Permit ,
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00400
� DEVELOPMENT SERVICES DATE ISSUED: 09/10/1999
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S110BB -RED02
SITE ADDRESS: 14155 SW 120TH PL
SUBDIVISION: REDWOOD VISTA ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: 5: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,400.00
Remarks: Installation of fire sprinkler system for single family residence.
Owner: Contractor:
FOUR D CONSTRUCTION GRINNELL FIRE PROTECTION
PO BOX 1577 GRINNELL CORP
BEAVERTON, OR 97075 5921 N MARINE DR
Phone: P 0 P hone NZ8 - u8 D 7203
Reg #: LAC 000632
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough -In
PRMT DEB 09/03/199E $59.25 99- 318097 Sprinkler Final
5PCT DEB 09/03/199E $4.15 99- 318097
FIRE DEB 09/03/199E $23.70 99- 318097
•
Total $87.10
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
Pe Signature: ORIGINA L
Signature: /L
Issued 6 - / / G--- --
Call 639 -4175 by 7 p.m. for an inspection the next business day
04/19/99 MON 08:55 FAX 503 598 1960 CITY OF TIGARD EJ 003
Fire Protection Permit Application Plan Check # %_ s�
CITY OF TIGARD Commercial or Residential Rec'd By
13125 SW HALL BLVD. Date Rec'd 9
TIrt4RD, OR 97223 Print or Type Date to P.E. S"
(, ` i 639 - 4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST 'a'gffir
P # 9151/1112—e°
fi-
Called ermit
Job Name of Development/Project Type of System (Complete A or B as applicable)
LoT * 1 gesvp e N t+E
Address y `g S%•• rZ.0." ` A.) Sprinkler Wet "EI, Dry ❑
Name. Standpipes
u... D C.DNS TR.t.4t- 0 N NO
Owner Mailing Address Hazard Group
?t 0. 3.0$ ■ S1 Additional ■ 3D
City /State Zip Phone Information Density r O ��
'Tt60 -+o I b A7bbS 5'10 - 0eo5
Name Design Area
\Z
Occupant Mailing Address K. Factor
4% z
City/State Zip - Phone A.1) Sprinkler Project Valuation
Contractor Name - � , � �
1, B.)'i' ire Alarm
(Sprinkler or G�iNM Ek,�.. motes.. reintteA)
Alarm Company) Mery Address Submittal Shall Include Battery Calculations YES ❑
Prior to permit 1- 12. \ N 00.. $4 IMAt„1 N L 0 2.
issuance, arty /State zip Individual Component ponent YES ❑
copy fLT,rc
trl0 91 z o3 Cut Sheets
of all licenses OK. Zip - / D8D B.1) Fire Alarm Project Valuation $ •
are required if State Const. Cont. Board Lic.# Exp. Dat
expired in COT 3 ZD s j �{ '-p a Project Valuation Subtotal (A & or B) $ z vtd V
III Name
Permit fee based on valuation $
Architect Mailing Address (see chart on back) ��' Z
77 "Surcharge $ 4 4 1 5.
City /State Zip Phone FLS Plan Review 40% of Permit $ 3 Q • 5 I
• Describe work A.) New 0 Addition 0 Alteration 0 Repair 0 TOTAL v
to be done: 10% • q f
B.) Modification to sprinkler heads only: V - —
1. 1 -10 heads= No plans required Plans required: Submit three sets of plans, including a vicinity map and
2. 11 += Plan review required the location of the nearest hydrant.
I hereby acknowledge that I have read this application, that the information given is
Number of sprinkler heads: correct, that I am the owner or authorized agent of the owner, and that plans submitted
are i , compliance with Oregon State laws.
Additional Description of Work: ,
gnat r of • • •ent Date
A.) In Existing Building 0 New Building JONI Sc. k 11'Z - z 89-9 05
Building Contact Person Name Phone e T I 0 S
Data B.) Commercial ❑ Residential'
FOR OFFICE USE ONLY: ��y
N0. of stories r7 �t — ; : 1 17 n r { t F ,{f a `i igaPti-a f 1==f: fic 7d
'* . w..f r iS`ll• 6 ,A { .iiii• : r (Y •c- -p er v .i. %f � .
Sq. Ft J m X4:1 S ' E �` 5 �.• C i�3 °� ibi r 7 c c' rs
3 S 1 I ;il J �• 1F L y A s ' - L.1 �' .t:'.4'41.1
I y y ''I ` ^�^ , Z i �I4 11 E4-0 �• g' ' r z :, rl,� ,.. ' z 2.. , 01;:n
Occupancy Class Type of Construction • t;-r 1 , 4 i r �ti �. ii. t i 4T .. g , � a ,� x i
SKI �, l,da ;. •L. }pa RI way •�li2'tir. `u -' u, . ` ° 4 ,- 1: .
_:�.{. ,p V.c i!', Ft u, x;•k,.. ax:-n:.. ,, e4i �r . a , . - .' s m
411
•
is \dsts \forms \firesupr.doc 11/5/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
rJ _ BUP 1 q 9 -oo �7' )
Date Requested L l 3 /c� AM X PM BLD
Location (�(1 S5 I P( Suite MEC
Contact Person C-ONi Ph 0 q - .J S PLM
Contractor Ph SWR
!I Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear - 1 /�� . 1 /,.,
Framing A � f 1 1't bI') ire I�(.0 �- I �C �i S L ! S .
D s wall on O b , , D , r 11 „ , req S L n
Drywall Nailing � Le. ' ' ►�(Jr L `�Y �Ll/I 1 _I > - me Ci
Firewall
FAMMIrri 1/ IA
Fire Alarm I / � � // A / / i
Susp'd Ceiling __of
-
Roof
Misc:
—5
PA SS PART FAI ' 'r ��u1i7.: '3l2c� �� - '��PorG — ! w� ,4P,'
PLUMBING
Post & Beam
Under Slab ,ft's Ql,ZA-,Ce.• Aviv, s"
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Date / /9�� Inspector - Ext
Other -
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP ( C e 'q q -61)(71CID
Date Requested /1 f #c: AM ! PM BLD
Location / (4 I 5S .v /AY' /Afrk P/ Suite MEC
A-6 Q LI
Contact Person Q/14k r4S /2Qrt t. I Ph 57) 3 c= -3
PLM
Contractor RD _d Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation Access: FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: l r01.X_S� ( /LLB+
Slab SIT
Post & Beam hc _ ] _ Q_ 7
Ext Sheath /Shear �C�eCS�'�
Int Sheath /Shear
Framing
Insulation ,,Z l0 ® ? . z r 2- /c r e , ' 7
Drywall Nailing '
Firew
ire Sprinkler
Fi
Susp'd Ceiling
Roof /
Misc: �1 .�or �s_..-.L
4 -Vp PART FAIL C ! -AGe-A -- ar-f-AZ CJ1.0
pLI 1NG
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains �# -. �� — - ���.�.� "
Final
PASS PART FAIL �7tfif , , / 9A .-� /24
MECHANICAL
Post & Beam
Rough In
Gas Line �� -
Smoke Dampers ,�� ( i'J /x �'�°'�"'`
Final
PASS PART FAIL
ELECTRICAL
Service nf C�C.¢•af�i.t�.^� -�
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA /'��
Approach /Sidewalk Date //- 7 -3`9 7 Inspector G� '�+'v Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST t9q'q - 00/ 51
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
O %/0(),_, J BUP J j9 `'C0 C(
Date Requested (D/ D /QO AM PM BLD F S
Location I L S S � 20`1 —d Suite MEC
Contact Person Jaw C Ph 72_0- W IS PLM
Contractor Ph SWR
101LDII I Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath/Shear
Framing ming : •y 0 o � L V I V „ 91/An 3 ,L
z`I� I
Drywall Nailing
Insulation 'nyA J
Drywal Y '�
Firewall
Fire Sprinkler ‘. � t Sf �J�- '�i2ia.2. rip 2/1 f1 ti
Fire Alarm
Susp'd Ceiling
Roof
final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Dfains
FinalV
PASS PART FAIL
NIC
earn
Rough In
Gas 5napive Dampers
( BRA
PASS PART
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm •
Final �/
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date F` Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST ( q ' S 7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP 190 FA
Date Requested 4/17/00 AM PM BLD
Location ' C/ I S S / Suite MEC
Contact Person f lUi - Ph - 7Z6 - 7q 1 1.5 PLM
Contractor Ph SWR
�`UILDII�G] Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation S K I FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam / , /� �'
Ext Sheath /Shear ► ,n p - 4 &P/ /' s l Gl t,w `�-,'1 or rl d o2 Dr. ?
Int Sheath /Shear 11
Framing C- az S[o CA-120 4, Cr -rye')
Insulation _
Drywall Nailing Y o - n.: C Awn. / ' A 425
Firewall ��--��.,,
Fire Sprinkler C� �
v.T14.- G4-171G4-1710 c 1r�S 1 - 477 0 /s) /4 _.,aq
Fire Alarm
Susp'd Ceiling �A�.l�r Lac1 � =�r� :r��L ��.�• 4, T=ST 1dZ Wiz.
