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Permit IN . CI TIGARD BUILDING PERMIT PERMIT #: BUP2007 -00519 ° COMMUNITY DEVELOPMENT DATE ISSUED: 10/19/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 115 BA -02600 SITE ADDRESS: 16230 SW PACIFIC HWY ZONING: C -G SUBDIVISION: TIGARD TOWNE SQUARE LOT: JURISDICTION: TIG PROJECT: TIGARD TOWN SQ. RETAIL EXPANSI Project Description: Sprinkler monitoring system. REISSUE: - FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 280 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,990.00 . Owner: Contractor: SN DEVELOPMENT NORTHWEST FIRE SUPPRESSION INC 1121 SW SALMON ST . 10200 SW ALLEN BLVD STE F PORTLAND, OR 97214 BEAVERTON, OR 97005 • Phone: 503 - 242 -2900 Contact #: PRI 644 -7720 Reg #: LIC 88629 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 10/8/2007 $62.50 [TAX] 8% State Surcha 10/8/2007 $5.00 [FLS] FLS Pln Rv 10/8/2007 $25.00 Total $92.50 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 than 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ( .:�.�..►- Permittee Signature: d'yL et_p _- Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. • Fire Protection System„ EcElv Build ing Permit Appl °- ' FOR OFFICE USE ONLY N . City of Tigard Dated �t�, Permit j ../ 2-100/ ■ a 13125 SW Hall Blvd., Tigar OR 9 2007 Plan Revi " �/ P hone: 503.639.4171 Fax: 503.59 Date/B ' ` t,L �p Other Permit: ..t TI GA R D Inspection Line: 503.639.4 �[[ y or + A �n Date Rea y : y: kris: ® See Page 2 for Internet: www.tigard -or.go I i 1 �/ 1 �� ' � ° '� Notified/Method: Supplemental Information E OO DIJ7SIO 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. El 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ ❑ Accessory building El Multi-family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: - JOB SITE INFORMATION AND LOCATION - / Total number of floors: Job site address: /446, 32 t ,C /C / sG,� ,� New dwelling area: square feet // City/State /ZIP: Dje / 7Z�L / �f Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: 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. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the *Ifr..7 ' DESCRIPTION OF � work indicated on this application. i/ �� / �Z �5 - 4'77 � �� Valuation: $ 9 96, 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: Phone: ( ) Fax: ( ) New: ,APPLICANT ❑ CONTACT PERSON NOTICE Business name: / ti , & � - � / 2 ;y5k/ –..4,1401411 _sA11 contractors and subcontractors are required to be Contact name: r� � f1� —` / ter fi r" licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: /�3��,j � ` - - , # -� e � ,-e jurisdiction in which work is being performed. If the City/State /ZIP: /rte e,,iv ,7T/ /� 9, 9��p aI ant is exempt from licensing, the following reasons apply: Phone} of/!/– 79 7 Fax: : b'�3 ,e,eSp_ ,FZ E -mail: �ll)/7fr 34 6,97,2 CONTRACTOR . BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Permit fee: ,'") Address: } City/State /ZIP: b – State surcharge (8% of permit fee): FLS plan review (40% of permit fee): Phone: ( ) /� t Fax: ( ) (Due upon application.) qjcS CCB lic.: I A X ( Total permit fees: �{-- Authorized signature Amount received: %v1. �V This permit application expires if a permit is not obtained `Rfint name: e 2 —��,., L /,2)/7 Date: /e4 /O; within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I: \Building TermitaPS- PermitApp.doc 03/23/06 440-4613T(11/02/COM/WEB) , i 7- G79 1 ? Addressable Monitored Fire Alarm System — Record of Completion AMFA -ROC blank.doc Protected Premise: Owner's Rep & Phone: Tigard Towne Square SN Development 16230 SW Pacific Hwy 1121 SW Salmon Street Tigard, OR 97223 Portland, OR 97214 1. Type(s) of System or Service: Local (per NFPA 72, Chapter 3) Remote Supervising Station (per NFPA 72, Chapter 4) Monitoring Provided By: Alarm Central Station Phone (for testing): 503- 641 -6761 Number of Phone Lines: 2 Means of Transmission: DACT Alarm Codes: Attached (see alarm response information sheet) This system was designed by, and equipment supplied by: Northwest Fire suppression, Inc., 15385 SW Beaverton Creek Court Beaverton, OR 97006 Phone: 503- 644 -7720 Location of "as built" drawings, owner's manual, test reports, and maintenance records: A contract for test and inspection in accordance with NFPA 72, 7 -3.2: (check one) is in effect. Owner has declined test and inspection contract at this time. Comments: fli•(, ' 01.1 S i1/40" J P�I_ (record of completion - page 2) 2. Record of System Installation: (Lead installing technician or electrician to complete prior to acceptance testing) This system has been installed in accordance with the National Electric Code, and meets all requirements of Article 760 as a Power Limited Fire Alarm system. After all device installation was complete (except control equipment final terminations), all initiation, signal and control circuit wiring was tested and found to be free of opens, shorts and ground faults. The entire system was installed per the AHJ approved plans, and complete, accurate "as built" notations have been provided to Northwest Fire Suppression, Inc. Exceptions: • Installing Contractor Rosevia n Elcc- ' G Responsible Journeyman 04no(y Lew S License # a29 9 qj Signature C:5?",e 7 5 Date il - - 0 3. Record of System Operation: (Responsible testing technician to complete prior to acceptance testing) All operational functions and features of this system were tested and found to be working properly in accordance with the approved plans, per NFPA 70, National Electric Code, Article 760, per NFPA 72, Chapters 1, 3, 4, 5, 6 and 7, and per the manufacturer's instructions. I have reviewed the "as built" drawings and find that they are accurate and complete. Exceptions: • Certifying Contractor b rA.-evA l jEst to.-1 Responsible Technician * Z)e...41 -- 40ia • 'License # I.I LE. Signature e - Date 04 - 15 -OR • • (record of completion — page 3) 4. Alarm Initiating Devices (indicate quantities) Manual Stations Ionization Smoke Detectors Photoelectric Smoke Detectors Photoelectric Duct Detectors Other Smoke / Flame Detectors, type Fixed Temperature Heat Detectors Fixed Temperature Heat / Rate of Rise Detectors Rate Anticipated or Compensated Heat Detectors . Feet of Linear Heat Detector 1 Sprinkler Waterflow Switches Other Initiating Devices (i.e. satellite panels, hood systems, etc.) List them: 5. Supervisory Signal Initiating Devices (indicate quantities) 3 Sprinkler Valve Tamper Switches Sprinkler Low Air Pressure Switches Other Supervisory Switches (i.e. fire pump, water supply, generator, etc.) List them: (record of completion — page 4) 6. Alarm Notification Appliances and Circuits (quantities) Notification Circuits (Zones) Horn / Strobes Strobes (only) Horns (only) I Bells Other (list them) Annunciators 7. Signaling Line Circuits Quantity: Style: 8. System Power Supplies . Fire Alarm Control Panel: Primary (Main): Nominal Voltage 120 VAC Breaker Current Rating: _ Amps Is this a dedicated branch circuit, with the disconnect means mechanically protected, and with a red marking (per NFPA 72, 1- 5.2.5.2)? Yes or No YES Breaker Location: ' e.A t, IZoow• C), .