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10500 SW GREENBURG ROAD #300 -1;0350 GREENBURG RD #300 1 OF 1 FILMED 2004 I 10500 SW GREENBURG R1) 300 CITY OF TIGARD CERTIFICATE OF OCCUPANCY PERMIT#: BUP2000-00324 DEVELOPMENT SERVICESPERMIT ISSUED: 08/18/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S i 35AB 01006 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 10500 SW GREENBURG RD 300 SUBDIVISION: I INC.fI N PI A7A BLOCK: LOT:002 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 2FR OCCUPANCY GRP. B OCCUPANCY LOAD: 17 TENANT NAME: REMARKS: Tenant Improverment - Adding space to existing Dental Office - Will require mechanical arid plumbi permit for medical gas Owner: KNICKERBOCKER PROP, INC XXIV BY NORRIS, BEGGS 4 SIMPSON 10300 SW GREENBURG RD STE 200 PORTLAND, OR 97223 Phone: Contractor: MARKET CONTRACTORS LTD 10250 NE MARX ST PORTLAND, OR 97220 Phone: 255-0977 Reg #: LIC 0062833 This Certificate issued Ih9/14/21111() grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Ore Specialty Codes for the group, occup Icy, and use under which the referen ed it was issued. LL LL - BUILDING I.INSPECTOR BUILDING FICIAL POST IN CONSPICUOUS PLACE I I _ ____ CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639.-4175 Business Line: 6 171 (Ls, / � euP�0✓0 -0 L 3'Z del __ Date Requested -/ Z AM PM BLD _�wI �,'1 Location 10 ) -' -54-.-' 6 r-t-�, w� --- - _. Suite Joy o)UX_ 150 34�P Contact Person Ph 3/ 4/ 2 Z blY PLM Contractor Ph SWR - BUILD 6 I Tenant/Owner ELC _ ,_ Retaining Wall ELR _ Footing Access. ' ' J Foundation �'QtkN C.r C''X ' �LJ�` rl/ FPS _ Fig Drain �►o�e'. ^'Y""'-� SGN Crawl Drain Inspection Notes - Slab -- — SIT Post R Beam - Ext Sheath/Shear — Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler _� 1 I Fire Alarm _ Susp"d Ceiling / .. Roof !pre fin / PART FAIL ---- - - —±LL ' BING 1)0-1Po;t A Beam 2600 .60))7 Y Unter SlabTi �/ Np Out ,�/DO Water Servu e S -- i 'Sanitary Sewer Rain Drains Final . A PASS_ RT FAIL _ 111N, t�_ coc �L JY HSNicILL Pest A [3eam10Gc 100/44 .. ._ Iffil Rough In Gas Line Smoke Dampers SS PART FAIL RICAL t L C. -- - Service nooe - Oeck - - — Rough In UG/Slab �a 1 f U I Low Voltage (C17 Fire Alarm Final PASS PART FAIL _ -- Backfill/Grading - - - - -- Sanitary Sewer Storm Drain i J Reinspection fee of$ _ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin I I Please call for reinspection RE �_ _-, ( J Unable to inspect- no access Fire Supply Line ADA Approach/Sidewalk 9/‘ ?/ D 0 , e. : LI -- --- Other Date �- Inspector v Fxt Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF T I G ^j R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00327 "' ' 4 isDATE ISSUED: 9/1/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10500 SW GREENBURG RD 300 PARCEL: 1S135AB-01006 SUBDIVISION: LINCOLN PLAZA ZONING: C-P BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: A-T GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 4 URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Moving two sinks, one 2"floor drain, one water heater, one backflow device, adding two new sinks, one lay arid one water closet. Additional fixtures du not increase the EDU count, thus no sewer fee required FEES Owner: --� -' — Type By Date Amount Receipt KNICKERBOCKER PROP, INC XXIV PRMT CTR 9/1/00 $117 00 27200000000 BY NORRIS, BEGGS + SIMPSON SPOT CTR 9/1/00 $9 36 27200000000 10300 SW GREENBURG RD STE 200 PORT LAND, OR 97223 Total $126.36 Phone 1: Contractor: D P PLUMBING/DARREN T PLACEK 904 S CHEHALEM NEWBERG, OR 97132 REQUIRED INSPECTIONS Top-out Ins) Phone 1: 537-9492 Reg 1: LIC 00110612 Insp existing/capped fixtures PLM 36-70PB Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Sp _ _ialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued By: � r ' { Permittee Signature: `1,q)(,tiAn 1 Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 3/H. 77B'' CITY OF TIGARD Plumbing Permit Application PtanChe 13125 SW HALL BLVD. Commercial and Residential Recd By t) TIGARD, OR 97223 Date Rec'd _ Y-So•ex) (503) 639-4171 Date to P E --"" Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit♦ tom.