Permit a CITY OF TIGAR BUILDING PERMIT
I PERMIT #: BUP2006 -00505
COMMUNITY DEVELOPMENT DATE ISSUED: 11/7/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134AD-06202
SITE ADDRESS: 10500 SW NIMBUS AVE T ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: SOLID ROCK. Fire Alarm System.
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: 3N : sf N: S: E: W:
OCCUPANCY GRP: A3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 1,558 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: $ 19,120.00
Owner: Contractor:
ROBINSON, CONSTANCE A +
ROBINSON, LYNN + BELL, KAY ET
BY INSIGNIA COMMERCIAL GROUP
BEAVERTON, OR 97008
Phone: Contact #:
Reg #:
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/7/2006 $235.30
[TAX] 8% State Surcha 11/7/2006 $18.82
[FLS] FLS Pln Rv 11/7/2006 $94.12
Total $348.24
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.
.4
\ ji i d/40 r
Issued By( .0 Permittee Signature: 1,,,_ "au a Set
11,
Call 503.639.4175 by 7:00 a.m. for an inspect - 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.
nt
Fire Pro S ys em , 1 1'm b o S
Building Permit Application FOR OFFICE USE ONLY
City of Tigard n , I' Received _ /J
�� � / 1. Permit N.., .
lig
e 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
_ Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
� , I � � � � � h Date/ / �
TIGARD Inspection Line: 503.639.4175 Date Rea. y/ : y. I �� -
i1, J 53 See Page 2 for
Internet: www.tigard- or.gov Notified/Method: I( I CV /� Supplemental Information
e s -- 4 TYPE OF WORK l REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition b 111 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
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ® Other: Church Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
lob site address: 10500 SW NIMBUS AVE. BLDG T. New dwelling area: square feet
City /State/ZIP: TIGARD OR. 97215 Garage/carport area: square feet
Suite/bldg. /apt. no.: T Project name: ROCK SOLID FELLOWSHIP 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: I 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 SYSTEM Valuation: $$19,120.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: 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: li ft/ W6 N 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
l. applicant is exempt from licensing, the following reasons
City/State/ZIP: / apply:
Phone: ( ) Kei / —9CPgy I Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: SIEMENS (Pleusereferto fee schedule)
Permit fee: 235 30
Address: 3025 SW CORBETT AVE.
City/ State/ZIP: PROTLAND OR 97201 State surcharge (8% of permit fee): f ,Z
FLS plan review (40% of permit fee):
Phone: (503) 234 -9995 Fax: (503) 234 8030 (Due upon application) t
CCB lic.: 133041 / _ Total permit fees: 3 ff.. 2 '
Authorized signature: ,� / , — ■ N. Amount received:
This permit application expires if a permit is not obtained
Print name: JOH ACTON I Date: 10 -19-06 within 180 days after it has been accepted as complete.
' Fee methodology set by Tri-County Building Industry
Service Board.
1:\ Building \Permits \FPS- PermitApp.doc 03/23/06 440-4613T(II /02/COM/WEB)
Fire Alarm System
Record of Completion
Name of Protected Property: Solid Rock Fellowship
Address:10500 SW Nimbus Ave. Bldg T Tigard, Or. 97223
Representative of Protected Prop y (name /pho(e):
Authority Having Jurisdiction: ' U 1 ttA- eZ-00"Co -64 5 e
Address /Phone Number: u
1. Type(s) of System or Service
X NFPA 72, Chapter 3 -- Local
If alarm is transmitted to location(s) off premises, list where received: Honeywell
Security
X NFPA 72, Chapter 3 -- Emergency Voice /Alarm Service
Quantity of voice /alarm channels: 1 Single: Multiple:
Quantity of speakers installed: 35 Quantity of speaker zones: 5
Quantity of telephones or telephone jacks included in system: N/A
NFPA 72, Chapter 6 -- Auxiliary
Indicate type of connection:
N/A Local energy: N/A Shunt: N/A Parallel telephone:
Location and telephone number for receipt of signals:
NFPA 72, Chapter 5 -- Remote Station
Alarm:
Supervisory:
NFPA 72, Chapter 5 -- Proprietary
If alarms are retransmitted to public fire service communications center or others,
indicate location and telephone number of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 5 -- Central Station
The 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:
(NFPA Record of Completion I of 4)
Organization Name /Phone Representative Name /Phone
Installer Shaw Electric
Supplier Siemens Building Technologies John Walton 503 -29 -9684
Service Organization
Location of Record (As- Built) Drawings: Owner specified
Location of Owners Manuals: Owner specified
Location of Test Reports: Owner specified
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 accordance with the NFPA standards as shown below, was
inspected by Siemens on 11 -09 -2006, includes the
devices shown below, and has been in service since 11 -08 -2006.
