Permit IT Y OF TIGARD BUILDING PERMIT
III
°' PERMIT #: BUP2007 -00408
COMMUNITY DEVELOPMENT DATE ISSUED: 8/22/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 103 D C -01000
SITE ADDRESS: 11265 SW GAARDE ST ZONING: R -3.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TIGARD ASSEMBLY OF GOD
Project Description: Fire Alarm.
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: E2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 86 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: N SMOK DET:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 1,550.00
Owner: Contractor:
TIGARD ASSEMBLY OF GOD FIRE PROTECTION SERVICES
11385 SW FAIRHAVEN ST 5573 SW ARTIC DR
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: Contact #: PRI 503 - 590 - 3732
FAX 503 - 628 -6214
Reg #: LIC 154333
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/22/2007 $62.50
[TAX] 8% State Surcha 8/22/2007 $5.00
[FLS] FLS Pln Rv 8/22/2007 $25.00
Total $92,50
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.
Issue By: 0 /l.�/4- 4L.4 Permittee Signature:
., (.../
Call 503.639.4175 by 7:00 a.m. for an inspection that bu ness day.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
• Approved plans are required on the job site at the time of each inspection.
•
'ire System t (2C,°0 ''AtA
Bu Permit Application ' F ' _
L � � ;r_� "" c r FOR_OFFICE_USE ONLY
City of Tigard Receive. , it Permit N <O ,, 2007 .. ,
13125 SW Nall Blvd., Tigard, OR 97223 ' ._ Plan •evte� °:fit 6
Phone: 503.639.4171 Fax: 503.598.1960 ` i0 ^ .i(i DateB : �.j � a � j �� v 1 Other Permit:
Inspection Line: 503.639.4175 AIU G 7 ? �a Date Re. • .:y: Q` Jn, i ® See Page 2 for
Internet: www.ci.tigard.or. U s Notified/Method: 21109- $1...t) i Supplemental Information
E: v ,,. i # z ; EQU _ ED DANA e l AND FAMILYxDWELLING
® 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
" �. F,- ° °:" '1 . " .l " work indicated on this application.
_` • :' CATEGORY\ "OF ONSTRUCTION; '
❑ I— and 2- family dwelling Valuation: $
® Commercial /industrial
❑ Accessory building 111 Multi-family Number of bedrooms:
•
❑ Master builder ❑ Other: Number of bathrooms:
, E ' . TIONXA
P ; z;;,;;?;i' JOByiSITE INFO,RNtATION AND: LOCATION - Total number of floors:
Job site address: 11265 SW Gaarde St. New dwelling area: square feet
City /State /ZIP: Tigard ,OR 97224 Garage /carport area: square feet
Suite /bldg. /apt. no.: Project name: Gaarde Christion School Covered porch area: square feet
Cross street/directions to job site: Gaarde St. / 115th Deck area: square feet
Other structure area: square feet
REQU[RED,DATA :COMMERCIAL- USECHECKLIS 3'.i-
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
z:: :' ""M t '` • - °" work indicated on this application.
eDESCRIPTION O p
.... .... ..
Installation of New Fire Alarm System Valuation: $51,550.00
Existing building area: square feet
New building area: 1800 square feet
sA P RO ER �' . .. . , " ; :.: . :< -:, ,. ,-,. „. ' M N e._ Number of stories: I
Name: same Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
t E . ,, �®: APPLICANT ^. : ; .' '” • ® CO PERSON•:. . ,'�' , ., ;,, -, •
��•v��r..r , -r -.,, m.. ".�� ., ,.. NOTICE
Business name: Fire Protection Services Inc. All contractors and subcontractors are required to be
Contact name: David M Phipps licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 5573 SW Arctic Dr. jurisdiction in which work is being performed. If the
City/State /ZIP: Beaverton, Oregon, 97005 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 590 -3732 Fax: : (503) 628 -6214
E -mail: phipps @fpsnw.com
' 'a '''f CONTRACTORr .z
Ea mxu x mat _ ,l, „. :', .,, <. r
Business name: Fire Protection Services Inc : I L ” P - ` ° * a '
�� ��BUILDIN �PERiVIIT ,IrEES � °uF�
Address: 5573 SW Arctic Dr � a =
Please refer to fee schedule.
City /State /ZIP: Beaverton, Oregon 97005
Fees due upon application
Phone: (503) 590 -3732 Fax: (503) 628 -6214 Amount received
CCB lie.: 154333 Date received:
A::i:t th signature: This permit application expires if a permit is not obtained
/�� within 180 days after it has been accepted as complete.
