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Permit _t CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT ''1 a • COMMUNITY DEVELOPMENT Permit# FPS2012 -00142 T f GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/06/2012 Parcel: 1 S135AB04500 Jurisdiction: Tigard Site address: 10250 SW GREENBURG RD 200 Project: GTS Subdivision: 1991 -055 PARTITION PLAT Lot: 1 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 09/06/2012 $123.72 12% State Surcharge - Building 09/06/2012 $14.85 Type of Use: COM Plan Review - Fire Life Safety - COM 08/22/2012 $49.49 Class of Work: FPS Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 09/06/2012 $10.00 Occupancy Grp: B Height: ft 11x17) Stories: 2 Houlry Building Rate 09/06/2012 $180.00 Hourly Building 12% State Surcharge 09/06/2012 $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: Smoke Detectors Req: No Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $399.66 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $4,657.00 • 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: 4 / � Permittee Signature: 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. .Buildin PP Permit Application RECE IVE •� Fire Protection System AUG 2 2 201 FOR OFFICE USE 0 a II City of Tigard Cr q Received G / permit No t ° 131 1 SW Hall Blvd., Tigard, o / TIGt]RD DateB : e �� / 4y . /5°5 /aZ D/ g r Plan Revie 2 I ' Phone: 503.718.2439 Fax: 503. ING DNISION Date/B : � ��� (Z Other Pern 6042.0ts � tom! TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: / ® See Page 2 for l' Internet: www.tigard- or.gov Notified/Method: T[ 1 - Supplemental Information i TYPE OF WORK REQUIRED DATA: 1- AN 2 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the v .lue of the work performed. Indicate the value (rounded tot le nearest dollar) of all ® Addition/alteration/replacement ❑ Other: equipment, materials, labor, ov,rhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this applicati m. ❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $ CI Accessory building ID Multi-family Number of bedrooms: ( ❑ Master builder ❑ Other: Number of bathrooms: j `0 �jo JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:1926KW GREENBURG RD New dwelling area: square feet City /State /ZIP: TIGARD OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: 200 Project name: GTS Covered porch area: square feet Cross street/directions to job site: LINCOLN 4 Deck area: square feet i Other structure area: square feet REQUIRED DATA: COMMI RCIAL -USE CHECKLIST Subdivision: �� Lot no.: Permit fees* are based on the \ .lue of the work performed. Tax map /parcel no.: i 5 / 5/'t y, IJ G eigoo Indicate the value (rounded to I. nearest dollar) of all equipment, materials, labor, ov rhead, and the profit for the DESCRIPTION OF WORK work indicated on this applicat m. FIRE ALARM Valuation: $$4,',57.00 1 7 42 5 era 1 Existing building area: square feet New building area: square feet I ❑ 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 NOT, , . E Business name: SAFE TECHNOLOGY GROUP INC. All contractors and subcontract ,rs are required to be Contact name: JASON SWEET licensed with the Oregon Cons; - uction Contractors Board under ORS 701 and may be remlired to be licensed in the Address: 6400 NE HWY 99 SUITE G375 jurisdiction in which work is IN ing performed. If the City /State /ZIP: VANCOUVER WA 98665 applicant is exempt from licens . ng, the following reasons apply: Phone: (360) 699 -2130 Fax: : (360) 719 -1527 E -mail: SALES @SAFETECHNOLOGY.NET i CONTRACTOR BUILDING PE..MIT FEES* (Please rejer[n reeschedufe 1 Business name: SAFE TECHNOLOGY GROUP INC. P.