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Permit CITY TIGARD BUILDING PERMIT PERMIT #: BUP2007 - 00517 COMMUNITY DEVELOPMENT DATE ISSUED: 10/9/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134AB-03300 SITE ADDRESS: 10330 SW SCHOLLS FERRY RD ZONING: R -12 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: MUSLIM EDUCATIONAL TRU Project Description: FLS 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: E1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf . LEFT: ft RGHT: ft FIR SPKL: SMOK DET:Y DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 7,192.00 Owner: Contractor: MUSLIM EDUCATIONAL TRUST ADT SECURITY SERVICES INC PO BOX 283 2815 SW 153RD DR TIGARD, OR 97223 BEAVERTON, OR 97006 Phone: Contact #: FAX 503 -469 -7110 PRI 503 - 469 -7100 Reg #: LIC 59944 FEES REQUIRED ITEMS AND REPORTS Description Date Amount [BUILD] Permit Fee 10/4/2007 $105.40 [TAX] 8% State Surchart 10/4/2007 $8.43 [FLS] FLS Pln Rv 10/4/2007 $42.16 Total $155.99 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 rf 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 r t 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 call' g 503.246.669• .:00. 3 . • I sued By:/ PermitteeSignaturek 414 fe "- 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 Syste m - r �--3 {l Building Permit Applica lint d • V r,,,, ,..1,.j FOR OFFICE USE ONLY Recetved� City of Tigard ( �rT Date /B O Pennu No 0.• 4.4./ Other Peri it 13125 SW Hall Blvd , Tigard, OR 9 79Z'J 2007 Plan Rem ►�4 17 �� y Phone 503 639 4171 Fa� 5QQ3 9� 19 0 Daterl3 ��` 1 Inspection Line 503.639.4k7.51f 1 1 u .IUARD) Date Ready /By )u El See Page 2 for TIGARD t�� a�'�'� Notified /Method Su Internet www.tigatd -oL� tL1JId. ING DIVISION Supplemental Information TYPE OF WORK DIVISION REQUIRED DATA: I- 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 IX Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ I- and 2- family dwelling Commercial /industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ID Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /D Q s60 _56 /44 Li s ` ,. . New dwelling area: square feet City /State /ZIP: �6 I)/ D 2 97 , 77.y 3 Z Garage /carport area: square feet Suite /bldg /apt. no.: Project nameiN S hi m Fbste 4 Covered porch area: square feet Cross street/directions to job site: TAWS cr Deck area: square feet Z•1 To 6/4 - /., tA) .-C42 a - 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. /�g� n7Si7YLLAkt --ivti e)- t-COLe- be-/ 4'/ 03 Valuation $ 1 I (�a / 3 . i. � � p _���M - re ms- Existing building area: square feet / v p, _ 9- (4 j New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction. Address: Occupancy groups. Q Existing: City /State /ZIP: Existin " !J Phone ( ) Fax: ( ) New • ,[]'APPLICANT ...la PERSON NOTICE Business name. /9..b j ...V 2+ SrAw/�ryg ,1 e , All contractors and subcontractors are required to be t \ � licensed with the Oregon Construction Contractors Board • Contact name �..�ID,C) /4_0 k-iZOm under ORS 701 and may be required to be licensed in the • Address: a0,9/s W / S`3 i2 — Dlu Jurisdiction in which work is being performed. If the t City /State /ZIP: RE04d/ B(4 -.0,), 0 g7 �( plicant is exempt from licensing, the following reasons ` apply: i Phone: V3) t/„9, 7/-7,5 TT Fax:: (993- L ib 9 .-- / f/D • K E- mail: .) X 2_om Cv A-7 , a P-rY1 • CONTRACTOR BUILDING PERMIT FEES* (Please refer In fee schedule) Business name: fig- � •3 Q � Permit fee: /0 5 Address: 'L State surcharge (8% of permit fee): 5 . £ City /State /ZIP: (40% FLS plan review (40% of permit fee): Phone ( ) Fax: ( ) (Due upon application.) y a - I ti CCB lic.: S-7; Total permit fees: Amount received: 1 ob • / 1 ID Authorized signature: ion f� `, A �-- _ / �-I'h'�t This permit application expires if a permit is not obtained Print name: p IJ A 0 Date: /' 03®7 within 180 days after it has been accepted as complete. * Fee methodology set by Tii- County Building Industry Service Board. i \Buiidmg\Permns \FPS- PennnApp.doc 03/23/06 440-4613T(I i /02 /COM /NEB) 04/23/2008 07:31 FAX 5034697110 ADT SECURITY 1 0 002 72 - 25 TUNDAMENTAt.SP 1P P7 AL; M SYSTE - i 2el a 7' VQ 9 7 Record of Completion Name of Protected Property Muslim Educational Trust Address: 10330 SW Scbolls Ferry Rd. Tigard,Ore.97223 Rcp. Of Protected Prop. ( name/phone): Authority Having Jurisdiction: City of Tigard Address/Phone Number: 13125 SW Hall Blvd. Tigard ,Ore. 1. Typc(s) of System Service: NFPA 7 Chapter 3 - Local If alarm is transmitted to location(s) off premise, list where received: ADT SECURITY SERVICES INC 14200 E. EXPOSITION, AURORA, CO 80012 NFPA 72, Chapter 3 - Emergency Voice/Alarm Service Quantity of speakers installed Quantity of speaker zones: Quantity of telephones or telephone jacks included in system: NFPA 72, Chapter 4 - Auxiliary Indicate type of connection: Local energy, Shunt, Parallel telephone Location and telephone number for receipt of signals: NFPA 72, Chapter 4 - Rcmotc Station Alarm: Supervisory: NFPA 72, Chapter 4 - Proprietary If alarms are retransmitted to public service communications center or others. indicate location and telephone number of the organization receiving alarm: indicate how alarm is retransmitted: 4 NFPA 72, Chapter 4 - Central Station The Prime Contractor: ADT SECURITY SERVICES, INC _ Central Station Location: ADT SECURITY SERVICES, INC 14200 E. EXPOSITION, AURORA, CA CO 80012 Means of transmission of signals from the protected premise to the central station: McCulloh Multiplex One -Way Radio J Digital Alarm Communicator Two -Way Radio Others Means of transmission of alarms to the public fire service communications center: (a) TELCO (b) TELCO System Location: ADT -1- 888 - 238 -2666 DUTY SUPERVISOR Organization Name/Phone Representative Name/Phone Installer ADT SECURITY SERVICES, INC 503 -469 -7110 KEN KRAUS 503 -469 -7212 Supplier ADT SECURITY SERVICES, INC 503 - 469 -7110 KEN KRAUS 503 -469 -7212 Service Organization ADT SECURITY SERVICES, INC 1- 888 -238 -2666 KEN KRAUS 503 -469 -7212 Location of Record (As- Built) Drawings: ON SITE W/MANAGER Location of Owners Manuals: ON SITE W/MANAGER Location of Test Reports: ON SITE W /MANAGER A Contract, dated l ` d. e J ' - D "7 , for test and inspection accordance with NFPA standard(s) No.(s) 72 ,dated , is in effect. Figure 1 -7.2.1 Certificate of Completion • 1996 Edition 04/23/2008 07:31 FAX 5034697110 • ADT SECURITY 8 003 72 -26 NATIONAL FIRE ALARM CODE 2. Certification of System Installation (Fill out after installation is complete and wiring 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 listed below, was inspected by on X , includes the devices listed below and has been in service since X ADT SECURITY SERVICES, INC NFPA 72, Chapters 0 3 ® 0 ( el (circle all that apply) NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Other (specify): — • Signed: X Date: X _ Organization: APT SECURITY SERVICES, INC 3. Certification of System Operations All operational features and functions of this system were tested by ADT SECURITY SERVICES, INC. on X and Found to be operating properly in accordance with the requirements of: NFPA 72, Chapters 0 3 ® © ® ® (circle all that apply) d NFPA 70, National Electrical Code, Article 760 Manufacnuer'S instructions Other (specify): NONE Signed: X Date: X Organization: ADT SECURITY SERVICES, INC 4. Alarm Initiating Devices and Circuits (Use blanks to indicated quantity of devices.) MANUAL a) 14 Manual Stations Noncoded, Activating 1 Transmitters Coded b) Combination Manual Fire Alarm and Guard'; Tour Coded Stations AUTOMATIC Coverage: Complete: Partial: a) 25 Smoke Detectors Ion X Photo b) Duct Detectors Ion Photo c) 6 Heat Detectors FT RR FT /RR RC d) Sprinkler Water Flow Switches Noncoded. activating 1 Transminers Coded e) Other: (list) 5. Supervisory Signal Initiating Devices and Circuits (Use blanks to indicated quantity of devices.) GUARD'S TOUR a) Coded Stations b) Noncoded Stations Activating Transmitters c) Compulsory Guard Tour System Comprised of Transmitter Stations and Intermediate Stations Note: Combination devices recorded under 4 (b) and 5(a). SPRINKLER SYSTEM a) Coded Valve Supervisory Signaling Attachments Valve Supervisory Switches Activating Transmitters — b) Building Temperature c) Site Water Temperature Points d) Site Water Supply Level Points Electric Pump: c) Pump Running f) Controller Off (AC Loss) g) AC Phase Reversal