�� /7 `J C Date: 08 -06 -2007 * Fee methodology set by Tn- County Building Industry
((( / /i / `--i Service Board.
i• \Building \ Permits \FPS- PermitApp.doc 12/03 440- 4613T( II /02 /COM /WEB)
NFPA 72 (2003 Edition)
Record of Completion
Name of Protected Property: Tigard Assembly of God f ! l-,-
Address: 12134 SW Gaarde Rd . , Tigard, OREGON 97140
Owner's Representative (name /phone): AUG 2 4 ? our
Authority Having Jurisdiction: City of Tigard Cfni,>
Address /Phone Number: ��j�.� a
Di trisiOii
1. NFPA 72, Chapter 4 -3 Proprietary Supervising Station System
If Alarms are transmitted to a public fire service communications center or others, indicate location
and telephone number of the organization receiving alarm:
Indicate how alarm is transmitted:
The Prime Contractor:
Alarm Central StationProprietary Station Location: OFFICE COI)
Means of transmission of signals from the protected premises to the proprietary station:
X Digital Alarm Communicator Other
Organization Name/Phone Representative Name /Phone
Installer: _David M Phipps 503 -590 -3732
Alarm Service Company FIRE PROTECTION SERVICES INC.
Location of Record (As- Built) Drawings:
Location of Owners Manuals:
FIRE PANEL LOCATED IN RISER ROOM
Location of Test Reports:
SAME
A contract, dated , 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 operational acceptance tests.)
This system has been installed in accrodance with the NFPA standards as shown below, was inspected
by on / / , includes the devices
shown below, and has been in service since / /
NFPA 72, Chapters 1 3 4 5 6 7 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
Manufacturer's Instructions
Other (specify):
Signed: Date: / /
Organization:
1 08/24/07
3. Record of System Operation
All operational features and functions of this system were tested by BRAD GORDON on
05/09/2006 and found to be operating properly in accordance with the requirements of:
X NFPA 72,
NFPA 70, National Electrical Code, Article 760
Manufacturer's Instructions
Other (specify):
Signed: Date: 05/10/2006
Organization: FIRE PROTECTION SERVICES INC.
4. Alarm- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
MANUAL
2_ Manual Stations Noncoded, Activating Transmitters Coded
AUTOMATIC
Coverage: Complete: Partial: XXXX
(a) Smoke Detectors Ion Photo
(b) Duct Detectors Ion Photo
(c) Heat Detectors FT 135 RR FT/FF RC
(d) Sprinkler Water flow Switches: Transmitters Noncoded, Activating
4 Coded
(e) Other (list):
5. Supervisory Signal - Initiating Devices and Circuits (use blanks to indicate quantity of devices)
SPRINKLER SYSTEM
(a) Coded Valve Supervisory Signaling Attachments
Valve 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 Supervisory Functions(s) (specify): LOW AIR SUPERVISORY
2 08/24/07
t.
6. Alarm Notification Appliances and Circuits
Quantity of indicating appliance circuits connected to the system: 49
Types and quantities of alarm indicating appliances installed:
(a) 1_ Bells 6" Inch diameter
(b) Speakers
(c) Horns
(d) Chimes
(e) Other:
(f) 2 Visual Signals Type: GENTEX COMMANDER 3 24V SERIES
2 with audible w/o audible
(g) Local Annunciator
7. Signaling Line Circuits
Quantity and Style (see NFPA 72, Table 3 -6) of signaling line circuits connected to system:
Quantity: 1 Style: CLASS B
8. System Power Supplies
(a) Primary (Main): Nominal Voltage: Current Rating:
Overcurrent Protection: Type: Breaker Current Rating: _20 amp
Location: Elec Panel nxt to Fire Panel
Secondary (Standby):
X Storage Battery: Amp -Hour Rating 24 V 7.0AH
Calculated capacity to drive system, in hours: X5MINX (24) (60)
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
(b) 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): 9.0
(b) Application Software Revision Level (s): 9.0
(c) Revision Completed by: David M Phipps FPS
(name) (firm)
/ f
(signed) (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:
(signet (title) (date)
Up t n a pletio e system(s) satisfactory test(s) witnessed by the authority having jurisdiction:
g -zy -07
(s gned) repr -, tative of the Authority Having Jurisdiction (title) (date)
3 08/24/07
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -t1t 8
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/22/2007
Phone: (503) 639 -4171 1 1 � c l
Inspection Requests (24 Hrs.): (503) 639 -4175 ..., J '
INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 11265 SW GAARDE ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD ASSEMBLY OF GOD
DESCRIPTION: Fire Alarm.
OWNER: TIGARD ASSEMBLY OF GOD, PHONE #:
CONTRACTOR: FIRE PROTECTION SERVICES PHONE #: 503.590 -3732
Inspection Request Scheduled For: Date: 8/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mess - -
998 Alarm final 054590 -01 503 -590 -3732 al "
/®•
Corrections /Comments /Instructions:
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X PASS • PARTIAL APPROVAL I CANCEL Fl NO ACCESS
I I FAIL r) , ALL FOR INSPECTION ❑ ADDITIONAL FE S ASSESSED
87 01 / 1
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Inspector: . Date: P hone #: (503) 718- ■ g • i
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