Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'1111 s V COMMUNITY DEVELOPMENT Permit #: FPS2012 -00134
TI GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/30/2012
Parcel: 26101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Clear Channel Radio Subdivision: VARNS ACRES Lot: 9
Project Description: TI: 3rd and 4th floor offices, fire alarm modification.
Contractor: BERGELECTRIC CORP Owner: TRIANGLE POINTE LLC
13650 NE WHITAKER WAY 901 NE GLISAN ST, #100
PORTLAND, OR 97230 PORTLAND, OR 97232
PHONE: 503 - 255 -1818 PHONE:
FAX: 503 - 255 -1919
FEES
Description Date Amount
Specifics: Permit Fee - COM 08/30/2012 $145.24
12% State Surcharge - Building 08/30/2012 $17.43
Type of Use: COM ' Plan Review - Fire Life Safety - COM 08/13/2012 $58.10
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 08/30/2012 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 5 Info Process /Archiving - Sm $0.50 (up to 08/30/2012 $7.50
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: Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $232.27
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,100.00
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
issuan r it wo suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili Notification Center. Those ules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You - ay obtain a c•.y of the rules
or erect questions to OUNC b . mg 503.232.1987 or 1.800.332.2344.
Is ed By: e // C2 / , , / Permittee Signature: /
Call 503.639.4175 by 7:00 a.m. for the next available inspectio e.
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
Fire Protection System ' FOP OFFICE USE ONLY
City of Tigard - ed
Date Receiv � n�� Permit No.: APe .� I -f
1, . 13125 SW Hall Blvd., Tigard, OR 97223 A UG z y
n 9 Pla R eview �� /. Other Permit
Phone: 503.718.2439 Fax: 503.598.1960 ZO I2 Date /B ': d J�k_�jE 1
TIGARD Inspection Line: 503.639.4175 (;'- - D ate ady /By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov � "0 �i Supplemental Information
TYPE OF WORK / V /QUIRED 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.
❑ I- and 2- family dwelling ® Commercial /industrial
Valuation: S
❑ 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: 13333 SW 68 Parkway (3.4 K y & Aeo e�) New dwelling area: square feet
City /State /ZIP: Tigard OR, 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Clear Channel 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.: Perm 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.
Revised existing FA panel and added new devices. Valuation: 556,100.00
Existing building area: 21745 square feet
New building area: 21745 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 2
Name: Clear Channel Radio Type of construction: 'IB
Address: 2625 South Memorial Dr. Occupancy groups:
City /State /ZIP: Tulsa, OK 74129 Existing: B
Phone: (502)585 -4181 Fax: ( ) Ncw:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Bergelectric Corp All contractors and subcontractors are required to be
Contact name: Paul Peterson licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13650 NE Whitaker Way jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97230 applicant is exempt from licensing, the following reasons
apply:
Phone: (503 ) 255 -1818 Fax: : (503) 255 -1919
E -mail: ppeterson@hergeleetrie.com
hergclectric.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Bet Corp Permit fee: /6Z a 1
Address: 13650 NE Whitaker Way rf
State surcharge (12% of permit fee): I �s2..
City /State /ZIP: Portland, OR 97230 0
FLS plan review (40% of permit fee):
Phone: (503) 255 -1818 Fax: (503) 255 -1919 (Due upon application.)
CCB lie.: 110521 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: *--: Dater within ISO days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I:\Buitding \Permits \FPS.PermitApp.doc Rev 01/05 /2012 440- 4613T( II /02 /CON1 /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 Firc Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ® Yes
include: Individual Component ® Yes
Cut Sheets
Fire Alarm Project Valuation: $ 6100.00
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
C: \Users\ppcterson\ Desktop \1 3583 - Clear Channel 'I'I \ Permit \13583 I PS- PcrmiiApp.yOoc Rev 01/05/2012
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'1111 s V COMMUNITY DEVELOPMENT Permit #: FPS2012 -00134
TI GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/30/2012
Parcel: 26101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Clear Channel Radio Subdivision: VARNS ACRES Lot: 9
Project Description: TI: 3rd and 4th floor offices, fire alarm modification.
