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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2011 00007 r r 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/18/2011 TIGARD Parcel: 2S 112DA01400 Jurisdiction: Tigard Site address: 15350 SW SEQUOIA PKWY 300 Project: Pacific Realty Subdivision: PACIFIC CORPORATE CENTER Lot: 0 Project Description: Relocate (4) horn strobes and install (2) strobes to existing fire system. Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS IN( Owner: PACIFIC REALTY ASSOCIATES 15495 SW SEQUOIA PKWY STE 100 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PORTLAND, OR 97224 PHONE: 503 - 968 -3353 PHONE: 503 - 624 -6300 FAX: 503 - 968 -3398 FEES Description Date Amount Specifics: Permit Fee - COM 01/18/2011 $86.06 12% State Surcharge - Building 01/18/2011 $10.33 Type of Use: COM Plan Review - Fire Life Safety - COM 01/18/2011 $34.42 Class of Work: FPS Type of Const: IIB Occupancy Grp: B Height: ft Stories: 3 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: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $130.81 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $0.00 Residential Square Footage: 0 Fire Alarm Valuation: $1,797.00 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 -009x. You may tain a copy of the rules or direct questions to OUNC by calling 03.232.1987 or 1.800.332.2344. Issued By: 41, ,� Permittee Signature: ` is --✓-- Call 503.639.4175 by 7:00 a.m. for the next available in ' ection 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. Building Permit Application i EC E\ ir fl - Fire Protection System F OR OFF USE ONLY J AN 18 2011 Received City of Tigard Re Date/By: / /i/ Permit No.: � � DOaea 2 11 4 . l ' : . °. 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review !!'�a /a . �� Ph one: 503.639.4171 Fax: 503.598.196�IT OF TIGARD Date/By: Other Perrot . TEGA -R Inspection Line: 503 BUILDI DIVISION Date Ready /By: Juris: H See Page 2 for - Internet: www.tigard- or.gov Notified /Method: - Supplemental Information ° „' r ` t ? x '' . �"TYPE t OF W ORKt ' : "' - ' 2 "'" * ' ' '': ' F - ,- 4 ” _ 4 � REQUII2E AT A ' 1 ^. ND:2 FAMIL'I' 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 r r , x work indicated on this application. - s CATEGORY OF CONSTRUCTION � Valuation: $ ❑ 1- and 2- family dwelling . ® Commercial /industrial • ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ` ❑ Other: Number of bathrooms: ' 1 ' JOB STTE, ., : INFORMATION' AND LOCATION , `' a , , Total number of floors: ,. ,_. . .x.,,. , -_.,n ,..Eli _ ^. ,- .-: 'ft - , A- . y. , ,u('. , m , ,. ss, ., .. y"' ft:' C Job site address: 15350 SW SEQUOIA PARKWAY New dwelling area: square feet City /State /ZIP: PORTLAND, OREGON 97224 • Garage /carport area: square feet Suite/bldg. /apt. no.: 300 Project name: PACTRUST Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA COMMERCINE=USE CHEGKLIST' 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 .,F.!.4,..,1 = � v ' ; DESCRIPTION ° C T C, i , work indicated on this application. RELOCATE FOUR HORN STROBE / INSTALL ftlItEr STROBE TO EXISTING Valuation: $1200 FIRE SYSTEM `'rWO Existing building area: square feet New building area: 1,797 square feet =. W - r - Number of stories: '.s a - , , ® PROPERTY „ r ®s TENANT" "'f Name: PACIFIC REALITY ASSOCIATES . Type of construction: Address: 15350 SW SEQUIOA PARKWAY Occupancy groups: 6 City /State /ZIP: PORTLAND, OREGON 97224 Ex • Phone: ( ) Fax: ( ) New: € ` •i r 4 1 a ❑° O CN` SON ' sNOTIGE ; x a ., ® 4APPLICANT tee. � . , _ . ur .. , ..., .:�.. �' �ar . - -, _•. . Ui. - F - tr "> t_. . ire a . . , � � v _ 3 ,V • Business name: STANLEY SECURITY SOLUTIONS All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: GARY TAUSCHER 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 applicant is exempt from licensing, the following reasons City /State /ZIP: PORTLAND, OREGON 97224 apply: Phone: (503) 968 -3355 Fax: : (503) 968-3398 • • E-mail: GTAUSCHER @STANL p4 OM b C; Y; � ` 77 Ot ' I ' ,;BUILNG PERMIT FEES* r , t t ,2 t ' r . ..m' . .,,, . , .,,. „ iyy .. ...:. . .... r ,.