Permit III C I TY� O F TI GARD BUILDING PERMIT
PERMIT #: BUP2007 -00365
COMMUNITY DEVELOPMENT
DATE ISSUED: 1/30/2008
TIGARD 13125 SW Hail Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 126DC -05000
SITE ADDRESS: 09397 SW LOCUST ST BLDG 2 ZONING: C -
SUBDIVISION: LEHMANN ACRE TRACT LOT: 003 JURISDICTION: TIG
PROJECT: FREEMAN OFFICE BUILDING
Project Description: Fire sprinklers
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: 5: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 21 BASEMENT: sf AREA SEP. RATED:
STOR: 2 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 : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 5,909.00
Owner: Contractor:
COOPER MOUNTAIN VINEYARD LLC WYATT FIRE PROTECTION INC.
9480 SW GRABHORN RD 9095 SW BURNHAM
BEAVERTON, OR 97007 TIGARD, OR 97223
Phone: 503 - 649 -0027 Contact #: PRI 503- 684 -2928
FAX 503 -684 -9657
Reg #: LIC 64077
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/11/2007 $91.10
[TAX] 8% State Surcha 7/11/2007 $7.29
[FLS] FLS PIn Rv 7/11/2007 $36.44
Total $134.83
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. Yo . may obtain a copy
of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. .
Issued By: P ennittee Signature ,✓ , ' .� A
Call 503.639.4175 by 7:00 a.m. for an inspection tha • usiness 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.
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;4 Fire Protectiot S
Buildin _ Permit A o _ FOR OFFICE USE ONLY .
sa
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City of Tigard,,.., Recei DateB ve. Permit No r 0(1'7x'
13125 SW Hall Blvd., Tigard, OR 97223 Plan Re• e ' A
.
Phone: 503.639.4171 Fax: 503.598.1960 JUL 11 ' .* E , . � I I L f� Date/B : Alkuigr �� Other Permit:
` .4
Inspection Line: 503.639.4175 1,► 6. Date Rea. :y: a See Page 2 for
Internet: www.ci.tigard.or.us CITY N i6ed/Method: V t' ' Supplemental Information
�� .- -- R EQUI t D DATA: 1- AND 2- FAMILY DWELLING
n New_ coigtrnnetirn _ n lrrnp6t Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
A 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 ACommercial/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: q 3 17 S 0 L U S � - .- New dwelling area: square feet
City/State/ZIP: —11 „ t () a.3 0i -i a � Garage/carport area: square feet
Suite/bldg. /apt. no.: " Q Project name: F Q in t y . p C e 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.
Valuation: $ O
5 q q
I _�L ' /.it / II A �� a - A iI r :� I. , I 1 1 .
51.04 4- building area: square feet
� , r , n .
New building area: square feet
❑ PROPERTY. OWNER ❑ TENANT Number of stories:
Name: Type of construction: A A-'► criJ
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
E.PPLICANT ❑ CONTACT PERSON NOTICE
Business name: 5 e_t✓ c C_"D,!" " t ,n �„ All contractors and subcontractors are required to be
Contact name: '� 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
City/ State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( ) qy /0
E - mail: � ., /�
CONTRACTOR D / `� n 7
Business name: �A ) (-)61 w - .v pY 1IA , . - F,ri„ . BUILDING PERM / IT' FEE
V v
Address: 0 ` S G r �
� Please refer to fee sch ule
City/State/ZIP: ---1- + Fees due upon application
Phone: ( 3) 6 gq_ 9 .8 Fax: (rte- 3) (� gC.I q6 5 / °� Amount received
(,L!
CCB lic.: 77 —
tCl Date received: `8 4.
Authorized signature: This permit application expires if a permit is not obtained
!�//� within 180 days after it has been accepted as complete.
Print name: E(J4 Lon Date: 7 -// -67 * Fee methodology set by Tri-County Building Industry
Service Board.
i:\ Building \Permits\FPS- PermitApp.doc 1 440-4613T(I1 /02/COM/WEB)
Rug 12 08 08:56a WYRTT FIRE \r 5036849657 p.2
AUTOMATIC FORM 2 -J
SPRINKLER SYSTEMS (Page 1 of 2)
CONTRACTOR'S MATERIAL AND TEST CERTIFICATE FOR ABOVEGROUND PIPING
PROCEDURE
Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All
defects shall be corrected and system left in service before contractor's personnel finally leave the job.
A certificate shall be filled out and signed by both representatives Copies shall be prepared for approving authorities, owners and contractor.
It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship,
or failure to comply with approving authority's requirements or local ordinances.
PROPERTY NAME
r z efliGcf2 I • . • D .
Dc.. PROPERTY ADDRESS
3 5 l,J L c I ST jT
ACCEPTED BY APPROVING P AUTHORITY(%) NAMES /� re..
' ADDRESS S
PLANS
INSTALLATION CONFORMS TO ACCEPTED PLANS
EQUIPMENT USED IS APPROVED. JyES El NO
IF NO, EXPLAIN DEVIATIONS
YES El NO
HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION
OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT
I ` YES NO
F NO, CONTROL V
INSTRUCTIONS
HAVE COPIES OF APPROPRIATE INSTRUCTIONS AND CARE AND MAINTENANCE CHARTS
AND NFPA 13A BEEN LEFT ON PREMISES YES NO
IF NO, EXPLAIN
LOCATION SUPPLIES CLOGS.
