Permit I , 1 w
"'CITY O F TI GARD BUILDING PERMIT
PERMIT #: BUP2004 -00526
, DEVELOPMENT SERVICES DATE ISSUED: 12/13/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113B0 -00600
SITE ADDRESS: 16580 SW 85TH AVE
SUBDIVISION: SEWER TREATMENT PLANT ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
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: 2N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 50 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:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 24,620.00
Remarks: Support Facility Building, fire alarm upgrade.
Owner: Contractor:
CLEAN WATER SERVICES NORTHWEST FIRE SUPPRESSION INC
2550 SW HILLSBORO HWY 10200 SW ALLEN BLVD STE F
HILLSBORO, OR 97123 -9379 BEAVERTON, OR 97005
Phone: 503 - 681 -3600
Phone: 644 -7720
Reg #: MET g 0 g 0 g 0 2 02 2 682
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 1 2/1 3/2004 $283.30 Final Inspection
[TAX] 8% State Surcharp 12/13/2004 $22.66
[FLS] FLS P1n Rv 11 /4/2004 $113.32
Total $419.28
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 than 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 these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: k- ' _, ` (i
Permittee
Signature: l /
/ Call 639 -4175 by 7 p.m. for an inspection the next business day
1 /' /2004 03: 3 5036448289 NW FIRE SUPPRESSION PAGE 01
1 14/2004 12:26 FAX 5035981960 CITY OF TIGARD al 002
Fire Oofeetion System
..lding Permit A Lion
City of Tigard 1 E i,,,, 4 4, ���r / ..,..
13125 SW Hall Blvd„ Tigard, OR 97 2 �°� a r �(f( fi�4� + ,� /( r // ,I I ,/, ;
Theme: 503.639.4171 Fax: 503.59: .: ' s} ''''''h f °thaehnnlr
Inspection Line: 503.(39.4175 [ T a- _ _ t far ® s e r
gard,or.us No
C! _ Notified/Meant i !! , o mea 2 for
Internet www,ct.ti tal infernatve.
, n' 0F TIGARD
atl ❑ Demoiition P ermit fees" ate based the • 4
[] New construction on lie o c wodtperdormed.
,Additional
tuatiotr/rzplacerneat ❑Other brdivate the value (rounded to the nearest dollar) of all
materials, labor, exveetfread, and the profit fix- the
equipment, ale +tbor
work indicated on this application.
❑ 1- and 2-f�7y &welling Commercial/industrial Va l ua tion S
❑ Accessory building ❑ Multi-f ly Number of bcdrvorn:
❑ Master builder U other! Number of bathrooms:
• - e rn i v, m.
'. - iii ` . : , - Total number of floors_
• I r _ NttW dwelling sea square fiat
CY/Slate/ZIP: Altb ► GRtratge/Gatport area: square feet
Saito/bldg. /apt. no.: Project name, .. _ 4. . lafFTLl2 Sae 1,-. / Covered porch area: square feet
Coss sttcet/directionv to job stet
beck area: square feet ■
Other armlike Wee: square feet \
Subdivision: Lot no.: Permit fees' are based on the value of the work . _, ..
Tax map/parcel no.: Indicate the vain (rounded to the pa fal l7ged.
- ( overhead, and do llar) of all
x „ - , . . . _ _ - - walk equipment, r ed o labor, ani ad, and the profit mr the ra +� t,, , e r' i �,; J e i .. "' '� werkiuudicsted on this •IicaN
t"7 re- - 1 5,y -a-.7 $ building area: square feet
lb • P- ' . (_ c.i ■t.- r ad, New building area: square stet
.ItY ke f ,i ; . 7 .e„ .1,-,1-1 -, 1 Number of stories:
Name: � Lti7fFr �' *,f Jr of S - -- -- Type of construction: ^/
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Address :,,,-0 f. .L
WiT _ 1 t CS • 14 .. ) OoCUPancY groups:
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Business name:
- r ' c - AIt contractors and subcontractors are required to be
Contact name: i z g. ,. i .r:. ' 1 licensed with the Oregon Chests t coon (bnvseoors Board
Address: wader ORS 701 and may be required to be licensed in the
/� • i. - _ -4: d V - c� _ jurisdiction in which work is being performed. If the
CIty/State/ZLP: : + ADO
applicant is exempt from licensing, the fbilowiug reasons
11 ■�
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Phone: Fete dun upon application
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. A112011211 received
� j 4. Date received; f
Authorized signature! %
/�' /�' � 'rills P.reaR xpplle:atloq ptplrp If a permit Y not obtained j
p names /men 150 days after It has been accepted as complete
�.�I/1/ �%7� Ante: �� 3,....145,2.----, • Pee methodology sat Oy'rei - county Bundirts btduetry ■
V , Wa'IdialtTemetbNT9.TentnlAw,da J :lni $*��e t3aard.
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Addressable Fire Alarm System — Record of Completion
AFA -ROC blank.doc
Protected Premise: Owner's Rep & Phone:
(7 z_c= Al (LHAen TO14 tviiVIAA/
1. Type(s) of System or Service:
Local (per NFPA 72, Chapter 3)
Monitoring Provided By: N/A
Phone (for testing): N/A
Number of Phone Lines: N/A
Means of Transmission: N/A
Alarm Codes: N/A
This system was designed by, and equipment supplied by:
Northwest Fire suppression, Inc., 10200 S.W. Allen Blvd., Suite F
Beaverton, OR 97005 Phone: 503-644-7720
Location of "as built" drawings, owner's manual, test reports, and maintenance
records:
A contract for test and inspection in accordance with NFPA 72, 7 -3.2:
(check one) is in effect.