�:, 7 Related SWR a ' Called_9/017 4 ..-1)(4.44, ,,,p Name of Development/Projed FIXTURES (Individual) --� QTY>!' .PRICE NAMTo, Job r (r I%.� --• Sink --- -- ----- 14 'e](,,,OO Address Street Addre$ I ulte Lavatory !Ye' -5r7 i DSOD sw (rrt't-nk4 _ Sb0 Tub or Tub/Shower Comb 9.00 Bldg If City/StateZip Shower Only 9.00 Name -1-.91.10 rl1.f -- Water Closet I 9�pe- II, r Dishwasher 900 Owner Mailing Address Suite Garbage Disposal 9.00 Washing Maclaine - -v 9.00 City/State Zip Phone Floor Drain/Floor Sink 2' 9A1- u IV - ---- 3" 900 Name 1 I J` ' 1Q 4" — 900 Occupant Mailing Address Suite Water uitWater Heater 0 conversion 0 like kind r Gas piping requires a separate mechanical permit i 1[5 Cly'State lip Phene Laundry Room Tray 9 00 Urinal 900 Name / Other Fixtures(Specify) 900 Contractor Mall ng dress �G�`� r Suite _ —_ 9 00 S C�+a'Citi �� -- 9°° _ , Prior to permit Cltyl$late Zip Phone 1L Sewer-1st 100' 30 00 issuance,a copy 1�,1 7 q i3 Z- .s-,�] Sewer-each additional 100' — -- 2b 00 of all licensee are Oregon Cos 1.. 10ont Boer.!Lie.0 Exp Date , :'i /' required if I 10‘ (Z, Water Service1st 100' v CO - -_ -- expired In COT Plumbing Lic 0 Exp Dar Water Service-each additional 200' 25 00 database 36 '70P6 __ I 0 _, Storm&Rain Drain-1st 100' — 30 00 Name ; 9; (f Storm&Rain Drain-each additional 100 25 00 ArchitectMobile Home Space 25 00 or Mailing Address Suite Commercial Rack Flow Prevention Device or Anti- 25 00 S-r d Pollution DeviceI e- Engineer City/Siete Zip Phone Residential Beckeow Preventior Device* 1500 (Irrigation timing devices require a separate Describe work to be done --- restricted energy permit) New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9 00 Residential 0 Commercial --- Catch Basin 9 00 Additional description of work p Insp of Existing Plumbing 40 00 R()-v.A0 I r ,"6" -- - per/hr Specially Requested Inspections 40 00 per/hr -- Rain Drain,single family dwelling 30 00 Are you topple cuing (replacln9 y fixtures Grease Traps 900 , Yes tTo II If yes, see back of form to indicate work performed by — -- QUANTITY TOTAL flrture. FAILURE TO ACCURATELY REPORT FIXTUREIsometric et riser diagram Is required If Quantity Total is >9 ' - _ WORK COULD RESULT ININCREASED SEWER FEES. •SUBTOTAL - /" I hereby acknowledge that Ihave read this application,that the information ' given is correct that I am the owner or authorl,ed agent of the owner.andr -'.44r/1I<SURCHARGE a, that plans submitted ere in co_phance with Oregon State Laws •Sig of of OwnerlAgrv�t Date **PLAN REVIEW 26%OF SUBTOTAL y , II 1 - Required only N!blunt qty total b>9 w W C/al TOTAL '_�� Contaet Parson Name -_�-- Ph.n• u 'Minimum permit fee is$25• 5%surcharge,excepl�eaMerMIN _ ' ' —OW rt IA tki-t k-- 5(4 " 7�4�__ Prevention Device.which Is f 15. 5%surcharge "All New Commercial Buildings require plans with isometric or riser diagram and plan review I`1ttioriumady Jac tRl9a PLEASE COMPLETE: Fixture Type _ Quanti b Work Performed New Moved Replaced Removed/Capped Sink _ - 2 — Lavatory _ Tub or Tub/Shower Combination Shower Only _ Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain/Floor Sink 2" 1 3" 4" Water Heater_ Laundry Room Tray Urinal .-- Other Fixtures (Specify) -� COMMENTS REGARD:`dG ABOVE: iSaLk1 tw OQ ice L oCcl 'i }D N.Cw r C +ukIcal i Id$tI ►,n.00 I Accumulative Sewer Tally Tenant Name—Dr� d This SWR# K.) 4 _ Add ess /D`;00 > CL'lgi.AI cv� te Loo This PLM# — ". — Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value Capped off value added# added as total Count off#s count value Flues T Baptistry/Font 4 Bath - Tub/Shower 4 — _- - Jacuzzi/Whirlpool 4 Car'Nash - Each Stall 6 - Drive Through 16 Cuspidor/Water Aspirator 1 Dishwasher- Commercial _ 4 _.�____,_�- - Domestic 2 _ Drinking Fountain 1 I - I _-_ Eye Wash 1 Floor Drain/sink -2 inch 2 7 (p _ , 3 inch 5 - • 4 Inch 6 Car'Nash Drn 6 _ _ _ , Garbage Disposal 16 - Domestic(to 3/4 HP) • Commercial to 5 HP) � 32 _ - Industrial Over 5 HP) 48 Ice Machine/Refrigerator Drains 1 1 1 , Oil Sep(Gas Station) 6 Rec Vehicle Dump Station 16 - Shower -Gang (Per Head) 1 , Stall 2 Sink - Bar/Lavatory 2 A 9-51 1 LI - Bradley 5 // ,,, - Commercial 3 �.l' - Service _ 3 Swimming Pool Filter 1 _ Washer - Clothes 6 Water Extractor _ 6 Water Closet • Toilet 6 �, I Q _ Urinal 8 / — (Q _ TOTALS `1a _ 8 _ &i Total fixture values 1. divided by 16 = 7, 95-EDU —/ -I-,u , J l-"e 01(4` HISTORY 'f: f , ct.tx /. , , i,, i-.s, u '`..d Y f/ « ':► PL.M# EDU# SWR# . PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# _, PLM# EDU# SWR# _ PLM# EDU# SWR# __ PLM# EDU# SWR# PLM# EDU# SWR#� ddstsiswnaly dot CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 B U P --� — Date Requested /61 ,.9 AM. _PM __ __ BLD Location1U G rto ,, 6ca _ Suite 3G0 MEC kicrU -6°3V Contact Person — $✓-‘• _— Ph 30 y_3 PLM Contractor — Ph SWR ( BUILDING Tenant/Owner ELC 7---"7".":6; all ELR Footing Access FPS Foundation Ftg Drain - SGN Crawl Drain Inspection Notes Slab __ SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Narlmg Firewall Fire Sprinkler F ire yyMisc `.YAS3,,) PART FAIL — PI LIMBING �'► / p�j L,C' rLc 4/t / ___ Post& l'•eam Under Slab Top Out l Water Service 3 e 4, 40 k/c- g--A.(5Sanitary Sewer Rain Drains —___--- --- — -- —- - Final PARS PART FAIL ------- CHANI Pos Beam -- Rough In Gas Line - - Smoke Dampers Fine --..—_— - --- Ai SS��ART FAIL �CTRICAL - - - ----- --- --- —_— --- Service Rough In UG/Slat) -- — Low Voltage Fire Alarm ----- Final PASS PART FAIL Backfill/Grading Sanitary Sewer Storm Drain f I Reinspection fee of S -required before next inspection Pay at City Hall 13125 SW Hall Blvd .Catch Basin Unable to inspect no acce,3 Fee Supply Line ( I Please call for reinspection RE _- _ ( p ADA Approar.h/Sidewalk Other Date ' (f.)/41/". 1( Inspectorr---_2 )1 ) _Ext Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY O F TI G A R DELECTRICAL PERMIT PERMIT#. ELC2000-005113 AIS,Al 41.-1 13125 SERVICES DATE ISSUED: 8/30/00 13125 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 151 15AB 1)1006 SITE ADDRESS: 10500 SW GREENBURG RD 300 SUBDIVISION: LINCOLN PLAZA ZONING: C-P BLOCK: LOT : 002 JURISDICTION: TIG Project Description: Tenant Improvement RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: : MANF HM/SVC/ FOR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L_ INSPECTIONS____ 0 - 200 amp: W/SERVICE UR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR• 401 - 600 amp: EA ADD'L BRNCH CIRC: 5 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1o00+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL. __Reconnect only_ SVC/FDR>= 225 AMPS: CLASS AREA/SPEC OCC__ Owner: Contractor: KNICKERBOCKER PROP, INC XXIV KEC ELECTPIC INC BY NORRIS, BEGGS + SIMPSON 2110 NW Al OCLEK DRIVE 10300 SW GREENBURG RD STE 200 SUITE 614 PORTLAND, OR 97223 HILLSBORO, OR 97124 Phone: Phone: 439-0904 Reg#: LIC 99267 SUP 44895 ELE 34-426c FEES __-- _ Required Inspections Type By Date Amount Receipt Elect'I Final PRMT CTR 8/30/00 $174 25 2720000000( 5PCT CTR 8/30/00 $9 94 2720000000( Total $134.19 This Permit is issued subject to the regulations contained in the Tigard Municipal Code State of OR Specialty Codes and all other applicable laws All work will be done in acooruance 