OF SYSTEM
• MAKE MODEL YEAR OF ORIFICE TEMPERATURE
I MANUFACTURE SIZE • QUANTITY
, P (rR �/,4 36 5 f ��� RATING
SPRINKLERS 0 7 I Z �•
^ i yc., - 1 - v 321 •cn y z , ` � 1 5 5 "F
1/1? /,'l. De v H&J V 34,,h . 20C) -7 l� , 2 5. 1 `j S "F
260 S I Cc L i _ s..
PIPE CONFORMS TO
N F P.4 11 STANDARD i�f
PIPE AND FITTINGS CONFORM TO N 1= Pit 1•t STANDARD rte! YES O NO
FITTINGS IF NO, EXPLAIN ®YES 0NO
ALARM ALARM DEVICE MAX1MIj,i TIME 'TO OPERATE ThROUGH
1'S
VALVE _ TYPE MAKE MST PIPE
OR FLOW MODEL MIN. SEC.
INDICATOR a 5/57er') '' > 0f7 1 41 c : 3
DRY VALVE
MAKE MODEL I SERIAL NO. MAKE D .O.D. f MODEL SERIAL NO.
1
TIME TO TRIP WATER AIR TRIP POINT TIME WATER ALARM
THRU TEST PIPE. PRESSURE PRESSURE AIR PRESSURE REACHED OPERATED
DRY PIPE MIN. SEC. PSI OUTLET' PROPERLY
OPERATING PSI PSI MIN. SEC. YES NO
TEST Without
O.O.D.
Wuto
O.O.D.
IF NO, EXPLAIN - -
1:,
• MEASURED FROM TIME INSPECTOR'S TEST PIPE IS OPENED. — — — — --
k.
Aug 12 08 08:57a WYATT FIRE 5036849657 p.3
AU I UMA I IC; runm c-J
SPRINKLER SYSTEMS (Page 2 of 2)
OPERATION
❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC
PIPINGSUPERVISED AYES LINO 1 DETECTING MEDIA SUPERVISED DYES ❑ NO
DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE CONTROL STATIONS ❑ YES ❑ NO
DELUGE & IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING IF NO, EXPLAIN _
PREACTION ❑ YES I0NO
VALVES _
•
GOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO
MAKE MODEL SUPERVISION IASS ALARM OPERATE VALVE RFI Paw OPERATE RELEASE
YES NO YES NO MIN. SEC.
HYDROSTATIC: Hydrostatic tests shall be made at not less than 200 psi 113.6 bars) for two hours or 50 Psi (3.4 bars) above static
pressure in excess of 150 psi (102 bars) for two hours. Differential dry-pipe valve clappers shall be left open during test to prevent damage.
All aboveground piping leakage shall be stopped.
TEST FLUSHING: Flow the required rate until water is clear as indicated by no collection of foreign material in burlap bags at outlets such as
DESCRIPTION ES hyorants and blow-offs. Flush at flows not less than 400 GPM (1514 Umin) for 4-inch pipe, 600 GPM (2271 L /min) for 5-inch pipe,
750 GPM 12839 Uminl for 6-inch pipe, 1000 GPM (3785 Umin) for 8 -inch pipe, 1500 GPM 15678 L /min) for 10 - inch pipe and 2000
GPM (7570 L/min) for 12 -inch pipe. When supply cannot produce stipulated flow rates, obtain maximum available.
PNEUMATIC: Establish 40 psi 12.7 bars) air pressure and measure drop which shall not exceed 1-16 psi 10.1 bars) in 24 hours. Test
pressure tanks at normal water level and air pressure and measure air pressure drop which shall not exceed 1 psi 10.1 bars) in 24 hours.
ALL PIPING HYDROSTATICALLY TESTED AT 2,'Ii PSI FOR 2 HRS, IF NO, STATE REASON
DRY PIPING PNEUMATICALLY TESTED ❑YES ONO
EQUIPMENT OPERATES PROPERLY . ar.YES ONO
GRAIN READING OF GAGE LOCATED NEAR WATER SUPPLY TEST PIPE, RESIDUAL PRESSURE WITH ES
VALVE IN TT PIPE OPEN WIDE
TESTS TEST STATIC PRESSURE: PS) PSI
Underground mains and lead in connections to system risers flushed before connection made to sprinkler piping..
VERIFIED BY COPY OF THE U FORM NO. 95B ❑ YES ❑ NO OTHER EXPLAIN
FLUSHED BY INSTALLER OF UNDER- ..
GROUND SPRINKLER PIPING )YES 0 N •
pig TESTING NUMBER USED LOCATIONS NUMBER REMOVED
GASKETS I�
WELDED PIPING [DYES ONO •
•
IF YES...
