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Permit CITY OF TIGARD SITE WORK PERMIT a COMMUNITY DEVELOPMENT Permit #: SIT2012 -00009 T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2012 Parcel: 1 S135ACO2550 Jurisdiction: Tigard Site address: 9208 SW MANDAMUS CT Project: LONGSTAFF APARTMENTS Subdivision: ASHBROOK FARM Lot: 19 Project Description: Site grading, excavation for building pads, erosion control and removal of fill dirt to another location outside city jurisdiction. 6/14/12, reprinted to revise description of work. 8/29/2012: REPRINT permit to add exterior sprinkler supply lines for building 4, 5, 6, 7 & 8; increase valuation from $6,000 to $18,000. Contractor: JT SMITH COMPANIES Owner: TRA 43 LLC 5285 MEADOWS RD, STE 171 5285 SW MEADOWS RD #161 LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 PHONE: 503 - 975 -7639 PHONE: FAX: 503 - 684 -0102 FEES Description Date Amount Specifics: Permit Fee - Site Work 06/14/2012 $134.48 12% State Surcharge - Building 06/14/2012 $16.14 Type of Use: COM Info Process /Archiving - Sm $0.50 (up to 06/07/2012 $1.00 11x17) Class of Work: OTR Erosion Control 06/07/2012 $100.00 Project Valuation: $18,000.00 Erosion Plan Review CWS 06/14/2012 $32.50 Erosion Plan Review COT 06/14/2012 $32.50 Building Permit - COM 08/29/2012 $199.04 Site Specifics: 12% State Surcharge - Building 08/29/2012 $23.88 Excavation Volume: cu. yd. Fill Volume: cu. yd. Impervious Surface: sq. ft. Engineered Fill: Soil Report Required: Paving: Grading: Landscaping: Site Prep: Storn Drains: Retaining Wall: Fire Underground: Accessible Parking: Fence: Total $539.54 Required Items and Reports (Conditions) 1 Ersn Cntrl 681 -4444 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 the 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 -0090. u may o.tain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: )I4 /t Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. CITY OF TIGARD SITE WORK PERMIT III e COMMUNITY DEVELOPMENT `'%� Permit #: SIT2012 -00009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2012 Parcel: 1 S135ACO2550 Jurisdiction: Tigard Site address: 9208 SW MANDAMUS CT Project: LONGSTAFF APARTMENTS Subdivision: ASHBROOK FARM Lot: 19 Project Description: Site grading, excavation for building pads, erosion control and removal of fill dirt to another location outside city jurisdiction. 6/14/12, reprinted to revise description of work. Contractor: JT SMITH COMPANIES Owner: TRA 43 LLC 5285 MEADOWS RD, STE 171 5285 SW MEADOWS RD #161 LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 PHONE: 503 - 975 -7639 PHONE: FAX: 503 - 684 -0102 FEES Description Date Amount Specifics: Permit Fee - Site Work 06/14/2012 $134.48 12% State Surcharge - Building 06/14/2012 $16.14 Type of Use: COM Info Process /Archiving - Sm $0.50 (up to 06/07/2012 $1.00 11x17) Class of Work: OTR Erosion Control 06/14/2012 $100.00 Project Valuation: $6,000.00 Erosion Plan Review CWS 06/14/2012 $32.50 Erosion Plan Review COT 06/14/2012 $32.50 Site Specifics: Excavation Volume: cu. yd. Fill Volume: cu. yd. Impervious Surface: sq. ft. Engineered Fill: Soil Report Required: Paving: Grading: Landscaping: Site Prep: Storn Drains: Retaining Wall: Fire Underground: Accessible Parking: Fence: Total $316.62 Required Items and Reports (Conditions) 1 Ersn Cntrl 681 -4444 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Noti •n e Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dire .uestions to OUNC , li • 5 3.232.1987 or 1.800.332.2344. Issu d By: , 0 /I Permittee Signatur . 0-1 Call 503.639.4175 by 7:00 a.m. for the next available inspectio date. 