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Permit v CITY OF TIGARD BUILDING PERMIT Ct3MMUNITY DEVELOPMENT PERMIT #: BUP2007 -00657 DATE ISSUED: 1/14/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134AB-03300 SITE ADDRESS: 10330 SW SCHOLLS FERRY RD ZONING: R -12 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: MUSLIM EDUCATIONAL TRUST Project Description: Fire alarm. Existing building (not part of BUP2006- 00396) 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: E1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 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:Y DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 14,000.00 Owner: Contractor: MUSLIN EDUCATIONAL TRUST ADT SECURITY SERVICES INC PO BOX 283 2815 SW 153RD DR TIGARD, OR 97223 BEAVERTON, OR 97006 Phone: Contact #: FAX 503 - 469 - 7110 PRI 503 -469 -7100 Reg #: LIC 59944 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 1/3/2008 $148.30 [TAX] 8% State Surcha 1/3/2008 $11.86 IFLS] FLS Pln Rv 1/3/2008 $59.32 Total $219.48 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 Utilit ification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of thes ules or dire : uesti• • to OUNC by calling 503.246.6699 or 1.800.332.2344. Is ed By: ' I ____ A ' Permittee Signature: 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 oft e project. Approved plans are required on the job site at the time of each inspection. it M--t aJ /L7 1- LA( I C7 - 3'`5 k 4 -LS t Y Building Permit Application Fire Protection S R FOR OFFICE USE ONLY CI of Ti and Received r Permit No. `.1 g DateB / ��_�e' / j (/ eld 65 q 13125 S50 Hall Blvd , Tigard, 97223 200 Plan Revie �.I f � Phone 503 639 4171 Fax 503 03 598 8 I9 196 DEC ebb 2 8 1Jl1 Date/B �1 Other Permit Inspection Line 503 639 4175 yf GARD Date Ready By 3urts 61 See Page 2 for T I G n R D Internet www tigard - gov �� D CIF �' w N Notify. ethod 1 / ,0 •� . Supplemental Information iii. tL • . }t; 'i i �0 I� . TYPE OF WORK O / / :1 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 M Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: r JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ) ®`33 c C W c c....4 f rAiki RZ New dwelling area: square feet City /State /ZIP: - r%. G,AR,ko ®o,,a..c ‘v K Garage /carport area: square feet M1f°T Suite/bldg. /apt. no.: Project name: `-'('� Covered porch area: square feet a tkl� 1J% .1C 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. ••► Valuation: $ I Li , ' 1�'1 %' Sy S .J►/1 LhI cI TA L L1A l I 0 N Existing building area: 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: 1 -4 4) ......._. 6E C Ni s • r �� c , All contractors and subcontractors are required to be Contact name: p�� ---1� 'Q '�ti 17 licensed with the Oregon Construction Contractors Board 1 1-1 7 - under ORS 701 and may be required to be licensed in the Address: 11�� i c— S I 1 6/ A.iJ 0 (10F jurisdiction in which work is being performed. If the City /State /ZIP: �� \1 `, ( A f q I" D Q ( a pplicant is exempt from licensing, the following reasons ` /" appl Phone: ( 51.1% yet -\.... Fax:: (6 D 4 (401 r 1 1 0 E -mail: pp a% -CotL. ti_._, ims-1 r o w\ CONTRACTOR BUILDING PERMIT FEES* (Please refer to fee schedule, Business name: NN'tV^ Permit fee: Address: City /State /ZIP: State surcharge (8% of permit fee): FLS plan review (40% of permit fee): Phone: ( ) Fax: ( ) (Due upon application) CCB tic.: 6qC &1 1 Total permit fees: Authorized signature: G Amount received: This permit application expires if a permit is not obtained Print name: , (�;\ QG1 Date: * within 180 days after it has been accepted as complete. � Fee methodology set by Tri -County Building Industry Service Board I \Buddmg\Permrts\FPS- PermttApp doc 03/23/06 440-4613T(1 I /02/COM/WEB) • r, • City of Tigard: Fire Protection Permit Checklist = • Page 2 - Supplemental Information Describe work to be done: 1.) El New 2.) Modification to ,sprinkler heads only: - ❑ Addition El 1 -10 heads: -No- plan - review- required. El Alteration ❑ 11+ heads: Plan review required. El Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler El Wet El Dry Additional Standpipes' • 1 ' Information: Hazard Group 1 ' :0 . ' Density :. A •, Design Area ' K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm ° Submittal shall Battery Calculations El Yes include: Individual Component El Yes Cut Sheets Fire Alarm Project Valuation: $ 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 1 • Sprinkler Project Square Footage: , , sq. ft. . - ; ' Fire Protection Permit Fees Project valuation subtotal (see A, B & C above): $ .e Permit fee based on project valuation (see fee schedule):' ' $ r , Permit fee based on square footage (see D above): $ State Surcharge (8% of permit fee): $ FLS Plan Review (40% of permit fee): $ TOTAL: $ 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. • - ' I:\ Building \Pemvts \FPS- PermrtApp.doc 2 • 04/23/2008 07:31 FAX 5034697110 ADT SECURITY t � 1j 002 72-25 FUNDAME4 CS OF FIRE ALARM SYSTEMS / ►J Record of Completion Namc of Protected Property Muslim Educational Trust Address: 10330 SW Scholls Ferry Rd. Tigard,Ore.97223 Rcp. Of Protected Prop. (name/phone): Authority Having Jurisdiction: Cityof Tigard Address/Phone Number, 13125 SW Hall Blvd. Tigard ,Ore. 1. Type(s) of System Service: NFPA 72, Chapter 3 - Local If alarm is transmitted to location(s) off premise, list where received: ADT SECURITY SERVICES INC 14200 E. EXPOSITION, AURORA, CO 80012 NFPA 72, Chapter 3 - Emergency Voice/Alarm Service Quantity of speakers installed Quantity of speaker zones: Quantity of telephones or telephone jacks included in system: _ _ NFPA 72, Chapter 4 - Auxiliary Indicate type of connection: Local energy, Shunt, Parallel telephone Location and telephone number for receipt of signals: NFPA 72, Chapter 4 - Rcmotc Station Alarm: Supervisor,: NFPA 72, Chapter 4 - Proprietary If alarms we retransmitted to public service communications center or others, indicate location and telephone number of the organization receiving alarm: Indicate how alarm is retransmitted: NFPA 72, Chapter 4 - Central Station The Prime Contractor: ADT SECURITY SERVICES, INC Central Station Location: ADT SECURITY SERVICES, INC 14200 E. EXPOSITION, AURORA, CA CO 80012 Means of transmission of signals from the protected premise to the central station: McCulloh Multiplex One -Way Radio Digital Alarm Communicator Two -Way Radio Others Means of n•ansmission of alarms to the public fire service communications center: (a) TELCO _ (b) TELCO System Location: ADT -1- 888 - 238 -2666 DUTY SUPERVISOR Organization Name/Phone Representative Name/Phone Installer ADT SECURITY SERVICES, INC 503 -469 -7110 KEN KRAUS 503 -469 -7212 Supplier ADT SECURITY SERVICES, INC 503 - 469 -7110 KEN KRAUS 503 -469 -7212 Service Organization ADT SECURITY SERVICES, INC 1- 888 -238 -2666 KEN KRAUS 503 -469 -7212 Location of Record (As- Built) Drawings: ON SITE W/MANAGER Location of Owners Manuals: ON SITE W/MANAGER Location of Test Reports: • ON SITE W /MANAGER A Contract, dated I o`l• - / ' - D 7 , for test and inspection accordance with NFPA standard(s) No.(s) 72 ,dated , is in effect. Figure 1 -7.2.1 Certificate of Completion • 1996 Edition 04/23/2008 07:31 FAX 5034897110 ADT SECURITY lJ003 72 -26 NATIONAL FIRE ALARM CODE 2. Certification 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 listed below, was inspected by on X , includes the devices listed below and has been in service since X ADT SECURITY SERVICES, INC NFPA 72, Chapters 3 ® 0 © O (circle all that apply) T NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Other (specify): Signed: X Date: X Organization: AOT SECURITY SERVICES, INC 3. Certification of System Operations All operational features and functions of this system were tested by ADT SECURITY SERVICES, INC. on X and Found to be operating properly in accordance with the requirements of: NFPA 72, Chapters 1 03 ® ©© ® (circle all that apply) NFPA 70, National Electrical Code. Article 760 1l Manufacturer's Instructions Other (specify): NONE Signed: X Date: X Organization: ADT SECURITY SERVICES, INC 4. Alarm Initiating Devices and Circuits (Use blanks to indicated quantity of devices.) MANUAL a) 14 Manual Stations Noncoded, Activating 1 Transmitters Coded b) Combination Manual Fire Alarm and Guard's Tour Coded Stations AUTOMATIC Coverage: Complete: Partial: a) 25 Smoke Detectors Ion X Photo b) Duct Detectors Ion Photo c) 6 Hcat Detectors FT RR FT /RR RC d) Sprinkler Water Flow Switches Noncoded. activating I Transmitters Coded e) Other: (list) 5. Supervisory Signal Initiating Devices and Circuits (Use blanks to indicated quantity of devices.) 