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Permit CITY OF TIGARD MECHANICAL PERMIT 11111 n COMMUNITY DEVELOPMENT Permit#: MEC2013 00606 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2013 Parcel: 1S135AB01003 Jurisdiction: Tigard Site address: 10330 SW GREENBURG RD Project: Red Lobster Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Gas piping for major remodel of existing restaurant. Contractor: TOM ALLENDER PLUMBING LLC Owner: LINCOLN CENTER LLC PO BOX 23753 BY SHORENSTEIN PROPERTIES LLC PORTLAND,OR 97223 555 CALIFORNIA ST 49TH FL SAN FRANCISCO,CA 94104 PHONE: 971-219-9313 PHONE: FAX: 503-213-5993 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 10/14/2013 $155.02 Class of Work: ALT Type of Const: VB Plan Review 10/14/2013 $38.76 Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 10/14/2013 $18.60 Stories: 1 Info Process/Archiving-Lg$2.00(over 10/14/2013 $10.00 Project Valuation: $3,260.00 11x17) Fuel Air Handlers Fuel Types: Natural Gas Units<10000 cfm: Gas Pressure: Units>10000 cfm: Furnaces Boilers&Compressors Furnaces< 100K BTU: 0-3 HP: Furnaces>=100K BTU: 3-15 HP: Floor Furnaces: 15-30 HP: Unit Heaters: 30-50 HP: Vents w/o Appliances: 50 or Greater HP: Air Conditioning: Heat Pump: Appliances Vent Fans: Vent Systems: Total $222.38 Hoods: Comm Incinerators: • Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: 14 Other Desc: Duct Work: Fire/Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance • ' • • is suspended for more the 180 days. ATTENTION: Oregon law requires you t• follow the rules adopted by the Oregon Utili otification Cente. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009L • -.y obtain a copy of the rules o direct questions to OUNC b. -lin• 503 32.1987 or 1.800.332.2344. Issued By: / ' Permittee Signature: N" Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completio, of the project. Approved plans are required on the job site at the time of each inspection. • l Mechanical Permit Application �a F:O12 OFFICE USE ONLY Received �) City SW Tigard 0 -. Date/By: /t/ / jJ Permit No.: L� �.�13 DU a 13125 SW Hall Blvd.,Tigard,O' • , 0 Plan Review /'� t Other Permit: ' Phorie;_503.718.2439 Fax: I,'4 ' !;!1,� Date/By: ' 50 lD ( ) 4P2O/3 ov18Li T I G n R D Inspection Line: 503.639.417 t r ! \.')') Date Ready t,: luris: ® See Page 2 for Internet: www.tigard-or.gov L`a Notified/Met .d t: _v ' /O y�3 7d%Cv Supplemental Information TYPE'OF ! CO ' WL FEE* SCHEDULE - USE CHECKLIST•; r ' Mechanical permit fees*are based on the value of the work 0 New construction Xiddition/alt:+..E lreplacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ,❑`Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ T_GO r CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT SYSTEMS FEES* ❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. Total ' JOB SITE INFORMATION AND.LOCATION Heating/cooling: 1 0 33O 5, C 6a cp.. Air conditioning (ducts/vents)) 46.75 Job site address: W L--0\-13,-6-‘7.61 Furnace 100,000 BTU ducts/vents 46.75 City/State/ZIP: .7173•A110 OZ 9.'22 3 Furnace 100,000+BTU(ducts/vents) - 54.91 I Suite/bldg./apt.no.: I Project name: KE I. Df3S7 Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above . 23.32 Subdivision: I Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 • . DESCRIPTION OF WORK Gas fireplace/insert 33.39 IV L, t ��� fre Flue p vent for water heater or gas (� fireplace 23.32 Log lighter(gas) 23.32 Wood/pcllet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 PROPERTY OWNER I ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: Range hood/other kitchen . equipment 33.39 Address: Clothes dryer exhaust - 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 • ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: Fuel piping: S14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace _ Range E-mail: Barbecue 'CONTRACTOR '• ' , Clothes dryer(gas) Business name:—Ts A L 19_9. T u ir , Other: MECHANICAL PERMIT FEES* Address: 110 ` 2. J Subtotal City/State/ZIP: eiNeT Minimum permit fee($90.00) ' ✓ I Plan review(25%of permit fee) Phone:(Cm) Z Iq.013 i 3 Fax:((.9g 213 J 599 State surcharge(12%ofpermit fee) CCB tic.: • 426 13 ' TOTAL PERMIT FEE ■ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: - • Fee methodology set by Tri-County Building Industry Service Board Print name: 1 1` i s C- I`j�6--yv) Date: I O -?-26 1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617r(11/02/COM/WEB) —r Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10330 SW GREENBURG RD, TIGARD, OR, 2013 -11 -26 00:00:00 97223 Record Type: Record ID: Commercial - Mechanical MEC2013 - 00606 Inspection Type: Result: 699 Mechanical final PASS - No C of 0 Comments: Violation Summary: Inspector Contractor tit EC. I 2 / -cOG cv ::eto::: COSCO Contractor's Material and Test Certificate for Aboveground Piping '•°•s•• Fire Protection 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 '(a{•Fy g :R l i _}.; • ers, and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for : 1. ':r I i■s(' orkmanship, or failure to comply with approving authority's requirements or local ordinances. Property Name NOV 26 2013 Date Red Lobster f1-25-j.3 Property Address CITY OF Ti 10330 SW Greenburg Road, Tigard, Oregon 97223 j�U1LDj�j�tc AR® Accepted by Approving Authorities(names) DIVISION City of Tigard Address Plans Installation conforms to accepted plans El Yes ❑ No Equipment used is approved El Yes ❑ No If no,explain deviations Has person in charge of fire equipment been instructed as to location ❑ Yes ❑ No _ of control valves and care and maintenance of this new equipment? If no,explain. Instructions Have copies of the following been left on the premises? 