•rmit fee: Address: 6400 NE HWY 99 SUITE G375 i State surcharge (12% of pe.lnit fee): I City /State /ZIP: VANCOUVER WA 98665 FLS plan review (40% of pe. mit fee): Phone: (360) 699 -2130 Fax: (360) 719 -1527 (Due upon ap/ tication.) CCB lie.: 173731 Total pe. mit fees: � p This ermit alicati Authorized signature: 5 Amount eceived: y7 , r / / 1 LL�{�� permit expir, > if a permit is not obtained Print name: JASON SWEET Date: 8 -21 -12 within 180 days after it has been accepted as complete. * Fee methodology set by Tri -C. unty Building Industry Service Board. / I:\Building\Permits \FPS - permitApp.doc 02/01 /II 440-4613T(I1 /02/COM/WEB) j 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 ❑ 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: $ 4657 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 2 sets of plans at submittal. Plan review fees are required at submittal. \ \Safescrver \d$ \SAFE \ Forms \Use these forms \Permit Apps \Tigard \FPS-PermitApp.ctc 02/01/11 - 1lM li ro ecTt C ) (3S'' 9 B90 1 FF Z -Dole 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: L.l AU)! A Li - GTS 21&A f c lz S i Te POO Address: `O WOO c W Cr cec-r t v r Ra . 1 1 F'sa OS cA TZ23 Description of property:_ IC- R JIL -cil Occupancy type: iS - i US I 1 \ess G ed" S it. . C+ Name of property representative: Sk «S� n i 1 A }emu . 1'T` ei-iiCe2-� Address: 111)22-0 S W Gv�v..)'0. Ti 3 R rd Ote, 9 722-3 Phone: Fax: E -mail: Authority having jurisdiction over this property; Ct T1 0 f T t J A ra . Phone: Fax: E -mail: 2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION Installation / contractor for this equipment: 'pr Pt- 1 CChnO � I C�V`!1v P l hiC, Address: 61-Ioo 1 - e- 1-1-v.iy 4q SJ1-re. G - 3 ay.co i v)PP 'Mb5 Phone: 8IDo 5 - Z I ' I'S1 Fax: E -mail: Service organization for this equipment: 'S ti'■ fla-r V' I" t n NE (I Address: (23° SW Rose- t000d t4i -kg- OSwe3 o OP 91 O'35 Phone: 5o 3 6$3 9 COD Fax: 5'03 675 fo5 2I E -mail: Location of as -built drawings: 5 r r Q 1-Pi IN Location of historical test reports: '' Location of system operation and maintenance manuals: - FI A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: 0 T I(f O 'J l� COATRLT S I'\Ore.nST -1 A Address: Phone: Fax: 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: 6 Name of organization receiving alarm signals with phone numbers (if applicable): I Alarm: !l `0 sr S CATRCT Phone: Li A CO I r SZcU r' 4 • Supervisory:' ko f J'STCt r O r LA /loin SE Cv I' l'T`'( Phone: 103 535 1 59 3 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: X Digital alarm communicator 0 McCulloh 0 Multiplex 0 2 -way radio ,1 -way radio 0 N/A If Chapter 9, note the type of connection: 0 Local energy ❑ Shunt 0 N/A 3.1 System Software Operating system (executive) software revision level: Site - specific software revision date: -2.607 Revision completed by: I IM Crr I (tell 4. SIGNALING LINE CIRCUITS Uc e A , S)( TT ► r\ Characteristics of signaling line circuits connected to this system (see NFPA 72, Table 6.6.1): Quantity: I Style: Class: 5. ALARM - INITIATING DEVICES AND CIRCUITS sVift Characteristics o 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 0 Conventional ❑ Coded ❑ Transmitter N/A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: Type of coverage: 0 Complete area 0 Partial area 0 Nonrequired partial area N/A Type of devices: 0 Addressable 0 Conventional 0 Coded ❑ Transmitter /A Type of smoke detector sensing technology: 0 Ionization ❑ Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: Type of coverage: Type of devices: 0 Addressable 0 Conventional 0 Coded ❑ Transmitter XN /A Type of smoke detector sensing technology: 0 Ionization 0 Photoelectric 5.2.3 Heat Detectors Number of heat detectors: Type of coverage: 0 Complete area ❑ Partial area 0 Nonrequired partial area (N/A Type of devices: ❑ Addressable 0 Conventional 0 Coded ❑ Transmitter XN /A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: Type of devices: ❑ Addressable ❑ Conventional 0 Coded ❑ Transmitter XN /A 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is: 0 Enabled XDisabled ❑ 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 6.1 Sprinkler System Number of valve supervisory switches: l er Type of devices: 0 Addressable ❑ Conventional ❑ Coded 0 Transmitter XN /A 6.2 Fire Pump ,xiSTiA) Type of fire pump: 0 Electrical 0 Diesel Type of pump supervisory devices: 0 Addressable 0 Conventional ❑ Coded ❑ Transmitter /A Fire Pump Functions Supervised 0 Fire pump power ❑ Fire pump running 0 Fire pump phase reversal 