / 1Gr�� r f D DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Pe ° fees' are based on the value of the work performed. Indicate the value (rounded to rite nearest dollar) of all ® Addition/alteration/replacement ❑ Other: equipment, materials, labor, o' :rhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling ® Commercial/industrial Valuation: $ ❑ 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: 10300 SW GREENBURG RD New dwelling area: square feet City /State /ZIP: TIGARD OR 97223 Garage/carport area: square feet Suite/bldg. /apt. no.: 360 Project name: DILORENZO 4 Crime r„ �r.. Covered porch area: square feet Cross street/directions to job site: LINCOLN 1 `�"" JJ Deck area: square feet Other structure area: square feet REQUIRED DATA: COMM E RCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees' are based on the .:Iue of the work performed. Tax map /parcel no.: Indicate the value (rounded to , :le nearest dollar) of all • equipment, materials, labor, o' rhead, and the profit for the DESCRIPTION OF WORK work indicated on this applicat . m. FIRE ALARM Valuation: $51.685.00 Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER I ❑ 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 Cons.ruction Contractors Board under ORS 701 and may be reouired 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 licens :erg, the following reasons Phone: (360) 699 -2130 I Fax: : (360) 719 -1527 apply: E -mail: SALES @SAFETECHNOLOGY.NET CONTRACTOR BUILDING P1 ,tMIT FEES* Business name: SAFE TECHNOLOGY GROUP INC. ( plea se ref m r schedule) Address: 6400 NE HWY 99 SUITE G375 1'crmit fee: City /State /ZIP: VANCOUVER WA 98665 State surcharge (12% of p, rinit fee): Phone: (360) 699 -2130 I Fax: (360) 719 -1527 FLS plan review (40% of permit fee): (Due upon ap, /!cation) CCB lic.: 173731 Pfi-11--- Total permit fees: t 3 b t 7p- Authorized signature: Amount received: This permit application expires if a permit is not obtained Print name: JASON SWEET Date: 4 -4-12 within 180 days after it has . .cen accepted as complete. Mudding \Permits \FPS- PermitApp.doc 02/01/11 440- 4613T(11/02/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 El 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: $ 1685 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): $ I� 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. \ \Safcserver \d$ \SAFE \Forms \Use these forms \Permit Apps \ Tigard \FPS- PermitAppAx 02/01/11 1 FPS Zc, Zs- o c>oTZ__. FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 - FIRE ALARM SYSTEM • RECORD OF COMPLETION ,1 Name of protected property: 4 I F') COf h •1 S uik1 3 t o I�ZL 0! E u Z v Address: /0300 S Gre'. bunr� RD "Ti • em 9. 2 2.3 Representative of protected property (name/phone): Authority having jurisdiction: C i '7 ic aYt7� Address/telephone number: Organization name /phone Representative name /phone Installer Safe Technology Group 360- 699 -2130 Supplier Sate Technology Group 360- 699 -2130 • Service organization Safe Technology Group 360- 699 -2130 Location of record (as- built) drawings: FACP Location of operation and maintenance manuals: FACP Location of test reports: Central Station A contract for test and inspection in accordance with NFPA standard(s) Contract No(s): Effective date: Expiration date: System Software • (a) Operating system (executive) software revision level(s): (b) Site - specific software revision date: (c) Revision completed by: (name) (firm) 1. Type(s) of System or Service • NFPA 72, Chapter 6 — Local If alarm is transmitted to location(s) off premises, list where received: NFPA 72, Chapter 8 — Remote Station Telephone numbers of the organization receiving alarm: Alarm: Supervisory: • Trouble: If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone numbers of the organization receiving alarm: Indicate how alarm is retransmitted: NFPA 72, Chapter 8 — Proprietary Telephone numbers of the organization receiving alarm: • - Alarm: • Supervisory: Trouble: If alarms are retransmitted to public fire service communications centers or others, indicate location a, id telephone numbers of the organization receiving alarm: Indicate how alarm is retransmitted: K NFPA 72, Chapter 8 — Central Station • Prime contractor: Central station location: (NFPA 72, 1 of 4) FIGURE 4.5.2.1 Record of Completion. • • 2002 Edition • ■ • 72 - NATIONAL FIRE ALARM CODE Means of transmission of signals from the protected premises to the central station: McCulloh Multiplex