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 rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain oopres of these rules or direct questions to OUNC at(503) 246-1987 / PERMITTEE'S SIGNATURE • ,/� �• ISSUED BY: / -jh 1 7 ' ` OW INSTALLATION ONLY The installation is being made on property I own whi is not intended for sale, lease or rent OWNER'S SIGNATURE: _ _ _ —__ —_____ DATE: — CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ _____-______ --__—_— DATE: LICENSE NO: ---- — ------ ----- — — — — Call 639-4175 by 7 00pm for an inspection the next business day I COY OF TIGARD Plan Chea.N 43125 SW HALL BLVD. Electrical Permit Application Rec'dBy_y _ __ __ ' e,Rr` ;CR 97223 Date Recd - _ 4' . x304 Date to P E --. _ Date to DST__ 4175 Print of Type Permit 0 Li2G2060Q)S(g 'ICU Incomplete or illegible will not be accepted Called l.2 Address: 4. Complete Fee Schedule Below. l ' r'' -t,,w,opment Number of Inspections per permit allowed ' ' ' ' ,.• of busin Ss) - )414(echry ., ,: /-e f. Service included: Items Cost Sunt /Vyi Q._ _, �' `1 nj• 4a. Residential•per unit ;!'y/r;13;elLp- / r y,f AG , 1000 sq ft or less --_ S 111 1r, 4 ' c — --— Each additional 500 sq ft or r�,� portion thereof S 2675 I r," ' •'•I '' Residential El _I imiied energy -_ $ 60 00 I ach Manul'd Hume or Modular • ' ft'r installation only: Itwelhnq•ervtce or I nndnr S 72 75 ' ••;,'nice,applicants must provide contractor license 4b.Services or Feeders ,,' :!'data base). Installation alteration or relocation ' • ;':."11- -19:,101 KEC ELrECTRIC, INC. 200 amps or leas S f,4 25 C NW ALOCLEK DR 614 201 amps to 400 amps _ $ 85 50 _ _i 2 1. — • ' , ' 'r•I' "` _ State OR Zip 97124 401 amps to 800 amps , $ 128 50 T— 2 801 amps to 1000 amps $ 192 50 2 '-439-0704 Over 1000 amps or volts _— 8 3133 75 2 CO LL52/___—____ - -.. Reconnect only S 53.50 2 •/ 'y ' Ice' No 34-426C Exp.Date 1O/1/ ___- 4c.Temporary Services or Feeders " " ::,t.''' :.':B rteg No 99627 _Exp Date 5/23/ _ Installation alteration.or relocation • CO r Business Tax or Metro No 4834 Exp Date-4/1/� 200 amps or less s 53 50 2 :::)2./ 201 amps 10 400 amps _ S 80 25 ___ 2 401 - ' ;!o^aturn Cf Supr. EIeC'n " i� ,r4'i., amps to 600 amps ___ S 100 00 ,4 2 • -- (twit 600 amps to 1000 volts. ' _ ExpDate /C.) C/ see"b„above. !�f --_ __... 4d.Branch Circuits .. �:'�-514-.9lBl New,alteration or extension per panel a)1M,lee for branch circuits rnr O'silations: with purchase of service or feeder fee. I rich branch circuit _ $ 5 35 10 Ihn len Int branch rncuiv,, _.._ -----._ ------ without purchase or service .,tale ZIP or feeder fee. • r� I ,I b d li h C1/13111 teabrtI S 35 35 I n ,ull.r, Ural branch urrtNl --- ) S 5 35 ‘,. ') ' Insta•latton 's being made on property I own which is not 4e.Miscellaneous trended Fol sale, lease or tent (Sarv$ce or tondo;not included) Foch pump or irrigation dicle5 42 75 _ '•,,'ti Signature . Fadi sign or oulline lighting S 42 75 _..__ Signal circull(s)or a limited energy — - Rrview section (if required):' panel. Inn of extension ____411 r s 00 00 Mot WO/[abets nls ti(10) S tlN)(K) ' • .,• i"-.r'c Porn and enter fee in section SB. 4f Each additional Inspection over I mit,in one stnrcture the allowable in any of the above imps or more ('r.r utspc cbrn $ 50 00 w!wogs nominal Per hour _ $ 50 00 In flan) J` S 59 on en •r ',',,•t,ties or structure containing special occupancy as - _ ,lo•-.,,bed in N I C Chapter 5 5. Fees: ir Sa f nine Inial of above lees it S (,,t y,l 7 ' Submit 2 sets of plans with application where any of the above apply 11%Surcharge(08 X total lees) F+ $ CI ?