Engine - Driven Fire Pump: h) Engine Running k) Engine trouble i) Controller Off I) Low Fuel j) Controller Trouble m) Fuel Spill Engine • Driven Generator: n) Selector in Auto Position o) Control Panel Trouble p) Transfer Switches q) Engine Running Figure 1 -7.2.1 Record of Completion (continued) • 1996 Edition 04/23/2008 07:32 FAX 5034697110 ADT SECURITY (1004 'UNDAMENTAL OF FIRE ALARM SYSTEM Other Supervisory Function(s) (specify) 6. Alarm Notification Appliances and Circuity Types and Quantity of alarm indicating appliances installed: a) Bells Inch Speakers b) X Horns c) Chimes d) Other: e) X Visual Signals Type ' HORN/VISUAL 22 With audible 6 without audible t) I Local Anaunciatur 7. Signaling Linc Circuits: Quantity and Style (Sec NFPA 72, Table 3 -6.1) of signaling line circuits connected to system; Quantity: _ 4 Style: B 8. System Power Supplies: a) Primary (Main) Nominal Voltage: is VAC Current Rating: 72 VA Overcurrent Protection: Type DEDICATED BREAKER Current Rating: 20 amp Location: Basement Furnace Room NE _ b) Secondary (Standby): Storage Battery: Amp Hour Rating: 2(12v 7 AH) Calculated capacity to rive system, in hours: +/ 24 60 Engine - driven generator dedicated to fire alarm system: C) Location of fuel store Emergency or Standby System used as backup to primary Power Supply, instead of using a Secondary Power Supply" - Emcrgcncy System described in NFPA 70, Article 700 - Legally Required Standby System described in NFPA 70, Article 71 - Optional Standby described in NFPA 70. Article 702, which also meets the performance requirements of Article 700 or 701 9. System Software a) Operating System Software Revision Level(s): N/A b) Application Software Revision Level(s): N/A • c) Revision Completed by: N/A (name) (firm) 10, Comments (Signed) for Central Station of Alarm Service Company (title) (date) Frequency of routine tuts and inspections, if other than in accordance with the referenced NFPA standard(s): NONE System deviations from the referenced NFPA standard(s) arc: (Signc ,r for Central S' of Alarm Service Company (title) (date) Upon complex .n of the sy em(s) satisfactory test(s) witnessed (if r,• uircd by the au ority having jurisdictio ): X ) • . _ • ZS C o (Signed) representative of authority having jurisdiction (title) (date) Figure 1 -7.2.1 Record of Completion (continued). 1998 Edition CITY OF TIGARD F BUILDING DIVISION PERMIT #: aqDD / 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 °'' �.. INSPECTION WORKSHEET FOR DATE: l6/0 5 TIME: PAGE: SITE ADDRESS: /6033D ,^,) , e-if J S E:-.)/( CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT TION: � 77 77104(105 tZ( S DESCRIPTION: & . � OWNER: %'�j'1i�71`1y' f`v/A PHONE #: CONTRACTOR: �+'� T: PHONE #: I Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message go fF Corrections /Comments/ Instructions: . _ 4 A i d • 1 , 't . / ./ ) 1114 4 _A_ / af X- ) I / A... , , . id/ i I .....dlar:A -- /M— Gpi 71 -�L mil f ' ' / 5 s . 1 6 )6e we' V )S{PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i Inspector: '� Date: J C 610t Phone #: (503) 718 - a Vik CITY OF TIGARD. - BUILDING DIVISION PERMIT #: 13UP2001 00517 13125 SW Hall Blvd., Tigard, OR 97223 ,4, DATE ISSUED: 10/W2007 Phone: (503) 639 -4171 ill i Inspection Requests (24 Hrs.): (503) 639 -4175 s_' ^_ INSPECTION WORKSHEET FOR DATE: 4/1512008 TIME: 7:07AM PAGE: 43 SITE ADDRESS: 10330 SW SCHOLLS FERRY RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MUSLIM EDUCATIONAL TRU DESCRIPTION: Alarms OWNER: MUSLIM EDUCATIONAL TRUST, PHONE #: CONTRACTOR: ADT SECURITY SERVICES INC PHONE #: 503 469 - "1100 Inspection Request Scheduled For: Date: 4/15/2008 Pour •• -: V Code # Inspection Description Confirm # Contact # Me :age 9:30 Alarm final 0693(4 -02 535.195-687# Y ° Corrections /Comments /Instructions: UGZvo - od Zi 4 (.?6•AiLde frtfikS‘) L( C, No vt) - .--p a 7 # O A:e9\4 dv-e.4 '%,„. C) .--K4-i C*l 6( a C (> 1 0 )00 — 0 0 AI•'1L. 1 `� ' ' !��7 - 0, < Jhe,5-;./ e,_, (Art •- yj — i - e _ e44___, ! - {) 4 60-7„ .-- )%k-c - s . oo ,t,,J tN fre P- - — 7 2 r(1 eA. 1 ki\ PA SS PARTIAL APPROVAL 1g CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED .74't Inspector: Date: Phone #: (503) 718- y