Permit t CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00404
Z DEVELOPMENT SERVICES DATE ISSUED: 09/15/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110BB -RED04
SITE ADDRESS: 12010 SW TREEVIEW CT
SUBDIVISION: REDWOOD VISTA ZONING: R -4.5
BLOCK: LOT: 004 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: $ 2,400.00
Remarks: Installation of fire sprinkler system.
Owner: Contractor:
FOUR D CONSTRUCTION GRINNELL FIRE PROTECTION
PO BOX 1577 GRINNELL CORP
BEAVERTON, OR 97075 5921 N MARINE DR
Phone: P p Pho e Ngat8y203
Reg #: LIC 000632
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough -In
PRMT GEO 09/10/199E $59.25 99- 318247 Sprinkler Final
5PCT GEO 09/10/199 $4.15 99- 318247
FIRE GEO 09/10/1995 ORIGINAL $23.70 99- 318247
Total $87.10
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.
Permitee
Signature: en XII e — W
Issued By: A
Call 639 -4175 by 7 p.m. for an inspection the next business day
05/30/97 11:06 $503 684 7297 CITY OF TIGARD g]002 /002
Fire Protection Permit Application P „ n o„ —2.k_5(2,
TY OF TIGARD Commercial or Residential Recd B
125 SW HALL BLVD. Date Recd G I — to
3AF OR 97223 Print or Type Date to P E. - -
)3) 639 -4171 Ext. 304 Incomplete or illegible applications will not be accepted Date to DST - i __ y •-
nn -7- �j
Permit* (3 P/ --00 del I • ' S v . 0 1.1 ---.. ( / - -• _. • . . .. Catlett
ntert+e of pereaomentlProtert . Type of System (Complete A or 8 as applicable)
.lob . L.oT 13 q '12,s5 % �>Z�ti
L
Address Address A.) Sprinkler Wet IX Dry ❑
t2.o I o SW 'C2EiLNI l� - reez At..� -
Name I Stanopipes
Fot,�tz D CotaSTrtxc-c1o,� No
Owner marling Address Additional Hazaro Group i 3 p
P•o. Box. 15
—
City/State Z,p Phone Information Density s to a
- Cib1 —,02 4 lOIS _ S90 - 08oS
Name . Design Area 2 Spw t-t r4o S
]ccupant &wing Address (Factor 3 •
City /State Zip Phone . Spnnkier Project Valuation $ 2 r q co
COT Business Tax or Mean s Exp. Date . ' B.) Fire Alarm
OrltraCtOr +e r , - _ Submittal Shall Indude battery Catcutandns YES Q
(Sommer or `�`{ 2 W N C.1..t. e.� �e. o - Te.C1 tow - . - - - Component YES
' m Company) Malang Address
Company) IIndividu d
pear to o.mw S ‘11-1 N , k pc-yz v t De.. Cut sheets •
4
mime mg •cot" city/state Lp Phone Fire Alarm Project Valuation
4•4:2 . PoG.Tt-A -.-/0t0e- A72 z$9- B obo
State Cont. Cant Board Lie.* Exp. Data
Project Valuation Subtotal (A or 8)
o '
oa
23T6 COT Business Tax or Metro It Exp. Data Permit fee based on valuation $ S`I,l 5
(see chart on back)
I Name 7 ss Surcharge $ 4 .15
'Irchitect � Mailing Address FLS Plan Review 40% of Permit
. _ � $ g3 00
City/State Zip .I Phone .. . TOTAL $ - $1,' t o
scnbe wont A., New Addition 0 Alteration 0 Reimer C • PLANS MUST BE SuSPATTED. *trowel, and a Deane -.Mod mot m rtataxam .
be acne: eta smog sans and see ptRn Ord wanly tram nsqia J wnic+ 3211740 10:2001 at
newest 11Yar2nt
B.) Basement 0 Hoo:WVent 0 Spray Booth 0 I nereoy aov mac I nave reap sns aaocaoon. My one Annnamn green a
Complete tIti Partial 0 Exitway 0 correct Mat I am Me owner or autnoraeo spent d Ole owner. and drat mans =masa
are m crmpaeroe wen Crew► Slate ids
,diAOnal Description of Worfc Si nature of Or.nedAgent Data
_.
7 ge,tih,ei 4.. / 3 o .S p s r
hi 141 Low Pc.." S' i .4o5 /1 of -10 -S
A.) In Existing Building New audding Contact er5on Name r Phone
3uilding , c I 1;4z • . 1..S
Data 84 Commercial p Resiaentrat lii - FOR OFFICE USE ONLY: -
Plat Map/TL#:
No. o stones: Z
__...
Sq. F,. a- la to 4 Notes
Occupancy Cass I Type at C 2nstrucoon
5n) J
Ltnresupr.aac
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP )919 -06 oy
Date Requested / 2 / Q0 AMPM BLD
Location 12 -o n �v\ei) I I° Suite MEC
Contact Person
COCA Ph PLM
Contractor Ph SWR
UILDIN a Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath /Shear _ S , / _ /1 L�
Framing \ GIJ \ /`}' (J
Insulation a I / / �(J
Q ,
Drywall Nailing v v Kam—
Firewall
p ri (Le, -k- S d�� ` S Q. �e Spng i� I
Fire Alarm Susp'd Ceiling atZ •
Roof
Misc: Q
Final _ '� Q �� 9 yt(' 0
PASS ART FAIL L��• _
PLUMB! off
` UV� -�P S
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 ` Appro ach /Sidewalk Date Inspector Ext
Other
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 l 1'c 9 _ co Yd
Date Requested 4 1- / 3 - 00 AM PM BLD
Location ("2- 0/0 -7y v / ma c ,_, e`- 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 il/ OA, Ai " G 6 M4 ► t7A Insulation
Drywall Nailing �ilscl A La ) w S✓� - •o<
Fier wall
Fire Sprinkler -
ire Alar
Susp'd Ceiling 4 ' I' i� t
Roof
Misc
in
PASS PART A
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
Other Date V-71- Inspector , Ext
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 UP 9qq
Date Requested 1 AM °,PM BLD
r
Location /ZOO - fib, / i -e - Suite ,, MEC
Contact Person COI Ph 7i('q ", X t 5 PLM
Contractor Ph SWR
(BQTLDI Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath /Shear
ftejAkce Framing � �
Inulati
D s wall on Y d ', `/l/l _ 1 c L GI/\ ` �
Drywall Nailing 1 /"t Q 'tC `
Firewall } C C U
dtalMfmnIrg
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
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 h
Other Date `5 V U Inspector ( Ext5
Final
PASS PART FAIL DO NOT REM.' VE this Bnspection record from the job site.
-'' , 130664 I
&up / '795 -o 4
fiditr ' I@ NEW
PN WS -AW WA ❑ EXISTING
BACKFLOW ASSEMBLY TEST REPORT ❑ REMOVED
PROPERTY �f ❑ REPLACEMENT
OWNER: f - b (i, ,,-( PHONE:
MAILING n
ADDRESS: / c? /, Ox' /S?
CITY 6 ,J.2.. OH, STATE (9).e- ZIP 9 70 ? C
ASSEMBLY /
ADDRESS: J 2c / D / V -r-e .../ •C..L C / 4 • i y . - • .44- �(
STREET
❑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 ,
SIZE: i I I I•jC i Cl MAKE: //.. 11 s MODEL: (''i (": 1 "If/ •
WATER R/ � SERIAL
PURVEYOR: (_'',' -ir ^ - 7 - 2 .5 ,,,,,Q • NUMBER: / ? t 'g
ASSEMBLY �' J
LOCATION: (rc, ., ,
.,
REDUCED PRESSURE ASSEMBLY P.V.B.A / S.V.B.A INITIAL TEST
NI CHECK I DOUBLE CHECK AIR CHECK PASSED I
PRESS DROP - (A CHECK #1 INLET FAILED ❑
INITIAL RELIEF VALVE
TEST OPENED AT (B)ITIGHT to /, � j OPENED AT. PRESS •DROP DATE:
INS !LEAKED ❑ PSI ,
RESULTS BUFFER PSID PSID //C. /7l'
A - B = I CHECK N2
RELIEF VALVE PSI 'TIGHT ® /, 5" DID NOT FAILED SYSTEM
. PASS ❑ FAIL ❑ 'LEAKED❑ no OPEN ❑ ❑ PSI
COMMENTS
REPAIRS
AND / OR
PARTS
•
REDUCED PRESSURE ASSEMBLY P. V.B.A. /S.V B A. AFTER REPAIRS '
N1 CHECK D.C.V.A,
TEST PRESS DROP I (A)I CHECK #1
DATE:
RELIEF OPENED AT PRESS DROP / /
AFTER OPENED (B) TIGHT ❑ PSID
REPAIRS WHIP= '
BUFFER CHECK #2
A B ■ bones: 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 WITH ALL APPLICABLE
RULES AND REGULATIONS OF THE WATER SYSTEM, AND STATE REGULATIONS.
GAUGE i a' �C 3 �TDETECTOR METER READING
.
¶ r ESTER SIGNATUR , r_ / (JS /n / CEI�T N
Anthony Cccut'
TESTERS NAME I GAUGE N
TE444 AWRt88 D. ¢GdTia .U, vii 972Q3 503.«)M) 1'080 PHONE A
ca4yelattee- otectl l
- c A y ' � .0 ' / r et � '"' ar SERVICE RESTORED
REPORT RECEIVED BY: (REPRESENTATIVE OF OWNER)
.i
CITY OF TIGARD BUILDING INSPEGTION DIVISION- MST r
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 11 99 - D 6 7 y
Date Requested (Pit /00 AM Xc PM BLD
Location (20) C� �� l (L) Suite MEC
Contact Person r4LoY) Ph Zoq -?Olos PLM
Contractor Ph SWR
ILDIN Tenant/Owner ELC
- g Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing / • .1'1'E A-. t4-C --s-
Insulation
Drywall Nailing
Firewall
ire Sprin -
Susp'd Ceiling
Roof
Misc:
4117 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 /
Other Date �v — - o 6 Inspe E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.