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13401 SW BENISH STREET-3 r Building Fixtures Plumbing Permit ,Application 7D,t',/'B ', Plumbing, t o P Permit No.11-61�0,City (If Ti and l Sewer Permit Na, 9c C''5-(1`,/7. 13125 SW Hall Blvd. \ Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-6394171 Fax: 503-558-1960 Yost-Review Land se v1 Date/By: _ Case No.: p Internet: www.ci.tigard.or.us Contact Juris.: 0 See Page 2 for � 24-hour Inspet hon Request: 50.-639-4175 AllName/Method: __ Supplemental Information. l., TYPE OF WORK FEE'SCHEDULE(for special Information use checklist) .4' pcian pfy• N^'.(ea ew construction Descrl Demolition _ _Total _ Addition/alteration/replacement!_Other: _ N^.w t-&2-family dwellings k., _CATE( ORY OF CONSTRUCTION includes 100 ft.for each utility connection SFR(I bath 249.20 1 &2-Family dwellingommercial/Industrial SFR(2)bath 350.00 Accessory Building y[Ulti-Family SFR ')hath 399-CO Master Builder F1 Other: Gach additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION- Fire sprinkler- ft.: Page 2 y Job site address: J 3 O W_ F,� _ Site Utilities Suite#: �� Bld ./Apt.#: i Catch basinlarea drain 16.60 Project Name: - Dr e:Uleach line/trench J.-ain 16.60 ---- FootinR drain(r.o.linear fl.) Pa c 2 Cross street/Directions to job site: Mani-^.ctured home utilities I IC.00 Ma- ales __ __ 16.60 Rain drain connector 16.60 Sanitary sewer(nu. I nrt r R.) _no e Subdivision: t#; Y Storm sewer no. lmcar R. Page 2 Tax map/parcel #: _ Water service no. linear ft.) Pae 2 DESCRIPTIO OF WORK Fixture or Item --- Absorption valve 16.60 AUDILL2 . r..t''' *' '� / Backflow prcventer Pa e 2 _ Backwater valve 16.60 Clothr.s washer 16.60 -- --- ---_ -- - Dishwasher 16.60 PROPERTY OWNER TENANT Drinking fountain 16.60 Ejectors/sum 16.60 am_e:Ct(N >~F!.t.! f k i-1 011140 If Expansion tank 16.60 Address: ��tJCI � t � + ',!l Fixture/sewer cap 16.60 Clt /State/Zip: Floor drain/floor sink/hub 16.60 -) --- - - Garbage disposal 16.60 Phone: Fax: Hose bib 3 16.60 -EYAPPLICANT CONTACT PERSON Ice maker 16.60 _Name: _ Interceptor/grease trap 16.60 Address: ^` Medical gas-value: $ Pae 2 _ City/state/Zip: Primer 16.60 Roof drain commercial 16.60 Phone: Fax: _ Sink/basin/lavatory 16.60 E-mail: Tub/showerishower pan 16.60 CONTRACTOR Urinal 16.60 Business Name: .r -- Water closet 16.60 O -- Water heater 16.60 2, �J ,address: _' i;?', I, 3 _ Other: City/State/Zip: ' Other: Phone: ;Z LeG �{ 3�� Fax: a l.G `13 C A Plumbi7R Permit Fees" CCB Lic. #: �Z 0 3) Plu b. Lic.#: 3 -� (vP x$72. 0 5 - - Minimum Permit Fee 572.50 S Authorised,' Residential Backflow Minimum Fee$36.25 1;4 3a 4 t7 Signature: Cl- �c.11( Da�te:��{ `!'S 1'j Plan Review 25%of Permit FEEL S State Surchar eS84b of Permit Fee) S / (Please print amc) TOTAL PERMIT FEE No!lce: This permit application expires If a permit Is not obtained within All new commercial buildings require 2 sets of plans with Isometric or 180 days after It has been accepted as complete. riser diagram for plan review. *Fee methodology art by Trl-('ounty Building Industry Service Board. i .Osis\Permit Fortes\PlmPernutApp d ^1103 Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilitie. Qty. Fee(ea) Total