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Permit : CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2000 -00010 iy; DEVELOPMENT SERVICES DATE ISSUED: 01/13/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110BB -06500 SITE ADDRESS: 11999 SW TREEVIEW CT SUBDIVISION: REDWOOD VISTA ZONING: R -4.5 BLOCK: LOT: 007 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: $ 3,025.00 Remarks: Fire suppression system Owner: Contractor: JT ROTH CONSTRUCTION INC GRINNELL FIRE PROTECTION 12600 SW 72ND AVE GRINNELL CORP TIGARD, OR 97223 5921 N MARINE DR Phone: P 0 Ph-o e Np8996:68y203 ORIGINAL Reg #: LIC 000632 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Sprinkler Rough -In PRMT BON 01/11/200C $68.50 00- 320995 Sprinkler Final • 5PCT BON 01/11/200C $5.48 00- 320995 FIRE BON 01/11/200C $27.40 00- 320995 Total $101.38 • • 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 mi itee Signature: • Issued By: K Call 639 -4175 by 7 p.m. for an inspection the next business day Fire Protection Permit Application Plan Check / —/ -/ CITY OF TIGARD Commercial or Residential Rec'd By 13125 SW HALL BLVD. Date Rec'd / — - 7 - c TIGARD, OR 97223 Print or Type Date to P.E. 00 (503) 639 -4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST -i / Permit # ii - „,}*r`J( b _ Called 111 - ' - '' a._D_ Job Name of Development/Project Type of System (Complete A or B as applicable) Reawaa I V i c jam Address Address - A.) Sprinkler Wet Z .-- Dry ❑ it 9 9 a Sw Treev.06, G/ Standpipes • l . ROTH C T WO Owner Mailing Address Hazard Group / 9.1ero - 79-” . fry (-' Additional 13 1) City /State Zip4 Phone _ Density 026 DO 97 . 63 - 37 Name Design Area . Occupant Mailing Address K. Factor k . City/State Zip Phone A.1) Sprinkler Project Valuation $ 3 G O Contractor Name B.) Fire Alarm N /4 (Sprinkler or ( ;;_ r, yw ) i r Alarm Company) Mailing Address Submittal Shall Include Battery Calculations YES ❑ I Prior to permit 5 l .j to, rr irte D . issuance, a City/State Zip Phone (5- 3 Individual Component YES ❑ Cut Sheets coin P r)'la ci oR ' 7ezi 3 a- — ) j $ of all licenses v H g / B.1) Fire Alarm Project Valuation are required if State Cons. Cont. Board Lic.# Exp. Date _ expired in COT G 3 �� 5._ 3 -1 - 04 Project Valuation Subtotal (A & or B) $ �' 1 O database Name Permit fee based on valuation $ (see chart on back) 64. 573 Architect Mailing Address 8% Surcharge $ City/State Zip Phone FLS Plan Review 40% of Permit $ -7, 1 -10 ' Describe work A.) New qe' 0 Alteration 0 Repair 0 TOTAL $ to be done: LGI. 33 B.) Modification to sprinkler heads only: Plans required. Submit three sets of plans, including a vicinity map and 1. 1 -10 heads= No plans required 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 P are in compliance with Oregon State laws. Additional Description of Work: Res, ( 13 D S)54ePvl Signature of Own Agent Date A.) In Existing Building ❑ New Building 0 Contact Person Name Phone Data B.) Commercial ❑ Residential ❑ -_ . S .... O ••• - ; ' • 7 0 FOR OFFICE USE ONLY: Plat # • - - _ . • Map/TL #: .. - -. - -, No. of stories: 3 - - - y•, ,iti Sq. Ft: .3 H7 - -, y_ Notes >, Occupancy Class Type of Construction .. • -'r.. ,' ••'4; 5-A/ R 3 . . - : . . is \dsts \forms \firesupr.doc 10/14/99 - - • CITY OF TIGARD BUILDING INSPECTION DIVISION MS 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 4119t000-000/0 pp�� 4119t000-000/0 Date Requested OV AM V PM BLD Location / 1 -1 / q Trebo 1 e( Suite MEC Contact Person C MIX Ph PLM Contractor Ph SWR 1t' 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 Framing T�; S��, � S ` I ' Q !� (� g 1(� l Insulation ,, /� Drywall Nailing ` e- W v cAn 0 / / • Firewall � ( D V ' t "P-2/.c- _ _, Fire Alarm 1 ! Susp'd Ceiling - AA._L ' �1 ■ / aC� Roof • (l.0 \ L p O "( `r \ Ste/ .5 1,1 Ni Misc: Final A _ 1 „ kicL4-Q—C- PASS FAIL 1 ` " � PLUM = ► t�, Post & Beam I L Under Slab - �[/ k -- -2� Top Out , Water Service .-- -e .Q S lti� 7 L ^e-- Ra Dr Sewer n _ -Q---C Rain Drains �/ ` r �� 'tom Final 1 ) CAM ( �� PASS PART FAIL MECHANICAL , (�` l -(� t Post & Beam ( 4� ') � ' � � 7 ` Rough In `� k' S 9 .-- ,'///���� _ Gas Line Y �� T - " - 1 — G,N\ Smoke Dampers �� J � ..,1[��� Final PASS PART FAIL a ^-�� p 1 � _ ,��� en ELECTRICAL Service -ek. S�.c -v"e'S _..e 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 V / U O Inspector V ( Ext� 6 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 2.CVC, - MO/0 Date Requested y- / 3 -O 0 AM PM BLD Location 1 L ?'i' ? Ew 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 - / Insulation Drywall Nailing w / , 1 Firewall ire prince • e Al Susp'd Ceiling Roof I, Misc PASS PART L, 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk �Op7 Other Date �/ Ins Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site 1g /D 20OO- QOOI a ©NEW P ❑ EXISTING PNWS-AWWA WA BACKFLOW ASSEMBLY TEST REPORT ❑ REMOVED PROPERTY L 1 / I[ l ❑ REPLACEMENT OWNER: .177 IA 6 to S 4 (: ( 4 : 6 L PHONE: MAILING ADDRESS: / j l 6 / 7 (C O �� o Scs 72 A c P � ; CITY I { r rA STATE /i ZIP (7 �' ASSEMBLY _ 1 ` I / ADDRESS: / / ' 9 I S v i I f t` e ( <- 1 t_) C 7 IT 1 c =1 : 1�..7) C^ 1/ STREET ❑R.P.B.A. D D.C.V.A. ❑ R.P.D.A. ❑ D.C.D.y�./ ❑ P.V.B.A. ❑ S.V.B.A. ❑ A.V.B. ❑ AIR GAP SIZE: I if ).1 MAKE: G� %� �� MODEL:a' ■/7/ 1 1 WATER SERIAL PURVEYOR: Tg tea( , NUMBER: /"' ASSEMBLY LOCATION: ti e( pi t ' F A t ■ REDUCED PRESSURE ASSEMBLY P.V.B.A. I S.V.B.A. INITIAL TEST NI CHECK ( DOUBLE CHECK AIR CHECK PASSED D PRESS DROP (A )I CHECK #1 INLET FAILED ❑ INITIAL RELIEF VALVE OPENED AT (B)ITIGHT 111 l 1 ' . OPENED AT: PRESS DROP DATE: TEST RESULTS MIN 2 PSID (LEAKED ❑ PsI / I / BUFFER I PSID PSID / `� /C A - B MIN J PSI I CHECK #2 TIGHT ❑I G � , ' DID NOT FAILED SYSTEM RELIEF VALVE I no OPEN ❑ ❑ PSI PASS ❑ FAIL ❑ ILEAKED COMMENTS REPAIRS - AND /OR PARTS REDUCED PRESSUREASSEMBLY P.V.B.A. /S.V B A. AFTER REPAIRS N1 CHECK PRESS DROP (A) I D DATE: • TEST CHECK #1 RELIEF OPENED AT PRESS DROP I AFTER OPENED (B) TIGHT ❑ PSID / / REPAIRS BUFFER "miv= I CHECK #2 A -B- MN )M (TIGHT ❑ P PSID PSID PASSED ❑ IN COMPLETING AND SUBMITTING THIS TEST REPORT, THE TESTER CERTIFIES THAT THE ASSEMBLY HAS BEEN TESTED AND MAINTAINED IN ACCORDANCE Wr(N ALL APPLICABLE RULES AND REGULATIONS OF THE WATER SYSTEM, AND STATE REGULATIONS GAUGE CALIBRATION AT /J 1 DETECTOR METER READING ` ��� TESTER SIGNATURE #2709 /�( TESTERAr tJNlf . GAUGE N . ��r l.Cfl1 ; TI y17 IV Marine Dr. Pnrtlanr1 OR 7 203 603 280 9080 PHONE N COMPANY NAME �4' Grignell Fire Prnttxtinn Air ll ( !c A ( • • A SERVICE RESTORED ■ REPORT RECEIVED BY (REPRESENTATIVE OF OWNER) vn�ns .r.... c....._...__.. ..n.v n.. -.._.. r__ v., . n..r...... r_.,.. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 ST BUP - 2. 0 00 — 000 Date Requested 6/ 1/b0 AM ){ PM BLD Location , 1 g � Ul�1l) Suite MEC Contact Person Ph /.0q S PLM Contractor Ph SWR DI 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 "4-7 ` 47--- Insulation - Drywall Nailing F' ire Sprinkler ire Ala sp'd Ceiling Roof Misc: 411P40 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 [ ] 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 Inspector Date C� — / nspeco Other t Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the ilob site