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10670 SW BLACK DIAMOND WAY 0 rn 0 Ln E co r w n I o w B r a E w 1 i t I t i . r i O670 SW BLACK DIAMOND WAY CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-41175 Business Line: 639-4171 MST - BUP Date Requested u 1L /2� AM PM BL0 Locationl�422 6 Y Suite MEC 6 Contact Person �s��2_ „�� lf�r Ph � //�/d PI M Contractor _ Ph JG1 SWR -- BUILDING ' Tenant/Owner ELC � 0-5 06 Retaining Wall ELR Footing Access: —� Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab _. _ — - SIT Post&Berni Ext Sher,-,(h/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ,+ — �— Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post& Beam - Under Slab Top Out Water Service Sanitary Sewer - Rain Drains Final P FAIT- _ ECHANIC L — am - - - -- Rough In Gas Line --- - S Dampers T FAIL TRIC �� ------ —__ -- Service Rough In _..-------- ------- - UG/0-lab Low Voltage FimAlarm IF A8 PART FAIL Backfill/Grading _ --- ---- — Sanitary Sewer Storm Drain [ j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SJV Hall Blvd Catch Basin [ ]Please call for reinspection RE: Fire Supply Line [ j Unable to inspect no access ADA Approach/Sidewalk OtherDate G Z Inspector Ext Final — PASS PART FAIL DO NOT REMOVE this inspection record from the job site. I n CITY QF TIGARDELECTRICAL ,F EI2MIT DEVELOPMENT SERVICES PERMIT #: ELC 38-0506 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISSUED: 618/26/98 PARCEL: 1 S 1;?41a17- 04400 .)ITE ADURE::3S. 1O6716 SW F.1_.ACK DIAMOND W`( SUBDIVISION. . . . :BLACK BULL PARK ZONING- R•-4. 5 BL.00K. . . . . . . . . . . 1...0T. . . . . . . . . . . . . :00C' JURISDICTION.; TIG Pro j er-t Dei scr i.pt ion : Installation of 2 branch circuits. - FIE SIDEhJTIAL UNIT---- __ -TF_IhP `JRVC/F=EEDERS_.- _-- ____._Ih1'SCEL._I_ANEOU'S 1000 SF OR LES£;. . . . : 0 0 - x:00 anip. . . . . . . : 0 PL)HP/IP.RIGAT ION. . . . : 0 EACH ADD' L. 5005F., . . : 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 L.11#1IT'ED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL./PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601. + amps -1000 volts. : 0 MINOR LABEL. ( 1O) . . . : 0 -----SERV1CF/FE'EDER•._--._ ---_.BRANCH CIRCUITS------ -•---ADD' L. INSPECTIONS---_.__ 0 _'00 amp. . . . . . : 0 W/SERVICE OR FEEDER: 1. PER INSPECTION. . . . . : I;h 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FUR. : 1 PIER HOUR. . . . . . . . . . . : 0 401. 600 amp. . . . . . : 0 EA ADD' 1... BR.NCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 GO 1. - 1000 amp. . . . . : 0 -----____________-- PLAN REVIEW SECTION----------------- 1000+ amp/volt. . . . . : 0 ) =4 REF; UNITS. . . . . . . . : ) 600 VOLT 1\10' iINAL. . : Reconnect only. . . . . : 0 SVC/FDR > - 225; AMPS. . : CLASS AREA/SPEC OCC. : Owner: _ _ ________._._.---________.. .._____._.____._.._..-- FF_F_S DAVID AUDETTE' F-- ^�-� type amni.+nt by date rerpt 10670 SW BL-ACF', DIAMOND W(1Y PRMT $ 40. 00 DEB 08/26/98 98-30862:3 TIGARD OR 97223 ffjj71Cj $ J:,. 00 DEP O8/26/98 98-3066 '3 Phcne #: 63.9-8901. Contractor: OWNER $ 4t':':'.. 