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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 2 COMMUNITY DEVELOPMENT Permit #: FPS2012 -00176 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Eil1 ED Date Issued: 01/03/2013 10 ii Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 110 Project: Fidelity National Title Subdivision: METZGER, TOWN OF Lot: 9 Project Description: Install fire alarm notification devices for TI 1/7/13 REPRINT adding 2 hr. minimum early morning inspection Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC 11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503 - 255 -9488 PHONE: FAX: 503 - 255 -1966 FEES Description Date Amount Specifics: Permit Fee - COM 01/03/2013 $91.44 12 %State Surcharge - Building 01/03/2013 $10.97 Type of Use: COM Plan Review - Fire Life Safety - COM 01/03/2013 $36.58 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 01/03/2013 $10.00 Occupancy Grp: B Height: ft 11x17) Stories: Info Process /Archiving - Sm $0.50 (up to 01/03/2013 $3.00 11x17) Misc Administration Fee 01/03/2013 $5.00 Commercial Sprinkler System: Houlry Building Rate 01/07/2013 $180.00 Sprinkler Required: Sprinkler Type: Hourly Building 12% State Surcharge 01/07/2013 $21.60 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: Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $358:59 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $2,000.00 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 b b J y calling 503.232.1987 or 1.800.332.2344. , f Issued By: '�� {//, I/ 6 h t d-- Permittee Signature: OL �.pPue477 0 I�r/ll..XX ! 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. r e4,h_ CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT s COMMUNITY DEVELOPMENT Permit #: FPS2012 -00176 T (GA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/03/2013 Parcel: 1 S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 110 Project: Fidelity National Title Subdivision: METZGER, TOWN OF Lot: 9 Project Description: Install fire alarm notification devices for TI Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC 11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503 - 255 -9488 PHONE: FAX: 503 - 255 -1966 FEES Description Date Amount Specifics: Permit Fee - COM 01/03/2013 $91.44 12% State Surcharge - Building 01/03/2013 $10.97 Type of Use: COM Plan Review - Fire Life Safety - COM 01/03/2013 $36.58 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 01/03/2013 $10.00 Occupancy Grp: B Height: ft 11x17) Stories: Info Process /Archiving - Sm $0.50 (up to 01/03/2013 $3.00 11x17) Misc Administration Fee 01/03/2013 $5.00 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: Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $156.99 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $2,000.00 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: �7A „ .}— Permittee Signature: D i ll r ok PPL C,/1 Ti OkN 'kVA/ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 1T 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. Building Permit Application !Fire Protection System RECEIVED FOR OFFICE USE ONLY q Received City of Tigard DEC Q � , 2012 Date /By: t ! / x. Sir Permit No.: (%P S )4,/,),.0 DV I IC/ r 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ► i Phone: 503.639.4171 Fax: 503.598.19(0 OF TIGARD Date/B s t/ 4 . I /2 , a Other Permit'Ategapa, o0s3 7 TI GARD Inspection Line: 503.639 Date Ready/By: + luris: El See Page 2 for Internet: www.tigard- or.gov B DIVISION Noti fied/Method: �, ? -I3 Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING El 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 El Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. k ❑ 1- and 2- family dwelling ® Commercial/industrial Valuation: $ El Accessory building ❑ Multi - family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: `' 1 Job site address: 10200 SW Greenburg Rd. (Five- Lincoln) New dwelling area: square feet n I City/State /ZIP: Tigard., OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: 110 Project name: Fidelity T.I. 