Permit 1
a CITY OF TIGARD
FIRE PROTECTION SYSTEM PERMIT
0 • COMMUNITY DEVELOPMENT Permit#: FPS2012 -00065 „
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2012
Parcel: 2S 101 DA00102
Jurisdiction:
Site address: 13221 SW 68th PKWY 450
Project: Spec Space Subdivision: YARNS ACRES Lot: 9
Project Description: Fire alarm.
Contractor: T & L COMMUNICATIONS INC Owner: GK TRIANGLE CORPORATE PARK III
PO BOX 87387 P.O. BOX 130174
VANCOUVER, WA 98687 -7387 CARLSBAD, CA 92013
PHONE: 360 - 737 -9725 PHONE: 503 - 221 -1900
FAX: 360 - 737 -9648
FEES
Description Date Amount
Specifics: Permit Fee - COM 04/24/2012 $51.09
12% State Surcharge - Building 04 /24/2012 $6.13
Type of Use: COM Plan Review - Fire Life Safety - COM 04/24/2012 $20.44
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 04/24/2012 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 5 Info Process /Archiving - Sm $0.50 (up to 04/24/2012 $3.00
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: Smoke Detectors Req: Yes
Battery Calcs Provided: No Cut Sheets Required: Yes
Total .. $82.66
•
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $450.00
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 -00.0 You may obtain a copy of the rules
or direct stions to NC b !ling 503.232.1 or 1.800.332.2344.
Issued By: G� i �� Permittee Signature: , � / __' f �
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.
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Building Permit Application
Fire Protection System rr FOR OFFICE USE ONLY
C�1 V
City of Tigard ff� P ermit No.: 1 7 9 420.9 _ e rr) , „,„„,,,,..„„e6s--
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review /
I Phone: 503.718.2439 Fax: 503.598.1960 APR 2 4 201 Date/By: ' Z. ( Other Permit: Q 90/a —
TI G A R D Inspection Line: 503.639 Date Ready/By: i 2,� r °cis: See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGA Notified/Method: a 7 / Supplemental Information
TYPE OF WORK IN REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rotnded 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.
El 1- and 2-family dwelling Valuation: $
y g ®CommerciaUindustrial
❑ 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: 13221 SW 68'" Parkway New dwelling area: square feet
City/State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 450 Project name: TCP3 -STE 450 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: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (romded to the nearest dollar) of all
equipment, materials, labor,. overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
.Fire alarm tenant improvement Valuation: $$450.00
• Existing building area . sq_uare feet •
. • New building area: square feet
•
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: T &L Communications, Inc All contractors and subcontractors are required to be
Contact name: Larry Bushaw licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be Lensed in the
Address: PO Box 87387 jurisdiction in which work is being performed. If the
City /State/ZIP: Vancouver, WA 98687 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 737 -9725 I Fax: : (360-) 737-9648
E -mail: office @tl- communications.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: T &L Communications, Inc (Please refer ro fee schedule)
Permit fee:
Address: PO Box 87387
City /State /ZIP: Vancouver, WA 98687 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (360) 737 -9725 I Fax: (360) 737 -9648 (Due upon application.)
CCB lic.: 67787 Total permit fees:
Authorized signature:
Amount received: g
This permit application expires if a permit is not obtained
Print name: Larry Bushaw Date: 4 -24 -12 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board
I:\Building\ Permits \FP$- PermitApp.doc Rev 01/05/2012 440- 4613T(II /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done: _
1.) El New 2.) Modification to sprinkler heads only:
El Addition El 1 -10 heads: No plan review required.
El Alteration El 11+ heads: Plan review required.
El Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
El 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: I $
C.) Fire Alarm •
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Submittal shall - Battery Calculations ❑ Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $ 450.00
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
http: / /www.tigard- or.gov /city_hall /departments /cd /docs /FPS- PermitApp.doc Rev 0115/2012
Z oIl - OOH
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72-31
FIRE ALARM SYSTEM
RECORD OF COMPLETION T 4S Q
Name of protected pro f • t3 ! C. cor r s °` e- A
Address: TS 22. • _
I — 12
Representative of protected property name, phone • [ NAM gra' IV &
Authority having Jurisdiction:
Address/ telephone number:
O aniz fionname /phone Representative name / phone
Installer: GT F L Co "VI �� P/ Vl ! C o�'t (O h S
Supplier: l � � C� -'1/1, i✓' tJ v/ / r— t eip j,-1
S
Service organization: Tt c/a tlep, -
j, �
Location of record (as- built) drawings: Q �C `7 1 /p-0r
Location of operation and maintenance manuals:
A ! UC YOL- C P G`E FtCE
Location of test reports:
A contract for test and inspection in accordance with NFPA standard(s):
Contract no(s): Effective Date Expiration date:
System Software e / ' J � J ' / e ` - l `
o
(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 to ions) ff premi es, list(where received: / SG
NFPA 72, Chapter 8 - Remote Station ` �� 7O /G
Telephone numbers of the organization receiving alarm: / CJ`s
Alarm
Supervisory: OL
Trouble: O�
If alarms are retransmitted to public fire service communication center 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 communication center or others, indicate location and telephone numbers of the
organization receiving alarm:
•
Indicate how alarm is retransmitted:
NFPA 72, Chapter 8 - Central Station
Prime Contractor:
Central Station Location:
(NFPA 72, 1 of 4)
FIGURE 4.5.2.1 Record of Completion
•
72-32 NATIONAL FIRE ALARM CODE
Means of transmission of signals from the protected premises to the central station:
McCulioh Mutiplex One -way radio
D 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
O NFPA 72, Chapters (check an that apply) Cr5 1 2 Pigs 44 ❑ 5 ❑ 6 '7 0-8 4Era ❑ 10 ❑ 11
NFPA 70, National Electrical Code, Article 760
Oy Manufacturer's instructions
Other (specify) - Organization: Signed: ,./a /(V/4 ( Date: 57 /6//
anization: Z- f' Co, L ,r'z U < v.e Ss /
9 r/ �' � /�ij �7 r o
�
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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:
O4 NFPA 72, Chapter (wed( all nat apply) ef6 ce 2 je3 5 R56 ❑ 7 ❑ 8 ,g9 ®'1 11
NFPA 70, National Electrical Code, Article 760
pL- Manufacturers instructions
Other (specify)
Signed: Date: 5.-- 6 (
Organization: A
4. Signaling Line Circuits
Quantity and class of ling line circuits connected to system ( NFPA 72 table 6.6.1):
X -
Quantity: G— Style: Class:
•
(NFPA 72, 2 of 4)
FIGURE 4.5.2.1 Continued
FUNDAMENTALS OF FIRE ALARM SYSTEM 72-33
5. Alarm- Initiating Devices and Circuits
Quantity and class of initi ' , device circuits (see NFPA 72, Table 6.5)
Quantity: Style: Class:
MANUAL
(a) Manual
stations Noncoded Transmitters Coded Addressable
(b) Combination manual fire alarm an gua 's tour coded stations:
AUTOMATIC
Coverage: Complete 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 stations .
- . Note: Combination devices- are.recorded unden5(b); Manual, and 6(a), Guard's .Tour ._ ._ ..... . . .._.. . _ .
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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 ❑
Q) 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):
FIGURE 4.5.2.1 Continued
(NFPA 72, 3 of 4)
J
r
72-34 NATIONAL FIRE ALARM CODE
7.Annunciator(s)
Number. ( Type: Location: 44' r^ /r ^ h
8. Alarm Notification Appliances and Circuits 6666 y
NFPA 72, Chapter 6 - Emergency VoiceJAlarm 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 3 With Visible
(d) Chimes With Visible
(e) Other. With Visible
(f) Visible appliances without audible:
9. System Power Supplies 1
(a) Fire Alarm Control Panel: Nominal Voltage: 770 Current rating: 2 Q it
Overcurrent protection: Type: .f El' .,-'- __ Current rating: J
Location: .1-.--Y —1 # Z 1- ' -(- •4 7`
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(b) Secondary (standby): .
Storage Battery: .. .. ,. , Am_ p- hour.rating; ,- . . .
Calculated capacity to drive system , in hours: _ . ..
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:
•• /(/ ' 4 1 - L.--''-- I 21 / ti . . (_..4 1 , - -77 . /�'_' i
(signed) for installation ntractor /supplier (title) (date) / _. —
(signed) for alarm service company (title) (date)
I I
(signed) for central station (title) (date)
Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
I
(signed) representative of the authority having jurisdiction (title) (date)
FIGURE 4.5.2.1 Continued (NFPA 72, 4 of 4)