�,,, . _, , .; . —.- . ,' . , s (P . b - 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 lie.: 161567 Total permit fees: Amount received: /3 ° ep/ Authorized signature: r) ) 3 . This permit application expires if a'permit is not obtained 1 l� within 180 days after it has been accepted as complete. Print name: GARY TAUSCHER Date: 01/13/2010 * Fee methodology set by Tri- County Building Industry • Service Board. El� ily, r ) I:\Building \Permits \FPS- PermitApp.doe 03/23/06 440- 4613T(11 /02 /COM/WEB) bra /y ?/ City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information y. o Descrlbe*WOrk'tbea;CIone :, ,1 z ; _..� �, ' . >�..; 1.) El New 2.) Modification to sprinkler heads only: El Addition ❑ 1 -10 heads: No plan review required. ® Alteration El 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: • T w e "of "S stem Corn lete -A BC or TDa= asa 4 hcalile �5 A ) Colnmercia1Sprrnkler n t: : 'rs _ . r; ' '5 ; ,'r ; . . ,. ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ H *oodaF S uppression System s w , n x ',4'.1'47.4"; _ .• , _ x, f; 4 Hood Project Valuation: $ C) Fl re Al arm, ., . a" " hv ,n C., Submittal shall Battery Calculations El Yes include: Individual Component ® Yes Cut Sheets • Fire Alarm Project Valuation: $ 600 ` D ), Tee' n tlal �Sprrrikler (Stand .System) 3 ` .mss `" r ",. P R._Fr : ,fw .$ <: W -4x r. .s ra. r. Y'.x .. ,. x x %,. `n �nY- a a � . R48F,4 Square Footage: Permit Fee: •, F 0 to 2,000 $187.50 2,001 to 3,600 $232.50 3,601 to 7,200 $292.50 „44 4,4, 7,201 and greater $381.50 � fi� Sprinkler Project Square Footage: sq. ft. 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 \gmt1026 \My Documents \ Permits \ FPS-PermitApp PAC CQLUMBIA SOFT 15495 SEQUOIA.doc • ppsz. l- 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: Pacific Corporate Center Address: 15350 SW Sequoia Parkway, Suite 300 Description of property: Pactrust Occupancy type: Name of property representative: Dennis Pagni Address: 15350 SW Sequoia Parkway #300 Phone: 503 - 624 -6300 Fax: E-mail: Authority having jurisdiction over this property: City of Tigard Phone: 503 - 639 -4171 Fax: E -mail: 2. Fire Alarm System Installation, Service, and Testing Information Installation contractor for this equipment: Stanley Convergent Security Solutions Address: 15495 SW Sequoia Pkwy Ste. 100, Portland, OR 97224 Phone: 5039683300 Fax: . 5039683397 E -mail: Service organization for this equipment: Stanley Convergent Security Solutions Address: 15495 SW Sequoia Pkwy Ste. 100, Portland, OR 97224 Phone: - 5039683300 Fax: 5039683397 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: Stanley Convergent Security Solutions Address: 15495 SW Sequoia Pkwy Ste. 100, Portland, OR 97224 Phone: 5039683300 Fax: 5039683397 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: Stanley CSS Phone: 8778990001 Supervisory: Stanley CSS Phone: 8778990001 Trouble: Stanley CSS Phone: 8778990001 Entity to which alarms are retransmitted: Phone: Method of retransmission of alarms to that organization or location: _ NFPA 72, Fig. 4.5.2.1 (p. 1 of 5) Copyright © 2009 National Fire Protection Association This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. If Chapter 8, note the means of transmission from the protected premises to the central station: ❑ Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio ❑ 1 -way radio ❑ N/A If Chapter 9, note the type of connection: ❑ Local energy ❑ Shunt ❑ N/A 3.1 System Software Operating system (executive) software revision level: 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 66.1): Quantity: 