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 (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Install Fire Alarm Notification Devices In Tenant Space per plans Valuation: $2,000.00 Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Shorenstein Realty Services Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: g Phone: ( ) Fax: ( ) New: ❑ APPLICANT El CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR BUILDING PERMIT FEES* Business name: Capitol Electric Company, Inc. (Please refer to fee schedule) Permit fee: 102.20 Address: 11401 NE Marx Street City/State /ZIP: Portland, OR 97220 State surcharge (12% of permit fee): 12.26 FLS plan review (40% of permit fee): 40.48 Phone: (503) 255 -9488 Fax: (503) 255 -1966 (Due upon application.) CCB lic.: 48748 Total permit fees: 155.34 Authorized signature: Amount received: This permit application expires if a permit is not obtained Print name: Dan Wilson Date: 11/30/2012 within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I 4 9 I: �Building�Pevni ts�FPS- PertnitApp.doc 03/23/06 440.4613T(I1/02/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 ❑ 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: $ $2,000.00 D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 3,601 to 7,200 $292.50 7,201 and greater $381.50 Sprinkler Project Square Footage: sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A, B & C above): $ 2,000.00 Permit fee based on project valuation (see fee schedule): $ 102.20 Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ 12.26 FLS Plan Review (40% of permit fee): $ 40.88 TOTAL: $ 155.34 Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. U: \FA Jobs \zz130031 -45 Fidelity @ 5Lincoln -110\ 1 FPS - PermitApp.doc 2 CITY OF TIGARD RECORDS RETENTION FEES WORKSHEET BUILDING PERMITS Fees for scanning building department submittals. Size # of Pages Cost per Page Total 8 1/2" x 11" 6 X $0.50 $3.00 8 1/2" x 14" X $0.50 $0.00 11" x 17" X $0.50 $0.00 18" x 24" X $2.00 $0.00 24" x 36" X $2.00 $0.00 30" x 42" 5 X $2.00 $10.00 Other formats X $2.00 $0.00 TOTAL RECORDS RETENTION FEE I $13.00 I zo /z- o 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: + t e c) \ \ 0 i � Address: d2O CD • w 2F E• v� \ \ (ok A v�� C 2 Description of property: 0 -F- f. Occupancy type: Name of property representative: • Address: Phone: Fax: E -mail: Authority having jurisdiction over this property: Phone: Fax: E -mail: 2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION Installation contractor for this equipment: e1 c : "I ` F c Y-2_ c- Address: `t. ekO . E M, n - S - C 0 �► --� Phone: Fax: E -mail: Service organization for this equipment: Address: Phone: Fax: E -mail: Location of as -built drawings: Location of historical test reports: Location of system operation and maintenance manuals: A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: 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: Name of organization receiving alarm signals with phone numbers (if applicable): Alarm: Phone: Supervisory: Phone: 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: I4•Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio 0 1 -way radio 0 N/A If Chapter 9, note the type of connection: ❑ Local energy 0 Shunt ❑ N/A 3.1 System Software Operating system (executive) software revision level: k 0 9, - U k Site - specific software revision date: Revision completed by: 4. SIGNALING LINE CIRCUITS Characteristics of signaling line circuits connected to this system (see NFPA 72, Table 6.6.1): Quantity: t Style: Class: 5. ALARM - INITIATING DEVICES AND CIRCUITS Characteristics of 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: 0 Addressable 0 Conventional ❑ Coded 0 Transmitter ❑ N/A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: Type of coverage: 0 Complete area ❑ Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ❑ Addressable ❑ Conventional 0 Coded ❑ Transmitter 0 N/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 ❑ Conventional 0 Coded 0 Transmitter 0 N/A Type of smoke detector sensing technology: ❑ Ionization ❑ Photoelectric 5.2.3 Heat Detectors Number of heat detectors: Type of coverage: ❑ Complete area 0 Partial area ❑ Nonrequired partial area 0 N/A Type of devices: 0 Addressable ❑ Conventional ❑ Coded 0 Transmitter 0 N/A 5.2.4 Sprinkler Watertlow Detectors Number of waterflow detectors: Type of devices: 0 Addressable 0 Conventional ❑ Coded 0 Transmitter 0 N/A . 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is: ❑ Enabled 0 Disabled 0 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: Type of devices: ❑ Addressable O Conventional ❑ Coded ❑ Transmitter ❑ N/A 6.2 Fire Pump Type of fire pump: ❑ Electrical ❑ Diesel Type of pump supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Fire Pump Functions Supervised ❑ Fire pump power ❑ Fire pump running ❑ Fire pump phase reversal ❑ Selector switch not in auto ❑ Engine or control panel trouble ❑ Low fuel Other: 6.3 Engine Driven Generator Type of generator supervisory devices: 0 Addressable ❑ Conventional 0 Coded ❑ Transmitter ❑ N/A ❑ Engine or control panel trouble 0 Generator running ❑ Selector switch not in auto ❑ Low fuel Other: 7. ANNUNCIATORS 7.1 Annunciator 1 ❑ Local 0 Remote Type: Addressable ❑ Directory 0 Graphic ❑ N/A Location: 7.2 Annunciator 2 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory 0 Graphic ❑ N/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: Number of multiple voice alarm channels: Number of speakers: Number of speaker zones: 8.2 Telephone Jacks Number of telephone jacks installed: Number of telephone handsets stored on site: Type of telephone system installed: ❑ Electrically powered ❑ Sound powered ❑ N/A 8.3 Nonvoice Audible System Characteristics of notification device circuits connected 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 Appliances Installed Bells: With visual device Horns: With visual device: Chimes: With visual device Bells: With visual device: Visual devices without audible devices: Other (describe): 9. EMERGENCY CONTROL FUNCTIONS ACTIVATED ❑ Hold -open door releasing devices ❑ Smoke management or smoke control ❑ Door unlocking ❑ Elevator recall ❑ Other 10. SYSTEM POWER SUPPLY 10.1 Primary Power Nominal voltage Amps Overcurrent protection: Type Amps Location (of primary supply panelboard): Disconnecting means location: 10.2 Secondary Power Location: Type: Nominal voltage: Current rating: Number of standby batteries: Amp hour rating: Location of emergency generator: Location of fuel storage: Calculated capacity of secondary power to drive the system In standby mode: In alarm mode: 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 ❑ NFPA 70, National Electrical Code, Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): System ' tions from referenced NFPA standards: �� /� Signed: Printed name: \✓�1.1 0 Aa. A- 2- Date: l - . D - a- c. l2_. Organization: S ■ r••• kEN. 12.N. non) e- k` Title: T . Phone: 5cY (o�'j3 --ck CGCJ 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: NFPA 72 <4 NFPA 70, National Electrical Code, Article 760 1 Manufacturer's published instructions ❑ Other (please specify): ❑ Doc ation in accordance with Inspection and Testing Form (Figure 10.6.2.3) is attached Signed: CJ-- : Printed name: DALI £ J9 a Date: I' ‘ G - X 0\2— Organization: >. 'h p ■ `�oY2 t — .. - \N Title: - V. i Phone:(J3 a'S 3 -- cwoc) 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 a pecified herein has been installed and tested according to all NFPA standards cited herein. Signed: l� 9 Printed name:,'( <�/ �eHe Date: �/ �v/ « Organization: `Q�/� / ,G(.t f i C Title: ���1-/ C /Cr Phone: S O - ; - LSO •• io 'P 7-- 13.2 System Service Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. • . Signed: Printed name: Date: Organization: Title: Phone: 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 witn; ••sed a satisfactory acceptance test of this system and find it to be installed and operating properly in accord. . -with its approved s • • :nd specifications, its approved sequence of operations; and with all NFPA . standard . ,, ed herei - . Signed ,L..... ..��- Printed name:Ch'( a 41 El Date: l — /C2 (� Organization: �U I i Title: t)U -b -. 1 S (t Phone:. 3 8 - 2-G4(54 L \ c, COv \i"\\ 0 �..� \ `2G E f. �cao ` ��C \ A ,---" i l \ \ _ I 1 f0 1� (3L); l d, -..,c\ 5 °Ai . 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)