Square Footage: Permit Fee: footing drain- I"100' 55.00 0 to 2,000 $115,00 _ f,wung drain-each additional 100' 46 2,001 to 3 600 $160.00.40 3601 to 7 200 _ $220.00 Sewer- Ist 100' 55.00 7,201 and $309.00 Sewer-each additional 100' 46A0 Water Service• Ist 100' 55.00 Medical Gas S stems• Water Service-each additional 100' 4.40 Valuation: Permit Fee: Storm&Rain Drain- Ist 100' 55.0(1 $1.00 to$5,000.00 M nimum fee$72 50 Stomt&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $/2.50 for the ftmst$5,000,00 and$1.52 for each additional$100.00 or fraction thereof,to and Fixture or Ilam Qty. Fee(ca) Total _ including$10,000.00. Commercial Back flow Prevention Device 46.40 $10,001.110 to$25,000.00 $149.50 for the first$10,000.00 and$1,54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to (minimum permit fee$36.25) 17.55 and including$25,000.00. _ Rain Drain,single family dwelling 65 25 $25,001 M to$50,O00.00 $379.50 for the first$25,000.00 and$1.45 for Inspection of existing plwnbing or each additional$100.00 or fraction thereof,to __ and includin $50,00(1.0(1. specially requested ins actions-per hour 72.5(( $50,001 00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction th.,,-of. Fixture Work: Are you capping,moving or replacing existing fixtures? If ",yes",please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Work Performed Comments regarding fixture work: Fixture Type: Replace New Moved Exl%tln Capped Ba ittst Font _ Bath -Tub/Shower -lacuzzi/Whirl oul — — Car Wnsh -Each Stall _ -Drive Thru Cuspidor/Water Aspirator Dishwasher -Commercial -Domestic _ Drinking FountainLye Wash _ — Hoor Drain/sink 2" 3^ ---— 4" Car Wash Drain *Note: If the fixture work under this permit results in an Garbage -Domestic Disposal -Commercial increase of sewer FDIJs,a sewer permit will be issued and -Industrial fees assessed for the sewer Increase must be paid before the Ice Mach./Refii .Drains plumbing permit can be issued. Oil Separator Gas Station Rec.Vehicle Dump Station Shower -Gang -stall Sink -Bur/Lavatory _ -Bradley .Commercial -Service Swimming Pool Filter Washer-Clothes Water Extractor Water Closet-"i oilet nal OtherOther Fixtures: ODstc\Permit Forms\PlmPetmitAppPg2.doc 01103 OIE91aN 61 CONSTRUCTION CO, SHEET NO OF-.."^------ hufill tC I --- --- PROJECT NO- --. ti � a u. rilet Cf) �, c� > r t r— :n CLjr G� JN --- U Ca 7 1/ 1 1 N. • � 1 lr _ t� C67 Ernes TECMNULUU Y - DEMON i CONOTRUCflON CO. SHEET NO. OF-- LAO SUBJECT PROJECT NO —� .h� tA �. ;� II w � i ... 40 �n to Q - 4+ r .e � .e , e e A/ •c% , , .. i 1 I i f CITYOF TIGARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT #: SWR2003-00127 13125 SW Hall Blvd., Tigard, OR 97223 k')03) 639-4171 DATF ISSUED: 4/28/03 SITE ADDRESS; 13401 SW BENISH ST PARCEL: 2 S 104A B-04 700 SUBDIVISION: ZONING: R-4.5 BLOCK: I_OT- JURISDICTION: TI(i TENANT NAME: OUR REDEEMER LUTHERAN CHURCH USA NO: FIXTURE UNITS: 24 CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: 1.5 EDU increj,e. Previoi.is EDU-3.0 for a total of 48 fixture values. Addition of 24 fixture values, for a new total of 72 fixture values =4.5 current EDUs. Owner: -- FEES OUR REDEEMER LUTHERAN CHURCH 13401 SW BENISH ST Description _ Date Amount TIGARD, OR 97223 I S\\ I I.A{ s r(unnecf 4/213/03 $3,450.00 r('(11111CO 4/28/03 110.00 Phone: 1 03-524-6646 - Total $3,450.00 _ Contractor: Phone: Reg #: Required Inspections This Applic,:nt agrees to comply with all the rules and regulation: of the Clean Water Services. The perrr.1 expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. Thn.Agency does -iot guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm Issued by:; ` } _�� i Permittee Signature V,--j-err1 (� Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Accumulative Sewer Tally Tenant Narr e. :)ut Redeemer Lutheran Church This SWRh 2003-00127 _ Address: 13401 SW Benish This PLM# 2003-00148 Fixture Value Previous Previous Credits Capped Fixture Fixture New Now # value capper' off value added added total total count off#s count # value #s values Baptise /Font 4 0 0 0 0 0 Bath-Tub/Shower 4 0 0 0 0 0 -Jacuzzi/Whirlpool 4 0 0 0 _ 0 0 Car Wash-Each Stall 6 0 0 - Drive through 16 0 0 0 0 0 _ Cris idor/Water AEirator 1 0 0 Dishwasher-Commercial 4 0 0 0 u 0 -Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 Eye Wash 1 0 0 Floor Drain/Sink-2 inch 2 0 0 1 _ 2 1 2 3 inch 5 0 0 _ 0 0 0 4 inch 6 0 0 _ 0 0 0 Car Wash Drn 6 0 0 — 0 0 0 Garbage Disposal Domestic(to 3/4 HP) 16 0 0 0 0 0 Commercial(to 5 HP) 32 0 0 0 0 0 Industrial over 5 HP) 48 0 — 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Oil Se Gas Station 6 0 0 0 0 0 Rec.Vehicle Dump station 16 0 0 0 0 0 Showei -Gang (per head) 1 0 0 ( 0 0 - Stall 2 0 — 0 0 0 0 Sink- Bar/Lavatory 2 0 0 5 10 5 10 Bradley 5 0 0 0 0 0 Commercial 3 0 0 0 0 _0 Service 3 0 0 0 0 0 Swimming Pool Filter 1 _ 0 0 0 0 Washer-Cloth,:- 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 2 12 _ 2 12 ')rinal 6 0 0 0 0 0 Previous EDU Count 3 48 --�_ 48 0 Capped EDU Credit TOTALS 0 48 0 0 8 24 8 72 Current Fixture Value 72 _ divided by 16= 4.5 Current EDU 1 EDU = $2,300.00 Previous Fixture Value 48 divided by 16= 3.0 Previous EDU Change 24 divided by 16= 1.5 over (under) _$ 3,450.00 Enter EDU Change Here 1.5 _HISTORY _ 3 EDU previous per Sheryl. PL EDU# SWR# _ PLM# EDU# SWR# PLM# EDU# SWR# Name: L!L �r �r '(J Date: y -ol`> -�J 3 Signature of person that calculated this tally sheet and date perfromed Is required Mechanical Permit Application hntereceived; ' �?��9 rertnitno.:/�/E�+��3 CAy of Tigard rmjccl/nppl.no.: �-�- Expire(late: r'illooffipmd Address: 13125 SW Ifnll my 2 D — �— Phom: (503) 639-4171 Untc issuccL it itcrcipl no. Nit: (503) 599.1960 i Case file Mno.: Payment lypc: _ Land use approval: - Building permit no.: �Gl/° 'dCyrZS -J 1 / U I A 2 family dwelling or accessory Crnnntcrcigl/huluslrinl U Multi-family U 1'emnt 1n provenlenl U New cmiginlction i t r, I till ,n/aherrilinn/repinccmrnl U f)Ihr r __ Job address: . - �.�1 �- T Indicate equipment quantities m boxes below. Inclicalr the dollar B141g,no.: _ Suite nu.: value of all nlec meal nnalclials,�Wipment,labor,nvcrhcad, 'fax map/lax lot/riceount no.:-� lmtfil. Value' IIL./pp Lot: illock: T Subdivision: "See checklist for imporinnt ripplientfon inforntalinn and Project name:QLD•. ,.,�,. jUnisdiclinit's fee schedule for residential permit fee. R-- srf[ �LlJ1�._ - City/county: ZIP! Q 2AI Description rind ocntinn of work on !(Jr••-.' ��.�* t�a_ Q LL..�.� /0•G'_!'�itl:Tt i•er(ea.) lolnl l:sl.time of completion/in�pc(tine: - _ Uescti ion Qty. Res.onl Res.onl) I cnnnl imprnvertirm or change of use: ' Is existing spnce healed or conditioned?U Yi• U No _Air handling unit CI'.M - 1(r conditioning(Rite nn requ Ice) - Is existing spnce intnlatetl1 U Yes CI Nn �itcnnl ono cx sl ng sysictm - Business name: CGS ; l `.. Stile boiler permit no.: =�'— Ile 1'ung nl,u/11 Address: �l, .L�f �/ T_ Ir smn c nmpers 1 uct slnu ct rtcctors City:�CZL��iL. Slatc:p 7.11': 977 A.2 licgl ump(s tc p an require(])- — - - Phune;, At -ax: fi-mail: -- nstn rep lice utnnc wrner.—iiI M CCB no.: - --- -�Including thrclwork/vcnl liner U Ycs U No /�� .lep nC to ocitlC 11CRICIR-'"Wr11 CI, City/Ime(to tic.no.: -- ------ wnll,ot floor mounted -- - - -. ---------._.------ Name(plense riot): ; eat ora 1, anccnl leer tan unnncc - e r Rerst nn: Ahsorpllon anis_______ Il'I'll/ Name �JG�4>r7�; � Chillers-----._- Address: Com ressors tl nr ronmenlri ex uuel AP- and ejlitn: City: Slate: ZIP: _ A cpHnncevent Phone: FIX: E-mail. )n crex nnust - Iloodg,'l ype It 111im lc ten n.mal — hnod fire su rpression system Name: Q/rf-,�i� E��yp�, GGt r / i'rr�?r' mlinust fan with Iingle duct(bash tans) Mailing address: 3 0/ jrp I Er ' S M tsustl�s Ilem R iinrl torn war n or i - Cil Slritgt"�� 71P: ue p p nR and�clr ul on(up In out Y 77�r /t/_ ty le: LPU NO U i'holte: ^� rax: E-mail: vc t n enc t a 1 odc7i i nalovct oullos rneesg p nR(sc tem rnciqu rel Nnnte: Number otpullCls - Uther limed appliance o nl Address: Uecotalive0re lace r City: _ -- _--_-- State: It!(P: — _ ]tigerl-type Thune: I C-mall,• roc slov pc eTiiat`ave Applicnnl's signature ti bale / t Per. — - _ � Other: Name (print):-- C�er�•,/ - — -� ----- NM all lurlediraPm am-pr n it t-wdr,plena call lurtuacllfm kw"W"Inrnnnadnn Permit fee... ................. _ U Visq U Mnslrt('Rill N llice 'ibis permit nppti blain Minimuttt fee................S ('r 111Ci Il q petflllt IS not obtained 111111review(nt _ %,) rredlf cad number - - ---- - - --- -- :a fel within Igo days alter II ling Veen Slnte surcharge.(R%).... Nartw n'I ratilho m a wn nn—cMTe-0 - -"- qc CCpled at complete. --- C'an m comer r�naT Int---- _ mnaM IMt l6tt irAm oho CITYOF T I GA R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00155 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/3/03 PARCEL: 2S 104AB-04700 SITE ADDRESS: 13401 SW BENISH ST SUBDIVISION: ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: NEW FLOOR t-URN: EVAP COOLERS: rYPr- OF USE: COM UNIT HEATERS: VENT FANS: ? OCCUPANCY GRP: A3 VENTS W/O APPL: lJ VENT SYS1 EMS: STORIES: 2 BOILERS/COMPRESSORS HOODS: _FUEL TYPES 0 - 3 HP: DOMES. INCIN: I_11(, 3 15 HP: 2 COMML. INCIN: MAX INPU1: 220.000 BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: N 30 - 50 HP: WOODSTOVES: GAS PRESSURE: U 50 + HP: CLO DRYERS: FURN < 100K BTU: _ AIR HANDLING UNITSOTHER UNITS: FURN >-100K BTU: 2 <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Valuation: 57078.00 Owner: _ FEES OUR REDEEMER LUTHERAN CHURCH Description Date Amount 13401 SW BENISH ST I'cimit I-ce 6/3/03 $101.42 TIGARD, OR 97223 X11 t'I'I.NI I'lan Rc� 6/3/03 $26.11 1 \\ `t StatCTa.t 6/3/03 $8.35 Phone: 5111-521-064 Total $138.88 Contractor: JACOBS HEATING +A/C 4474 SE IVIILWAUKIE AVE PORTLAND, OR 97202 REQUIRED INSPECTIONS Phone: 503 214.7331 Mechanical InspDuct Inspection Reg #: LIC 1441 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is riot 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 in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 i i Issued 13y: j �t; Permittee Signature:i r it L' . Call (503) 09-4175 by 7:00 P.M. for inspections needed the next business day 1 3 ''`Ul S pu b Gli i�: i'� Ss P IAMicatinn ' ' ' ONLY- Mechanical .. Kcccivcd� s� 0S McmliatI al 9EC20o3'AD/�� Date/B . Permit No.:� Itli of Tigard ` Planning Appro al Building City g M��, tOO.' Date/By: Permit N-J&1, r'oog-00 YA"? r 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 ;;I1 Y (_)V- i IGAW Date/By:q-Zy s Permit No.: M Phone: 503-639-4171 Foil 00998allowISl� Post-Review Land UseDate/By �� Internet: www.ci.tigard.or,us : Case No.: Lv Contact Juris.: 0 See Page 2 for 24-hour inspection Request: 503-639-4175 Name/Method: T/ Supplemental Information. TYPE OF WORK COMMERCIAL_FEE*SCHEDULE.-USE CHECKLIST �� ldditionlaiteration/replaccment w construction Demolition Mechanical pcmtit fees•are based on the total value ofthe work I LJ Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. �. 1 & 2-Family dwelling Commercial/Industrial Value: S '� See Page 2 for Fee Schedule Accessory Building multi-Family RESIDENTIAL E UiPMENT/SVSTEMS FEE"SCHEDULE Master Builder 0 Other: — _Description t Fee ea. Tolai Heatin Coolin JOB SiTE INFORMATION and LOCATION Furnace-add-on air conditionin •• 14.00 Job site address: J?d1't-v SW t-tJ J S hP- eT Gas heat pump 14.00 Suite #: Bld ./A t.#: Duct work _ 14.00 I'roject Name: POOL QW*W,t C H dronic hot waters stem 14.00 Cross street/Directions toob site: Residential boiler ; 1 (for radiator or hydronic system) 14.00 Unit heaters(fuel,not electric) in wall,in-duct suspended,etc. 14.00 Flue/vent for any of above 10.00 Subdivision: Re air units i 12.15 �- Other Fuel A ollances Tax map/parcel#: Water heater 10.00 DESCRIPTION OF WORK — _ Gas fireplace 10.00 _ Flue vent water heater/ as fireplace) 10.00 Log lighter as 10.00 _ ----- - - -- --- Wood/Pellet stove 10.00 - _ Wood fireplace/insert 10.00 _ Chimney/liner/flue/vent 10.00 PROPERTY OWNER TENANT Other: 10.00 ame: UQ J2gS5 �/� I� J� Environmental Exhaust&Ventilation "'�Y- �1`' Address: SrRange hood/other kitchen equipment 10.00 •sy,� l�t_S H _ -- Clothes dryer exhaust 10.00 CjtY/StSte/Zi 1) &4.(W l'Z Single duct exhaust Phone: Fax (bathrooms,toilet compartments, W7kPPLICANT I LJ CONTACT PERSON uti I ity rooms) 6.80 Name: Attic/crawls ace fans 10.00 Address: '��stC M1�3 tj�lil to_ , Other: Fuel Piping 10.00 City/State/Zip: Fbmr&A 40 **($5.40 for rirst 4,$1.00 each additional FurPhcre: , H j . ;0917 Fax:1� I%$2 57 Gas heat etc. •* — Gas heat um •' E-mail: f 10 '3/1t'p bS1�Vwe 1GO0411 Wall/suspended/unit heater •• CONTRACTOR Water heater __ '• Business Nati !_ 4C-Pr .