00 TOTAL -- ----- REQUIRED INSPECTIONS ---- Roi.rgh- in F_lect' 1 Final Phone #: E:lect' 1. Service Reg #. . . This pewit is issued subject to the regulations contained to the Tigard Municipal Code, State of Oregon Specialty Codes and all othrr applicable laws. All work will be done in accordance with approved plans. This pewit will expire if work is not started within 180 days of issuance, or if work is suspended for sore than 180 days. ATTENTION: Oregon I es "au to follow the rules adopted by N 952-001- through OAR -001-1987. You gay obtain a copy the Oregon Utility Notification Center. Those rules are set forth in DA of these rules or direct questions to OUNC calling (50- -1987. 1 I 'ermittae Signati.rre : �� ss�ie By :- INSTALLATION ONL.Y--------------------'-----------_. The installation is hei made nn voperty I own which is not intended for sale, lease, or rent. r OWNER'S SIGNATURE: _ _ DATE IF U INSTAI.-I.ATTON SIGNATURE OF SUF'R. EL_.EC' N: DATE LICENSE N O: 1 t++++++-1-+•-+++++++••1++++++++++++++•+++++{•++++++++-h++++ ++A-++++++++i•++++.++++++ F1+ Ca 11 639--4175 by 7:00 p. m. for an inspection needed the next bi.1sine55 day + +++++++++'h++++++4.+t+++++++•4-++4++++++++++++++4-++++++++++++++++++•++++4+•4.++++++•E+ Q..17Y OP TIGARD Electrical Permit Application Plan ec 13125 SW HALL BLVD. Date Recd TIGARD Off' 97223 Date to P.E. Phone (503)6:19-4171, x304 Date to DST Inspection (5031639-4175 Print or Tyke Permit N E1X F� _a� Fax (503)684-7297 Incomplete or illegible will riot be iccepted Called____�_�__ Job Address: _ 4. Complete Fee Schedule Below.-� Name Of Development Number of Inspections per permit allowed - Name(or name of business) 12a V UD k%TE Service included: Items Cost r Sum Address.1e/l/a ZO Slob TSZ ACK 01AA_1IeA)L 4a. Residential-per unit 1000 sq.ft.or less - $110.00 City/State/Zip l(�AR1� (�� _ Each additional 500 sq.ft.or Gommercial ❑ Residential YJ Limited thereof $25.00 � \ Limped Energy $25.00 Each Manuf'd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $68.00 (Attach copy of all co-rent licenses) 4b.Services or Feeders Elec,rical Contractor Installation,alteration,or relocation 200 amps or less $60.00 Address -_- --- 201 amps to 400 amps $80.00 Ciry_ State-- Zip_._ _ 401 amps to 600 amps $120.00 Phone NO. 601 amps to 1000 amps $180.00 Job No. _y Over 1000 amps or volts $340.00 _ Elec.Cont. Lice. No. Exp.Date_-_ Reconnect only $50.00 _. OR State CCB Reg. No.-_ -Exp.Date 4c.Temporary Services or Feeders COT Business Tax or Metro No. Exp.Dat?__�_. Installalion,alteration,or relocation 200 amps or less $50.00 s to 400 ams $75.00 Signature of Supr. Elec'n____-_ 401 amps to 6,10 amps _ $100.00 Over 600 ampe to 1000 volts, License No. _-_ -_Ext. Date see"b"shave. Phone No. .._-..___ - -- 4d.Brenatr Circuits Nov, alteration or extension per panel 3b1 For owner installations: a)The fee for branch circuits with r;,1rrhsse of service or Print Owner's Name_VA y 117 1 , A U t2 ieede-Me. Address 10&7Q Std L.A Ctr' 17l A t11 AI Tom_ Each b anch circuit $5.00 2 -��-- h)The rde for branch circuits City -r'/A._,A a D State' QjR Zip_q72-2_3 _ without purchase of U Phone No. 6 -A 9 -LEI 6 _ _ service or feeder fee. S' First branch circuit $35.00 2 The installation is being a on property I own which is not Each additional branch circuit�_ $5.00 2 intended for sale,lease r