_i Not required for temporary construction services Subtotal S Sb I Mel 25%of line Sa for NOTICE 14a0 Review fl ferpatPd 1,;'- 1) S ' • '.' "')'r WORK OR CONSTRUCTION AUTHDRIII It Subtotal $ -- " '80 DAYS.OR IF CONSIRUCIJON DR ' 'nNDONED FORA PERIOD or 180 DAYS ❑ trust Account II • 'lr NCED Total balance Due $ y F t GAS AND VACUUM SYSTEMS I t 99-57 2. The presence and correctness of labeling required by this no cross-connection of piping systems exists by either of the standard for all components (e.g.,station outlets, shutoff following methods: valves, and signal panels) shall be verified. 1. All medic•sl gas systems shall be reduced to atmospheric (d) Piping Purge Test.In order to r:move particulate matter pressure.All sources of test gas from all of the medical gas in the pipelines,a heavy,intermittent purging of the pipeline systems, with the exception of the one system to be shall be done.The appropriate adapter shall be obtained,and checked,shall be disconnected.This system shall be pres- a high-flow purge shall be put on each outlet. The outlet surized with oil-free,dry nitrogen(see Section 2-2,Definitions) shall be allowed to flow fully until the purge produces no to 50 psig (350 kPa gauge). With appropriate adapters discoloration in a white cloth. matching outlet labels,each individual station outlet of all (e)* Standing Pressure Test. After testing of each individual medical gas systems installed shall be checked to determine medical gas system in accordance with 4-3.4.1.2(b),the corm_ that test gas is being dispensed only from the outlets of pletely assembled station outlets and all other medical gas the medical gas system being tested. system components (e.g., pressure-actuating switches for a. The source of test gas shall be disconnected and the alarms,manifolds,pressure gauges,or pressure relief valves) system tested reduced to atmospheric pressure.Proceed shall be installed,and all piping systems shall be subjected to a to test each additional piping system in accordance with 24-hour standing pressure test at 20 percent above the normal 4-3.4.1.3(a)I. operating line pressure. The test gas shall be oil-free, dry b. Where a medical vacuum piping system is installed, nitrogen (see Section 2.2, Definitions).The source shutoff valve the cross-connection testing shall include that piped shall be closed. vacuum system with all me•:ical gas piping systems. 1. After the piping system is filled with test gas, the supply 2. An alternate method of testing to ensure that no cross- valve and all outlets shall be closed and the source of test connections to other piping systems exists follows: gas disconnected.The piping.system shall remain leak-free a. Reduce the pressure in all medical gas systems to sumo for 24 hours.When making the standing pressure test,the spheric. only allowable pressure changes during the 24-hour test b. Increase the test gas pressure in all medical gas piping period shall be those caused by variations in the ambient systems to the values indicated in Table 4-3.4.1.3(a)2. temperature around the piping system.Such changes shall Simultaneously maintain these nominal pressures be permitted to be checked by means of the following throughout the test. pressure-temperature relationship:the calculated final ab- c. Any medical-surgical vacuum systems shall be in opera- solute pressure (absolute pressure is gauge pressure plus tion so that these vacuum systems are tested at the same 14.7 psig if gauge is calibrated in psig) equals the initial time the medical gas systems arc tested. absolute pressure times the final absolute temperature(ab- 4 solute temperature is temperature reading plus 4607 if Table -1.4.I.S(04 Alternate Test Pressures thermometer is calibrated in Fahrenheit degrees),divided Pressure by the initial absolute temperature. li`e►4114 Medical Gas psig kPa gauge P t T 1) Gas mixtures 20 140 Nitrogen 50 VII) 2. Leaks, if any, shall be located, repaired, and retested in Nitrons