Contractor: BERGELECTRIC CORP Owner: TRIANGLE POINTE LLC
13650 NE WHITAKER WAY 901 NE GLISAN ST, #100
PORTLAND, OR 97230 PORTLAND, OR 97232
PHONE: 503 - 255 -1818 PHONE:
FAX: 503 - 255 -1919
FEES
Description Date Amount
Specifics: Permit Fee - COM 08/30/2012 $145.24
12% State Surcharge - Building 08/30/2012 $17.43
Type of Use: COM ' Plan Review - Fire Life Safety - COM 08/13/2012 $58.10
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 08/30/2012 $4.00
Occupancy Grp: B Height: ft 11x17)
Stories: 5 Info Process /Archiving - Sm $0.50 (up to 08/30/2012 $7.50
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: Smoke Detectors Req: Yes
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $232.27
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $6,100.00
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
issuan r it wo suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili Notification Center. Those ules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You - ay obtain a c•.y of the rules
or erect questions to OUNC b . mg 503.232.1987 or 1.800.332.2344.
Is ed By: e // C2 / , , / Permittee Signature: /
Call 503.639.4175 by 7:00 a.m. for the next available inspectio e.
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.
•
S Zm / Z — cC7 I' 4 /
FIRE ALARM SYSTEM RECORD OF COMPLETION
To be completed by the system installation contractor at the time of system acceptance and approval.
1. PROTECTED PROPERTY INFORMATION
Name of property: 6I- ' PItt}TG � ^ Ct-�T/ C.1a1y► WL
Address: 1333'3 5 6 15 ' TCs 't
Description
of` property: CC r.4 i/i
� � '
Occupancy type: Q c.c.-
Name of property representative: /7Tr► tL /�i�
Address: , < ov a dye.
Phone: <Q3 Z h 7 8 7/ / Fax: n E -mail:
Authority having jurisdiction over this property: l�G��f✓ _ 7; �g. fe
Phone: .2 — 779 — Fax: -X3 - ,24 7 - 7 E -mail:
2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION
Installation contractor for this equipment: rr G„ ,Q L cT� i { - /� 7
Address: /3�o NE /AY-w le,.- 4 iw y ! r Lkn o� ! z6 0
PhonefOz) ASS /5/8 Fax: E -mail:
Service organization for this equipment: _ _,—
Address:
Phone: r, Fax: E- mail:
Location of as -built drawings: `� L p its �do.% L of historical test reports:
Location of system operation and maintenance manuals: 74i1 iiur 8o (h.
A contract for test and inspection in accordance with NFPA standards is in effect as of
Contracted testing company:
Address:
Phone: Fax: E -mail:
Contract expires: Contract number: Frequency of routine inspections:
3. TYPE OF FIRE ALARM SYSTEM OR SERVICE // q
NFPA 72 Chapter Reference of System Type: (,.la g N 6
Name of organization receiving alarm signals with phone numbers (if applicable):
Alarm:I/ ,1 J 4, Phone:C 27) 6 h / - 676/
C (J
Supervisory: Akivl f/al/ 014 -- Phone: v3, e // 677/
Trouble: nkik, C.lis7 , � 7Y�ln Phone: (se.?) 6/I -• 6 Z
Entity to which alarms are retransmitted: Phone: _
Method of retransmission of alarms to that organization or location: Tj&0et4d eJc
C) 2007 National Fire Protection Association NFPA 72 to. ; of 5
FIGURE 4.5.2.1 Record of Completion.
COPYRIGHT 2007 NFPA, REPRODUCED WITH PERMISSION.
