Permit , Ni
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
114 n
s COMMUNITY DEVELOPMENT Permit #: FPS2009 -00094
T t G ARD 13125 SW Ball Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009
Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15495 SW SEQUOIA PKWY 190
Subdivision: Lot: 0
Project: Columbia Soft
Project Description: Install (1) horn strobe/ (1) strobe to existing fire system.
Owner: FEES
Description Date Amount
Permit Fee - COM 10/13/2009 $62.50
12% State Surcharge - Building 10/13/2009 $7.50
PHONE: Plan Review - Fire Life Safety - COM 10/13/2009 $25.00
Contractor:
STANLEY SECURITY
15495 SW SEQUOIA PKWY #100
PORTLAND, OR 97224
PHONE: 503 - 968 -3353
FAX: 503- 968 -3398
Type of Use: COM
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: B Height: ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Hazard:
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $95.00
Valuations: _ Required Items and Reports (Conditions)
Sprinkler Valuation:
Residential Square Footage:
Fire Alarm Valuation: 1200
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
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.
1uilding Permit Application
Fire Protection System ' ����® FOR OFFICE USE ONLY
1 Received c e
City of Tigard
RECEIVED Date/By.. PertnitNo.:�P�200 l- Lt q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revew ( n �/� 11
0 ^ IDI1 Other Permit: 6uPZ O
OG .00 L(
Phone: 503.639.4171 Fax: 503.598Gtq 1 n Date/By:
TIGARD Inspection Line: 503.639.4175 Date Ready /B . Joni ® See Page 2 for
Internet: www.tigard-or.gov
CITY OF TIGARD Notified/Method: I c Supplemental Information
TYPE FAV,M DIVISION 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.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ 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: 15495 SW SEQUOIA PARKWAY New dwelling area: square feet
City/State /ZIP: PORTLAND, OREGON 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: 19 d Project name: COLUMBIASOFT Covered porch area: square feet
Cross street/directions to job s Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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 ONE (1) HORN STROBE / ONE (1) STROBE TO EXISTING FIRE SYSTEM Valuation: $1200
Existing building area: square feet
New building area: 1,797 square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PACIFIC REALITY ASSOCIATES Type of construction:
Address: 15350 SW SEQUIOA PARKWAY Occupancy groups:
City/State /ZIP: PORTLAND, OREGON 97224 Existing:
Phone: ( ) Fax: ( )
New:
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: STANLEY SECURITY SOLUTIONS All contractors and subcontractors are required to be
Contact name: GARY TAUSCHER licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15495 SW SEQUOIA PARKWAY jurisdiction in which work is being performed. If the
City/State /ZIP: PORTLAND, OREGON 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 968 -3355 I Fax: : (503) 968 -3398
E -mail: GTAUSCHER @STANLEYWORKS.COM
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: STANLEY SECURITY SOLUTIONS
Permit fee:
Address: 15495 SW SEQUOIA PARKWAY
State surcharge (12% of permit fee):
City/State /ZIP: PORTLAND, OREGON 97224 FLS plan review (40% of permit fee):
Phone: (503) 968 -3355 Fax: (503) 968 -3398 (Due upon application.)
CCB lic.: 161567 Total permit fees:
Authorized signature: Amount received: 95. 00
�9 G+�� /(/ /j 7J This permit application expires if a permit is not obtained
Print name: GARY TAUSCHER Date: 9/24 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\ Building \ Permits \FPS- PermitApp.doc 03/23/06 440-4613T( I I /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 ❑ 1 -10 heads: No plan review required.
® Alteration ❑ 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
❑ 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: $ 600
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): $
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.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
C: \Documents and Settings \ dennisp \Local Settings \Temporary Internet Files \OLK3DVPS- PemutApp PAC COLUMBIA SOFT 15495 SEQUOIA.doc
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FIRE ALARM SYSTEM
RECORD OF COMPLETION
Name of:protected property: -U 1f1 1 S.O f
Address:
`J'4 Ci■ -U..5 5 .)0 1 -tb6X21-V1 P' ()f Ct O
Representative of protected property (name /phone): +'����� t �-- t 1 4 1 73r✓
Authority having jurisdiction: Q-V V'' GG T\
Address /telephone number: 1 _ j 'S_ 2, L - LV l `t : I Q _
O -
1. Type(s) of System or Service 50 IS' `t 4 1 1
NFPA 72, Chapter 3 — Local
If alarm is transmitted to locatio_n(s) off, premises, list where received:
2L\/ �1("� i `l--\ 11\N
NFPA 72, Chapter 3 — Emergency Voice /Alarm 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:
NFPA 72, Chapter 6 — Auxiliary
Indicate type of connection:
Local energy Shunt Parallel telephone
Location of telephone number for receipt of signals:
NFPA 72, Chapter 5 — RemoteStation
Alarm:
Supervisory:
NFPA 72, Chapter.5 — Proprietary
Ifalarms are retransmitted to public fire service communications centers or others, indicate location and
telephone numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
>`• NFPA 72, Chapter 5 — Central Station
Prime contractor: \-/ t- ) Li i O t■j
Central station location: ? t � �� A t .