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. CITY OF TIGARD SITE WORK PERMIT a COMMUNITY DEVELOPMENT Permit #: SIT2012 -00009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2012 Parcel: 1 S135ACO2550 Jurisdiction: Tigard Site address: 9208 SW MANDAMUS CT Project: LONGSTAFF Subdivision: ASHBROOK FARM Lot: 19 Project Description: Site grading and erosion control and removal of fill dirt to another location outside city jurisdiction. Contractor: JT SMITH COMPANIES Owner: 5285 MEADOWS RD, STE 171 LAKE OSWEGO, OR 97035 PHONE: 503 - 975 -7639 PHONE: FAX: 503 - 684 -0102 FEES Description Date Amount Specifics: Permit Fee - Site Work 06/07/2012 $91.44 12% State Surcharge - Building 06/07/2012 $10.97 Type of Use: COM Erosion Control 06/07/2012 $80.00 Class of Work: OTR Erosion Plan Review CWS 06/07/2012 $26.00 Project Valuation: $2,000.00 Erosion Plan Review COT 06/07/2012 $26.00 Info Process /Archiving - Sm $0.50 (up to 06/07/2012 $1.00 11x17) Site Specifics: Excavation Volume: cu. yd. Fill Volume: cu. yd. Impervious Surface: sq. ft. Engineered Fill: Soil Report Required: Paving: Grading: Landscaping: Site Prep: Storn Drains: Retaining Wall: Fire Underground: Accessible Parking: Fence: Total $235.41 Required Items and Reports (Conditions) 1 Ersn Cntrl 681 -4444 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 the 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 -0090. You y obtain a copy of the rules or direct questions to • UNC b calli • 503.232.1987 or 1.800.332.2344. Issued By: 41/.191,/,- � Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. %Wilding Permit Application Site Work ��j �j��j miz OFFICE: USE OiN1.1 RECEIVED Received �I (� 5. /oS 9 City of Tigard Date/By: • i Permit No ° 13125 SW Hall Blvd., Tigard,OR 97223 MAY Plan Review ` / , ' 0 . Phone: 503.718.2439 Fax: 503.598.1960 MAY 3 1 2012 Date/By: / /" , other Perm{ S'�� 05 �� �_ Inspection Line: 503.639.4175 Date Ready/By: Junr. ® See Page 2 for TIC A It U Internet: www.tigard or.gov C ITY OF Ili � t]ll1J D 4 — 71 6 PP Notified/Method .. Supplemental Information BUILDING DIVISION TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING 156■Iew construction ❑ Demolition Permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ 4 0021 ❑ 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: 9ROf 0°446w m at el o t a.44 as (L, New dwelling area: square feet City/State /ZIP: 1; q v d 7 ZZ 3 Garage /carport area: square feet Su' /bld /apt. no.: 7 f 4 Project name: L O AJGE rni / Covered porch area square feet Cross street/directions to job site: Deck area: square feet laveeL.afi✓f /f5JteiCit1i. to, , Other structure area: square feet U REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 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. 7,- - , © 1", / o /) e. g � Valuation: $ • `J Y � Q �' D Existing building area square feet Di ft ' to s wt? klet t For 6.0;14;e1 le r r ii fo be i'ssveol New building area: square feet ' PROPERTY OWNER I ❑ TENANT Number of stories: Name: 7T S rvti r i Type of construction: Address: 5 z 95 ^/( jytvs l ei4 Occupancy groups: City /State /ZIP: / e.,e, 05 �o LZ.. 1 703 S Existing: Phone: (r03 ) ef ZS ' 7631 Fax: (.5-03 ) - 6 fig -Ofo L New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: 7 _r•t W C . All contractors and subcontractors are required to be Contact name: �l Q/L� licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be lensed in the Address: 5 Z85 f i a jurisdiction in which work is being performed. If the City /State /ZIP: ( _ OS, ,�p (,e 471, applicant is exempt from licensing, the following reasons " ' apply: Phone: (S'3 4 7$ -- 74734 Fax: : (50 6l -0/0 -- E -mail: Clare 'GK -!/tom /V o-i-s 'i /Y4 co . Ces+>< CONTRACTOR Business name: BUILDING PERMIT FEES* Address: (Please refer to fee schedule) Structural plan review fee (or deposit): City/State /ZIP: Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon apilication: Amount received: Authorized signature: This permit application expires if a permit is not obtained Print name: I Date: '' within 180 days after it has been accepted as complete. Fee methodology set by Tri-County Building Industry Service Board I:\ Building \Permits\S1T- PermitApp.doc 10 /01/09 440- 4613T(11 /02/COM/WEB) City of Tigard: Site Work Permit Checklist Page 2 - Supplemental Information Commercial, Multi - Family and One- and Two-Family Dwellings: No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review (SLR). Please complete all items below, unless otherwise noted. Excavatiori Volume: / 819 cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete ❑ Other: e_ *Total new impervious area including all buildings, sidewalks, and paving: sq. ft. Site Utilities Plumbing Work: Complete the Plumbing Permit Application for site utilities plumbing work. Plans Required: See "Site Work Permit Application -Plan Submittal Requirements" attached. The following must accompany this application: ❑ Site Plan with Vicinity Map showing ADA ❑ *Parking (including ADA) and Lighting compliance Plan ❑ Grading Plan and details ❑ *Landscaping Plan ❑ Erosion Control Plan and details ❑ Soils Report required) ❑ Retaining Structures *Does not apply to One- and Two - family dwellings. • Plan Submittal: Permit Fee: TYPE OF SUBMITTAL # of Plans Valuation: Permit Fee: (New, Additions or Required at $.00 to $500.00 $51.09 minimum permit fee Alterations) Submittal $500.01 to $2,000.00 $51.09 for the first $500.00 and $2.69 for each additional $100 or fraction Commercial 3 thereof, to and including $2,000.00. $2,000.01 to $25,000.00 $91.44 for the first $2,000.00 and Multi - Family R - Occupancy 3 $10.76 for each additional $1,000 or fraction thereof, to and including $25,000.00. One- & Two - Family Dwelling 2 $25,000.01 to $50,000.00 $338.92 for the first $25,000.00 and $8.06 for each additional $1,000.00 or • fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $540.42 for the first $50,000.00 and $5.38 for each additional $1,000.00 or , fraction thereof to and including $100,000.00. $100,000.01 and over $809.42 for the first $100,000.00 and $4.49 for each additional $1,000.00 or • fraction thereof. I: \ Building \Permits\SIT- PermitApp.doc 03/03/2011 2 Building Division � ° g Development Code Provision Review 0' i tfr TIGARD Commercial Projects with Approved Land Use . #,Of Building Permit No.: 5/2" ' 4000 9 L-0 A/6S775 7 Land Use Casefile No.: S/ aeOs" 'OOO // Routed Plans: Submittal Date: -/7//2. Submittal Date: Submittal Date: To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. STAFF: please only mark those items on the left side that are approved. Plannin . Review contact 1972 #3 at 503 -718- 2 : {. or • ' _ P @ti • • d- or.gov) .2r Use Approval 1 ,Buildin Plans Match Approved Plan: Yes–B No ❑ H Building Height / No Conditions Met direr ea . �J G I.05 /3, Notes: !� K fey& G� �c�c� y W411(,)6 Original Plan: ApprovedeEr Not Approved ❑ Date: b I – l L Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engine eview (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) ❑ Actual Slope: ❑ PFI Permit # ❑ Conditions Met Notes: Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 i Arborist Review ontact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) ❑ Street Trees ❑ Protected Trees Notes: Original Plan: Approved l3 Not Approved ❑ Date: 6 l1 !a Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit nator Review (contact Albert Shields at 503 -718 -2426 or albert@tigard-or.gov) ❑ P nning Okay to Issue Permit ❑ Arborist Okay to Issue Permit ❑ Engineering Okay to Issue Permit Notes: Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant • Revision 2: Date Sent to A plicant Okay to Issue Permit: Yes - Date Routed to Building: • • • • • Page 2 of 2 i • 9o29 8' Ma no(a I'l'l vs Cj- I RECEIN ED I I . ` LE GEND O 1 L 1 . g 1 2 : 2-FT ENTOUX , alpha F ,..J -1T- i 0 2-FT D711,Di1 T'9 1 H ` w - I --170 f0 10-FT CENICUR ? 11 COMMUNITY C . j ISION . I , I '- DEVELOPMEN1B13U.Y I I ` e®•m••• 511111E1/1 iF/DICE I lI • =AC wan F , . .. ] i < awn. is 9200 i Ave. M I*q p Beaverton, OR 97x06 I II ' wog E>< TKO TO IIENNN m MUM= IA I�mw I ,•� I Ei IRKS TO MOWED i wom.cloTo�1aFV'IM tom / OAT! I I FO REVISIONS 1 Am • I ... p,Yt♦/ \ =OR Cg ON/ a _ nnve• (MI `� NG OATH •ReePS I ' '. ...� .nc... .e... - ' NOTES t _ l n OFFICE ! . : ' i � I - -- TN w , :.� WS 6QI IIL PEp COPY $ eI BFH 234 Tid! BBC �Taf1FOU! y l -' ' � v' ` (3 INS,ALL E EDW]11 FENCE PER 1$iK j /2--0710/ � �o0 0 I - _ r`,,.0 /` �' `,. WAIL IDEPORART GRAVEL y � O / � �� � .1 f ' y . :� .■� ;,., 1 ,• ` ]Q CL45R41C1OR ENTRANCE KR O E7ILL • StoG { IJ �,s S //� s/ 1 I , : ��� - �: �` , INSTALL 17 20• ..• IA[P CTpIa�,E ; • T a�Ir� rr.,,:�: _ / a E1 `. � C:ITIa , 5 E; � E 41 , LONGS 7-ftJ� i� ,. Ia. , •.wF•o e' A- � 0 - Y ,...sa AREA G % I " � Aatirab ( •y -•• ` 1 lTJ t ick SQ OGV0. STAGING it PAYgNG AKA. . 3 I iI / I 1t r � ", ) ' _ "� ' � 4 ' `\� PRO➢03D SO>L ST( I CIR4! AREA 1 LL 1 1,314916*11 .i _ r:L 1y� ♦� �COVp{Ppt OCTNL •-A DAM RAMT .1 1 2711 q9=a' "17g� ' QZ{ o N 31. RE V •EAnml MASER i1; r 1 I : � 3 7y �•TF•, m•axed 4dI'�p- f I P li d - 1 `' i! ! I H iiii„... � J ♦I�\�� Y -WET WEATHER' CONSTRUCTION �" / if * / i I ••-•1/4v _ 't) MEASURES NEED TO BE APPLIED / 't, • L. 1 ��1 CCI. 1 TO OCTOBER IST AND tt! I 111 - �, ` > � _ MAY 31ST. - MD T RDIOI a ->o-m - - — - - - - - - —L - - -�7. - - �- - - \ 1, �� D � • SEE 1200_C DRAWINGS FOR I: ", i I °, I r �► t I N �1� 1� SCHEDULES FULL REQUIREMENTS AND S I A ,---- 1 ■ p� l 1 IP` . I LA EV`� Tree Protection Verification — Langstaff Condominiums ' 1 1 11 �� , LONGSTAFF Tree protection has been installed for new construction as shown on I � , •- e .+, -� � 1 '+- '" �r��'.'r' CONDOMINIUM: this plan and erified by me in the field on 5- 30 -12. 1 + ,�!�� �, •�' .' "' Walter H. Kna�� ��i� J Vii' 4 r� & - �a „ .d., " s ,. dl_ - = - rA W% • • e e Q . Certified Arborist PN -0497A a Legend: Tree Protection Fence ® �(p ' m' T e• � `.` " ° i° CONTROL !�, , _ 4...a. •� i 7 ' y sae ` S e • s • a e e I1,8 : 8 I / . PLAN 4 e. ,t/ ... s .k . __/-- . 6) '- I • II e: 0 ' 0 - i s ' - I - - .',,,,:"- N Iiii: • , • • A ell iii I �F�. Rl' " -1 + ; • • •° • et®e V,' •� •'i'4 -• ` -®' �\ ` "u I . ► WALE , 1ED inlealeet ISD.3 Mee - - -- - _ - 1--- 1 ,..m eallertelICTON MOWED wn _ m W a o m ■ 1200., fyiii ■ ■ ■>• �■ 6 .. .w.o sT •• ®.2 0= P.M - U I . I i I I 1 . I ,I I i S 11 zo i2-- ob °I,G = ■ UNDERGROUND PIPING 13-97 Contractor's Material an Test Certificate for Underground 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 i workmanship, or failure to comply with approving authority's requirements or local ordinances. Property name A �� �/ Date 4 Tie. Se/'dP� / /� Property address _ i mes Accepted by approving authorities (names)- J --cin til Go. tyli Address $ 7� g 9 2 48 �- al(o0 .sw yAa�daM us G � ; i., i Plans Installation conforms to accepted plans es ❑ No Equipment used is approved es ❑ No • If no, state deviations Has person in charge of fire equipment been instructed as to location of XYes ❑ No control valves and care and maintenance of this new equipment? It no, explain ���/// Instructions Have copies of appropriate instructions and care and maintenance ' Yes ❑ No charts been left on premises ? / If no, explain Location Supplies buildings / 5 _( 1:- Pipe types and class '7 i / CPv Type joint Sp , , Pipe conforms to L standard '(Yes ❑ No Fittings conform to ■ .' -_ standard Fr Yes ❑ No Underground If no, explain pipes and joints Joints needed anchoraoe clamped, strapped, or blocked in Yes Xr..No accordance with L _ standard If no, explain Flushing; Row the required rate until water is clear as indicated by no collection of foreign material in burlap bags at outlets such as hydrants and blow -offs. Flush at flows not less than 390 gpm (1476 Umin) for 4-in. pipe, 880 gpm (3331 Umin) for 6 -in. pipe, 1560 gpm (5905 Umin) for 8-in. pipe, 2440 gpm (9235 Umin) for 10-in. pipe, and 3520 gpm (13,323 Umin) for 12 -in. pipe. When supply cannot produce stipulated flow rates, obtain maximum available. Hydrostatic: Hydrostatic tests shall be made at not less than 200 psi (13.8 bar) for 2 hours or 50 psi (3.4 bar) above Test static pressure in excess of 150 psi (10.3 bar) for 2 hours. description Leakage: New pipe laid with rubber gasketed joints shall, If the workmanship is satisfactory, have little or no leakage at the joints. The amount of leakage at the joints shall not exceed 2 quarts per hour (1.89 Uhr) per 100 joints irrespective of pipe diameter. The leakage shall be distributed over all joints. If such leakage occurs at a few joints, the installation . shall be considered unsatisfactory and necessary repairs made. The amount of allowable leakage specified above can be increased by 1 fluid ounce per inch valve diameter per hr. (30 mU25 mm/hr) for each metal seated valve isolating the test section. If dry barrel hydrants are tested with the main valve open so the hydrants are under pressure, an additional 5 ounces per minute (150 mUmin) leakage is permitted for each hydrant. rte New u derground piping flushed according tol Yes El No standard by (company) / ' ` If no, am Ho suing flow was obtained Through what type opening Flushing ublic water ❑ Tank or reservoir ❑ Fire pump ❑ Hydrant butt ��--✓✓ ❑ Open pipe tests IS�Yes El No Lead -ins flushed according to standard by (company) If no, explain . How flushing flow was obtained Through what type opening li blic water ❑ Tank or reservoir ❑ Fire pump ❑ Y connection to flange ❑ Open pipe and spigot FIGURE 10.10.1 Sample of Contractor's Material and Test Certificate for Underground Piping. 2002 Edition • 13 INSTALLATION OF SPRINKLER SYSTEMS Joints covered All new underground piping hydrostatically tested at fo e No Hydrostatic hours Yes Y � test £ i' zB psi for Total amount of leakage measured Leakage 00-21,----- gallons hours test Allowable leakage hours j, T e and make All operate satisfactorily Number installed Type 0 Yes O No Hydrants [. Yes [1 No Water control valves left wide open / It no, state reason • Control . valves Yes No Hose threads of fire department connections and hydrants interchangeable with those of fire department answering alarm Date left in service Remarks Name of installing contractor / , t� _ J,‘ Signatures Title - Date U y 7 ..„...pAr ,../.,_;......._, For prop owner (s ned / . , �i Ti t le. Date i 'tractor (signed) F i Additional explanation a o • FIGURE 10.10.1 Continued ( 2) *The amount of allowable leakage specified in Table 10.10.2.1.3 Flow Required to Produce a Velocity of 10 10.10.2.2.4(1) shall be permitted to be increased by 1 fl oz ft /sec (3 m /sec) in Pipes (30 ml) per inch valve diameter per hour for each metal- seated valve isolating the test section. Pipe Size Flow Rate (3) If dry barrel hydrants are tested with the main valve open in. so the hydrants are under pressure, an additional 5 fl oz/ mm gpm L/min min (150 ml /min) of leakage shall be permitted for each . 1,476 hydrant. 4 102 390 (4) The amount of leakage in buried piping shall be mea- 6 202 880 5,9054 2,440 1,560 9,235 5 sured at the specified test pressure by pumping from a 0 2 calibrated container. 10 254 2,440 9,235 12 305 3,520 13,323 Chapter 11 Design Approaches 11.1 General. R 10.10.2.2.2 Loss shall be determined by a drop in gauge pres- 1 om1 th follow demand requirements shall be determined sure or visual leakage. 10.10.2.2.3 The test pressure shall be read from a gauge lo- (1) Occupancy hazard fire control approach cated at the low elevation point of the system or portion being (2) Storage design approaches of Chapter 12 (3) Special design approaches of Chapter 13 l tested. 11.1.2 For buildings with two or more adjacent occupancies 10.10.2.2.4 The permitted amount of underground piping that are not physically separated by a barrier or partition ca leakage shall be as follows: pable of delaying heat from a fire in one area from fusing • (1) *The amount 9 of r) per 100 t joints skets o joints nrespecti a ton for the more demanding occupancy shsprinkler l xtendr15 ft 2 of pipe iam ter. (4.6 m) beyond its perimeter. per ( of pipe diameter. 1 ) 2002 Edition 1 i S Z.o 12 - o ocC c.c.,. UNDERGROUND PIPING 13-97 Contractor's Material and Test Certificate for Underground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractors representative and witnessed by an owners representative. All defects shall be corrected and system left in service before contractors personnel finally leave the job. A certificate shall be filled out and signed by both representatives . Copies shall be aa d for i a ap �nng au tho c roe , o m poor contractor. It is understood the owners representative's signature in no way prejudices Y claim • workmanship, or failure to comply with approving authority's requirements or local ordinances. i Property name A 3 / r� I Date tl/� �h I eP ser ✓P� /'t d f Property address Accepted by approving authorities (names) . Ste` y! /� i 1. Address n � , L j 5 q. ...a t 3oLl _C&/ Me.rt - T /4 No Plans �C- i Installation conforms to accepted plans es ❑ No Equipment used is approved If no, state deviations Has person in charge of fire equipment been instructed as to location of Yes ❑ No control valves and care and maintenance of this new equipment? If no, explain Instructions y(Yes CD No Have copies of appropriate instructions and care and maintenance / charts been left on premises? If no, explain Location Supplies buildings ( "y 5 1 1 Pipe types and class 2 i / Type joint Spi 17 irra.... st andard '(Yes ❑ No Pipe conforms conform to ► for to K Y ❑ No Fittings con ra r - standard Underground If no, explain pipes and joints Joints needed anchorage clamped, strapped, or blocked in Yes jg,.No accordance with _ _ standard II no, explain Flushing; Flow the required rate until water is clear as indicated by no collection of foreign material in burlap bags at outlets such as hydrants and blow -offs. Flush at flows not less than 390 p U(11 mi) 4-in. and 3528 gp (13,3 Umin) for 6 - in. pipe, 1560 gpm (5905 Umin) for 8 - in. pipe, 2440 gpm (9235 ) for Umin) for 12 -In. pipe. When supply cannot produce stipulated flow rates, obtain maximum available. Hydrostatic: Hydrostatic tests shall be made at not less than 200 psi (13.8 bar) for 2 hours or 50 psi (3.4 bar) above Test static pressure in excess of 150 psi (10.3 bar) for 2 hours. at description � �' New pipe laid with rubber gasketed joints shall, If the workmanship r (ts8 cto�ry pave t 00 joints irrespe t joints. The amount of leakage at the joints shall not exceed 2 quarts per hour of pipe diameter. The leakage shall be distributed re If such ch l o a kt of occu a f g nts, specified installation n shall be considered unsatisfactory and necessary repairs be increased by 1 fluid ounce per inch valve diameter per hr. (30 mU25 mmlhr) for each metal seated valve isolating the test section. If dry barrel hydrants are tested with the main valve open so the hydrants are under pressure, an additional 5 ounces per minute (150 mUmin) leakage is permitted for each hydrant. Yes C3 No T New underground piping flushed according to I ' �t� r standard by (company) If no, a lain Through what type opening Ho shing flow was obtained Open i El Fi re pump ❑ Hydrant butt ❑ P pipe Flushing ublic water 0 Tank or reservoir Sr tests standard by (company) Yes CD No Lead-Ins flushed according to If no. explain Through what type opening How flushing flow was obtained Y connection to flange ❑ Open pipe Public water ❑ Tank or reservoir ❑Fire pump and spigot FIGURE 10.10.1 Sample of Contractor's Material and Test Certificate for Underground Piping. 