Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
�. COMMUNITY DEVELOPMENT Permit #: FPS2012 -00032
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 . Date Issued: 03/15/2012
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 601
Project: Matrix Absence Management Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Fire alarm
Contractor: SAFE TECHNOLOGY GROUP INC Owner: LINCOLN CENTER LLC
6400 NE HWY 99 SUITE G375 . BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98665 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360 - 699 -2130 PHONE:
FAX: 360 - 719 -1527
FEES
Description • Date Amount
Specifics: Permit Fee - COM 03/07/2012 $112.96
12% State Surcharge - Building 03/07/2012 $13.56
Type of Use: COM Plan Review - Fire Life Safety - COM 03/07/2012 $45.18
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 03/07/2012 $8.00
Occupancy Grp: B Height: ft 11x17)
Stories: 6 Houlry Building Rate 03/07/2012 $180.00
Hourly Building 12% State Surcharge 03/07/2012 $21.60
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: Smoke Detectors Req:
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $381.30
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $3,765.00
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ee Signature:
Call 503.639 :00 a.m. for the next available insp ction 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.
Building Permit Applicati tell
'I _, I ti ==
` '" C FOR OFFICE USE LY
Fire Protection System 7 O C
City of Tigard MAR Q 2012 Received Permit N,: i r / J �
`J g DateB : ' 7 Je1�l P 3
13125 SW Hall Blvd., Tigard, OR 97 Plan Review
ll Phone: 503.718.2439 Fax: 503.596 OFTIG,�;; Date Nan : 1 `w� �n Other Permit Q O�Ofa -' ''■ Y
TI G n Ii D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By. lure: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK 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.
❑ 1= and 2- family dwelling ® Commercial/industrial
Valuation: $
❑ 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 New dwelling area: square feet
City/State/ZIP: TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: 601/9' Project name: MATRIX Covered porch area: square feet
Cross street/directions to job site: LINCOLN 3 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
FIRE ALARM Valuation: $53,765.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City / State/ZIP:
Existing: B
Phone: ( ) Fax: ( ) New: B
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: SAFE TECHNOLOGY GROUP INC. All contractors and subcontractors are required to be
Contact name: JASON SWEET licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6400 NE HWY 99 SUITE G375 jurisdiction in which work is being performed. If the
City/State /ZIP: VANCOUVER WA 98665 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 699 -2130 I Fax: : (360) 719 -1527
E -mail: SALES @SAFETECHNOLOGY.NET
CONTRACTOR BUILDING PERMIT FEES'
(Please refer to fee schedule)
Business name: SAFE TECHNOLOGY GROUP INC.
Permit fee:
Address: 6400 NE HWY 99 SUITE G375
State surcharge (12% of permit fee):
City /State/ZIP: VANCOUVER WA 98665 FLS plan review (40% of permit fee):
Phone: (360) 699 -2130 Fax: (360) 719 -1527 ( u pon application. —
CCB lic.: 173731 Total permit fees:
Authorized signature: . ,<4 e.s# Amount received: (581.
w / This permit application expires if a permit is not obtained
Print name: JASON SWEET Date: 3-1 -12 within 180 days after it has been accepted as complete.
Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permits\FPS- PermitApp.doc 02/01/11 4404613T(I1 /02/COM/WEB)
r
Fi I c1Z' 0003
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -
FIRE ALARM SYSTEM
RECORD OF COMPLETION
Name of protected property: /H c I i' 3 50116 p t p
Address: /O 2 0 .5 4 divan 1 ✓ �
Representative of protected property (name/phone):
Authority having jurisdiction: • . writ
Address/telephone number: •., s
Organization name /phone Representative name /phone
Installer Safe Technology Group 360- 699 -2130
Supplier Sate Technology (iroup 360- 699 -2130
Service organization Safe Technology Group 360- 699 -2130
Location of record (as- built) drawings: FACP
Location of operation and maintenance manuals: FACP
Location of test reports: Central Station
A contract for test and inspection in accordance with NFPA standard(s)
Contract No(s): Effective date: Expiration date:
System Software
(a) Operating system (executive) software revision level(s):
(b) Site - specific software revision date:
(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:
X NFPA 72, Chapter 8 — Central Station
Prime contractor:
Central station location:
(NFPA 72, 1 of 4)
FIGURE 4.5.2.1 Record of Completion.
2002 Edition
72 - NATIONAL FIRE ALARM CODE
Means of transmission of signals from the protected premises to the central station:
McCulloh Multiplex One -way radio
X 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 standards as shown below, was inspected by
on , includes the devices shown
in 5 and 6, and has been in service since
X NFPA 72, Chapters 1 2 3 9( (( f( 7 gi !d 10 11 (circle all that apply)
X NFPA 70, National Electrical Code, Article 760
K Manufacturer's instructions
Other (specify):
Signed: Date: 3/i �r 2..
Organization: S echno y roup
3. Record of System Operation •
Documentation in accordance with Inspection Testing Form, Figure 10.6.2.3, is attached .
All operational features and functions of this system were tested by date
and found to be operating properly in accordance with the requirements of:
, NFPA 72, Chapters 1 2 3 4 5 6 7 8 9 >ISl 11 (circle all that apply)
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's instructions
Other (specify):
Signed: Date: j /2 9// 2
Organization: Sa echno y Group
4. Signaling Line Circuits
Quantity and class of signaling line circuits connected to system (see NFPA 72, Table 6.6.1):
Quantity: Style: Class:
(NFPA 72, 2 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -33
5. Alarm Initiating Devices and Circuits
Quantity and class of initiating device circuits (see NFPA 72, Table 6.5):
Quantity: Style: Class:
MANUAL
(a) Manual stations Noncoded Transmitters Coded Addressable
(b) Combination manual fire alarm and guard's tour coded stations
AUTOMATIC
Coverage: Complete PC Partial
Selective Nonrequired
(a) Smoke detectors Ion Photo Addressable
(b) Duct detectors Ion Photo Addressable
(c) Heat detectors FT RR FT/RR RC Addressable
(d) Sprinkler waterflow indicators: Transmitters Noncoded Coded Addressable
(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
(i) Fire pump running
ENGINE - DRIVEN GENERATOR:
(a) Selector in auto position
(b) Control panel trouble
(c) Transfer switches
(d) Engine running
Other supervisory function(s) (specify):
(NFPA 72, 3 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition
72 - 34'" NATIONAL FIRE ALARM CODE
7. Annunclator(s)
Number: Type: Location:
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:
Types and quantities of notification appliances installed:
(a) Bells With Visible
(b) Speakers With Visible
(c) Horns . With Visible C–
(d) Chimes With Visible
(e) Other: With Visible
(f) Visible appliances without audible:
9. System Power Supplies
(a) Fire Alarm Control Panel: Nominal voltage: 120VAC Current rating:
Overcurrent protection: Type: Breaker Current rating: 20A
Location:
(b) Secondary (standby):
Storage battery: 2 Amp -hour rating:
Calculated capacity to drive system, in hours: 24
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):
System deviations from the referenced NFPA standard(s) are:
(signed) for in - . tion contr.r' :r/ i pplier (title) ( ate)
(signed) for alarm service company (title) (date)
(signed or central station (title) (date)
Up% pletion of . = system(.) satisfactory test(s) witnessed (if required by the authority havi jurisdicti n):
_ — zg i
°ned) represent Yrit : of the authority having�'!• n (title) ( ate)
(NFPA 72, 4 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition •