Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2000 -00431
DEVELOPMENT SERVICES DATE ISSUED: 10/19/00
" j II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12442 SW SCHOLLS FERRY RD 200 PARCEL: 1S1346C -00401
SUBDIVISION: ZONING: C -N
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: • 3N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,500.00
Remarks: Modification of existing fire protection system, add 4 smokkes and 8 strobes & horns.
Owner: Contractor:
SISTERS OF PROVIDENCE IN OR METRO SAFETY AND FIRE INC
BY STEVE FOSTER 7055 NE GLISAN
POOR BOX 139938 7213 PORTLAND, OR 97213
P Ph - o a N P0 625 Phone: 231 -2999
Reg #: E E 803RET
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required
PRMT CTR 10/18/00 $62.50 27200000000 Fire Alarm Insp
Final Inspection
5PCT CTR 10/18/00 $5.00 27200000000
FIRE CTR 10/18/00 $25.00 27200000000
Total $92.50
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: rajlA1'_A__,%
Issued By: ;
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
I Of * Crr OAAP tei IN
■ A Building Permit Application
• Date received: /D / S - et ) Permit no.: 414/61900 :Q
` �. <�., °�y'�^ City of Tigard
�!!- Project/appl.no.: Ex. ire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 ��
Phone: (503) 639 -4171 Date issued: Ma Receipt no.:
Fax: (503) 598 -1960 `� /� Case file no.: Payment type:
an proval: tJ z 'C0 6 G / 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial .❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ■• Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: I 2 ,41Z S ■ L Pe Rd. ZOp Bldg. no.: Suite no.:
Lot: ( Block: Subdivision: (Tax map /tax lot/account no.:
Project name: . . . , . ■ . !_ _
Description and location of work on premises/special conditions: .40.N y - u.,o ^ d- g Silts L 2-s c1 - wvs
OWNER FOR SPECIAL INFORMATION, USE CIIECKLIST
( Floodplairt, septic capacity, solar, etc.
Name: S, S 4, n� ,. r 0,2,.......e... . .1/4, c�� • • )
Mailing address: pp Z0,--A t 153 1 & 2 family dwelling:
City: i t . _ , . , State:(' ZIP: ' z 13 Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
• Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: S sr +"ts L....). Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: ( State: ( ZIP: Other structure area (sq. ft.)
Phone: Fax: E- mail: Commercialimdustrial/multi- family:
CONTRACTOR Valuation of work $ 1 Jt0�
Business name: 4- a I il a_ -J-A.1(... Existing bldg. area (sq. ft.)
M el S�F. I New bldg. area (sq. ft.)
Address: "2 OSS N E. c / , CAA sr: Number of stories
City: ve, ,e_IA .....11 ( State:OK ZIP: s 7 Z/3
Type of construction
Phone:. 7_31 254 y ( Fax: (E -mail: Occupancy group(s): Existing:
CCB no.: L'3 i ,S' 1 New:
City /metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: `Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: Amount received $
Phone: ( Fax: (E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the ' Not all jurisdictions accept credit cards, please call jurisdiction for more information
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be compli . w' I whether • . died herein or not. credit card number: F
Expires
Authorized signature: � a-A..' . t ■ i Date: 10 - ! k- Zoo D Name of cardholder as shown on credit card
Print name: Tvk Art. CA Or $
Cardholder signature Amount
Notice: This permit application expires if permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (dao/codt)
.w. ab O 20_ -0- / 0/
v .
FILE COPY 0./
1 - 7.2.1* A record of completion (see Figure 1 - 7.2.1) shall be prepared for each system. Parts 1,
2, and 4 through 10 shall be completed after the system is installed and the installation wiring has
been checked. Part 3 shall be completed after the operational acceptance tests have been
completed. A preliminary copy of the record of completion shall be given to the system owner '
and, where requested, to other authorities having jurisdiction after completion of the installation
wiring tests, and a final copy shall be provided after completion of the operational acceptance
tests.
Record of Completion
Name of Protected Property: RLOVibiJNCE - SL0 t.s 4 PIg to oaks QFFt -
Address: taI`IZ Sp(ts Firl� IDOL• SLo it, ZOO
Rep. of Protected Prop. (name /phone):
Authority Having Jurisdiction: C 1 L 0 1 . 3 v ( 4
Address /Phone Number: 1
I . Type(s) of System or Service
NFPA 72, Chapter 3 Local
If alarm is transmitted to location(s) off premises, list where received:
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 4 Auxiliary
Indicate type of connection:
Copyright NFPA
Local energy: Shunt: Parallel telephone:
Location and telephone number for receipt of signals:
NFPA 72, Chapter 4 Remote Station
Alarm:
Supervisory:
NFPA 72, Chapter 4 Proprietary
If alarms are retransmitted to public fire service communications center or others, indicate location and telephone
number of the organization receiving alarm:
•
l 4 s. coC .i d�c
Indicate how alarm is retransmitted:
" b : 5 ' 1 en ppi i,iC I-42
NFPA 72, Chapter 4 - Central Station
The Prime Contractor:
Central Station Location:
Means of transmission of signals from the protected premises to the central station:
McCulloh Multiplex One -Way Radio
Digital Alarm Communicator Two -Way Radio Others
Means of transmission of alarms to the public fire service communications center:
(a)
Copyright NFPA
(b)
System Location:
•
Organization Name/Phone Representative Name/Phone
Installer 1Y)ILTRo SAip..4 4- F‘et I TMC. CAray I -29
Supplier Lb .. .a /
Service Organization fi T'RtO SAFe. c1 �IRL INC. f1/Qttt Ciuy ,„13 49
Location of Record (As- Built) Drawings:
AT F, rc� r4 kuni Ra ki cs- l
Location of Owners Manuals:
A r 'Flea- A (A,Rm Pn4-0J
Location of Test Reports:
kT F , R g A Igfty. F3a+ -42—I
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 MA ILL
on ie - '20 - leo0 , includes the devices shown below, and has been in service since /0 • IC- Ica&
x NFPA 72, Chapters 51Mcircle all that apply)
NFPA 70, National Electrical Code, Article 760
Manufacturer's Instructions
Other (specify):
•
Copyright NFPA _ I
•
. = " 1/141-'%.e) al•-1,
Signed: /rI s2C_ / Date: I L s()
Organization: /1I C D SqF 4 FRIZZ j. NC
3. Record of System Operation
All operational features and functions of this system were tested by /0 - to - Lwo on /1440. `A , and
found to be operating properly in accordance with the requirements of: /
X NFPA 72, Chapter094 5(circle all that apply)
NFPA 70, National Electrical Code, Article 760
X Manufacturer's Instructions
Other (specify):
Signed: A � Date: / o - Le • 2.5a00 Organization: /P' ir i S!zi Pe-41 F. f t 71. NC
4. Alarm- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
MANUAL
(a) Manual Stations Noncoded, Activating Transmitters Coded
(b) Combination Manual Fire Alarm and Guard's Tour Coded Stations
AUTOMATIC
Coverage: Complete: Partial: V
(a) Smoke Detectors Ion Photo
(b) _ Duct Detectors Ion Photo
(c) _ Heat Detectors FT RR FT /RR
RC
(d) _ Sprinkler Waterflow Switches: Transmitters Noncoded, Activating
Coded
Copyright NFPA I
(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 recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) _ Coded Valve Supervisory Signaling Attachments
Valve 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
(t) _ Fire Pump Running
(g) _ Phase Reversal
Engine- Driven Fire Pump:
(h) _ Selector in Auto Position
(i) _ Engine or Control Panel Trouble
(j) _ Fire Pump Running
Copyright NFPA
Engine- Driven Generator:
(k) _ Selector in Auto Position
•
(I) _ Control Panel Trouble
(m) _ Transfer Switches
(n) _ Engine Running
Other Supervisory Function(s) (specify):
6. Alarm Notification Appliances and Circuits
Quantity of indicating appliance circuits connected to the system:
Types and quantities of alarm indicating appliances installed:
(a) _ Bells Inch
(b) _ Speakers
(c) _ Horns
(d) _ Chimes
(e) _ Other: i
(0 ) ( . Visual Signals Type: IL 151-0bes 4- 54-NRa toly
with audible s w/o audible
(g) _ Local Annunciator
Copyright NFPA
7. Signaling Line Circuits
Quantity and Style (see NFPA 72, Table 3 -6) of signaling line circuits connected to system:
Quantity: Style:
8. System Power Supplies
(a) Primary (Main): )/K7 Nominal Voltage: Ile 7 Current Rating: • 7C)
Overcurrent Protection: Type: G it : •l 82m, LA_ Current Rating: 20 •o70 •
Location:
(b) Secondary (Standby):
7" Storage Battery: Amp -Hour Rating 7c0
?c 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)
Copyright NFPA
10. Comments:
&fib/
(signed) for Central Station or Alarm Service Company (title) (date)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standards(s):
System deviations from the referenced NFPA standard(s) are:. t N ._
C. �T -0 SAJ e`�
(signed) for Central Stati or Alarm Service Company (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)
Figure 1 -7.2.1 Record of Completion.