2002 Edition a i 13 INSTALLATION OF SPRINKLER SYSTEMS Joints covered All new underground piping hydrostatically tested at Hydrostatic - hours Yes 0 No test (dell 7_80 psi for Total amount of leakage measured Leakage 110-Ate---2- gallons hours test Allowable leakage hours I All operate satisfactorily �' l Number installed Type and make No r .. I ❑ Yes El Hydrants > Yes El No Water control valves left wide open . I Control If no, state reason ` valves (� Yes CD No Hose threads of fire department connections and hydrants interchangeable with T those of fire department answering alarm Date left in service Remarks r Name of installing contractor .4 t ...__Je AA Signatures Title _ Date y 7, ..2_,_:,__-_ For prop ` owner (sned / - EP Title. Date e L7 grr iei� tractor (signed) Y FIGURE 10.10.1 Continued Table 10.10.2.1.3 Flow Required to Produce a Velocity of 10 ( 2)*The amount of allowable leakage specified in ft /sec (3 m /sec) in Pipes 10.10.2.2.4(1) shall be permitted to be increased by 1 fl oz (30 ml) per inch valve diameter per hour for each metal - seated valve isolating the test section. Pipe Size Flow Rate (3) If dry barrel hydrants are tested with the main valve open so the hydrants are under pressure, � addition f511 oz/ in. mm bPm L /tom min (150 ml /min) of leakage permitted 1,476 hydrant. 6 4 102 890 3,331 (4) The amount of leakage in buried piping shall be mea- 152 880 sured at the specified test pressure by pumping from a g 203 1,560 5,905 calibrated container. 10 254 2,440 9,235 12 305 3,520 13,323 Chapter 11 Design Approaches 1 1.1 General. P. 10.10.2.2.2 Loss shall be determined by a drop in gauge pres- � de and requirements shall be determined i sure or visual leakage. 10.10.2.2.3 The test pressure shall be read from a gauge lo- (1) Occupancy Storage design approaches d on o Ch hazard fire control approach Occu P an fir Chapter , h tried at the low elevation point of the system or portion being (3) Special design approaches of Chapter 13 , leakage tested. 11.1.2 For buildings with two or more adjacent occupancies ' 2.2.4 The permitted amount of underground piping that are not physically separated by a barrier or partition ca leaka shall be as follows: pable of delaying heat from a the r in d area pro e i g (1)*The amount of leakage at the joints shall not exceed sprinklers in the adjacent area, sh extend of ft 2 qt /hr (1.89 L /hr) per 100 gaskets or joints, irrespective ion m) beyond its d occupancy of pipe di ( i I 2002 Edition .. ITZo0Z -W0vl UNDERGROUND PIPING 13-97 Contractor's Material and Test Certificate for Underground 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 � Date h � Q � Se � A s ! ��� % J a I Property address ! j tSj7lb , I i Accepted by approving authorities (names)--r— T "fMi C D. r A ddress I Plans ( 6 R ,c� Mew 6+. , 7L Installation conforms to accepted plans ' Ves ❑ No Equipment used is approved Jam'°' ❑ No It no, state deviations • Has person in charge of fire equipment been instructed as to location of 'Yes ❑ No control valves and care and maintenance of this new equipment? If no, explain Instructions Have copies of appropriate instructions and care and maintenance ' Yes ❑ No charts been left on premises? If no, explain Location Supplies buildings s s Pipe types and class -7 1/ C.- n n�G Type joint Pipe conforms to 2 T A u standard '(Yes ❑ No Underground Fittings conform to 1 �r - standard Yes ❑ No pipes and joints If no, explain Joints needed anchorage clamped, strapped, or blocked In Yes No accordance with _ _ standard If no, explain Flushing; Flow the required rate until water is clear as indicated by no collection of foreign material in burlap bags at outlets such as hydrants and blow -offs. Flush at flows not less than 390 gpm (1476 Umin) for 4-in. pipe, 880 gpm (3331 Umin) for 6 -in. pipe, 1560 gpm (5905 Umin) for 8-in. pipe, 2440 gpm (9235 Umin) for 10 -in. pipe, and 3520 gpm (13,323 Umin) for 12 -in. pipe. When supply cannot produce stipulated flow rates, obtain maximum available. Hydrostatic: Hydrostatic tests shall be made at not less than 200 