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY
WITH THE REQUIREMENTS.OF AT LEAST AWS 1320.9, LEVEL AR-3 ❑ YES ❑ NO
00 YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN
WELDING COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS 010.9, LEVELAR•3 - OYES ❑ NO
DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A
DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE
RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER
WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF
PIPING ARE NOT PENETRATED ❑ YES ❑ NO
HYDRAULIC NAMEPLATE PROVIDED IF NO. EXPLAIN
DATA
NAMEPLATE OYES ❑ NO
DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN:
REMARKS
NAME OF SPRINKLER CONTRACTOR
«J -lyA1Y Fir _ 1) rOTe CZ)'OtJ
TESTS WITNESSED BY
SIGNATURES FOR PROPERTY OWNER (SIGNED) TITLE DATE
_/
FOfjs�pRl�� CONT AC (SIGN O) TITLE. DATE"
1 /....f . 4/74-.., I 3 ..- — '0 '
ADDITIONAL EXPLANATION AND NOTES
•
CITY OF TIGARD - r -.
BUILDING DIVISION PERMIT #: gUP "1007- OQ3f;5
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED 1/30/2008
J
Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 _
INSPECTION WORKSHEET FOR DATE: 8/14 /2008 TIME: 7:00AM PAGE: 20
SITE ADDRESS: 09397 SW LOCUST ST BLDG 2 CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 003 TYPE OF USE:
PROJECT NAME: FREEMAN OFFICE BUILDING
DESCRIPTION: Fire sprinklers
OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503649 -0027
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 - 684 -2928
Inspection Request Scheduled For: Date 9/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Ze Sprinkler final 074180-01 5038102038 N ,
Corrections /Comments /Instructions:
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(t wy /e7 De rr -+ Alt r>, /3 — Zec_ewed Ac, 17 0
CG S i-\
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: d
i 4v 1l Phone #: (503) 718- 2-2---> �
CITY OF TIGARD • ..'�
BUILDING DIVISION PERMIT # BUP2007- 00365
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/30/2008
Phone: (503) 639 -4171 , 1,. l i i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/12/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 09397 SW LOCUST ST BLDG 2 CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 003 TYPE OF USE:
PROJECT NAME: FREEMAN OFFICE BUILDING
DESCRIPTION: Fire sprinlders
OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503 - 6499 -0027
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503.684 -2928
Inspection Request Scheduled For: Date 8/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
9 99 Sprinlder final 074063-01 503.684 -2928 d Tex!)
Corrections /Comments /Instructions:
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a j-1 ►� pA #.11 t ( /-I LA-e Ai f? o o ,"(
s` -r r •
PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
gr fr CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N Date: 5 /Z, Phone #: (503) 718- Z
y
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00365
13125 SW Hall Blvd., Tigard, OR 97223 j DATE ISSUED: 1/30/2008
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/30/2008 TIME: 7:01AM PAGE: 52
SITE ADDRESS: 09397 SW LOCUST ST BLDG 2 CLASS OF WORK:
SUBDIVISION: LE1 IMANN ACRE TRACT LOT #: 003 TYPE OF USE:
PROJECT NAME: FREEMAN OFFICE BUILDING
DESCRIPTION: fire sprinklers
OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503. 649 -0027
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 - 6842926
Inspection Request Scheduled Date: r
p q ed For te. 5/30/2008 Pour T ime:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 070561 -01 503 684 -2928 N
Corrections /Comments /Instructions:
•
V` PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (1" v Date: Phone #: (503) /
P � ) 718-
,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007- 00365
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 /30 /260Ei
Phone: (503) 639-4171 - --j4411141./11
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/6/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 09397 SW LOCUST ST BLDG 2 CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 003 TYPE OF USE:
PROJECT NAME: F REEMAN OFFICE BUILDING
DESCRIPTION: Fire sprinklers
OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503-649-0027
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 -684 -2928
Inspection Request Scheduled For: Date: 3/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
920 Suppression trip test 066200-01 503.684 -2928 N
Corrections/Comments/Instructions:
2v 9 % i0 t/.
Z / • A/ /.
• i
'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Dater / Phone #: (503) 718- d" .1---U7 I
d
_.i-
CITY OF TIGARD `
BUILDING DIVISION ` PERMIT #: BUP2007- 003(6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/30//2009
Phone: (503) 639 -4171 1,»t���r�
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 3/512008 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 09397 SW LOCUST ST BLDG 2 CLASS OF WORK:
SUBDIVISION: LEIIMANN ACRE TRACT LOT #: 003 TYPE OF USE:
PROJECT NAME: FREEMAN OFFICE BUILDING _
DESCRIPTION: F ire sprinklers
OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503. 6490027
CONTRACTOR: WYAIT FIRE PROTECTION INC. PHONE #: 503 - 684 - 2928
Inspection Request Scheduled For: ` ) Date: 3/5/2008 Pour Time:
Code # Inspection Description I //Confirm # Contact # Message
920 Suppression trip 066127 -01 503684 -2928 N
Corrections /Comments /Instructio s: , a 4C1
oL -----
,,,
❑PASS
U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
PC-S4/ ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` / ' � Date: �/ r Phone #: (503) 718- 2-4