<7C 3 Secondary (Standby): Sealed Lead Acid Batteries, 5 Amp Hrs. Providing (24, 60 or 90) Z4 Hrs. Or Emergency Standby System (U.P.S.): (check as applies) ' Per National Electric Code, Article 700 Per National Electric Code, Article 701 Per National Electric Code, Article 702 (plus Article 700 or 701) Notification Expansion Panels: Primary (Main):. Nominal Voltage 120 VAC Breaker Current Rating: _ Amps Is this a dedicated branch circuit, with the disconnect means mechanically protected, and with a red marking (per NFPA 72, 1- 5.2.5.2)? Yes or No Breaker Location(s): Secondary (Standby): Sealed Lead Acid Batteries, Anip Hrs. Providing (24, 60 or 90) Hrs. (record of completion — page 5) 9. System Software Operating System Software Revision Level (on IC): 2.4 Application Software Revision Level: Verifier 200, version 1.0 Revision Completed (Installed) By: ". ca.1 c— 0. Company: tAparn,. W. =�� 1-v1- 10. Comments System Deviations From the Referenced NFPA Standards (list if any): 11. Acceptance Testing Statements Commissioning Technician: I have tested and witnessed satisfactory performance of all system devices and control functions, and/or have noted any exceptions on this Record of Completion. Sign Date 614 — 1 5 -n$ Local Authority (or Authorities) Having Jurisdiction: This system has been inspected and is accepted for the jurisdiction I represent. Name 1 d 1 Q,/` Representing - Comments: 13 ,A4), 6) - Q 4 5 1 � Signed Date 4/' c/o Name Representing Comments: Signed Date 04/15/2008 11:39 5036448429 ALCESTE PAGE 01 METRO SAFETY AND FIRE INC Report Run Date: 04/15/08 PO BOX 33650 Report Run Time: 11:38:30 • PORTLAND OR 97292 -3650 61 -01 -0661 Cl: * * * * * * * * * * ** Report Message * * * * * * * * * * ** * * * ** Report Legend * * * ** ATTN: RICK BOLEN Date : Month /Day mm /dd Day : Day of the Week Recvd : Received Time Cmplt : Completed Time Code : Event Code Meg : Event Type HARSH TIGARD TOWN SQUARE(NO HARDCOPY) Desc : Description PAD User : User Info 16230 SW PACIFIC HIGHWAY TIGARD OR 97224 r rise Zdh Fold Here All Events Detail 04/15/08 - 04/15/08 HARSH TIGARD TOWN SQUARE (NO HARDCOPY) 16230 SW PACIFIC HIGHWAY DATE DAY RECVD CMPLT CODE MSG DESCRIPTION (USER INFORMATION) 04/15 Tue 07:39 :42 Event Operator: 28A at: on 04/15 •Opn /Clo: Closed ws24 * Out -Of- Service: 04/15/08 Until 04/15/08 Strt: 07:39 Until: 10:00 Zone(s): Comment: MARC -TIL 1000 04/15 Tue 07:39 07:39 OUS OUT OF SERVICE Comment: MARC CASEY W /PC CREATED ACCOUNT OUS TIL 1000 =0P28 Passcard Name: MARC CASEY Completed on: 04/15/08 at: 07:39 :46 Operator: 28A Disposition: System Out of Service 04/15 Tue 08 :51:54 Event Operator: 28A at: on 04/15 Opn /Clo: Closed ws24 Comment: MARC CASEY W /PC CHECKING SIGNALS =0P28 Passcard Name: MARC CASEY Completed on: 04/15/08 at: 08:52:16 Operator: 28A. Disposition: Comments /Schedule Entered 09:07 09:07 3080000 >INV ALARM -CHECK HC/ZONE PAGE - FOLLOW INSTRUCTION 09:07 09 -:07 3080000 >RST RESTORE 09:07 09:07 3080000 >INV ALARM -CHECK HC /ZONE PAGE- FOLLOW INSTRUCTION 09:09 09:09 3080000 >RST RESTORE 09:10 09:10 3080000 >INV ALARM -CHECK HC /ZONE PAGE - FOLLOW INSTRUCTION 09:12 09:12 3080000 >RST RESTORE 09:13 09:13 1150001 >INV ALARM -CHECK HC /ZONE PAGE - FOLLOW INSTRUCTION 09:13 09:13 1150001 >RST RESTORE 09:15 09:15 1100005 >FIR AN UNKNOWN TYPE - UNSPECIFIED AREA 04/15 Tue•09:15:10 04/15/2008 11:39 5036448429 ALCESTE PAGE 02 Event Operator: 28A at: on 04/15 Opn /Clo: Closed we24 Comment: MARC CASEY W /PC CHECKING SIGNALS =0P28 Passcard Name: MARC CASEY Completed on: 04/15/08 at: 09:16:10 Operator: 28A Pg 1 Disposition: Comments /Schedule Entered 09:15 09:15 1100005>RST AN UNKNOWN TYPE- UNSPECIFIED AREA 09:15 09:15 1100005 >FIR AN UNKNOWN TYPE - UNSPECIFIED AREA 09:15 09:15 1100005 >RST AN UNKNOWN TYPE - UNSPECIFIED AREA 09:17 09 :17 2000004 >SV2 SERVICE REQUIRED ON FIRE SYSTEM - VERIFY /ALMC 09:17 09:17 2000004 >RST SERVICE REQUIRED ON FIRE SYSTEM- VERIFY /ALMC 09:19 09:19 1110002 >FIR SMOKE DETECTOR- UNSPECIFIED AREA 09:19 09:19 1110002 >RST SMOKE DETECTOR - UNSPECIFIED AREA 09 :20 09:20 3080000 >INV ALARM -CHECK HC /ZONE PAGE - FOLLOW INSTRUCTION 09:21 09:21 3080000 >RST RESTORE 10:01 10:01 RTS RETURNED TO SERVICE 11 :23 11:23 1150001 RST RESTORE 04/15 Tue 11:23:16 1150001 INV ALARM -CHECK HC /ZONE PAGE - FOLLOW INSTRUCTION Event Operator: 96A at: 11:24:12 on 04/15 Opn /Clo: Closed ws22 * Contact Called: WASH CO /TV FIRE DISP Phone Number: (503) 520 -1357 Contact Result: NOTFD Auto -Dia at: 11:24:34 - 11:25:16 11:25 11 ;25 1110002 RST SMOKE DETECTOR - UNSPECIFIED AREA 11:26 11:26 2000004 RST SERVICE REQUIRED ON FIRE SYSTEM - VERIFY /ALMC Comment: FD NOTFD. INC #4326 (0P57) MSG MARC CASEY. OP96 Completed on: 04/15/08 at: 11 :27:38 Operator: 96A Disposition: On Hold Pndg Disposition 04/15 Tue 11:25:02 1110002 FIR SMOKE DETECTOR - UNSPECIFIED AREA Event Operator: 96A at: 11:27:38 on 04/15 Opn /Clo: Closed ws22 11:26 11:27 2000004 SV2 SERVICE REQUIRED ON FIRE SYSTEM - VERIFY /ALMC Completed on: 04/15/08 at: 11:27:42 Operator: 96A Disposition: Alm Curently being Handled 04/15 Tue 11 :27:52 1100005 FIR AN UNKNOWN TYPE - UNSPECIFIED AREA Event Operator: 34A at; 11:28:34 on 04/15 Opn /Clo: Closed WS29 Completed on: 04/15/08 at: 11:28:48 Operator: 34A Disposition: Alm Curently being Handled 11:28 11:28 1100005 RST AN UNKNOWN TYPE - UNSPECIFIED AREA 04/15 Tue 11:29:46 Event Operator: 96A at: on 04/15 Opn /Clo: Closed ws22 Comment: DANNY BRAYTON CALLED W /ACCT## AND REQUESTED HISTORY BE FAXED TO BLDG INSPECTOR RICK BOLEN @ 503- 624 -3681. OP96 Passcard Name: HARSH TIGARD TOWN SQU Completed on: 04/15/08 at: 11:38:14 Operator: 96A Disposition: Comments /Schedule Entered End of Report . . . CITY OF TIGARD . BUILDING DIVISION PERMIT #: 13UP7007 -00519 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/ 19/ ).007 Phone: (503) 639 -4171 /�r { Inspection Requests (24 Hrs.): (503) 639 -4175 " I � .. 9 - - INSPECTION WORKSHEET FOR DATE: 4/15/2008 TIME: 7:02AM PAGE: 50 SITE ADDRESS: 16230 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE: PROJECT NAME: TIGARD TOWN SQ. RETAIL EXPANSI DESCRIPTION: Sprin)der monitoring system. OWNER: SN DEVELOPMENT, PHONE #: 503-242 -2900 CONTRACTOR: NORTHWEST FIRE SUPPRESSION INC PHONE #: 644.7720 Inspection Request Scheduled For: Date: 4/15/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 998 Alarm final 068348 -01 503-644 -7720 N Corrections /Comme is /Instructions: tki A- ,r. --- )Y te, urd■ 1(Ac ../t „,,__6,j - LAryN — Cc(/' a. v.st I 6,41i-fry-‘- _ 11 ; /1173 �� -1)� — i Z j % C f ive�i007 bo - fo`i .,2_,,..,,,- 7 cf:?)---1- J f j ) // PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / Phone #: (503) 718-