psi (13.8 bar) for 2 hours or 50 psi (3.4 bar) above Test static pressure in excess of 150 psi (10.3 bar) for 2 hours. description Leakage: New pipe laid with rubber gasketed joints shall, If the workmanship is satisfactory, have little or no leakage at the joints. The amount of leakage at the joints shall not exceed 2 quarts per hour (1.89 Uhr) per 100 joints irrespective of pipe diameter. The leakage shall be distributed over all joints. If such leakage occurs at a few joints, the installation . shall be considered unsatisfactory and necessary repairs made. The amount of allowable leakage specified above can be increased by 1 fluid ounce per inch valve diameter per hr. (30 m1125 mm/hr) for each metal seated valve isolating the test section. If dry barrel hydrants are tested with the main valve open so the hydrants are under pressure, an additional . 5 ounces per minute (150 ml/min) leakage is permitted for each hydrant. New underground piping flushed according to t Yes ❑ No l r . standard by (company) If no, eilain Ho thing flow was obtained Through what type opening Flushing ublic water ❑ Tank or reservoir ❑ Fire pump ❑ Hydrant butt ❑ Open pipe tests Lead -ins flushed according to standard by (company) Yes ❑ No If no, explain • . How flushing flow was obtained Through what type opening li'li water ❑ Tank or reservoir ❑ Fire pump ❑ Y connection to flange ❑ Open pipe and spigot FIGURE 10.10.1 Sample of Contractor's Material and Test Certificate for Underground Piping. 2002 Edition . _ 13-98 INSTALLATION OF SPRINKLER SYSTEMS Joints covered All new underground piping hydrostatically tested at Hydrostatic hours Yes No test �/ Z BO psi for Total amount of leakage measured Leakage t f gallons hours test Allowable leakage hours T and make All operate satisfactorily Number installed YPe 0 Yes 0 No �' .� - Hydrants - Yes 0 No s Water control valves left wide open Control II no, state reason valves No Hose threads of fire department connections and hydrants interchangeable with those of fire department answering alarm Date left in service Remarks Signatures Title Date 7 1 For prop owner (si . ned ■ , i Date r� Z 7 �, tractor (signed) Title FIGURE 10.10.1 Continued ( 2)*The amount of allowable leakage specified in Table 10.10.2.1.3 Flow Required to Produce a Velocity of 10 10.10.2.2.4(1) shall be permitted to be increased by 1 fl oz ft /sec (3 3 m/sec) in Pipes (30 ml) per inch valve diameter per hour for each metal - Flow Rate seated valve isolating the test section. Pipe Size (3) If dry barrel hydrants are tested with the main valve open in. mm gpm L/min so the hydrants are under pressure, an additional 5 fl oz/ min (150 ml /min) of leakage shall be permitted for each 1,476 hydrant. 4 102 890 (4) The amount of leakage in buried piping shall be mea- • • 6 203 560 5,90 2,440 sured at the specified test pressure by pumping from a 0 254 ,40 5,905 calibrated container. 10 254 2,4440 9,235 12 305 3,520 13,323 Chapter 11 Design Approaches 11.1 General. 10.10.2.2.2 Loss shall be determined by a drop in gauge pres- the Water following: md requirements shall be determined F sure or visual leakage. from 10.10.2.2.3 The test pressure shall be read from a gauge lo- (1) Occupancy hazard fire control approach cated at the low elevation point of the system or portion being (2) Storage design approaches of Chapter 12 , ! (3) Special design approaches of Chapter 13 tested. 11.1.2 For buildings with two or more adjacent occupancies , 10.10.2.2.4 The permitted amount of underground piping oat are not physically separated by a barrier or partition ca leakage shall be as follows: pable of delaying heat from a fire in one area from fusing xceed (1)•The amount of leakage at the joints shall irr ton for the mo a demanding occupanry hall extendr15 1 2 qt /hr (1.89 L /hr) per 100 gaskets or�o n p (4.6 m) beyond its perimeter. of pipe diameter. i F . NW N+1ion