Roof
Misc: /���%.. -�lt�E / d . `re�xS,.-5 cn 0" 4-1(
frriO
PASS PART FAIL & -S.1/'/7°2r- LSu Q', t! `r- a"r y`�
PLUMBING 7 .66> - - r4
Post & Beam
Under Slab !,r? , o,ti,oLE D,,. / ct, /1 .S -
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PAkr FAIL
AN
gECHICA
Post & Beam
Rough In
Gas Line
Smoke Dampers
ASS PART /l
A ���/
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Z/. 7 -ac Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION , M ST q o
MST ' 1 (� U
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 er /99 — 00`-t
Date Requested 1111'? I `i'`3 AM / PM BLD
Location / 4-6 I SS l 3 Suite MEC
Contact Person 4t iWt_ 6 ✓vnrrt( ( Ph 5 3 P- 3" PLM
Contractor Prv dvt — d ph SWR
Tenant/Owner Z2Q- ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Ins y Cti n jote$ P iLejc- � sd
Slab C� SIT
Post & Beam �� /� ^ - Y � . I • J
Ext Sheath /Shear l� 'GC�'
Int Sheath /Shear
Framing /� S P1 'i ICJ. S i 5T
Insulation le 3 8 0 4 l / o
Drywall Nailing lei �llnt S � : 9) • N r c0`
Fir- . -
ire Sprinkl- � ? - �C E`Tf7 � 3
1�� L S '� � Sr S'� T. •'u�st�S � 11 �.c
Fire Alarm
Susp'd Ceiling "S"'rtipS
Roof +.
Misc: JtJll ‘ = • �G ��l �"` �. ,! _ -
Final
PASS PART
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CHANIC ► )
Post & Beam
Smo e l per
Final
PART FAIL
EL TRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk //
Other Date / / - 1r r Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INACTION DIVISION
24 -Ho r.Inspection Line: 639 -4175 Business Line: 639 -4171 ,
P
Date Requested // '6 t - 7-- - &29 AM PM BLD 1444 —Deg 4' O
Location Suite MEC
Contact Person Ph - 2-9 - O - 74/(./s PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation ACCe j lTT FPS
Ftg Drain h �J-� SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing titAI- C /zaseai./ C da rr
Insulation
Drywall Nailing ( T /'o/2r
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
erir
SS T FAIL
G I Post & Beam
Under Slab
Top Out
Birk
Water Service
Sanitary Sewer
Rain Drains
Final p
PASS PART FAIL jA C i
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL (a+
Service
Rough In 44
UG /Slab VaA,
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date � � ��'� Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
JUN -10 -2000 02:40PM FROM - GRINNELL FIRE & PROTECTION 503 - 288 -8062 T -023 P.001/001 F -358
s -
312624
aiow
CI EXISTING
•< PN s .AW IVA BACKFLOW ASSEMBLY TESTREPORT .1g REMOVED
PROPERTY REPLACEMENT
OWNER: 1 - 1 Cr, PHONE:
} MAILING
if ADDRESS: , .45 / 3
CITY 0‘,(I•P"" `bra STATE el e ZIP 9 ' .7
ASS>ZDKBLY 1 , / �
ADDRE I / S-s" Sc.� I Z 0 f v- J�� i if, a ..�f�
STREET -�
. . DR.P.B.A. lid D.C.V,A 0 R.P.D -A. Q D.Cp.A. CI P,V.B.A. O S.V.B.A, O A.v.a. to AIR GAP
SIZE: LIII.M.6
MAKE; alp Arai _ _ _— MODEL: e" Z -
WATER SERI A.I
PURVEYOR: I i ,/ rz. , NUMBER: 07 7 C_`) — 7
ASSEMBLY -_ L
LOCATION: o•► t
W
REDUCED PRESSURE ASSEMBLY PAULA. F S.V.B.A INITIAL TEST
•l CBE= r DOUBLE iacic AIR CHECK PASSED
PRESS DROP (A) CHECK MI INLET FAILED 0
INITIAL nun TEST OPESW AT (B) FTIGHT An / /0 arswEP AT! PRESS D
— LEAIGED Q 1. DATE:
RESULTS HUF 8 R f CHECK n PRP PILO _i., / 7 /Ca(� ho i
RELIEF VALV !nowt ci •3 DID NOT FAILED SYSTEM
PASS ❑ FAIL ❑ LEAKED Q P OPEN C! 13 PSI
! common's
REPAIRS
AND /OR
PARTS
�� E riYSIM Y e
nCH F 1!A P.V,B.A.JS.V.B.A. AFTER REPAIRS
TPST ROP (A 11 f ECI.�— orprED AT PREIS DROP DATE:
AFTER OPENED (3) T IGHT ❑ PsiD ...1___L..._
REPAIRS euPPER '°"00 I CHECK 12
~' n- '— ( TIGHT Ca PAD Pal NRD PASSED Q
! ` IN COLMPt.FIUIC AND E111M1I71N0 Y1is MST Wear, THE Tamil. CEETTFIE$ THAT ma
! A.%3nIZLY MA3 BUN =ED AND MAINTAAJED IN ACCORDAI C'E WM ALL APPIXA3L3
RULES AND REL7LATIONS OP TIEE WATER. SYSTEM. AND EPATE REiEA.AS%ON6.
GAUGE B • l ' ETECTOR METER READING.
<.: #2709
A'; . .,;, .'"4.. �" /x"
50. Vail P. Portland. OR 97203 503 - 283-1080 _ 4A:rc& •
RICHE s
... - N. u.....
E IiCE[v s� SY • ' '� Li S$RVICE RESTORED
T (Airmilar1'ATN OF OWNER)
WHITE • Was Sys= Copy PINK • C gan= Copy YELLOW • Tote Capy
•