X NFPA 72, Chapters ® 1 ® 2 Z 3 Z 4 ❑ 5 ❑ 6 ❑ 7
X NFPA 70, National Electrical Code, Article 760 •
X Manufacturer's instructions
Other (specify):
Signed: Date: 11 -09 -06
Organization: Siemens Building Technologies, Inc.
3. Record of System Operation
All operational features and functions of this system were tested by Siemens on 11 -08-
06 , and found to be operating in accordance with the requirements of:
X NFPA 72, Chapters 01 ®2 Z3 04 05 06 07
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's instructions
Othe (sp if ):
Signed: Date: 11 -08 -06
Organi : Siemens Building Tec
4. Alarm — Initiating Devices and Circuits
Quantity and class of initiating device circuits (see NFPA 72, Table 3 -5)
Quantity: 1 Style: B Class: B
MANUAL
(a) 8 Manual stations X Noncoded, activating Transmitters Coded
(b) Combination manual fire alarm and guard's tour coded stations
AUTOMATIC
Coverage: Complete: Partial: X
(a) 35 Smoke detectors _ Ion X Photo
(b) 9 Duct detectors Ion X Photo
(c) 1 Heat detectors FT RR 1 FT /RR RC •
(NFPA Record of Completion 2 of 4)
■
(d) 1 Sprinkler waterflow switches: Transmitters X Noncoded, activating
Coded
(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) 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
(I) Control panel trouble
(m) Transfer switch
(n) Engine running
Other Supervisory Function(s) (specify): (2) Tamper Switches
6. Alarm Notification Appliances and Circuits
Quantity and class (see NFPA 72, Table 3 -7) of notification circuits connected to the system:
Types and quantities of alarm indicating appliances installed: Quantity: 2 Style: A Class: Z
(a) 1 Bells 8 Inch
(b) 35 Speakers
(c) 1 Horns
(d) Chimes
(e) Other:
(NFPA Record of Completion 3 of 4)
6
(f) 46 Visual Signals Type: Strobe
36 with audible 10 w/o audible
(g) 1 Local Annunciator
7. Signaling Line Circuits
Quantity and Style (see NFPA 72, Table 3 -6) of signaling line circuits connected to system:
Quantity: 5 Style: W Class: B
8.System Power Supplies
(a) Primary (Main): PANEL L4#6 Nominal Voltage: 120V Current Rating: 20A
Overcurrent Protection: Type: Circuit Breaker Current Rating: 20A
Location: MAIN ELECTRICAL ROOM
(b) Secondary (Standby):
X Storage Battery: Amp -Hour Rating (7) 7.5ah
X Calculated capacity to drive system, in hours: X 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): Siemens ALS2, Version 2:1
(b) Application Software Revision Level(s): 2.3
(c) Revision Completed by: MIKE WEST Siemens Building Technologies
(Name) (Firm)
10. Comments:
(Signed) for Central Station or Alarm Service Company title) (date)
Frequency of routine tests and inspections, if other th r accordance with the referenced
NFPA standards(s):
System deviations from the referenced NFPA standard(s) are:
(Signed) for Central Station or Alarm Service Company (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 Record of Completion 4 of 4)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200G -00605
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/112U0€.
Phone: (503) 639 -4171. �'
Inspection Requests (24 Hrs.): (503) 639 -4175 - �'II�
INSPECTION WORKSHEET FOR DATE: 11/9/2006 TIME: 7:02AM PAGE: 87
SITE ADDRESS: 10500 SW NIMBUS AVE T CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SOLID ROCK FELLOWSHIP
DESCRIPTION: SOLID ROCK. Fire Alarm System.
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 11/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
998 Alarm final 039419 -01 503 -209 -9684 N
Corrections /Comments/ Instructions:
(U C - - ' P.
t&_L-- ,A
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
F AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED
f
Inspector:
A&„1________ Date: (l 1� Phone #: (503) 715A-2I
CITY OF TIGARD C-AiteZoa (o -06 `i b5
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171a
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: I V 1 L OW TIME: PAGE:
SITE ADDRESS: ( b 6 6 0 Zr l vmA01.4,5 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # inspection Description Confirm # Contact # Message
q4 5‹ Midipo -rt,vvJ
Corrections /Comments/ Instructions:
r
II •
0 ,
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V ` Date: 1 1 I LA/66' Phone #: (503) 718- VI /141