Copyright NFPA
1
r
LETTER OF TRANSMITTAL
DATE RECEIVED
R ECEIVED
NOV 3 2000
COMMUNITI DEVELOPMENT
TO: G?. c 66,A/en)
DEPT: [10�
FROM: McA,ro S � � e � y d - r i f t IOC -
TELEPHONE NUMBER: So3 - 23 / — 2-5Q
COMMENTS:
13u Z000- oo (f3/
L
•
r �
BUP - Building Permit ELC -Electrical Permit
Inspection Description Date Passed By J Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural ,2.r/j- / 0 0 6
Shear walls /anchors ELR - Restricted Ener Permit
Roof nailing Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final 710-1411 ,4' S
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing 4 Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in •
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
4 Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
I Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final /f131 //r PP Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS
4!
CITY OF TIGAR BUILDING PERMIT
PERMIT #:.BUP2000 -00431
. ,. I DEVELOPMENT SERVICES DATE ISSUED: 10/19/00
_— ��J ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12442 SW SCHOLLS FERRY RD 200 PARCEL: 1S1346C -00401
SUBDIVISION: ZONING: C -N
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: • 3N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,500.00
Remarks: Modification of existing fire protection system, add 4 smokkes and 8 strobes & horns.
Owner: Contractor:
SISTERS OF PROVIDENCE IN OR METRO SAFETY AND FIRE INC
BY STEVE FOSTER 7055 NE GLISAN
PO BOX 139938 g72�3 PORTLAND, OR 97213
P Ph - o 0P85=65Z6 Phone: 231 -2999
Reg #: ELE 803RET 1
F
glir
EES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required
V
PRMT CTR 10/18/00 $62.50 27200000000 Fire Alarm Insp
Final Inspection
5PCT CTR 10/18/00 $5.00 27200000000
FIRE CTR 10/18/00 $25.00 27200000000 ,
Total $92.50
i
I
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. 0
Permitee
1
Signature: .-zyz,,,,,,?,4 4 i
1 10
Issued By: — ,
OP
Call 639 -4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION _ '
24 -Hour Inspection Line: 639 -4175 Business.Line: 639 -4171
Date Requested AM PM Zb 7 BLD
Location /2 ((GFZ -SGr. 5c4/6 Suite MEC
Contact Person Ph 57 )3 - 3/ 29f9 PLM
Contractor Ph SWR
BUILDI Tenant/Owne — VoWv. C: erk - r-n 7L( ELC
Retaining Wall Is--4Cj�2�G� c��� --� — J ELR
Footing ' Access: l>G vZ0
Foundation f %AC I r � L - FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear * t L,Y 20o � - oo 4 — r (� , /�„ •
Framing l� V �T� V
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof ,c
Misc: f�Sr u
Final
PASS PART FAIL
PLUMB! ( ?SYV` 6 S ^� vt oil S v
Post & Beam
Under Slab
Top Out O �
Water Service c-r w'..._ -
Sanitary Sewer / 3 G / S
Rain Drains O '!� r
Final
PASS PART FAIL
MECHANICAL
Alck J Post & Beam / 1f1�\ l S
Rough In C � �_ b , K- 4 5
Gas Line
Smoke Dampers ' 1
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 Q
/ U '3 l I
Other Date 6 Z I nspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.