Owner has declined test and inspection contract at this time.
Comments:
(record of completion - page 2)
2. Record of System Installation:
(Lead installing technician or electrician to complete prior to acceptance testing)
This system has been installed in accordance with the National Electric Code, and
meets all requirements of Article 760 as a Power Limited Fire Alarm system.
After all device installation was complete (except control equipment final
terminations), all initiation, signal and control circuit wiring was tested and found to
be free of opens, shorts and ground faults.
The entire system was installed per the AHJ approved plans, and complete, accurate
"as built" notations have been provided to Northwest Fire Suppression, Inc.
Exceptions:
Installing Contractor AfOef#yv& i F7,26 PP .5/0 t /
Responsible Jo rn-, man )vs / 0. V4(4Pi /1 License # 3£ z-&
Signature ,./ - / ,.,,1 -,--.— Date / ` /
5
3. Record of System Operation:
(Responsible testing technician to complete prior to acceptance testing)
All operational functions and features of this system were tested and found to be
working properly in accordance with the approved plans, per NFPA 70, National
Electric Code, Article 760, per NFPA 72, Chapters 1, 3, 4, 5, 6 and 7, and per the
manufacturer's instructions.
I have reviewed the "as built" drawings and find that they are accurate and complete.
Exceptions:
Certifying Contractor /V O e77tt0C3r Fi P 6(,,pP es✓'oAt; 7,6
Responsible T . cian JI 0 s TOA/ `b1) YA640%7 License # 30 100 Lc
Signature Ag /.ij,��,r— - Date /7 / -105-
(record of completion — page 3)
4. Alarm Initiating Devices (indicate quantities)
3 I Manual Stations
Ionization Smoke Detectors
eZ Photoelectric Smoke Detectors
2 Photoelectric Duct Detectors
7 Other Smoke / Flame Detectors, type &f►lt J �t- ? S
213 Fixed Temperature Heat Detectors
Fixed Temperature Heat / Rate of Rise Detectors
Rate Anticipated or Compensated Heat Detectors
Feet of Linear Heat Detector
Sprinkler Waterflow Switches
Other Initiating Devices (i.e. satellite panels, hood systems, etc.)
List them:
5. Supervisory Signal Initiating Devices (indicate quantities)
,3 Sprinkler Valve Tamper Switches
2 Sprinkler Low Air Pressure Switches
Other Supervisory Switches (i.e. fire pump, water supply, generator, etc.)
List them:
•
(record of completion — page 4)
6. Alarm Notification Appliances and Circuits (quantities)
5 Notification Circuits (Zones)
5 Horn / Strobes 5 Strobes (only) Horns (only)
1 Bells Other (list them) 1 Annunciators
7. Signaling Line Circuits
Quantity: / Style: Y
8. System Power Supplies
Fire Alarm Control Panel:
Primary (Main): Nominal Voltage 120 VAC Breaker Current Rating: 2cAmps
Is this a dedicated branch circuit, with the disconnect means mechanically
protected, and with a red marking (per NFPA 72, 1- 5.2.5.2)? Yes or No )
Breaker Location: pp-,30/2. C le l Z
Secondary (Standby):
Sealed Lead Acid Batteries, le Amp Hrs. Providing (24, 60 or 90) Zg Hrs.
Or
Emergency Standby System (U.P.S.): (check as applies)
Per National Electric Code, Article 700
Per National Electric Code, Article 701
Per National Electric Code, Article 702 (plus Article 700 or 701)
Notification Expansion Panels:
Primary (Main): Nominal Voltage 120 VAC Breaker Current Rating: _ Amps
Is this a dedicated branch circuit, with the disconnect means mechanically
protected, and with a red marking (per NFPA 72, 1- 5.2.5.2)? Yes or No
Breaker Location(s):
Secondary (Standby):
Sealed Lead Acid Batteries, Amp Hrs. Providing (24, 60 or 90) Hrs.
(record of completion page 5)
9. System Software
Operating System Software Revision Level (on IC): 2.4
Application Software Revision Level: Verifier Tools, version 3.0
Revision Completed (Installed) By:
Company:
10. Comments
System Deviations From the Referenced NFPA Standards (list if any):
VOvt_v mrvilLy V -74 - lDc`vtc6 rVYL T'Pvle EXC(.i*1J66
11. Acceptance Testing Statements
Commissioning Technician:
I have tested and witnessed satisfactory performance of all system devices and control
functions, a9d/o� have noted any exceptions on this Record of Completion.
Signed Y /l //// __. Date /
Local Authority (or Authorities) Having Jurisdiction:
This system has been inspected and is accepted for the jurisdiction I represent.
Name Representing
Comments:
Signed Date
Name Representing
Comments:
Signed Date
tITt 01= TIGARD
BUILDING DIVISION PERMIT #: BUP2004 00626
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/13/2004
Phone: (503) 639 -4171 /rm fi gp ° 9� "ild ; �� � � 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/15/2006 TIME: /.O2AM PAGE: 109
SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEAN WATER SERVICES
DESCRIPTION: Support Facility Building, fire alarm upgrade.
OWNER: CLEAN WATER SERVICES, PHONE #: 503681 - 3600
CONTRACTOR: NORTHWEST FIRE SUPPRESSION INC PHONE #: 644 - 7720
Inspection Request Scheduled For: Date: 11/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 021067 -01 503-819-9247 N
Corrections /Comments /Instructions:
—
V — /. E R - i� 1-- (ICYC–T146-6,
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ASS PARTIAL APPROVAL E CANCEL 11 NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
A LIA '
Inspector: A/WA L Date: t(/5/Tione #: (503) 718-
go.—