$ 146A-41w&- Fireplace •' Address: '-t f!C� MIUM44 !tr t OX0 tRange BBQ City/State/Zi 01 & Clothes C othes dr eras •• Phone: *?,LQ4 0WJ7Z1 ax,! 0%.0110. VLS7 Other: •• CCB Lic. #: a��-jH J� -- Mechanical Permit Fera" _ Authorized Signature: _ Dat 5�f^C� Subtotal: Minimum Permit Fee$72.50 S _ Plan Review Fee(25%of Permit Fee) S 2 ' (Please print name) State Surcharge 8%of Permit Fee $ J • 3b TOTAL PERMIT FEE $ is. 65 Notice: This permit application expires If a permit Is not obtained within 'Fee methodol9gy set by Tri-County Building Industry gervice Board. Igo days after it has been accepted as complete. "Site plan required for exterior A/C units. i:Msts\Permit Fomts\IVlecPetmitApp.doc 01/01 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: _ Total Valuation: Permit $1.00 to$5,000.00 Minimum fee$72.50 $5,001.00 to SM.000.00 572.50 for the first$5,000.00 and$1.52 for each addition.!$100.00 or fraction thereof,to ane mcludin $10000.00. $10,001.00 to 525,000.00 $148.50 for the first$10,000.00 and $1.54 for each additional$100.00 or fraction thereof,to and including $25,000.00. $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 fuer each additional$100.00 or fraction thereof,to and including $501000-00 $50,001.00 and up $742.00 for the first$50,000.00 and $1.20 for each additional$100.00 or fraction thereof. Assumed Valuations Per APO nee: Value Total Deacription: t Ea mount Furnace to 100,000 BTU,including 955 ducts&vents Furnace> 100,000 BTU including ductsL��1 1,170 2-340 &vents Floor furnace including vent 955 Suspended heater,wall heater or floor 955 mounted heater Vent not included in appliancc permit 445 Repair units 805 <3 hp;absorb.unit, 955 to I 00 BTU _ 3-15 hp;absorb.unit, 1,700 101k to 500k BTU 3(4 15-30 hp;absorb.unit,5011:to I mil. 2,310 BTU 30-50 hp;absorb.unit, 3,400 1-1.75 mil.BTU >50 hp;absorb,unit, 5,725 >1.75 mil.BTU Air handling unit to 10,000 cfm 656 Air handling unit>10,000 cfm 1,170 Non-portable eve rate caoier . 656 Vont fen connected to a single duct_ 3 446 Vent system not included in appliance 656 permit Ilood served by mechanical exhaust 656 Domestic incinerator 1 170 Commercial or industrial incinerator 4,590 i Other unit,including wad stoves, 656 inserts,etc. Gas piping 1-4 outlets 360 Each additional outlet 63 TOTAL COMMERCIAL $•7�y -,� VALUATION: i\Dsts\Pennit Forms\MccPermitAppPg2.doc 01103 FILE COPY April 24. 2003 CITY OF TIGARD Jacobs Heating OREGON 4474 SE Milwaukie Portland, OR 97202 RE: MI CI IANICAL EQUIPMENT(a)� OUR REUFIFIMER ftject_Information Building Permit: MEC2003-00155 Construction Type: VN Tenant Name: Our Redeemer Occupancy Type: A3 Ad.rens: 13401 SW Benish Street Occupant load: NA Arca: NA Stories: 2 The plan review was performed under the State of Oregon Structural Specialty Code(OSSC) 1998 edition; the State of Oregon Mechanical Specialty Code(OMSC) 2002 edition;and the Tualatin Valley Fire & Rescue Ordinance 99-01 (TVFR99-01) 1999 edition. The submitted plans are approved subject to the following. 1. Each appliance shall be provided with a shutoff valve separate from the appliance. The shutoff valve shall be located in the same room and within six feet of the appliance scrved. Access shall be provided to the shutoff valve. 0409.5 GMSC 2. Equipment and appliances regulated by this code requiring electrical connections shall have a positive means of disconnect in accordance with the Electrical Code. 301.7 GMSC 3. Permanent equipment supported by the structure,400 lbs and over, shall have their attachments deEigned in accordance with the Building Code. 301.16 OMSC 4. Appliances sertiing different areas of a building other than where they are installed shall be permanently marked in an approved manner that uniquely identifies the appliance and the area it serves. 304.10 OMSC 5. Appliances shall be accessible for inspection, service, repair or replacement without removal of permanent construction. 306.1 OMSC 6. Manufacturer's installation instructions shall be available on the jobsite at the time of inspection. 304.1 OMSC 7. Condensate from cooling coils or evaporators shall be collected and discharged to an approved plumbing fixture or disposal area. 307.1 OMSC 13125 SW Hall Blvd., Tigard, OR 97223(.503)6394171 TDD(503)584-2772 — Approved Plans: 1 set of approved plans, bearing the City of Tigard approval stamp. shall be maintained on the jobsite. The plans shall be available to the Building Division inspectors throughout all phases of construction. 106.4.2 OSSC f Premises Identification: Approved numbers or addresses shall be provided for all new buildings in such a position as to be plainly visible and legible from the street or road fronting the properly. When submitting revised drawings or additional information. please attach a copy of the enclosed City of'Tigard, Letter of T nsmittal. The letter of transmittal assists the City of Tigard in tracking and processi docui.ients. Respectfully ��ian Bi ck, Senior Plans Examiner 6 i CITY OF T I^VA ^,/��[D ELE�...ICAL PERMIT T PERMIT#: ELC2003-00666 1EVELOPMENT SERVICES DATE ISSUED: 11/3/03 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104AB-04700 SITE ADDRESS: 13411 SW BENISH ST ZONING: R-4.5 SUBDIVISION: BLOCK: LOT: JURISDICTION: TIG Prc.ject description: Insld. (1)branch circuit to shed. ___ REcIDENTIAL 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: ",jInraF HMI SVC/I OR: 691+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 • 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+amp/volt: -4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: OUR REDEEMER LUI HERA 4 CHURCH ATLAS ELECTRICAL CONTRACTORS 13401 SW BENISH ST 4403 SE ROETHE RD TIGARD,OR 97223 MILWAUKIE,OR 97267 Phone: 503-j24-6646 Phone: F-659-4944 Reg#: W. 9-2212 2591S -- — LIC 1532 FEES Et.h. 3-2t' Description Date Amount Required Inspections (I I I'liNITI I I ( I'crnut 11 10 $46.85 k.irchargc 1 I 1 u c $3.75 Rough-in Elect'I Final Total $50.60 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 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 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules direct questions to OUNC at(503)246.6699 or 1-800-332-2344 � r Issued By: � ; ,ty_—j , Gtr Permit Signatu, . � ti _ OWNER INSTALLATIOWONLY The installation is being made on property I own which is not intended for( e, lease or rent. OWNER'S SIGNATURE: _ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE:— LICENSE ATE:LICENSE NO: Call 639-4175 by 7:00pm for an inspection the rex; b-isiness day i Electrical Permit Aimlication Received Electrical ---_---- — — DateB I 7> Permit Planning Sign CityOfTIgar1 Date/By: No. 1%GE�r1'p� Permit No 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-6394171 Fax: 503-598-1960 ..