oxide 40Ofir 40 2so accordance with 4-3.4.1.2(c). Oxygen Q \ 50 350 4-3.4.1.3 System Verification. The following tests shall be Compressed air ` 60 420 performed after those listed in 4-3.4.1.2,Installer Performance Note:Systems at nonstandard pressures shall be tested at a pressure Testing. The test gas shall be oil-free, dry nitrogen. This testing shall be conducted by a party technicallycompe- at least to psi (69 kPa) greater or less than any other system tent and experienced in the field of medical gas pipeline d. Following the adjustment of p assures in accordance testing.Such testing shall be performed by a party other than with 4-3.4.1.3(a)2h and c, each station outlet for each the installing contractor. medical gas system shall be tested using the gas-specific When systems have been installed by in-house personnel, connection for each system with a pressure (vacuum) testing shall be permitted by personnel of that organization gauge attached. Each pressure gauge used in per- who meet the requirements of 4-3.4.1. forming this test shall be calibrated with the line pres- All tests required under 4-3.4.1.3 shall he performed after sure regulator gauge used to provide the source installation of any manufactured assemblies employing plexi- pressure. ble hoses or tubing.Where there are multiple possible connec- e. Each station outlet shall be identified by label (and tion points for terminals,each possible position shall be tested color marking,if used),and the pressure indicated on it►dependcntly' the test gauge shall he that listed in 4-3 4.1.3(a)2b for Il'xreptton 417th►permttterl by the atithontt having/unsdirtion,for the system being tested. vmal/projects affecting a limited number of aceta where the use of stttrogen is impractical, the ••nitre gar shall be pmnitted to be usnl (h) Val se lest Valles installed in ear h medical gas piping 1 for the osis lilted in 4-3.4.1.3(a)l, (r)l, (d)2, and paragraph 2 o/ system shall be tested verify proper operation and rooms tet or areas of control. Records shall be made listing the rooms or areas controlled by each valve for each gas.The information (a) Cruts-t:rmnertion lint.After closing of walls and comple- shall be utilized to assist and vends the proper labeling of the tion of requirements of 4-3.4.1.2,it shall be determined that valves. 1999 Edition II 99-58 HEALTH CARE FACIUTIFS (c) Outlet Flow Trst. All outlets shall be tested for flow. outlet most remote from the source. The filter shall accrue 1. General.These flow tests shall be performed at the station no more than 0.1 mg of matter from any outlet. If any outlet outlet or terminal where the user makes connections and fails this test, the most remote outlet in every zone shall be tested. The test shall be performed with the use of oil-free, disconnections.Tests shall be performed with the use.of oil-free,dry nitrogen or with the gas of system designation. dry nitrogen. 2. Oxygen, nitrous oxide, and air outlets shall deliver 3.5 (f) Piping Purity Test.For each positive-pressure system,the SCFM with a pressure drop of no more than 5 psig (35 purity of the piping system shall be verified.The test shall be kPa),and static pressure of 50 psig (349 kPa). for dew point,total hydrocarbons (as methane),and haloge- 5. Nitrogen outlets shall deliver 5.0 SCFM with a pressure nated hydrocarbons,and compared with the source gas.This drop of no more than 5 psig and static pressure of 160 test shall Lx performed at the outlet most remote from the psig (1118 kPa). source. The two tests shall in no case exceed variation as (d) Alarm 'listing. with in Table 4-3.4.1.3(f). The test shall be performed with the use of oil-free,dry nitrogen gas. I.a General.All warning systems for each medical gas piping system shall be tested to ensure that all components func- Table 4-3.4.1.3(f) Maxim Allowable Variation Table tion properly prior to placing the piping system in service. __. __._.