vent. 4e.Miscellaneous -� (Service or feeder not Included) Owner's Signature. Each pump or Irrigation circle $40.00 _ Each sign or ou,llne lighting $40.00 3. Plan Review section (if required)' Signal lintes)or a limped energy - panel,alteration or extension � $40.00 Please check appropriate item and enter fee in section 5B. Minor Labels(to) 5100.00 4 or more residential units In one structure 4f.Each additional Inspection over Service and feeder 225 amps or more the allowable In any of the above ..,ystem over 600 volts nominal Per Inspection - $35.00 _ Classified area or structure containing special occupancy Per hour $55.00 _ as described In N E.r Chapter 5 In Plant $55.00 O 'Submit 2 sets of plans with application where any of the above apply. Jam. Fees: 0r Not required for temporary construction services. 5a.Enter total of abovs fees $ 121, U 5%Surcharge(.05 X total fees) $ NOTICE Subtotal $ 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review It reguired(Sec.3) $ -- NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. Trust Accourt N_ -7 Total balance nue $ 109TSTI.C9B AP- Rev 9re6 CITY Q F TIGARD MEC"HANICAL DEVELOPMENT SERVICES PERMIT PERMIT #. . . . . . . : MEC98-0301 13125 SW rlall Blvd., Tige,-d,OR 97223 (503)639.4171 DATE ISSUED: 07/2'9/98 PARCEL: 1S134AD-04400 SITE ADDRESS. . . : 11/4-1/0 SW L-L.A(-'.K DIAMOND WY SUBDIVISION. . . . : 31-ACK BULL PARK ZONING: R--4. 5 BLOCK. . . . . . . . . . . LOT. . . . .. . . . . . . . . ::0 0 d' JURISDICTION: TIG ---------------- CLASS OF WORK. . :PLT FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . : R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : IZI BOILV-'RS/COMPIRESSORS HOODS. . . . . . . : 0 FUEL 0-3 HP. . . . : 1, DOMES. INCIN: 0 3-15 HPI. . . . . 0 COMML. INCIN: 0 MAX INPUT- 0 BTU 15-30 HPI. . . .. : 0 REPAIR UNITS: 0 F J PE DAMPERS?. . : 30-50 HP. . . . 0 WOODSTOVES. . : 0 GAS PPESSURE. . . 50+ HP. . . . 0 CLO DRYERS. . : 0 NO. OF AIR HANDLING UNITS OTHER UNITS. : o TURN ( 100K BTU: 1 10000 cfm : 0 GAS OUTLETS. : I TURN ) =100K BTU: 0 > 10000 r. fm : 0 Remar; s : remove existing electric furnace and replace w/gas furnace and ads' A/C unit. A/C unit cannot je placed within the required setback areas. Owner-: FEES DAVID AUDETTE type amol_knt by date rer-pt 1,0670 SW BLACK DIAMOND WAS' PRMT $ 25. 00 GEO 07/29/98 98-307798 TIGARD OR 5PCT s 1. 2L) GEO 07/29/98 98-307798 Phone #: 639-8901 Contractor: ---------------------------------- OWNER -------------------------------- - - $ 26. 25 TOTAL Phone #-. ------- REOP I RED INSPECTIONS This permit is is-ued subjer' to the regulations contained in the Gas Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Insp applicable laws. All work will be done in accordance with Cooling Unt Insp approved plans. This permit will expire if work is not started Misc. Inspection within 180 owes of issuance, or if work is suspended for more Final Inspection than 180 days, PTTFNTION: Oregon law requires you to follow rules adopted by the 0-egon Utility Notification Center. Those rules are set forth in OAR 95c' At-*If through OAR 952AMI-8888. You may obtain copies of these rules or direct questions to ON by calling .6-9187. Tssl-te By. ----.L d 4...... .......t.............................................. ................1-4.4-+4 Ll 1�- 1),44 Call 639-4175 by 7:00 p. m. for inspections needed the next business day +++-4...................................................