2007 Edition
3. TYPE OF EIRE ALARM SYSTEM OR SERVICE (continued)
if Chapter 8, note the means of transmission from the protected premises to the central station:
Digital alarm communicator U McCulloh U Multiplex U 2 -way radio U 1 -way radio U N/A
If Chapter 9, note the type of connection: J Local energy J Shunt U N/A
3.1 System Software
Operating system (executive) software revision level: _�--- _._---- . — - -- - — --
Site- specific software revision date: Revision completed by:
4. SIGNALING LINE CIRCUITS
Characteristics of signaling line circuits connected to this system (see NPPA 72, Table 6.6.11):
Quantity:__ -- Style: 9- Class. - _ - -. - — _ —
5. ALARM- INITIATING DEVICES AND CIRCUITS
Characteristics of initiating, device circuits connected to this system :see NFPA 72, Table 6.5):
Quantity: Style: Class:
5.1 Manual Initiating Devices
5.1.1 Manual Pull Stations Number of manual pull stations:
Typo of devices: Addressable U Conventional CI Coded Transmitter N/A
5.2 Automatic Initiating Devices
5.2.1 Area Smoke Detectors Number of smoke detectors: 3 _
Type of coverage: J Complete area Partial area J Nonrequired partial area J N/A
Type of devices: Addressable .! Conventional U Coded ;J Transmitter U N/A
Type of smoke detector sensing technology: Ionization 54 Photoelectric
5.2.2 Duct Smoke Detectors Number of duct smoke detectors:
Type of coverage.:
Type of devices: °i Addressable U Conventional CI Coded U Transmitter U N/A
Type of smoke detector sensing technology: U Ionization U Photoelectric
5.2.3 Heat Detectors Number of heat detectors:
Type of coverage: 0 Complete area J Partial area 'U Nonrequired partial area J N/A
Type of devices: U Addressable U Conventional a Coded U Transmitter N/A
5.2.4 Sprinkler Waterilow Detectors Number of waterflow detectors:
Type of devices ❑ Addressable J Conventional U Coded '_# Transmitter ei NIA
5.2.5 Alarm Verification Number of devices subject to alarm verification:
Alarm verification on this system is: J Enabled U Disabled J Set for seconds
0 2007 National Fire Protection Association NFPA 72 (p. 2 of 5)
FtiND AMENTAI.S OF FIRE Al...AR,M SYSTEMS 72-55
6. SUPERVISORY SIGNAL - INITIATING DEVICES AND CIRCUITS
6.1 Sprinkler System Number of valve supervisory switches:
_-- -
Type of devices: -=J Addressable J Conventional i Coded J Transmitter N/A
6.2 Fire Pump
Type of ti pump: 0 Electric i Diesel
type of fire pump supervisory devices: Li Addressable J Conventional Li Coded i Transmitter Ci N/A
Fire Pump Functions Supervised
U Fire pump power :J Fire pump running rJ Fire pump phase reversal C1 Selector switch not in auto
Engine or control panel trouble C Low fuel
Other:
6.3 Engine - Driven Generator
Type of generator supervisory devices: U Addressable U Conventional U Coded E=3 Transmitter LI N/A
U Engine or control panel trouble a Generator running Li Selector switch not in auto U Low fuel
Other: - -- � — _
7. ANNUNCIATORS
7.1 Annunciator' Li Local ' Remote
Type: Li Addressable ..i Directory V( Graphic N/A Location: Ai/0D1 NI L--' + � L
7.2 Annunciator 2 C Local u Remote
Type: G Addressable U I)i 0 Graphic U N/A Location: - -_ - - -- — ^ --
7.3 Annunciator 3 U Local Li Remote
Type: Li Addressable U Director} 0 Graphic J N/A Location:
8. ALARM NOTIFICATION DEVICES AND CIRCUITS
8.1 Emergency Voice Alarm Service
Number of single voice alarm channels: Number of multiple voice alarm channels:
Number of speakers: Number of speaker zones: - -.._.
8.2 Telephone Jacks
Number of telephone jacks installed :..___ Number of telephone handsets stored on site:
Type of telephone system installed: °:3 Electrically powered Ci Sound powered 0 N/A
8.3 Nonvoice Audible System
Characteristics of notification device circuits connectc-,il to this system (see NFPA 72, Table 6.5):
Quantity: 5 Style: �/ Class: -- — __—
I
G� 2007 National Fire Protection Association NFPA 72 (p. 3 of 5)
.GURE 4.5.2.1 Continued
COPYRIGHT 2007 NFPA, REPRODUCED WITH PERMISSION.