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: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization ❑ Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: Type of coverage: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization ❑ Photoelectric 5.2.3 Heat Detectors Number of heat detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is: ❑ Enabled ❑ Disabled ❑ Set for • seconds 6. Supervisory Signal Initiating Devices and Circuits 6.1 Sprinkler System Number of valve supervisory switches: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A NFPA 72, Fig. 4.5.2.1 (p. 2 of 5) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. • 6.2 Fire Pump Type of fire pump: ❑ Electric ❑ Diesel Type of fire 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: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A ❑ Engine or control panel trouble ❑ Generator running ❑ Selector switch not in auto ❑ Low fuel Other: 7. Annunciators 7.1 Annunciator 1 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic ❑ N/A Location: 7.2 Annunciator 2 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ 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: _ 8.4 Types and Quantities of Nonvoice Notification Appliances Installed Bells: With visual device: Horns: JdZ With visual device: Chimes: With visual device: Bells: With visual device: Visual devices without audible devices: Other (describe): • NFPA 72, Fig. 4.5.2.1 (p. 3 of 5) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. 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 ® , Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): System deviations from referenced NFPA standards: Signed: Printed name: Date: Organization: Stanley CSS Title: Field Service Technician Phone: 503 -968 -3300 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 ❑ NFPA 70 Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): ❑ Documentation in accordance with Inspection and Testing Form (Figure 10.6.2.3 of NFPA 72 ® ) is attached Signed: Printed name: Date: Organization: Stanley CSS Title: Field Service Technician Phone: 503 - 968 -3355 NFPA 72, Fig. 4.5.2.1 (p. 4 of 5) Copyright ® 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sate or distribution. 13. Certifications and Approvals 13.1 System Installation Contractor This system as speci led herein has been installed and tested according to all NFPA standards cited herein. Signed: t Printed name: )rti 1. C 7 Date: J j:e4-/ f Organization: Stanley CSS Title: Field Service Technician Phone: 503 - 968 -3300 13.2 System Service Contractor . This system as s c ied herei has be i stalled and tested according to all NFPA standards cited herein. �j I Signed: Printed name: �� / L L. q Date: v pg(J ^1/ Organization: Stanley CSS Title: Field Service Technician Phone: 503 - 968 -3300 13.3 Central Station This syst s specified herein will be onitored according to all NFPA standards cited herein. q Signed: , �� Printed name: Gary Tauscher Date: -�`v�� / Organization: • nley CSS Title: Operations Manager Phone: 503 - 968 -3355 13.4 Property Representative I accept this sys as een *nstalled and tested to its specifications and all NFPA standards cited herein. Signed: �� Printed name: �P�,, ,„ is yw Date: 5y0 9// Organizati : //�� } `L Title c) /� Phone: �,✓/ / 13.5 Authority Having Jurisdiction ./ ./ y� �� I have wit ssed a satisfactory ceptance test of this system and find it to be installed and operating properly in accordance with its . • ,. , ved plan d sp cifications, its approved sequence of operations, and with all NFPA standards cited herein. Signed \ Printed name: 0,4-1 p >RN Date: .. S• Z 1 • // Organization: iyy 6 4;77 & OTitle: Bvt,....1. 1 Aw l , ncSP Phone: SCE 1 7 - Z6 .. /y NFPA 72, Fig. 4.5.2.1 (p. 5 of 5) Copyright © 2009 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution.