Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00342
�1� DEVELOPMENT SERVICES DATE ISSUED: 10/14/2004
�=- -' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09725 SW DURHAM RD PARCEL: 2S111CD -00400
SUBDIVISION: ALDERBROOK FARM ZONING: R -7
BLOCK: LOT: JURISDICTION: TIG
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: 5 -1 HR : sf N: S: E: W:
OCCUPANCY GRP: A2.1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 940 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:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 4,471.00
Remarks: Fire alarm
Owner: Contractor: .
SOUTHWEST CHURCH OF POINT MONITOR
CHRIST 4755 SW OLESON RD.
9725 SW DURHAM ROAD PORTLAND, OR 97225
TIGARD OR 97223
one
Phone: 503 - 292 -5533
Reg #: LIC 135901
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 7/16/2004 $91.30 Final Inspection
[TAX] 8% State Surcharl 7/16/2004 $7.30
[FLS] FLS Pin Rv 7/16/2004 $36.52
Total $135.12
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 -0 th`gh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calli n 503) 246-66•• or 1- 800 - 332 -2344.
Issu d By: ` l/ �•! ,,LJ
C Permittee
Signature: 1:11671MirdrA%.
.
Call .+�'� -4175 by 7 p.m. for an inspection the next business day
c /;7 Sw p I F!1n
• $uilclina i o � I D Permit.A plieation= FOR +OFFICE U DONLY
•
4Ir a oecHitt
city of Tigard Date /B : i Permit No', '�/ �
13125 SW Hall Blvd., Tigard, OR 97223 ' 20U4
Received
Plan Revie •
Phone: 503.639.4171 Fax: 503.598.1960 t` 'I I _ Date /B 8 — -y' /3 Other Permit:
Inspection Line: 503.639.4175 LITY OF I IGARD� , ,A! ,. Date Ready /By:
tea DIVISION H See Attached Checklist for
Internet: www.ci.tigard.or.us BUILDING DIVISION Notified /Method: Supplemental Information •
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❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
. 1Rt Addition /alteration/replacement ❑ Other: - equipment, materials, labor, overhead, and the profit for the
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❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building
❑ Multi- family Number of bedrooms:
❑ Master builder Fij . Number of bathrooms:
Other: ^ t {/�' ' Ul n /
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;t' ; ; � ; =�,� � ,:,,: ON �•AND,tLOCt1Tl0 �-' -.• „�,�s`�� _ o floors:
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Job site address: C 7 25 61,0 0 1, r H A-M 12dA.19 New dwelling area: square feet
City /State /ZIP: 'r
i&I A 1ZD l � Garage /carport area: square feet ..%
Suite/bldg. /apt. no.: 1 Project name: 30 lr lU IZO (-I C*. '` 0 H j� I5 Covered porch area: square feet
Cross street /directions to job site: ` Deck area: square feet
Other structure area: square feet
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Z$R QUIREDI COMME JSE * CHECKLIST /t
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
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'.., °. R ,4 4 � `'DESCRIPTION. OF WORKZ- � H_ - work indicated on this.a application.
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1UST-LL/ (Fou A � � F 02r ALA 12N1 �1,[51FM Valuation: $
IN- r Jiro \ A oiii Ii I t I I Ir17' .T1-1F; Existing building area: square feet
a moo �j New building area: square feet
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A -':� t, NZ- R" 4 ' r> , :k, „_ TEN AI4tT; ;<, v.
3'��x �...,.,� � �+��,n rx=�. � n om: ��s� :.�`��ick � :���,�,' >, .���i �� Number of stories:
Name: Type of construction:
Address: • Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
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Business name: ?) r}.1-- I" *1 2 All contractors and subcontractors are required to be
Contact name:.4 t1 I i J • fl� 1 6,e_ t I —� licensed with the Oregon Construction Contractors Board
1 � �� �" under ORS 701 and may be required to be licensed in the
Address: � 7 50 0 � jurisdiction in which work is being performed. If the
City /State /ZIP: it 10V- g127v applicant is exempt from licensing, the following reasons
�j(�� I �^ ! p�7 n r
apply:
Phone: 3 @ ' �//y� J F ax: : ('.l )-)) 7 — 5") 2
E -mail IC )yy ( f P t v NYldrl�( * r. VI') .
;�,y.. , » *Si'"ao,V, . .. ::2 '..*�'cr. ;a ',' v,'' akkr'ft�,` ::tw . t:,:aex',.sr,. -`. : a •r; d' - ',.'c : oN.ca . ,,e,.,.:<: s, .
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Business name: ••- .u:
in (5 cr vt ern., ,ff _ �. . , W ... r. .� .-. -
���`� x � ' ";�BUI LDi IV G �I RERIV1ITv'FE ES*' �;,t•gs,� � �'
Address: sM...,,.. ; rxMr :Mra. xz;a.,_ . _ - .,r.:m::; v..rs...t 1?k4: > uir,�.:.....
Please refer to fee schedule.
City /State /ZIP: -
v 1 Fees due upon application
Phone: ( ) Fax: ( )
`�� ✓ Amount received
CCB lie.: 1 r
D ate received:
Authorized signature: pC��p 060114.-- This permit application expires if a permit is not obtained
a within 180 days after it has been accepted as complete.
Print name:` IQAtJ F P O m n i (7 /4,id Date: r)—'` 404 * Fee methodology set by Tri County Building Industry
/ Service Board.
is \Building \Permits \BUP- Permit.4pp.dnc 12/03 440 4613T(11/02/C1OM /WEB)
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -27
Figure 1 -6.2.1 Record of completion.
Fire Alarm System
Record of Completion
Name of protected property: S yl/, C- (k,, r elA -j C.L.rl i 7 [
Address:. Cr( 2S '3 W 1) kr Wm �►q �ldd d e lF„
Representative of protected property (name /phone):
Authority having jurisdiction: ?"1 ad fj ,,,(J'K' 1 7,
Address /telephone number:
1. Type(s) of System or Service
NFPA 72,_Chapter 3 — Local , `
If alarm is transmitted to location(s) off premises, list where received: la Y t G Q ipt. �/ e+e r d Vl 6
NFPA 72, Chapter 3 — Emergency Voice /Alarm Service
Quantity of voice /alarm channels: Single: Multiple:
Quantity of speakers installed: Quantity of speaker zones:
Quantity of telephones or telephone jacks included in system:
NFPA 72, Chapter 5 — Auxillary
Indicate type of connection:
Local energy Shunt Parallel telephone
Location of telephone number for receipt of signals:
NFPA 72, Chapter 5 — Remote Station
Alarm:
Supervisory:
NFPA 72, Chapter 5 — Proprietary
If alarms are retransmitted to public fire service communications centers or others, indicate location and
telephone numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 5 — Central Station
Prime contractor: ir^ G' i' - er & V Z°. `1
l"P r,A . c.--(41`)
Central station location: A-
Means of transmission of signals from the protected premises to the central station: _
McCulloh Multiplex One'-way radio .
X Digital alarm communicator Two -way radio Others
Means of transmission of alarms to the public fire service communications center:
(a) T (c cQbcr \ e
(b) LO 14. 14-• l t e
System location: S A u L E n74- r a. v), C� 2
` € t
1999 Edition
" r
72 -28 NATIONAL FIRE ALARM CODE
Figure 1 -6.2.1 (Continued)
Organization name /phone Representative name /phone
Installer y. d ;
Supplier
Service organization
Location of record (as- built) drawings:
Location of owners manuals:
Location of test reports:
A contract, dated , for test and inspection in accordance with NFPA standard(s)
No(s). , dated , is in effect.
2. Record 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 shown below, was inspected
by r k M Q tft■ t A r on ( , includes the devices shown below, and has been in service
since 123 0/0 L-I .
_ NFPA 72, Chapters 1 2 3 4 5 6 7 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
Manufacturer's instructions
Other ( specify : 0 3 " 2- 9 Z — r 5 3 3 /
Signed: Date: �lS` e2 5— Organization: 0 1 At MO VI, I 0 d` 41 r p, •
3. Record of System Operation
All operational features and functions of this system were tested by PO i A t' ,llt" vii for on ‘ /01],
and found to be operating properly in accordance with the requirements of:
NFPA 72, Chapters 1 2 3 4 5 6 7 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
_ Manufacturer's instructions g�
) ( Other (specify): A (IA P.a - O t a e, r - t"d ek► 517 ✓L F ft-
Signed: fA7/ ,0,1:. Date: 1 7 670
Organization: Pe9 t I t MO n 1 1 r e
4. Alarm- Initiating Devices and Circuits
Quantity and class of initiating device circuits (see NFPA 72, Table 3 -5) Quantity: Style: Class:
MANUAL
(a) L Manual stations Noncoded, activating Transmitters Coded
(b) Combination manual fire alarm and guard's tour coded stations
AUTOMATIC ✓
Coverage: Complete: Partial:
(a) Smoke detectors Ion Photo
(b) ' Duct detectors Ion Photo
(c) Heat detectors FT RR FT/RR RC
1999 Edition
•
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -
Figure 1 -6.2.1 (Continued)
(d) I Sprinkler waterflow switches: Transmitters Noncoded, activating Coded
(e) Other (list):
5. Supervisory Signal- Initiating Devices and Circuits (use blanks to indicate 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 are recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) Coded valve supervisory signaling attachments
Value supervisory switches, activating transmitters
(b) Building temperature points
(c) Site water temperature points
(d) Site water supply level points
Electric fire pump:
(e) Fire pump power
(f) Fire pump running
(g) Phase reversal
Engine -dr ven fire pump:
(h) Selector in auto position
(i) Engine or control panel trouble
(j) Fire pump running
Engine - driven generator:
(k) Selector in auto position
(1) Control panel trouble
(m) Transfer switches
(n) Engine running
Other supervisory function(s) (specify):
6. Alarm Notification Appliances and Circuits
Quantity and class (see NFPA 72, Table 3 -7) of notification appliance circuits connected to the system:
Types and quantities of notification appliances installed: Quantity: Style: Class:
(a) I Bells Inch
(b) _. Speakers
(c) Horns
(d) Chimes
(e) Other: •
1999 Edition
•
72 - NATIONAL FIRE ALARM CODE , • N
• k `l
M
•
. Figure 1 -6.2.1 (Continued) C •
(f) / 0 Visual signals Type: 54 5evt5or
with audible .. w/o audible
(g) Local annunciator
i
7. Signaling Line Circuits
Quantity and class (see NFPA 72, Table 3 -6) of signaling line circuits connected to system:
. Quantity: Style: Class: S
8. System Power Supplies _
(a) Primary (main): t Xc 941 titer{ Nominal voltage: Current rating:
Overcurrent protection: Type: J Current rating:
Location:
(b) Secondary (standby):
Storage battery: Amp -hour rating:
Calculated capacity to drive system, in hours: 24 60
Engine - driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) 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 701
Optional standby system 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):
(b) Application software revision level(s):
(c) Revision completed by:
(name) (firm)
10. Comments:
(signed) for central station or alarm service company or installation contractor /supplier (title) (date)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):
System deviations from the referenced NFPA standard(s) are:
(signed) for central station or alarm service company or installation contractor /supplier (title) (date)
Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
(signed) representative of the authority having jurisdiction (title) (date)
1999 Edition
CITY OF TIGARD 24 -Hour
BUILDINf Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Busine ine: (503) 639 -4171
BU
Received Requested 1 AM PM BUP
Location .7Z- Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Ina Sheath /Shear j A , 1 , , A L!1
Framing
Insulation — �� �j `• Drywall Nailing U%"� Lialrai, ,= i1
Firewall Mir
Fir- • ' kler
Susp'd Ceiling
Roof ' ,
■�TW FAIL
Post & Beam
Under Slab ► I ,� i
Rough - In (V 1\
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ; _ Please • - II for rei pection RE: ❑ Unable to inspect — no access
Fire Supply Line /
ADA
Approach/Sidewalk Date Inspector , : Est
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL