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Permit 11114 y n CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT s COMMUNITY DEVELOPMENT Permit#: FPS2014 00055 T[GA R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/26/2014 Parcel: 1 S136DB00201 Jurisdiction: Tigard Site address: 11565 SW PACIFIC HWY Project: Fred Meyer Subdivision: 2000-025 PARTITION PLAT Lot: 2 Project Description: Replace current fire sprinkler backflow with an Ames C300 DDCV Contractor: DELTA FIRE INC Owner: FRED MEYER INC 14795 SW 72ND AVE STORE#375 PORTLAND, OR 97224 1014 VINE ST PROPERTY TAX 7TH FLOOR CINCINNATI, OH 45202 PHONE: 503-620-4020 PHONE: FAX: 503-620-1058 FEES Description Date Amount Specifics: Permit Fee-COM 03/26/2014 $188.28 12%State Surcharge-Building 03/26/2014 $22.59 Type of Use: COM Plan Review-Fire Life Safety-COM 03/26/2014 $75.31 Class of Work: ALT Type of Const: Occupancy Grp: Height: ft Stories: Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $286.18 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $10,450.00 Residential Square Footage: 0 Fire Alarm Valuation: $0.00 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 may obtain a copy of the rules or direct qu- • OUNC by calling 503.232.1987 or 1.800.332.2344. Issue. By: / /,n I,,,A 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. MAR/26/2014/WED 02:01 PM FAX No. P. 002 Fire Protection System 1. Building P Permit Ap licatio- C , E For,O1Flc•! tisr:ONL\ City of Tigard I.' R G 6 Dar v 312 i1 �I oO 4`e • 13125 SW Hall Blvd_,Tigard.,OR 97223 Plan Review Phone: 503.639A171 Fax: 503.598.1960 Dete/B other Permit I I G A It IInIx ctiun Lin : 503 639.4175 cm Of- t' , Dote Ready/By, ]mu ® 9rr rage 2 far Internet: www.tigard-orgov -• �i�• Notified/method: Supplemental lnfotnutlon TYPE OF WORK • REQUIRED DATA;1-AND 2-FAMILY DWELLING . ❑New construction Q 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 0 Other: equipment,materials,labor,overhead.and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. I=1 1-and 2-family dwelling ®Commercial/industrial Valuation $ 0 Acccasory building CI Multi-family Number of bedrooms. ❑Master builder Q Other: Number of bathrooms: . 116 7.0 C; . JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address; SW Pacific Highway New dwelling area: square feet City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: _Project nama:Fred Meyer- Back Flow Replace Covered porch area: square feet Cross street/directions to job site: Deck area, square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Tax ntnp/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. Replace current backflow device with an Ames C300 DDCV. Valuation: S 10,450.00 Existing building area; square feet New building area: square feet © PROPERTY OWNER Q TENANT - Number of stories: Name: Fred Meyer Corporation Type of construction: Address; Occupancy groups: y City/State/ZIP: Existing: Phone:( ) Fax:( ) New: xi APPLICANT © CONTACT PERSON NOTICE Business name: Delta Fire, Inc. All contractors and subcontractors are required to be Contact name: Heidi ScR>bx4>� Il licensed with the Oregon Construction Contractors Board g under ORS 701 and may be required to be licensed in the Address: 14795 SW 72nd Ave. jurisdiction in which work is being performed.lithe City/State/ZIP: Portland, OR 97224 _ applicant is exempt from licensing,the following reasons apply: Phone:(503) 620-4020 Fax::(50.3) 620-1058 E-mail: heid.is @deltafire.com _ T CONTRACTOR BUILDING PERMIT FEES* Business name:Delta Fire,Inc. Mn ea referrofee�elieaLJel - Permit fee: Address: 14795 SW 72nd Ave. City/State/ZIP: Portland,OR 97224 State surcharge(8%of permit fee): ' FLS plan review(40%of permit fee): Phone:(503) 620-4020 Fax:(503 ) 620-1058 (Due upon application) CCB lie.: 64174 Total permit fees: -,gitzeik Authorized signature. Amount received:T 4 This permit application expires if a permit i5 not obtained Print name:Heidi Scarbrough Date: 3-26-14 within 180 days after it has been accepted as complete. " Fee methodology set by Ili-County Building Industry Service Board. r:lBuilJiaa Porm la\FF5-Psrrmt4pp.do;03/23/06 440-4613T(J iioilcos-YWEB) MAR/26/2014/WED 11 :25 AM FAX No, P. 003/009 City of Tigard: Fire Protection Permit Checklist • Page 2-Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition C) 1-10 heads: No plan review required. ® Alteration ❑ 11+heads: Plan review required. ❑ Repair Number of sprinider heads: 0 Additional description of work Type of System (Complete A,B,C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K.Factor Sprinkler Project Valuation: $ B.) Type I- Hood Fire Suppression System Hood Project Valuation: 1 $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler(Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 • • 3,601 to 7,200 $292.50 • 7,201 and greater $381.50 Sprinkler Project Square Footage: sq. ft. Fire Protection Permit Fees Project valuation subtotal(see A,B&C above): $ Permit fee based on project valuation(see fee schedule): $ Permit fee based on square footage(see D above): $ State Surcharge (8%of permit fee): $ FLS Plan Review(40%of permit fee): , $ TOTAL: $ Plan review requires a completed application and 2 sets of plans at submittal Plan review fees are required at submittaL "New"fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer,or N10ET level"3"technicians. IMuiletne wniteAP&PamiApp.doc 03/306 440.4613T(I1/02/CQtd/WBS) MAR/26/2014/WED 11 :25 AM FAX No. P. 001/009 EJELTLI 1 4795 SW72Avnue PORTLAND,OR 97224 i PHONE 503-820-A020 INC. 503-620-1058 FIRE, INC F Yf tlr �Rot ? � k_; 1l°111 FACSIMILE TRANSMI AL SHEET Heidi Scarbrough DATE: City of Tigard Building Department 3-26-14 FAX NUMBER; TOTAL NO.OF PAGES INCLUDING COVER; 503-598-1960 9 • RE: Permit Application for Back low Replacement _URGENT —FOR REVIEW PLEASE COMMENT _PLEASE REPLY NOTES/COMMENTS: r- w --, • FIRE PROTECTION CONTRACTORS MAR/26/2014/WED 11 :25 AM FAX No, P. 004/009 EXISTING r Ie sEY 0.S,&YVAL ' }'RETAINING ROOTO '-14 .4 L91' 1'4 ■<TING P TO FOC Fr A --i eat•• ■��\i%►�1' `IMliMiliw9 U I MIrIII _ _ 0 NEW •GeOL FLANGE ADAPT ER :,Ih.:lip 1" s•Aces C4OQ r PLx GI V sPoOL OCPA PIECE PLAN VIEW SUPPORT DEVICZ FROM VAULT TOP Yd CONCRETE REMOTE RYJCHPAO READER IF REC DIRE r im tl .11. C f0 FCC kg • Il Pi111113::►MIIi■Il1r�ll�a !I ii`-8'C.1.PIPE EXISTING r HERSEY 03,61'. NEW IPAMES 11 EXISTING POURED IMPLACE CONCRETE VAULT ELEVATION VIEW (LOOKING NORTH) APPROXIMATE VAULT LOCATION ADDRESS IS 10840 SW 71ST AVE FREDMEYER ;YIN TYPE! , MPGJA=t1. SII4 TEMP.I SIZS 'FINISH CANOPY FINISH OTY ' TIGARD STORE DELTA ______1__ 11613oW PACIFIC ENVY TIGARD,OR FIRE.INC. . TITLE FIRE WATER VAULT OETNL FIRE PROTEG'fIQN CX7ATFLO,GTORS fgat 3W.7L,R 00R1WO.OR LTM. 1563)641ALO DATE 3"2014 SCALE 3/8`■1.-0' row 1 OONT. 1h518B DRIM.I. $.N. 6Y3TEM ACT ._ MAR/26/2014/WED 11 : 26 AM FAX No, P. 005/009 ES-A-C300/C300N ColtTM Series C300, C300N A M ES , Double Check Detector Assemblies FIRE WATERWORKS Sizes: 21/2" —10" (65—250mm) •C3000SY C300BFG ' r • '1 • • .ranl.r, • _ - Mgr 1411111,41: .101111 .0•01.010m01 • mr cda Features The Colt C300, C300N Double Check Detector Assemblies are used to • Extremely Compact Design prevent back-flow of pollutants,that are objectionable but not toxic, from • 70% Lighter than Traditionsl entering the potable water supply system,The Colt 0300, C300N may Designs be installed under continuous pressure service and may be subjected • 304(Schedule 40)Stainless Steel to backpressure. The Colt C300, C300N is used primarily on fire line Housing&Sleeve sprinkler systems when It Is necessary to monitor unauthorized use of • Groove Fittings Allow Integral water. For use in non-health hazard applications. Pipeline Adjustment • Patented Id-Link Check Provides Specifications Lowest Pressure Loss The Colt C300, 0300N Double Check Detector Assemblies shall consist • Unmatched Ease of Serviceability of two independent Tri-Link Check modules within a single housing, • Available with Grooved Butterfly sleeve access port, four test cocks and two drip tight shutoff valves. Valve Shutoffs Tri-Link Checks shall be removable and seiviceable, without the use of May be Used for H special tools. The housing shall be constructed of 304 (Schedule 40) • Vertical or N Pattern Horizontal,zont atlons stainless steel pipe with groove end connections.Tri-Link Checks shall have reversible elastomer discs and in operation shall produce drip tight • Replaceable Check Disc Rubber closure against the reverse flow of liquid caused by backpressure or backsiphonage. The bypass assembly shall consist of a meter, which registers in either gallon or cubic measurement, a double check valve assembly and required test cocks. Assembly shall be a Colt 0300, 0300N as manufactured by the Ames Company. . Job Name Contractor Job Location Approval Engineer Contractor's P.O.No. Approval _ Representative Amcor product specifications in U.S.customary units and metric am approximate and are provided for reference only For precise measurements,please contact Ames Technical Servico.AmeS reserves the right to change or modify product design,construction,specifications,or materials without prior notice and without Incurring any obligation to make such changes and modifications on Ames products previously or subSciglrerrvy sold www.arnesfirewater.com MAR/26/2014/WED 11 :26 AM FAX N:. P. 006/009 Configurations Available Models • Horizontal Suffix: • Vertical up OSY- UUFM outside stern and yoke resilient • "N"pattern horizontal seated gate valves BEG- UUFM grooved gear operated butterfly valves Materials with tamper switch • Housing&Sleeve:304(Schedule 40)Stainless Steel "OSY FxG-Flanged Inlet gate connection and grooved • Elastomers:EPDM, Silicone and 13una'N' outlet gate connection • Tri-Link Checks: Noryls, Stainless Steel 'OSY GxF-Grooved inlet gate connection and flanged • Check Discs: Reversible Silicone or EPDM outlet gate connection • Test Cocks: Bronze Body Nickel Plated "OSY GxG-Grooved inlet gate connection and grooved outlet gate connection • Pins&Fasteners:300 Series Stainless Steel Available with grooved NRS gate valves- consult factory" • Springs:Stainless Steel Post Indicator plate and operating nut available-consult factory' °Consult factory for dimensions Dimensions — Weights Pressure —Temperature Temperature Range: 33°F— 140°F (5°C—60°C) Maximum Working Pressure: 175psi (12,06 bar) ;!i 0 l A , ,rl, (Wen) 14 ►• MN=_ I login 0 OVA i�i S N rA I �AI� ir-1) I•' ir?) s H ------A— s -- P -- C300, C300N SI7r(ON) rlr,w0c4Or15 WdGMI A C(0BY) D G H I J P 0300 C30PN Intl Mal _In. mm In. mm In mm M,, mm b, me In. mm In, mar In. torn Ha. _kgl,__ t7S. (r/1G, 21/2 65 3) j$7 161/2 416 31/2 89 2916 738 22 559 151/2 393 814/6 223 134/6 335 139 63 147 67 3 80 3171As 805 181/2 479 311/6 94 301/4 768 22% 578 17116 435 9446 233 141/z 368 159 72 172 78 4 100 33'1/20 850 , 2Zt_ 576,_, 4 102 33 639 24 610 181/2 470. 