Permit - CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
�'l <<' COMMUNITY DEVELOPMENT Permit #: FPS2011 00093
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2011
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 400
Project: K Force Subdivision: Lot:
Project Description: Fire alarm.
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 - 257 -7121
FEES
Description Date Amount
Specifics: Permit Fee - COM 07/20/2011 $102.20
12% State Surcharge - Building 07/20/2011 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 07/20/2011 $40.88
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg Sheet (over 07/20/2011 $8.00
Occupancy Grp: B Height: ft 11x17)
Stories: 7 Info Process /Archiving - Sm Sheet (up to 07/20/2011 $2.00
11x17)
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: Yes Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $165.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $2,100.00
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 que ons to U . C by cg 503.232.1987 or 1.800.332.2344.
Issued B [ f� / Permittee Signature: ,v.,.-.
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.
V
' Building Permit Application ��
Fire Protection System �j 1\ FOR OFFICE USE ONLY
�O Permit No.: " I
City of Tigard R atetvea
Pr
Y �, Date /B : / 11 V ,: A , 1l x_41
1 3125 S W Hall Blvd., Tigard, OR 97223 `Cj S�� Plan Review i Other Permit:
Inspection Line: 503
Phone: 503.639.4171 Fax: 503.598.1969 O 4S \ Date/13 : li
TIGARD .639.4175 � Notified/ thud: Supplemental Information
� Date Ready /By: tuns: ® See Page 2 for
'S 1� 7.�2p�ee
Internet: www.tigard or.gov C \ CIAO .
$`ti G�� t ✓/Lt.. W na 12) •
TYPE OF WORK 0 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.
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
111 Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder 111 Other: Number of bathrooms:
/c 36=041041, SITE INFORMATION AND LOCATION Total number of floors:
Job site address: _1J .3 fr5W Greenburg Rd. (Five - Lincoln) New dwelling area: square feet
City/State /ZIP: Tigard., OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 400 Project name: K - Force 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: 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 Valuation: $2100
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:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ 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*
(Please refer to fee schedule)
Business name: Capitol Electric Company, Inc.
Permit fee:
Address: 11401 NE Marx Street
State surcharge (12% of permit fee):
City/State /ZIP: Portland, OR 97220 e
FLS plan review (40% of permit fee):
Phone: (503) 255 - 9488 Fax: (503) 255 - 1966 (Due upon application.)
CCB lie.: 48748 Total permit fees:
Amount received:
Authorized signature:
Print name: Dan Wilson A/Yt'lL//''
Date: 7/18/2011 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Pernuts \FPS- PennitApp.doc 03 /23/06 440- 46I3T(I I /02 /COM /WEB) @ /r . _ 1 �( fir 3
UV�( 0 - ,- - , 1^'El
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 El 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: $ $2100
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): $ 2100.00
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 \zz110991 -45 KForce Q 1Lincoln -400\ 1 FPS- PermitApp.doc 2
PERMIT FEE DOUBLES IF WORK HAS STARTED WITHOUT BENEFIT OF PERMIT
tO CALCULATE TOTAL FEE
PERMIT FEE CALCULATION (REFER TO TABLE)
$ 2,100.00 ROUNDED VALUATION
$ 91.44 (BASE FEE FOR FIRST $ 2,000.00 OF VALUATION)
+ $10.76 ($ 10.76 PER $ 1,000.00
$102.20 BASE PERMIT FEE
+ $12.26 STATE SURCHARGE = 12% OF BASE PERMIT FEE
+ $40.88 PLAN REVIEW CHARGE = 40% OF BASE PERMIT FEE
$155.34 TOTAL DUE FOR THIS PERMIT
EXAMPLE
NFPA -72 Fire Alarm System Record of Completion
Date: 8/5/2011
City of Tigard Information: Permit No. FPS2011 -00093
Name of protected property: K -FORCE TENANT IMPROVEMENT, SUITE 400 @ 1- LINCOLN CETER
Address of protected property: 10300 SW GREENBURG ROAD TIGARD, OR 97223
Representative of protected property (name /phone): SHORENSTEIN RELATY SERVICES
Authority having jurisdiction: City of Tigard, Building Services
Address /telephone number: 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639 -4171
1. Type(s) of System or Service
NFPA 72, Chapter 3 -- Local
If alarm is transmitted to locations(s) off premises, list where received:
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 5 -- Auxiliary
Indicate type of connection:
Local energy Shunt Parallel telephone
Location of telephone number for receipt of signals:
NFPA 72,
Alarm:
Supervisory:
NFPA 72, Chapter 5 -- Proprietary
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 5 -- Remote Station
Prime contractor:
Central station location:
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:
Organization name /phone Representative name /Phone
Installer Capitol Electric Co. Inc. Dan W. Wilson 503 255 -9488
Supplier Capitol Electric Co. Inc. Dan W. Wilson 503 255 -9488
Service organization Capitol Electric Co. Inc. Dan W. Wilson 503 255 -9488
Location of record (as- built) drawings:
Location of owners manuals:
Location of test reports:
A contract, dated , for test and inspection in accordance with NFPA standard(s)
No(s). , dated , is in effect.