Means of transmission of signals from the protected premises to the central station:
McCull'oh Multiplex One -way radio
X Digital alarm communicator Two -way radio Others
Means of transmission of alarms to the public fire service communications center:
( '1 1=1CF
(b)
System location:
(NFPA Record of Completion 1 of 4)
•
•
1 12 )0 \c BO , 7 Z4 CIS
Organization name /phone Representative name /phone
Installer
‘51141l-e-\1 4 .A:7A w GttQti rit 33SC
Supplier ff
Service .organization
Location of record (as- built) drawings:
Location of owners manuals:
Location of test re o I. �.� , � �%
�L 1 � 1' � -- �� r U
Acontract, dated l a / , for test and inspection in accordance with NFPA standard(s)
.No(s). ,dated , is in effect.
2. Record of System Installation
(Fill out after installation is complete and wiring checked for opens, shorts, ground faults, and improper
branching, but prior to conducting , tests.)
Thi's'system has been installedin accordance with the NFPA standards as shown below, was inspected
by. , includes the devices shown below, and has been in service
since
NFPA 72, Chapters 1 2 3 4 5 6 7 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
Manuf. u er's instructions
Other (sp 'fy). -
Signed: 2 a �L 1 L _ Date: , ANT ry �
Organization: lIA Lt I j1�LL2dStt 'l
3. Record of System. Operation /
All operational features and functions of this system were tested by`s� tALCy - r on 1 � �j"` } �
and found to be operating properly in accordance with the requirements of:
NFPA 72, Chapters 1 2 3 4 5 6 7 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
Manufac urer's instructions
Other #
Signed: 4)J . �y. '_:al 3 Date: 4 1 � 2 4
Organization: e tiS t1ANc -ei ` ,L..)11 �
4. Alarm- Initiating Devices and Circuits
Quantity and class of initiating device circuits (see NFPA 72, Table 3 - 5) Quantity: Style: Class:
MANUAL
(a) Manual. stations Noncoded, activating Transmitters Coded
(b) Combination manual fire alarm and guard's tour coded stations
AUTOMATIC
Coverage: Complete: .Partial:
(a) Smoke detectors Ion . Photo
(b) Duct detectors Ion Photo
(c) Heat detectors FT 'RR. FT/RR RC
(NFPA Record of Completion 2 of 4)
•
•
(d) Sprinkler waterflow switches: Transmitters Noncoded, activating Coded
(e) Other (list):
5. Supervisory Signal - Initiating Devices and Circuits (use blanks to: indicate 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
N ote: Combination devices are recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) Coded valve supervisory signaling attachments
Value supervisory switches; activating transmitters
(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
(j) Fire pump running
Engine - driven generator:
(k) Selector in auto position
(1) Control panel trouble
(m) Transfer switches
(n) Engine running
Other supervisoryiunction(s) (specify):
6. Alarm Notification; Appliances and Circuits
Quantity,an&class (see NFPA 72, Table - 3 =7) of notification appliance circuits connected to the system: •
Types and quantities of notification appliances installed: Quantity: Style: IS Class:
(a) Bells Inch
(b) Speakers
(c) Horns
(d) Chimes
Other:
ls; it Lb& EL
(e) X �'�f) ?.0 l
(NFPA Record of Completion 3 of 4)
(f) Visual signals Type:
with audible w/o audible
(g) Local. annunciator
7. Signaling Line Circuits
Quantity and class (see NFPA 72, Table 3 =6) of signaling line circuits connected to system:
Quantity: Style: Class:
8. System Power Supplies
(a) Primary (main): Nominal voltage: Current rating:
Overcurrent protection: Type: Current: rating:
Location:
(b)Secondary (standby):
Storage battery: Amp -hour rating:
Calculated capacity to drive system, in hours: 24 60
Engine- driven.generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency or used as backup to primary power supply, instead using a secondary
power supply:
Emergency system described in NFPA 70, Article 700
Legally required standby system described in NFPA 70, Article 701
Optional standby system 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):
(b) Application software revision level(s):
(c) Revision completed by:
(name) (firm)
10. Comments:
(signed); for central station or alarm service company or installation contractor /supplier (title) (date)
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:
(signed) for central station or alarm service company or installation contractor /supplier (title) (date)
Upon completion of the,system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
• (signed) representative of the authority having jurisdiction (title) (date)
(NFPA Record of Completion 4.ofe4)
•