9i5/s 252 153/6 386 175 79 198 90 6 150 431/2. 1105 301/2 765 511 140 44% 1137 93% 857 23/6 589 13V 332 19 483 309 140 350 159 8 200 , 50 12,70_ 3Zyi 9 "/6 170 541/2 1375 405/6 1032 272/6 697 1511/6 399 21446 538 494 224 569 258 10 250 571/2 1460 4544 1162 64/6 208 66 1676 50 1270 321/2 826 179he 4.40 24 610 795 361 965 438 Pi delii_. ::. 11,, i 1 . .. ,,....,, 0,,, 1 . . __ - c = .1 ..— IOW a am j.0.71111- "! i" Il4 L� 1. ,..... A I H --I P C3008FG,C300NBFG G SI7c,InN) OIMEIISIONO WEIGHT A C D 8 H I J P G3008F0 C30IXr3FG in mm in. mm M. mm In. arm la mm In ran In. mm 0. mm in. mm lbs. kph. IDs. Vs. 21/2 66 28 711 8. 203 ,31/2 89 294 759 22 559 1415/6 379 84S6 223 . 13 330 70 32 78 35 9 80 281/2 724 85/6 211 311/6 94 30,1/46 779 22'4 578 151/6 302 9$/2 33 _131 ,+343, 68 31 81 37 4 100 393/1 74j 8''/+c j 311/6 94 3115/6 811 24 610 161/4 412 911/26 252 14 356 75 34 98 44 6 150 3611 927 10 254 5 127 434/6 1097 3344 857 19"1/26 500 13'/e ,.33?,_144 ,353 131 59 , 171 78, 8 200 43 1092 121/4 311 61/2 165 511/6 1297 401/2 1032 235/i6 592 15146 399 18445 462 275 125 351 159 Noryle is a registered trademark of General Electric Company. MAR/26/2014/WED 11 :26 AM FAX N . P. 007/009 Approvals y c►`�55ry� ; '1,9c (21 us el 0 4401„, 1 I Approved 1048 884.4 For additional approval information please contact the factory or visit our website at www.smesfirewater.com Capacity 11UFM Certified Row Characteristics Row chwacterlsIcs collected using butterfly shutoff valves. See Ilteratue S-Colt-200/300 for gate valve flow characteristics *= Rated Flow "= UL Tested —Horizontal Vertical N-Pattern 2h" (65mm) ** kpa 8" (150mm) * ** 96 14 83 12 -N 83 12 w �� •• N 69 10 .0- v 69 10 — + ,, V 55 8 i ' 41 6 r- r ... ."" 14 2 — 14 2 "' 0 0 0 0 . 0 so 100 150 200 250 300 350 gpm 0 300 B00 900 1200 1500 gpm 0 190 380 570 760 950 1140 1330 ipm 15 0 1140 2280 3420 4560 5700 (pm 15 fps 4.6 mps 4.5 mps lea psi 3" ( ) ** ldya psi 8" memo ** 89 12 . 83 12 . N 69 10 H 69 10 ' •'" H 65 8 J=�+ r�+ V 55 8 _ 41 6 ` r 41 6 ,Al' 28 4 _`.- ..r-- 28 4 —1 14 2• 0 0 . _ 0 0 • 0 100 200 300 400 500 gpm 0 500 1000 1500 2000 2500 gpm D 380 760 1140 1520 1900 Ipn 0 1000 3800 5700 7800 9500 fpm 15 fps 15 fps 4.6 mpa 4.6 mps 4" (106Amm 10" (250mmL **83 12 138 20 .r r;11 69 10 __•._�I N 110 16 ` 1 H 55 8M•_ • I N 55 12 i" 41 6 —_■M_ V ,...,— 28 4 glah.°,1111.,...M11 ME 28 4 I '� 0 0 — 0 0 M�__IM•__I 0 100 200 300 400 500 600 700 800 gpm 0 380 760 1140 1520 1900 2280 2660 3040 Ipm 0 500 1000 1500 2000 2500 3000 3500 gpm 15 fps 0 1900 3800 5700 7800 9500 11400 13300 1pm 4.6 mps fps raps IMPORTANT INQUIRE WITH Gt VE rNMVG AUTHORITIES FOR LOCAL INSTALLATION REQUIREMENTS MAR/26/2014/WED 11 :26 AM FAX No, P. 008/009 For additional information, visit our web site at: www.amesfire^water.com A M E S Q 4i-2000' FIRE 6 WATERWORKS www.amesfirewater.com rCERTIFIED A Watts Water Technologies Company USA: Beckdaw-1427 N.Market Blvd•Sude 02•Sacramento.CA 95834•T.916-928-0123•F:916-928-9333 Control Valves-18550 Hansen Road•Houston,TX 77075•T'713-943.068B•F:713-944-9445 Canada: 5435 North Service Rd.•Burlington,ONT.L7L 5H7.T:g55-332-4090•F:905-332-7068 ES-A-C300/C300N 1006 @ 2010 Ames Fire&Waterworks