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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 1111 4 1 COMMUNITY DEVELOPMENT Permit #: FPS2010 -00169 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/09/2011 T t G .fit t Iy g Parcel: 1 S 135CA90125 Jurisdiction: Tigard Site address: 11046 SW GREENBURG RD 125 Project: Ash Creek Condominiums Subdivision: ASH CREEK CONDOMINIUMS Lot: 0 Project Description: Fire alarm system for all units in building addressed as 11046 & 11048 SW Greenburg. Contractor: WESTERN STATES FIRE PROTECTION Owner: PHIL- ALEXANDER, LORRAINE 13896 FIR ST STE B 11046 SW GREENBURG RD #125 OREGON CITY, OR 97045 TIGARD, OR 97223 PHONE: 503 - 657 -5155 PHONE: FAX: 503 - 657 -5182 FEES Description Date Amount Specifics: Permit Fee - MF 02/09/2011 $199.04 12% State Surcharge - Building 02/09/2011 $23.88 Type of Use: MF Plan Review - Fire Life Safety - MF 02/09/2011 $79.62 Class of Work: ALT Type of Const: VB Occupancy Grp: R -2 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: Manual Pull Station Required: Yes Smoke Detectors Req: Yes Battery Calcs Provided: Yes Cut Sheets Required: Yes Total $302.54 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: Residential Square Footage: 0 Fire Alarm Valuation: $11,800.00 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility • ification • er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-0090. You may obtain a copy of the rules or • ect questions to OU • .. I . • • 503.232.1987 or 1.800.332.2344. • I sued By: Permittee • nat fri . 16 ffi Call 503.639.4175 by 7:00 a.m. for the next available i . - .n date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 1 Building Permit Application Fire Protection System "'"' *„, FOR OFFICE USE ONLY City of Tigard '$/ !/ ,I6t9 M o..,� Per mit No.: Tigard ,/ 6n ., Tigard, OR 97223 1/ tan Review / '� • 13125 SW Hall Blvd ▪ Phone: 503.639.4171 Fax: 503.598.1960 Df C' q V . ate/e : l�/l'� �2ndi Other Permit i 1 , ` i , Inspection Line: 503.639.4175 : City G 9 2 o ' Date B �y��+ H 2 Internet: www.tigard - or.gov O Notified/Method: Readyy: ���/ !'%NJ, Supplemental Information TYPE OF WORK, D /t//ct REQUIRED DATA: .)1 - AND 3- FAMILY DWELLING j gi New construction El Demolition +L/t y Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Additionlalteration/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 XMulti- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: i lO /I ( 0 S 6 i."Gfr1 bat, Ad. New dwelling area: square feet City/State /ZIP: T Toy r o f , Q R Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 4..7 h 6 '✓`2 °0 CI, e+f_91,25 Covered porch area: square feet Cross street/directions to job site: 99t to ! U & e el) &I ✓ iq/ Deck area: square feet SHY r' / 5 0.1 r / ski Aafar (1 S 1d 1 o (2 Sfrtet /.- 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 D ., ;; { , °; , , , - 4 - work indicated on this application. ✓in Valuation: $ r „ . , ,.1. q q d , , ,, /'cf icn - `1 ) .45 Vet Existing building area: square feet New building area: square feet 1 ❑ TENANT Number of stories: Name: /q s A (r,e e k (c''7 c /05 J-( 4 Type of construction: Address: // 0 ( SGCJ e* r.' e.'.'1 b r.j /c( . Occupancy groups: City/State /ZIP: T c?t/t O/Z Existing: Phone: (5 c 2c - Z Z / 5' Fax: ( ) New: a `E CONTAC PERSON APPLICANT NOTICE • Business name: I.{1 err? 3 /,, /-e5 / 'rie Pry. tr'c f7'o n C . All contractors and subcontractors are required to be Contact name: 841 0 licensed with the Oregon Construction Contractors Board J under ORS 701 and may be required to be licensed in the Address: / 31396 `i'r 57 / 5, p, /3 jurisdiction in which work is being performed. If the City /State /ZIP: �, applicant is exempt from licensing, the following reasons +as,y/7 r /� C N 7 70`/5 app Phone: (5 : 57 _ Fax:: (S- -3) 6,5-7 - 5/ 6 ,. E -mail: b ; )1 . rGy r•5- e� c.t) ; (.. Id 5 r. -` { ° t `' BU ILDING. /-� (PAaatrero/tr:te kkesf4Mr1 h Business name: `1/�S�r', -,, S "7TT-5 l t .4 1 e li k n Permit fee: / QQ . Address: ,' 3t; `/ Fi 5 5 - /r• /3 s (' l State surcharge (12 %ofpermit fee): A S' City/State /ZIP: �r 5e-yi f / i 6 -' -) o y S FLS plan review (40% of permit fee): ( Phone: ( 503) L• -) - $) c S- Fax: ( rU3) tz 5) - 5 / Fly. (Due upon application.) �� CCB lie.: j 5 7L' Total permit fees: SIR •SSA Authorized signature: , c" )2,441 Amount received: (�`�` This permit application expires if a permit is not obtained Print name: .i �� Y' / Date: within 180 days after it has been accepted as complete. / 2 Z `/ - �' * Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \PenultsWPS- PermitApp.doc 10 /01/09 440- 4613T(11/02/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 ❑ We ❑ D ry 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 El Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 7,201 and greater $404.39 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. I: \Building \Permits \FPS- PermitApp.doc 10/01/09 2 FFS Z 6/0 -00 16' FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -31 FIRE ALARM SYSTEM C` RECORD W RD O Name of protected property: Ai 'I ` C -Q- K - co, 4005 Address: ____1 1'-1L? , .s G17- t-sE.1416w0 R-0 - TWw-Ar¢j c'&. Ol/1 -57 Representative of protected property (name/phone): iF1TNC.10 03 193 5'1_- Authorit havingjurisdiction: C% tM O TIC5A -17 ) Address/telephone number: 131 5,,s 1-1 1.1. gLA o3 b'y 1.1 1Z C Organization name/phone //�� Representative name/phone Installer W TEQ%J JT�_ QE FT -S � gQ EC.Ttoe► C . Sca1t G1\aOCC t62 Supplier e G -2Z. Service organization >4 t Location of record (as- built) drawings: Location of operation and printenance manuals: .As l� Location of test reports: yc%.1 t-. A contract for test and inspection in accordance with NFPA stan rd(s Contract No(s): Effective date: \■ 1.- ._ 1 011 Expiration date: ta\171)701 System Software ` 1 (a) Operating system (executive) software revision I el(s): V •t * b (b) Site - specific software revision date: 1 (c) Revision completed by: (name) (firm) 1. Type(s) of System or Service NFPA 72, Chapter 6 — Local If alarm is transmitted to location(s) off premises, list where received: NFPA 72, Chapter 8 — Remote Station Telephone numbers of the organization receiving alarm: Alarm: Supervisory: Trouble: If alarms 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 8 — Proprietary Telephone numbers of the organization receiving alarm: Alarm: Supervisory: Trouble: If alarms 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 8 — Central Station + Prime contractor: ANrJ*` “T C Vat (-S00 -- ( 1p Q -c) (o13 Central station location: (NFPA 72, 1 of 4) FIGURE 4.5.2.1 Record of Completion. 2002 Edition 72 -32 NATIONAL FIRE ALARM CODE Means of transmission of signals from the protected premises to the central station: McCulloh Multiplex One -way radio _ Digital alarm communicator Two -way radio Others Means of transmission of alarms to the public fire service communications center: (a) (b) System location: NFPA 72, Chapter 9 — Auxiliary Indicate type of connection: Local energy Shunt Parallel telephone Location of telephone number for receipt of signals: 2. Record of System Installation (Fill out after installation is complete and wiring is 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 stand r ds shown below, was inspected by C t T` � o F T I C� 414) J W ,5 . F . on to in l_vt t , includes the devices shown in 5 and 6, and has been in service since 10 `2') 1.151% . ✓NFPA 72, Chapters 1 2 3 4 © 10 11 (circle all that apply) NFPA 70, National Electrical