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Permit li CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP1999 -00543 AIlAr DEVEL SERVICES (503) 639-4171 DATE ISSUED: 12/30/1999 - 13125 SW SITE ADDRESS: 12001 SW TREEVIEW CT PARCEL: 2S11066 06400 SUBDIVISION: REDWOOD VISTA ZONING: R -4.5 BLOCK: LOT: 006 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: S: 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: $ 2,755.00 Remarks: Residential 13D fire sprinkler system. Owner: Contractor: J T. ROTH, JR GRINNELL FIRE PROTECTION 12600 SW 72ND GRINNELL CORP SUITE 200 5921 N MARINE DR o TIknD OR 97223 P 0 Phone N Z8- 908u Reg #: SIC 000632 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Sprinkler Rough -In PRMT GEO 12/23/199E $59.25 99- 320603 Sprinkler Final 5PCT GEO 12/23/199E $4.74 99- 320603 FIRE GEO 12/23/199E $23.70 99- 320603 • Total $87.69 ORIGINAL 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. c Pemtitee / Signature: [Y� G� I ( e`Gc ok. — p4 Issued By: J c/ / ��i� " /WI_ Call 639 -4175 by 7 p.m. for an inspection the next business day Fire Protection Permit Application Plan Ch:a /. - /ie. CITY OF TIGARD Commercial or Residential edd : • _ • - 13125 SW HALL BLVD. Date Redd /A --A - --, / T \RD, OR 97223 Print or Type Date to P.E/ -a3 S (b...,) 639 -4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST G 1 414 ° 1• 115r/ 99- ,r # aq�� �T Job Nam of Deve t/P menroject Type of System (Complete A or B as applicable) ge \u \)IS - I -- "— Address Address A.) Sprinkler Wet Dry 0 l "?..1n I S \...J rt a lt. U,.,, LT_ � X--OT 00 ‘057-61 e-r-/ ha) Standpipes No Owner Ma�ili Add S Hazard Group /- z 7a / Additional 13 t, ity/Sta 749 Zip 9 Phone Information Density Name Design Area .. S P K gegj Occupant Mailing Address K Factor 4. .-- City /State Zip I Phone A.1) Sprinkler Project Valuation $ a 7 S-5 Contractor Name �^ B.) Fire Alarm (SPrinkler 6 6 n1NQ .- l t t pee. Alarm Company) Mailing Address Submittal Shall Include Battery Calculations YES 0 Prior to permit 5c yesil 0 • 1/1 yte Dr. issuance. a City/State Zip Phone (sa3) Cut Sheets .J l Component YES ❑ copy of all licenses Po /UR 47aio3 ) B.1) Fire Alarm Project Valuation $ are required if State Const Cant Board Lice* Exp. Date _ "ed in C Project Valuation Subtotal (A & or B) $ tabors (p3 "x0 S 3 — 14 - 0 0 �O -�' S S r Name Permit fee based on valuation $ c- Architect Mailing Address (see chart on back) ✓ `l. as 5% Surcharge $ Lf , '71t- City/State Zip I Phone FLS Plan Review 40% of Permit $ Descnbe work A.) New o/ Addition 0 Alteration 0 Repair 0 �' to be done: TOTAL $ $ 7 4,1 B.) Modification to sprinkler heads only 1. 1 -10 heads= No plans required Plans required: Submit three sets of plans, including a vicinity map and 2. 114= Plan review required / the location of the nearest hydrant I hereby acknowledge that I have read this appucatxxi. that the wnfomtabah given IS Number of sprinkler heads: =rect. that I am the owner or authonzed agent of the owner. and that plans submslted are in compliance with Oregon State laws. Additional Descnpuon of Work: Res; 1 .. 1 4 -:Q 13 C• Sys-lei-4'1 Signature of OwnerlAgent Date A.) In Existing Building ❑ New Building [ 1 . "'�� 99 , Building Contact Pe on Name Phone Data B.) Commercial ❑ Residential t$ We N L' D "5O Al I s'a 3 - - 8q -1O$' FOR OFFICE USE ONLY: No. of stories: Plat ft Mapfak Sq. Ft ‘ i O 3 ? Notes Occupancy Class Typed Construction 5N i 1, i `,firesupr.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 7 l q-0,0Sy? Date Requested ZIOD AM l` PM BLD Location I zoo/ i ✓Ne.P u l Suite G MEC Contact Person 6 Ph g(C' 50 2 / PLM Contractor Ph SWR r1�CJILDING� Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam 'T Ext Sheath /Shear - J Int Sheath /Shear • �_ \ •� Framing (�(J Insulation Drywall Nailing Fire wall <ire Sprin �— gy I2 Z, 'Nv� -.� � --yam —Q Fire Alarm Susp'd Ceiling c � --�— `N (/ U � Roof Misc: Fin PAST PART FAIL PLUMBING Post & Beam Under Slab 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 [ I 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: [ j Unable to inspect - no access ADA Approach/Sidewalk / , Other Date ( ( Inspector v �-�, . Ex� t Final PASS PART FAIL DO NOT REMOVE this inspection record frow the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP /` 9- do Su3 Date Requested (— J3 —CO AM PM BLD Location l Z CO t —►-n V C32 Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING 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 Framing i ��/�: �i/�r��1v�/ T�S� - �Z5Pv.c - T Insulation Drywall Nailing c • v— i Ar Aro Firewall Sprinkler I" Sc.)hA -T �r�i'2�•vll�.���c S� ��A�UL 57 Susp'd Ceiling 3 A.6/ 4V0/ lo7 ,ry Roof Misc: PASS PART PLUMBING Post & Beam Under Slab 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 /� p Other /7 — l 7 Ins ec Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. I ea _ .',u_ ,99Y-t 143 l�l.a . [3 NEW PN WS -AW WA BACKFLOW ASSEMBLY TEST REPORT ❑ REMOVED PROPERTY r ❑ REPLACEMENT OWNER: �� R- el 4 PHONE: MAILING ADDRESS: / / f - - 0 'S(.) 7_2 ,. CITY 7 ; f , .• _I� STATE ZIP ,7i C f ASSEMBLY • _ , -. ADDRESS: / 7 !) G'/ II �' L•' 1 v.-e -cv . - ,.: L -- / STREET _ t . . r id _ t Y : ❑R.P.B.A. ❑ D.C.V.A. ❑ R.P.D.A. ❑ D.C.D,A. ❑ P.V.B.A. ❑ S.V.B.A. ❑ A.V.B. ❑ AIR GAP L SIZE: I I 1 I. - V I tl MAKE: (. / - MODEL: 7 (" .. .? , . 1 WATER %-' --- n SERIAL i. PURVEYOR: !--, 4- ' r) ( / t' t ., mot" ' NUMBER: l .1 "! a c''!: S LOCATION: -, -. .r,,._ v „ t REDUCED PRESSURE ASSEMBLY P.V.B.A. / S.V.B.A INITIAL TEST f NI CHECK CHECK ( DOUBLE CHECK AIR PASSED R PRESS DROP (A l CHECK #1 INLET FAILED INITIAL OPENED VALVE (B �,. / OPENED AT. PRESS DROP DATE: TEST MIN 2 PSID PSID r' ' RESULTS BUFFER 'LEAKED ❑ PSID PSID s /f !` !'1 F A - B= I CHECK #2 MIN J PSI Q _ ,- ,7 DID NOT FAILED SYSTEM 4 • RELIEF VALVE (TIGHT PsD OPEN ❑ ❑ PSI PASS ❑ FAIL ❑ ILEAKED❑ COMMENTS REPAIRS AND /OR PARTS REDUCED PRESSURE ASSEMBLY P.V.B A. /S.V.B.A. AFTER REPAIRS NI CHECK D.C.V.A. TEST PRESS DROP (A)I CHECK 111 DATE: • RELIEF I OPENED AT PRESS DROP AFTER OPENED (B) TIGHT ❑ PSID REPAIRS BUFFER '@1°® ( CHECK #2 A - B■ mme,ra I TIGHT ❑ PSID PSID PSID PASSED ❑ IN COMPLETING AND SUBMITTING THIS TEST REPORT - THE TESTER CERTIFIES THAT THE ASSEMBLY HAS BEEN TESTED AND MAINTAINED IN ACCORDANCE WM-I ALL APPLICABLE RULES AND REGULATIONS OF THE WATER SYSTEM, AND STATE REGULATIONS. GAUGE CALIJR (,1Q DA -3/ i ? METER READING t .. -1,-<- - TESTEIGNATU�IE - / _ . CERJq . 1 / 1 -1 /. rS„� ( C �"✓•4 ` (- l ,, TESTERS NAME PRINTED i I _ iAUGF,, II TT TESTER , ADDRESS // PHONE R 4 COMPANY NINE,/ E / REPO BE / E . ` .,�f 2, 7 ( , La" SERVICE RESTORED (REPRESENTATIVE OF OWNER) • WHITE.. Water S.nMm (:nnv PINK - Customer ('env YELLOW - Triter Cnov CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 9qq'5cis_ Date Requested ( AM < PM BLD Location 1.2-60 I TrketuI (fL Suite MEC Contact Person C14 J J3/1 Ph '7,0 -3 8 Co S PLM Contractor - Ph SWR 1�IN 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 Framing - i _ /-1rTv4C -1,_ Ar_ l �� Insulation Drywall Nailing Firewall ( ire Sprinkler ire Alarm Susp'd Ceiling Roof Mi . '_►" PART FAIL • II BING Post & Beam Under Slab 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 /-- Q 0 Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job sate.