2007 Edition
•
8. ALARM NOTIFICATION DEVICES AND CIRCUITS (continued)
8.4 Types and Quantities of Nonvoice Notification Appliances Installed
Bells: With visual device: Horns: 3 With visual device: 3 1
Chimes: With visual device: Bells: With visual device:
Visual devices without audible devices: 3 S M__ Other (describe):
9. EMERGENCY CONTROL FUNCTIONS ACTIVATED
('TTold -open door releasing devices J Smoke management or smoke control
yr Door unlocking ' Elevator recall U Other
10. SYSTEM POWER SUPPLY
10.1 Primary Power
Nominal voltage _ I to VAt- Amps
Overcurrent protection: Type sAK - Amps
Location (of primary supply panelboard): t S' FL. / .1.42 c? 1 7, Z _
Disconnecting means location: S ic.r+� goorfr, _
10.2 Secondary Power
Location: Type: Nominal voltage: Current rating:
Number of standby batteries: 2. . Amp hour rating: - -_ 12.2 __ _�- Location of emergency generator:
Location of fuel storage:
Calculated capacity of secondary power to drive the system
In standby mode: in alarm mode:
11. RECORD OF SYSTEM INSTALLATION
Pill out after all installation. is complete and wiring has been. checked for opens, shorts, ground faults, and improper
branching, but before conducting operational acceptance tests.
The system has been installed .in. accordance with the following NFPA standards: (Note any or all that apply.)
NFPA 72 ', ""NFPA 70, National Electrical Code, Article 760
IX Manufacturer's published instructions U Other (please specify):
System deviations from referenced NFPA standards:
Signed: ___ . - Printed name: Date:
Organization: Title: Phone:
i2. RECORD OF SYSTEM OPERATION
All operational features and functions of this system were tested by or in the presence of the signer shown below, on
the date shown below, and were found to be operating properly in accordance with the requirements of:
NFPA 72 *NFPA 70, National Electrical Code, Article 760
Manufacturers published instructions rf Other (please specify):
LI Documentation in accordance with Inspection and Testing Form (Figure 10.6.2.3) is attached
Signed: -- Printed name: — Date:
Organization: Title: Phone:
D 2007 National Fire Protection Association NFPA 72 (p. 4 of
13. CERTIFICATIONS AND APPROVALS
13.1 S ystem installation Contractor
Tins system as specified herein has been installed and tested according to all NFPA standards cited herein_
Signe a , f a A Printed name: ur atel t€ !, Date: "0� �.Z
Organization: P 4, dec irlc Title: fec'7Fikeko Phone: 7) ∎.S.S =/8 /P
13.2 System Service Contractor
This system as specified herein has been installed and tested according to all NFPA standards cited herein.
Signed: Printed name: Date:
Organization: _ Title: Phone:
13.3 Central Station
This system as specified herein will be monitored according to all NFPA standards cited herein. •
Signed: Printed name:.,.._. Date:
Organization: Title: Phone:
'c 13.4 Property Representative
I adept this as ving been installed and tested to its specifications and all NFPA standards cited herein.
Signed: Printed name: (. t4 Date: l 1 111
Organization: S D 9 Title: __.. S vp ir _ _.._ Phone: 5 — ) 4 1 — is $ Q
K 13.5 Authority Having Jurisdiction
I have witnes a satisfactory acceptan• est of this system and find it to be installed and operating properly
in accordan /with its approved • a and specifications, its approved sequence of operations, and with all NFPA
standards fl : , herein. I F
,
Signed: r. �_ \ -: , ted name:5 Ate �c! `r __ Date :. 7- ___ ___. . !_e?
Organization: 4e - . Ca -- Title: SO IL-b /Ai6 /A(. <p D 18 Z 9.,.
0 2007 National Fire Protection Association NFPA 72 (p. 5 of 5)
FIGURE 4.5.2.1 Continued
COPYRIGHT 20E17 NFPA. REPRODUCED WITH PERMISSION_