Code, Article 760 Manufacturer's instructions Other (specify): Signed: Date: a 1'x-'1 \ P 1- 0-11 Organization: V` . . P • 3. Record of System Operation Documentation in accordance with Inspection Testing Form, Figure 10.6.2.3, is attached N O All operational features and functions of this system were tested by W .S. 1 • Ci date 1 c \—C? I2o I 1 and found to be operating properly in accordance with the requirements of: V NFPA 72, Chapters 1 2 3 4 5 6 7 8 9 0 11 (circle all that apply) NFPA 70, National Electrical Code, Article 760 Manufacturer's instructions Other (specify Signed: / /_ -_n k _ Date: 10 \Z- 11 Organization: . X . . 4. Signaling Line Circuits Quantity and class of signaling line circuits connected to system (see NFPA 72, 712ble 6.6.1): Quantity: I Style: Class: T I (NFPA 72, 2 of 4) FIGURE 4.5.2.1 Continued 2002 Edition FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 - 5. Alarm- Initiating Devices and Circuits Quantity and class of initiating device circuits (see NFPA 72, Zhble 6.5): Quantity: Style: Y Class: MANUAL (a) Manual stations Noncoded Transmitters Coded Addressable (b) Combination manual fire alarm and guard's tour coded stations AUTOMATIC Coverage: Complete Partial Selective Nonrequired (a) Smoke detectors t Ion Photo S. Addressable ( b) Duct detectors Ion Photo Addressable (c) Heat detectors FT RR FT/RR RC Addressable (d) Sprinkler waterflow indicators: Transmitters Noncoded ,e_ Coded Addressable f (e) The alarm verification feature is disabled or enabled , changed from seconds to seconds. (f) Other (list): 6. Supervisory Signal- Initiating Devices and Circuits (use blanks to indicate quantity of devices) GUARD'S TOUR (a) Coded stations (b) Noncoded stations (c) Compulsory guard's tour system comprised of transmitter stations and intermediate stations Note: Combination devices are recorded under 5(b), Manual, and 6(a), Guard's Tour. SPRINKLER SYSTEM Check if provided ✓ (a) valve supervisory switches (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: (a) Selector in auto position (b)� Control panel trouble (c) Transfer switches (d) Engine running c Other supervisory function(s) (specify): E Q T T Qc.e 0 Ni rcxS' S .-tO JQA 1 ��=1 E2 PC (NFPA 72, 3 of 4) FIGURE 4.5.2.1 Continued 2002 Edition 72 -34 NATIONAL FIRE ALARM CODE 7. Annunciator(s) Number: ( Type: l C, J Location: FA-Lig L 8. Alarm Notification Appliances and Circuits NFPA 72, Chapter 6 — 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: Quantity and the class of notification appliance circuits connected to system (see NFPA 72, Table 6.7): Quantity: Style: Class: IS Types and quantities of notification appliances installed: (a) Bells With Visible (b) Speakers With Visible (c) Horns With Visible to (d) Chimes With Visible (e) Other: With Visible (f) Visible appliances without audible: 9. System Power Supplies (a) Fire Alarm Control Panel: Nominal voltage: 1 2.o v C- Current rating: 2 V.. Overcurrent protection: Type: C' Q Current rating: 15 44 Location: e (b) Secondary (standby): Storage battery: '5,1_ a . Amp -hour rating: - 7 pi-k1 Calculated capacity to drive system, in hours: ,QL4 �i $t4SJQ)'f Engine -driven generator dedicated to fire alarm system: Location of fuel storage: (c) Emergency system used as backup to primary power supply: Emergency system described in NFPA 70, Article 700: 10. Comments Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s): 1_ System deviations from the referenced NFPA standard(s) are: W • . . � o . 201 (signed) for in . - on contractor /supplier (title) (d• te) SEC 1 . 1 z 20 • 061 7 -- - or ..‘:‘• •- ompany (title) (date) (signed) for central station (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 72, 4 of 4) FIGURE 4.5.2.1 Continued 2002 Edition