1.System components instructions ❑ Yes ❑ No 2.Care and maintenance instructions ❑ Yes ❑ No 3.NFPA 25 ❑ Yes ❑ No Location Supplies Building System No. of System Entire Building 1 Year of Orifice Temperature Make Model Manufacture Size Quantity Rating Viking VK300 QR SSU 2013 '/z" 89 155 Viking VK302 QR SSP 2013 'h" 71 155 Sprinklers Viking VK176 QR DP 2013 1" 1 200 Viking VK176 QR DP 2013 1/2" 4 286 Viking VK300 QR SSU 2013 %" 2 200 Pipe and Type of Pipe Black Schedule 10 and Schedule 40 Fittings Type of Fittings Grooved and threaded ductile iron Alarm Device Maximum time to o erate through test connection Alarm Valve or Type Make Model Minutes Seconds Flow Indicator Flow Switch Potter VSR-21/2 Z 6 Dry Valve Quick Opening Device Make Model Serial No. Make Model Serial No. Time to trip Alarm through test Water Air Trip Point Time water reached operated connection(1,2) Pressure Pressure Air Pressure test outlet(1,2) properly Minutes Seconds PSI PSI PSI Minutes Seconds Yes No Dry Pipe Without Operating Test Q.O.D. 0 ❑ With Q.O.D. If no,explain (1) Measured from time inspector's test connection is opened (2) NFPA 13 only requires the 60-second limitation in specific sections Operation ❑ Pneumatic ❑ Electric ❑ Hydraulic Piping supervised ❑ Yes ❑ No I Detecting media supervised El Yes ❑ No Deluge and Does valve operate from the manual trip,remote,or both control stations? ❑ Yes ❑ No Preaction Is there an accessible facility in each circuit for ❑ Yes ❑ No If no,explain Valves testing? Does each circuit operate Does each circuit operate Maximum time to Make Model supervision loss alarm? valve release? operate release Yes No Yes No Minutes Seconds ❑ ❑ ❑ ❑ Location and Make and Setting Static Pressure Residual Pressure(Flowing) Flow Rate Pressure Reducing Floor Model Inlet(PSI) Outlet(PSI) Inlet(PSI) Outlet(PSI) Flow(GPM) Valve Test Hvdrostatic;Hydrostatic tests shall be made at not less than 200 PSI(13.6 bar)for 2 hours or 50 PSI(3.4 bar)above static pressure in excess of 150 PSI(10.2 bar) Test for 2 hours.Differential dry-pipe valve clappers shall be left open during the test to prevent damage.All aboveground piping leakage shall be stopped. Description Pneumatic:Establish 40 PSI(2.7 bar)air pressure and measure drop.which shall not exceed VA PSI(0.1 bar)in 24 hours.Test pressure tanks at normal water level ,and air pressure and measure air pressure drop.which shall not exceed 1''/,PSI(0.1 bar)in 24 hours. All piping hydrostatically tested at 2.00 PSI for 2 hours If no,state reason Dry piping pneumatically tested ❑ Yes ❑ No Equipment operates properly ❑ Yes ❑ No Do you certify as the sprinkler contractor that additives and corrosive chemicals, sodium silicate or derivatives of sodium silicate,brine,or other corrosive chemicals were not used for testing systems or stopping leaks? O Yes ❑ No Tests Drain Reading of gauge located near water supply test connection: Residual pressure with valve in test connection wide open: Test Static Pressure Cl 2 PSI PSI 7 Underground mains and lead in connections to system risers flushed before connection made to sprinkler piping Verified by copy of the U Form No.85B ❑ Yes ❑ No Other Explain Flushed by installer of underground sprinkler piping ❑ Yes ❑ No If powder-driven fasteners are used In concrete. If no,explain has representative sample testing been satisfactorily completed? ❑ Yes ❑ No Blank Testing Number Used Locations Number Removed Gaskets Welded Piping ❑ Yes ❑ No If yes... Do you certify as the sprinkler contractor that welding procedures comply with the requirements of at least AWS © Yes ❑ No B2.1? Welding Do you certify that the welding was performed by welders qualified in compliance with the requirements of at least lJ Yes ❑ No AWS 82.1? Do you certify that the welding was carried out in compliance with a documented quality control procedure to ❑x Yes ❑ No ensure that all discs are retrieved,that openings in piping are smooth,that slag and other welding residue are removed,and that the internal diameters of piping are not penetrated? CutOUtS Do you certify that you have a control feature to ensure that all cutouts(disks)are retrieved? x❑ Yes ❑ No (Disks) Hydraulic Data Nameplate provided If no,explain Nameplate ❑ Yes ❑ No Date left in service with all control valves open Remarks Name of sprinkler contractor Contractors License No. Cosco Fire Protection, Inc. COSCOFPIIONM Tests witnessed by For property (signed) / Title ate Signatures /44-/eic. C�-s '; ?Ppep- rrrc, fi For s older or(si ned) Title Date Fl4.1-e r //-2S-!3 $' approving authority(signed) Title Date