#--+-+++++4-+4•.......4........ Plan Check# CITY Or TIGARD Mechanical Permit Application Recd By 13125'SW HALL BLVD. Commercial and Residential DateRec'd _ TIGARD, OR 97223 J� Date to P.E. (503) 639-4171, x304 Date to DST Print or Type Permit# _Incomplete or illegible applications will not be accepted called N,(me of DevelopmentIPro)e l n ,/ -O DeSCrlption (VL/�j� 7/r'L e. �/-� /` - _Table 1A Mechanice.l Code _ Qt Price Amt JOt) Street Address SUR A) Pe,mit Fee __ 10.00 Address MV70 Srl 6LACK D),(4tCM>l w9hr 1) Furnace to 100.000 BTUs — I including ducts&vents 6,00 Bldg# Chylsiate ZIP 2) Furnace 100,000 BTU+ 7'1 6 Aft D 7 7�z 3 including ducts&vents 7.50 v- Name(or name of business) 3) Floor Furnace Owner pAV rD A O P E T'f`E� including vent 6.00 _ Mailing Address 4) Suspended heater,wall heater w ro 50,15LAC K P lA M o wn k/'a Y or floor mounted heater — 6.00 — 5) Vent not included in appliance permit CRY/State ZipPhone 3.00 _ TldARO, e9R Q7 - - CHECK ALL 'Boiler Heat Air Name(or name of business) THAT APPLY: or Pump Cone, Qty Price Amt Comp- —� 6)<3HP;absorb unit to Occupant Malang Address 100K BTU / 6.00 7)3-15 HP;absorb unit CRY/State Zip Phone 100k to 500k BTU _— 11.00 --_ 8) 15-30 HP,absorb unit 5-1 mil BTU 15.00 Contractor Name — — -- ("}fa9 (PekV1P A0P&-T7 ) 9)30-50 HP;absorb unit 1-1,75 mil BTU_ _ 22.50 Prior to permit Mailing Address 10)>5011P,absorb unit issuance,a copy i'd^'"�' _ >1.75 mil BTU 37.50 of all licenses Cny/state zip Phone 11)Air handling unit to 10,000 CFM are required 9 4.50 expired in COT Oregon Const.Cont Board Lic.# Exp.Date 12)Air handling unit 10 J00 CFM+ database 7.50 Architect Nerne 13)Non-portable evaporate cooler 4 50 or Matting Address --- 14)Vent fan connected to a single duct 300 15)"entilation system not included in Engineer CRy/Slaty Zip Phene pliance permit _ — _4.50_ 16)Hood served by mechanical exhaust Describe work to be done: _ __ 4.50 17)Domestic incinerators New O Repair 0 Replace with like kind: Yes O No G 7.50 Residential j8( Commercial O 18)Commercial or industrial type incinerator 30,00 Additions'information or description of work: 19)Repair units (©NI%E.RT I�46GTiQ(G'. r-V1j!eVAC-E 1< 450 _ 20)Wood stove GAS iti!I;f/ A/,� eZ V P/7 /ONIell 4.50 21)Clothes dryer,etc. 4 E0 _ Type of fuel: oil O natural gas LPG O electric O 22)Other units _ 4 50 I hereby acknowledge that I have read this application,that the information 23)Gas piping one to four outlets given is correct,that I am the owner or authorized agent of 2 00 the owner,that plans submitteu are in compliance with Oregon State laws 24)More than 4-per outlet(each) 50 SI a ore of Own Agent Date 7 d Minimum Permit Fee$25.00 SUBTOTAL 5%SURCHARGE �? Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL r Rewired for ALL commercial permits onl %T� 37� �9(?� --- TOTAL G� 'State Boiler Certification required —Residential A/C requires site plan showing placement of unit I Vnechperm Coc rev 07/20/98 I __ Permit if: L' J 0,3 C)f' fi F Q ti v -0 Address: LJ61:;rO 56J Gr46K vo7u N !. Z/ Issued by: _ - _ Date: 9- Statement: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: 1. 