Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11 4 COMMUNITY DEVELOPMENT Permit #: FPS2009 -00038
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/25/2009
TIGARD Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 120
Subdivision: Lot: 0
Project: Ameriprise Financial
Project Description: TI - Fire alarm
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee - COM 06/02/2009 $62.50
CALIFORNIA ST 49TH FL 12% State Surcharge - Building 06/02/2009 $7.50
PHONE Plan Review - Fire Life Safety - COM 06/02/2009 $25 00
Contractor:
CAPITOL ELECTRIC CO INC
11401 NE MARX STREET
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX• 503 - 257 -1966
Type of Use: COM
Class of Work: FPS Type of Const: IIB
Occupancy Grp: B Height: ft
Stories:
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: No Smoke Detectors Req. No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $95.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 0
Residential Square Footage: 0
Fire Alarm Valuation: 1000
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 -0100. ,emu ay obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
f; F -�
Issued By: k ctu S; o rs � �� Permittee Signature: �,�- �'
4
1 Call 503.639.4175 by 7:00 a.m. for an inspection that - business day.
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
n Fire Protection System E`.O
FOR OFFICE USEONLY
City of Tigard Date /B / og 69 , � Permit N ,err bid
-
o.: i
E
" 1 1 SW Hall Blvd., Tigard, OR 97223
° " Phone: : 503.639.417171 Fax: 503.598.1960 � � j �� j / / Other Permit:
TIGARD
Inspection Line: 503.639.4175 8\1J L . s:'.te Rea. : Juni • El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: (e Supplemental Information
JUN 02 7009
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Dempqj
I TY OF TIGARD Permit fees* are based on the value of the work performed.
d DING DIVISION 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.
❑ 1 - and 2-family dwelling Valuation: $
y g ®Commercial /industrial ,
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION' Total number of floors:
Job site address: 10220 SW Greenburg Rd. (Two - Lincoln) New dwelling area: square feet
City /State /ZIP: Tigard., OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 120 Project name: Ameriprise Financial 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: $$1,000.00
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 PERMITTEES*
Business name: Capitol Electric Company, Inc. (Please refer m fee schedule)
Permit fee: '60.50
Address: 11401 NE Marx Street
State surcharge (12% of permit fee): 7.50
City/State /ZIP: Portland, OR 97220
FLS plan review (40% of permit fee): 25.00
Phone: (503) 255 -9488 Fax: (503) 255 - 1966 (Due upon application.)
CCB lie.: 48748 Total permit fees: 95.00
Amount received:
Authorized signature:
1 / This permit application expires if a permit is not obtained
Print name: Dan Wilson e 1ir _ Date: 5/28/09 within 180 days after it has been accepted as complete.
• * Fee methodology set by Tri- County Building Industry
Service Board.
1: \Buitding\Pennits \FPS- PemiitApp.doc 03/23/06 440- 46I3T(I I /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
❑ 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: $ $1,000
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): $ 1,000.00
Permit fee based on project valuation (see fee schedule): $ 62.50
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 7.50
FLS Plan Review (40% of permit fee): $ 25.00
TOTAL: $ 95.00
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 \z290657 -45 Ameriprise, 2Linclon -120 \ 1 FPS - PermitApp.doc 2
NFPA -72 Fire Alarm System Record of Completion
Date: 6/26/2009
City of Tigard Information: Permit No. FPS2009 -00038
Name of protected property: Ameriprise Tenant Improvement, Suite 120 @ 2 Linclon Center
Address of protected property: 10220 SW Greenburg Road Tigard, OR 97223
Representative of protected property (name /phone): Shorenstein Realty 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 120 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 Morrow on 06/26/09 , included the devices shown below, and has been in service
since 06/26/09
x NFPA 72, Chapters 1 2 3 4 5 6 7 (underline all that apply)
x NFPA 70, National Electrical Code, Article 760
x Manufacturer's instructions
Other (specify):
Signed: Jeff Morrow Date: 06/26/09
Organization: Capitol Electric Company, Inc.
3. Record of System Operation Suite 120 Only
All operational features and functions of this system were tested by Jeff Morrow on 06/26/09
and found to be operating properly in accordance with the requirements of:
x NFPA 72, Chapters 1 2 3 4 5 6 7 (underline all that apply)
x NFPA 70, National Electrical Code, Article 760
x Manufacturer's instructions
Other (specify):
Signed: Jeff Morrow Date: 6/26/2009
Organization: Capitol Electric Company, Inc.
4. Alarm- Initiating Devices and Circuits
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
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 120 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: 4 Style Y Class: B
(a) Bells Inch
(b) Speakers
(c) Horns
(d) Chimes
(e) Other:
(f) 4 Visual signals Type: ADA SYNCHRONIZED
2 with audible 2 w/o audible
(g) Local annunciator
7. Signaling Line Circuits
h. 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 NAC 1.1)
(a) Primary (main): NAC 1.1 Nominal voltage: 120 VAC Current rating: 2.5 Amps
Overcurrent protection: Type: Circuit Breaker Current rating: 20 Amps
Location: FLOOR 1 ELECTRIC ROOM
(b) Secondary (standby):
X Storage battery: Amp -hour rating: 7 Ah @ 24 VDC
Calculated capacity to drive system, in hours: 2.419 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. Comments:
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 120 Only
Devices installed conform to NFPA standards.
System deviations from the referenced NFPA standard(s) are: NONE
Dan Wilson Capitol Electric Co., FLS Supervisor
(si. - • /or central station o ..rm service company or installation contractor /supplier (title)
U col ompletion of ttrstem(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
! gned) reMilintative of the authority having jurisdiction (title) date)