2. Record of System Installation Suite 400 Only
(Fill out after installations complete and wiring 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 standards as shown below, was inspected
by Jeff Haak on 08/05/11 , included the devices shown below, and has been in service
since 08/05/11
x NFPA 72 (2007), Chapters 1 2 3 4 5 6 7 (underline all that apply)
x NFPA 70 (2008), National Electrical Code, Article 760
x Manufacturer's instructions
Other (specify):
Signed: 0 Date: #REF!
Organization: Capitol Electric Company, Inc.
3. Record of System Operation Suite 400 Only
All operational features and functions of this system were tested by Jeff Haak on 08/05/11
and found to be operating properly in accordance with the requirements of:
x NFPA 72 (2007), Chapters 1 2 3 4 5 6 7 (underline all that apply)
x NFPA 70 (2008), National Electrical Code, Article 760
x Manufacturer's instructions
Other (specify):
Signed: Jeff Haak Date: 8/5/2011
Organization: Capitol Electric Company, Inc.
4. Alarm- Initiating Devices and Circuits Suite 400 Only
Quantity and class of initiating device circuits (see NFPA 72, Table 3 -5) Quantity: Style: Class:
MANUAL
(a) 0 Manual stations Noncoded, activating Transmitters Coded
(b) Combination manual fire alarm and guard's tour coded stations.
AUTOMATIC
Coverage: Complete: Partial:
(a) 0 Smoke detectors Ion Photo
(b) 0 Duct detectors Ion Photo
(c) 0 Heat detectors FT RR FT /RR RC
(d) 0 Sprinkler waterflow switches: Transmitters Noncoded, activating
(e) Other (list):
5. Supervisory Signal- Initiating Devices and Circuits Suite 400 Only
GUARD' S TOUR
(a) Coded stations
(b) Noncoded stations, activating transmitters
(c) Compulsory guard tour system comprised of transmitter stations and
intermediate stations
Note: Combination devices are recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) Non coded valve supervisory switch at sprinkler riser
(b) Non coded valve supervisory switch at sprinkler vault
(c) Non coded supervisory air pressure switch at sprinkler riser
(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
(I) Control panel trouble
(m) Transfer switches
(n) Engine running
Other supervisory functions(s) (specify):
6. Alarm Notification Appliances and Circuits Suite 400 Only
Quantity and class (see NFPA 72, Table 3 -7) of notification appliance circuits connected to the system:
Types and quantities of notification appliances installed: Quantity: 7 Style Y Class: B
(a) Bells Inch
(b) Speakers
(c) Horns
(d) Chimes
(e) Other:
(f) 7 Visual signals Type: ADA SYNCHRONIZED
2 with audible 5 w/o audible
(g) Local annunciator
7. Signaling Line Circuits Suite 400 Only
Quantity and class (see NFPA 72, Table 3 -6) of signaling line circuits connected to system:
Quantity: Style: Class:
8. System Power Supplies (Notification Panel NAC4)
(a) Primary (main): NAC4 Nominal voltage: 120 VAC Current rating: 2.5 Amps
Overcurrent protection: Type: Circuit Breaker Current rating: 20 Amps
Location: FLOOR 4 ELECTRIC ROOM
(b) Secondary (standby):
X Storage battery: Amp -hour rating: 7 Ah @ 24 VDC
Calculated capacity to drive system, in hours: 3.575 Ah 24 60
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency or standby system used as backup to primary power supply, instead of 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): N/A
(b) Application software revision level(s):
(c) Revision completed by: N/A
(name) (firm)
10. C nts:
Dan Wilson Capitol Electric Co., FLS Supervisor
(signed) for central station or alarm service company or installation contractor /supplier (title)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):
This record of completion applies to Suite 400 Only
Devices installed conform to NFPA standards.
System deviations from the referenced NFPA standard(s) are: NONE
4 10 /1
Dan Wilson Capitol Electric Co., FLS Supervisor
(si• e• for central sta '•n or alarm service company or installation contractor /supplier (title)
U•orf completion t e system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
,OP S ,��� s� .1A1 • 5 1
( •ned) rep ese -tive of the authority having jurisdiction (title) (date)