1 own, reside in,or will reside in the completed structure. 2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. ❑ 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If 1 change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Proper Owners about 'onstructi n Responsibilities on the reverse sid:--�of�this form. (Si nature o W permit aj)phcant) (Date) (White copy to issuing agency permitfile, pink copy to applicant) Information Notice to Property Owners About Construction Responsibilities "Vote. 1*hv, (ni(jrnwtioii Nofiv,'lol'.-opertv (.)ii ticrs ahom, t ()—trur 1,,n was(fiel-rhoped 17Y[he Cors?rtirtion Contrar'tors Boorird,ip; J..,- {1 1'Iril ve aclirq�_, A', v CIL)U(WA,It(0 11 It ac I of I o Coil,,Ir1iCl ,.t flew It owe or inah e o r, i 1),,i;i I I t 1,i I I I I I III o I I I le 111 itt oil I C I I I I I t'Llk,11 1 I can [)jV V Vj I I IJWJPKA)Ic ills t?y )gill' awn re o I'I I(-- I ol I ow i oW, nos sp it it. it EMPLOYER RESPONSIBIL11 IES: tHl h i ry h't' ntl', Inti 1 tv 4k.I II 10, iiI , 4, 1 ol I Aruc(I.it I (.,(,I I(I a1. I Las Bu,lid Lo do 1i1 III if 111 C,)1,'111 1 C01% yl :r�tilShtlC !II Illi' of .l t—ld-c-illia! Sill chlre,pml t,i :, P (Ail. l" ,o l.'r iijil tho Voll hire will A', flit- wil IlltN ..o:ol:Jlv v.111-1 file l"Alowill". Oregon's m ithliolirling tax law: A,� 'vi-t vm) ruler withhold ineoniv Inv- are paid. YOU %o,Ill he lohkfor the tax 01;.to If yoh don't�W!Ilnllv withbirilhill,the t.1, tl inforimition, call flit, oref,,von i)cp(. of,lit.%crikil. I! I'nctinployment insuranve tax: v, ;m i,,,yiiroI fit pity :I i:r, ;-Or unomp11.11 1 li,L lit 11)'!It dll' i;I ITI 1)1.11,ees. If 0 111 f'onmiti 011" all the OregonI"ll-I Ploy I no,I I i LJ i%o'slon iii I ho D�partrinuii 1 4),I'j jumir,lZe-wilivi'• Workers'compensaflion, insuralice: eN, :r; 01111111 Al)If,L'IS'0 !*of f.,11t f1:lilll'l aid v,ill lk, li;tl,ft Ill, ;ill c(h)ill coc.j"it one of i' in lufled ill)th,°job 1*or .111 Oir W''i kcl'" f )I%tal Ille +'h,I)m1me'll of G111,1111111 0111,1 klflnvvl 'SovviceoS a 0I '.S. Internal Revenue Set-%ice. A" Ill ol 1 llplo ,.1, f oll I,fust vvitllllold 1"Wcral 111col lie lil'i froill Inn0t)VA's, lite" yol, will ht' the Intumol if 1 8(482WI040, OTHER RESPONSIBlUTIES AND AHEA.SOF CONCERW the pertilit holdvt tiff this lit vc,pollofle f t1ml mat he brought to N Ilia,attention throtigil inspecnolls I 4abilit -wid propully dunnage ittsurafrice: ('(iniac- o olur,insulalice ag('111 Lo*�T 11 Wit Jlayc adcquaw CA hl' It, 141cill, -11111 ontls,+iow, ,iidi as falling 1,iiinl '.,(:vprjt}, wmer imnitgu froll; llipe pill"durcs, flit-, (.)I tN()I.k 111:11 IIIIINI I re (1()I)C. Tinnif, to supervise elinployet's: MAC '111V V011 haw ,111,11cient 111111t It, "Illit I\[',I' \toll, I,,\totirv\%ngonvr0 wvvkof roiwh iii anO fitikh vlotif'v hilildillp fifficink ;I[ the tipproprinfe iii-nv,, sn they cm,poIrfowk flit,rf�qiiiwd ;nqr(-Laioi (. 11,WC 101111111al ILII.IeYlons. Nytile or I.-all the Cons(ructiOn it', titn'06t's BOOM(W) Box 141.1(!, SHICITI,(.M Hie Bowd is located m 7W Stinimer St. NF Stifle 30(t. in Salem. I] i pig I \.