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 recorded under 4 (b) and 5(a). SPRINKLER SYSTEM a) Coded Valve Supervisory Signaling Attachments Valve Supervisory Switches Activating Transmitters - b) Building Temperature c) Site Water Temperature Points d) Site Water Supply Level Points Electric Pump: c) Pump Running f) Controller Off (AC Loss) g) AC Phase Reversal Engine - Driven Fire Pump: h) Engine Running k) Engine trouble i) Controller Off I) Low Fuel j) Controller Trouble m) Fuel Spill Engine Driven Generator: n) Selector in Auto Position o) Control Panel Trouble p) Transfer Switches • q) Engine Running Figure 1 -7.2.1 Record of Completion (continued) • 1996 Edition 04/23/2008 07:32 FAX 5034697110 ADT SECURITY a 00 `UNDAMENTAL OF FIRE ALARM SYSTEM Other Supervisory Function(s) (specify) , 6. Alarm Notification Appliances and Circuits Types and Quantity of alarm indicating appliances installed: a) Bells Inch Speakers b) X Horns c) Chimes d) Other: e) X Vuual Si;nals Type HORN/VISUAL 22 With audible 6 without audible f) I Local Annunciator 7. Signaling Linc Circuits: Quantity and Style (Sec NFPA 72, Table 3 -6.1) of signaling line circuits connected to system: Quantity: 4 Style: B 8. System Power Supplies: a) Primary (Main) Nominal Voltage: ltl VAC Current Rating: 72 VA Overcurrent Protection: Type DEDICATED BREAKER Current Rating: 20 amp Location: Basement Furnace Room NE b) Secondary (Standby): Storage Battery: Amp Hour Rating: 2(12v 7 AH) Calculated capacity to drive system, in hours: J 24 60 Engine - driven generator dedicated to fire alarm system: c) Location of fuel storage 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 71 Optional Standby 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): N/A c) Revision Completed by: N/A (name) (Finn) 10. Comments (Signed) for Central Station of Alarm Service Company (title) (date) Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):. NONE System deviations from the referenced NFPA standard(s) arc: . . _ (Signc for Central S' of Alarm Service Company (title) (date) Upon complet of th sy em(s) satisfactory test(s) witnessed (if rm uircd by the au ority having jurisdiction): x . �� • • . Z- (Signed) representative of authority having jurisdiction (title) (date) Figure 1 - 7.2.1 Record of Completion (continued). 1998 Edition CITY OF TIGARD, , - BUILDING DIVISION PERMIT #: t3UP20f7- 0O6'.�7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/14 /200 Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 I �.. INSPECTION WORKSHEET FOR DATE: 4/15/200B TIME: 7:02AM PAGE: 44 SITE ADDRESS: 10330 SW SCHOLLS FERRY RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MUSIiM EDUCATIONAL TRUST DESCRIPTION: F ire alarm. Existing building (not part of BUP2006,00396) . • OWNER: MUSLIN EDUCATIONAL TRUST, PHONE #: CONTRACTOR: AD ( SECURITY SERVICES INC PHONE #: 503 -469 -7100 Inspection Request Scheduled For: Date: 4/15 Pour Time: Code # Inspection Description Confirm # Contact # Message 998 Alarm final 068364 -01 53& 195-687# N . Corrections /Comments /Instructions: b1V - V‘ ,l/t aw__." X l . 0 , I • `_, - mo d? --00S r — ?- 4 . 4, s A 4- , 4 b �1 U �, PASS pi)PARTIAL APPROVAL till CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V( � I / (JCL/. Date: I Ciar Phone #: (503) 718 2, 1-1 CITY OF TIGARD ga, BUILDING DIVISION PERMIT #: 2ft 7-230-g• 7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 ... '' I.. INSPECTION WORKSHEET FOR DATE: S �l/6 /G % TIME: PAGE: SITE SUBDIVISION: / 5 k� 544,15 LOT #: CLASS OF W OF O RE: PROJECT NAME: / DESCRIPTION: / e t (�', 97 ix, _ 7 1 i 4 i4 44i-•.i5 OWNER: PHONE #: CONTRACTOR.` / >;J,f � L / - 14 "' PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message ofgg 4-k 6 d Corrections /Comments/ Instructions: / 14( I/ T& PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ■ I Date: �f ( i ? Phone #: (503) 718-