0 Selector switch not in auto ❑ Engine or control panel trouble ❑ Low fuel Other: • lA 6.3 Engine Driven Generator E. 1 i y"5 Type of generator supervisory devices: 0 Addressable ❑ Conventional 0 Coded ❑ Transmitter /A ❑ Engine or control panel trouble ❑ Generator running 0 Selector switch not in auto ❑ Low fuel Other: I /R • 7. ANNUNCIATORS 7.1 Annunciator 1 ❑ Local ❑ Remote f Type: ❑ Addressable ❑ Directory ❑ Graphic XN/A N/A Location: b 7.2 Annunciator 2 ❑ Local ❑ Remote Type: 0 Addressable 0 Directory ❑ Graphic XN /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: e Number of multiple voice alarm channels: Number of speakers: Number of speaker zones: 8.2 Telephone Jacks Number of telephone jacks installed: 0 Number of telephone handsets stored on site: Type of telephone system installed: 0 Electrically powered ❑ Sound powered XN /A 8.3 Nonvoice Audible System c:7 C L y s A 1 5T► r1 (rid S S 1 s-a- Characteristics of notification device circuits connecte7 to this system (see NFPA 72, Table 6.5): Quantity: Style: Class: 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.3 of 5) NATIONAL FIRE ALARM CODE 8. ALARM NOTIFICATION DEVICES AND CIRCUITS (continued) 8.4 Types and Quantities of Nonvoice Notification Appliance Installed Bells: With visual device Horns: 3 S d With visual device: Chimes: With visual device Bells: With visual device: Visual devices without audible dev z Q U theer (describe): 9. EMERGENCY CONTROL FUNCTIONS ACTIVATED Ex �sTI r J �a 0 Hold -open door releasing devices ❑ Smoke management or smoke control Door unlocking / A- re-ssAble_ ❑ e - Elevator recall ❑ Other 10. SYSTEM POWER SUPPLY �.Sa;-1a.`l "PO V f'T'c -SS CO1^Tro 10.1 Primary Power s ^ Nominal voltage t �V v d4� Amps ao Overcurrent protection: Type I "C,( Amps 1 d Location (of primary supply panelboard): A .rT To OYN R.1 S'T Disconnecting means location: S Ni N 0 U V\ot ' r k L •6( " f 10.2 Secondary Power Location: nccp Type: Kr -re-VI Nominal voltage: I Z Current rating: a S Number of standby batteries: 2.- Amp hour rating: as" Location of emergency generator: Location of fuel storage: Ex /5 701 Calculated capacity of secon power to drive the system In standby mode: c. L O v'T 5 In alarm mode: 1 h I v T L 5 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 XI'NFPA 70, National Electrical Code, Article 760 0 Manufacturer's published instructions .0 Other (please specify): System deviations from referenced NFPA standards: Q Signed: / /�� Printed name: �� Date: / - 4! // Organization: 1a "yj Title: Phone: 300 (ay 30 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: 0 NFPA 72 ❑ NFPA 70, National Elec rical Code, Article 760 Manufacture published instructions XOther (please specify): r0.■/n1S / Pours . 0 Document i i ccordance with Inspection and Testing Form (Figure 10.6.2.3) is attached Signed: Printed name: RS r witT$fe) Date: ' Organization: Jim p�TMfte - Title:TCCr1 /�I / LEA Phone: So 653 / ?DOO Reprinted with permission from N PA 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.4 of 5) • FUNDAMENTALS OF FIRE ALARM SYSTEMS 13. CERTIFICATIONS AND APPROVALS 13.1 System Installation Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. Signed: f Printed name: SZ Date: 9 — ? /e— Organiz tioa n: e •i2 CA. WCF by 6/ic Title: few. Phone: 3G6 -15 4f a 0 13.2 System Se ice Contractor . This system a• ,eked herein has been installed and tested according to all NFPA standards cited herein. // Signed: �� Printed name: ?. f i S 1--1 Date: 2 9 ' b - 1 Organization: k.40( Il e..I Title: Te ).1 I GeT 1.6 A Phone: 5O3 La 3 9 oo° • 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 witnes /d a satisfactory acc- • ., ce test of this system and find it to be installed and operating properly in accordan = w'th its . ;,. ; oved • ans and specifications, its approved sequence of operations, and with all NFPA standards i • - ' erein. Signed Lam` - - ted name: «'h P 3/4(410 Date: (7' 7 _ 2 - Organization: Can/ ei i IC�st2t? Title: gt • ir■ f t S/ /hone: .5 7/(, Z G yy 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)