One -way radio X Digital alarm communicator Two -way radio Others Means of transmission of alarms to the public fire service communications center: (a) (b) System location: NFPA 72, Chapter 9 — Auxiliary Indicate type of connection: Local energy Shunt Parallel telephone Location of telephone number for receipt of signals: 2. Record of System Installation (Fill out after installation is complete and wiring is checked for opens, shorts, ground faults, and improper branching, but prior to conducting operational acceptance tests.) This system has been installed in accordance with the NFPA standards as shown below, was inspected by on , includes the devices shown in 5 and 6, and has been in service since X NFPA 72, Chapters 1 2 3 k k it 7 ps 10 11 (circle all that apply) NFPA 70, National Electrical Code, Article 760 X Manufacturer's instructions Other (specify): Signed: Date: c / /1G//Z Organizatio Sa Technology Group 3. Record of System Operation Documentation in accordance with Inspection Testing Form, Figure 10.6.2.3, is attached All operational features and functions of this system were tested by date and found to be operating properly in accordance with the requirements of: , NFPA 72, Chapters 1 2 3 4 5 6 7 8 9 )m 11 (circle all that apply) X NFPA 70, National Electrical Code, Article 760 X Manufacturer's instructions Other (specify): Signed: Date: / 6/1'2_ Organization: of chnol Group 4. Signaling Line Circuits Quantity and class of signaling line circuits connected to system (see NFPA 72, Table 6.6.1): Quantity: Style: Class: • (NFPA72, FIGURE 4.5.2.1 Continued 2002 Edition • FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 - 5. Alarm- Initiating Devices and Circuits Quantity and class of initiating device circuits (see NFPA 72, Table 6.5): Quantity: Style: Class: MANUAL (a) Manual stations Noncoded Transmitters Coded Addressable_, (b) Combination manual fire alarm and guard's tour coded stations AUTOMATIC Coverage: Complete X Partial Selective Nonrequired (a) Smoke detectors Ion Photo Addressable (b) Duct detectors . Ion Photo Addressable (c) Heat detectors FT RR FT/RR RC Addressable (d) Sprinkler waterflow indicators: Transmitters Noncoded Coded Addressable (e) The alarm verification feature is disabled or enabled , changed from seconds to seconds. (f) Other (list): • 6. Supervisory Signal - Initiating Devices and Circuits (use blanks to indicate quantity of devices) GUARD'S TOUR (a) Coded stations (b) Noncoded stations (c) Compulsory guard's tour system comprised of transmitter stations and intermediate eta tions Note: Combination devices are recorded under 5(b), Manual, and 6(a), Guard's Tour. SPRINKLER SYSTEM Check if provided (a) Valve supervisory switches (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: (a) Selector in auto position (b) Control panel trouble (c) Transfer switches (d) Engine running Other supervisory function(s) (specify): • (NFPA 72, 3 of 4) FIGURE 4.5.2.1 Continued 2002 Edition 72 - NATIONAL FIRE ALARM CODE 7. Annunciator(s) Number:_ Type: Location: 8. Alarm Notification Appliances and Circuits NFPA 72, Chapter 6 — 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: Quantity and the class of notification appliance circuits connected to system (see NFPA 72, Table 6.7): Quantity: Style: Class: Types and quantities of notification appliances installed: (a) Bells With Visible (b) Speakers With Visible (c) Horns With Visible o� (d) Chimes With Visible (e) Other: With Visible (f) Visible appliances without audible: / 9. System Power Supplies (a) Fire Alarm Control Panel: Nominal voltage: 120VAC Current rating: Overcurrent protection: Type: Breaker Current rating: 20A Location: • (b) Secondary (standby): Storage battery: 2 Amp -hour rating: Calculated capacity to drive system, in hours: 24 Engine -driven generator dedicated to fire alarm system: Location of fuel storage: (c) Emergency system used as backup to primary power supply: Emergency system described in NFPA 70, Article 700: 10. Comments 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: 6) 2 (signed stal onto or /supplier (title) - (.:te) (signed) for alarm service company (title) (date) (signed) fo central station (title) - (date) Upon o,j . etion of the system(s) satisfactory test(s) witnessed (if required by the authority having juris ' ction): JL. fD /MS (si. w ed) representative' . uthority having jurisdiction (title) (da ) (NFPA 72, 4 of 4) FIGURE 4.5.2.1 Continued • • • 2002 Edition