________—__ Permanent records of these tests shall be maintained. Dew point 5°C®50 psig Warning systems that are part of an addition to an Total hydrocarbons as methane I ppm existing piping system shall be tested prior to the connec- tion of the new piping to the existing system. Halogenated hydrocarbons 2 ppm 2. Warning Systems.Teats of warning systems for new installa- tions (initial teats) shall he performed after the cross- connection testing (4-3.4.1.3(a)),but before the purging (g)5 Final Tie-in Tut. Prior to the connection of any work and verifying (4-3.4.1.3(e)). Initial tests of warning syr or any extension or addition to an existing piping system,the sums that can be included in an addition or extension tests in 4-3.4.1.3(a) through 4-3.4.1.3(f) shall be successfully to an existing piping system shall be completed before performed.After connection to the existing system and before connection of the addition to the existing system. Test use of the addition for patient care, the tests in 4-3.4.1.3(h) gases for the initial tests shall be oil-fn try nitrogen or through 4-3.4.1.30) shall be completed. Pertnanent records gas of system designation, of these teats shall be maintained in accordance with 4-3.5.3. 3. Matter Alarm Systems. The final connection between the addition and existing a. The master alarm system tests shall he performed for system shall be leak-tested with the gas of system designation each of the nonflammable medical gas piping systems. at the normal operating pressure.This pressure shall be main- ( Permanent records of these tests shall be maintained tained until each joint has been examined for leakage by with those required under 4-3.5.3. means of soapy water or other equally effective means of leak b. The audible and noncancellable visual signals of detection safe for use with oxygen. 4-3.1.2.1(b)3e shall indicate if the pressure in the main line increases or decreases 20 percent from the normal (h) Operational Anna!m t. operating pressure. 1. General.These flow tests shall be performed at the station 4. Area Alarm Systems. The warning signals for all medical outlet (inlet) or terminal where the user makes conned gas piping systems supplying anesthetizing locations and tions and disconnections. other vital life-support and critical care areas, such as post-anesthesia recovery, intensive care units, coronary 2. Piping systems, with the exception of nitrogen systems, care units, and so forth, shall indicate if the pressure in shall maintain pressure at 50 +5/-0 psig (345 +35/-0 the piping system increases or decreases 20 percent from kPa gauge) at all station outlets at the maximum flow rate the normal operating pressure. /See 4-3.1.2.1(c)1./ in 4-3.4.1.3(h)5. 3. A nitrogen system shall be capable of delivering at least 160 (e) atter Purge Thst In order to remove any traces ofpanic- psig(1103 kPa gauge)to all outlets at flow in 4-3.4.1.9(h)6. %late matter deposited in the pipelines as a result of construe- I non, a heavy, intermittent purging of the pipeline shall be 4. Piping systems that vary from the normal pressures in done. The appropriate adapter shall be obtained from the 4-3.4.1.3(h)2 and 3 shall be capable of delivering flows and facility or manufacturer,and high purge rates of at least 225 pressures consistent with their intended use. L/min (8 cfm) shall be put on each outlet. After the purge 5. Oxygen, nitrous oxide, and air outlets shall deliver 9.5 is started, it shall he rapidly interrupted several times until SCFM with a pressure drop of no more than 5 psig (35 the purge produces no discoloration in a white cloth loosely kPa) and static pressure of 50 psig (345 kPa). held over the adapter during the purge. In order to avoid 6. Oxygen and air outlet serving critical care areas shall pet- possible damage to the outlet and its components, this test I mita transient flow rate of 6.0 SCFM for 3 seconds. shall not be conducted using any implement other than the proper adapter. 7. Nitrogen outlets shall deliver 5.0 SCFM with a pressure drop of no more than 5 psig (95 kPa) and static pressure For each positive-pressure gas system, the cleanliness of of 160 psig (I 109 kPa). the piping system shall be verified. A minimum of 35 fts (1000 1 ) of gas shall be filtered through a clean,white 0.45-CF (i) Medical Gases(;oncentration Test. After purging each syr micron filter at a minimum fiowtate of 3.5 SM (100 I. tem with the gas of system designation,the following shall be min).Twenty-five percent of the tones shall be tested at the performed: 1999 Edition CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — Date Requested_ Y---- _ _AM______ ------) BUP __-___ BLD Location /0 ; " 5 w 6'A-et,,6 N Y., Suite - '—v MEC _ Contact Person ____ Ph / — 8 PLM .7-e‘-'`i -° ° 52- 7 Contractor Ph - SWR BUILDING Tena it/Owner ELC -- Retaining Wall ELR Footing Access Foundation FPS — — Ftg Drain SGN Crawl Drain Inspection Notes: ------- Slab iSIT Post& Beam _ ------------- Ext Sheath/Shear - -- Int Sheath/Shear Framing - ------ ---Insulation Drywall Nailing -- — -- — — Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling i / .,. �") Roof �.i2 7.--) ....1:-?-146Z' �'� Misc — • ,rN.._ Final P PART r. LUM ) FAIL L AO• ' ' — 1 ,----- am - Under Slab — —--- — —------- ---- -- Top Out Water Service — — ---- --.--- -- —_-- _-- Sanitary Sewer Rain Drains — --- ,. ---- --- — *.i........_PART FAIL ANICAL Post& Beam Rough In —_— , --- -- Gas Line — — — --- - — — Smoke Dampers -rpt --... Final — ------ L- - PASS PART FAIL -_--- ELECTRICAL - ServiC.e - --- -'--- Rough In UG/Stab - — - ---- --.:- Low Voltage Fire Alarm ___ __ — -- Final PASS PART FAIL ______----- _-- - BITE Backfill/Grading ______ — - Sanitary Sewer Storm Drain ( )Reinspection fee of$ iequired before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( I Please call for reinspection RE _ . ( I Unable to inspect - no access Fire Supply Line -'— ADA Approach/Sidewalk (14141/1/ Inspector Ext i1 Other Date __7/1_40 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 — /Date Requested 9 /1 Uv AM ' r BLU Location—�,/�2�� S1� -. --1-e__,—..J)..)/5. Sui • 7)0C MEC —_ — Contact Person _ Ph ( PLM _ — Contractor — Ph -_ SWR -_ BUILDING Tenant/Owner _ ELC .02.O00— UU.r/,T Retaining Wall ELR Footing Access Foundation FPS ___ Ftg Drain — " SGN Crawl Drain Inspection Notes -- SlabSIT Post& Beam Ext Sheath/Shear — Int Sheath/Shear Framing Insulation Drywall Wailing Firewall Fire Sprinkler —__.---_ —_ Fire Alarm Susp'd Ceiling --------- — Roof Misr. — -- Final PASS PART FAIL ------ — --- -- PLUMBING Post&Beam Under Slab Top Out Water Service Sanitary Sewer ----------------- --- -- —__.f—.�----- Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam Rough In Gas Line -- — — — _ _-- — -- ---- —— - — Smoke Dampers Final _----__—___----- P•SS FART FAIL . rrv,r Rough In --- - ---- - - - -_- - ---- ----_-- UG/Slab ---------__--._-- Low Voltage i File 'I:rm —.—_ — — — -- - --- IIV 1 i. PASS ART FAIL —. ------ r~rCr Backfill/Grading -- — —`------- — -- Sanitary Sewer Storm Drain I )Reinspection fee of$_ _____ _required before next inspection Pay at City Hall. 13125 SW Hall Blvd Catch Basin Fire Supply Line I I Please call r reinspection RE __ )Unable to inspect- no access ARA Aff Approach/Sidewalk Date jDO Inspector—_ t Other _ -- Final PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.