� r Post-Review Land Use Dalt./By: Case No.: Internet: www.ci.tigard.or.us Contact ��tUE.pplumental See Page 2 for 24-hour Inspection Request: 503-639-4175 Namc.'Method Information. TYPE OF WORK PLAN REVIEW Please check all that apply) New construction I L1 Demolition Service over 225 amps- Health-care facility - commercial C1 Hazardous location Addition/alteration/re lacement Other:_--- _ ❑Service over 320 amps-rating of ❑Building over 10,000 square fret, CATEGORY OF CONSTRUCTION _ _ 1 &2 family dwellings four or more residential units in 1 &2-Family dwelling ❑ Commercial/Industrial �System over 600 volts nominal one structure Accessory Building Multi-Family ❑Building over three stories ❑Feeders,400 amps or more _ B y.. ❑Occupant load over 99 persons I]Manufactured structures or RV park Master Builder ❑Other: ❑Fgress/lighung plan ❑Oth,!r:- JOB SITE INFORMATION and LOCATION Submit—sets of plans with any of the above. The above are nota rlicable to temporary construction service. 5 Job site address: '3140( U—r ----�- FEE*SCIIEDULE Suite#: Jld ./A t.#: _ — _ Number of ins ectlons per permit allowed Prcie-tName:OV R- E1,A QR VA "eCIkW Uescrl p Ilon -- ---- r)h Fee(ea.) Total Cross street/Directions t0 job site: New rng unit.In l Includes or muted garage.per .) dwelling unit.Includes attached Rarage. t S l� `,U NL.hi LJ r Service Included: 1000 sq.ft.or less 145.15 4 Each additional 500 sq.ft.or portion thereof 33.40 1 _ Lot#: Limit:d energy,residential 75.00 2 Subdivision: �` Limited energy,non residential 75.00 2 Tax map/parcel #: Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 2 .j t`�(N C O OZ. Services or feeders-Installation, .11 alteration or relocation: O V(L- i rG V i`�"-MR(Q U b��tr.J 200 amps o less 80.30 2 - 201 ampsttn 4110 ams 106.85 2 401 amps to 600 amps 160.60 2 PROPERTY OWNER TE ANT 601 em to 1000 ams 240.60 2 V Q � Over 1000 am or volts 454.65 2 Nanieo(J(Z l C C)e �2 - = a Reconnect only 66.95 2 Address: 3 4 ' k S 0-) L 6 N L (+ S Temporary services or feederc-installation, alteration,or relocation: Cit /StateiZip:-t IG-A It 0 2 V1 3 200 amps or less — 66.95 1 201 amps to 400 amps—_-_ 100.30 2 Phone: !1Z4 - 4t,�►� Fax:'ZI "3 - Q 3 401 to 600 amps 133.75 2 APPLICANT I LJ CONTACT PERSON � Branch circulis-new,alteration,or Name: J RVA G7 S C .1;3 A2-u A,k'L> er,tenslon per panel. A.Fee for branch circuits with purchase of Address: w L"LV 160 L service or feeder fee,each branch circuit 6.65 2 City/ tate/Zi : B IL-tN)G O-V V., t O 2 '700 r B.Fee for branch circuits without purchase of service or feeder fee,first branch circuit 46.85 F 2 Phone:S� "� �'a'b�-�` Fax: — Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included): _ CONTRACTOR Each pump or irrigation circle 53.40 2 — — Each sian or outline lialiting $3.40 2 Job No: Signal circuit(s)or a limited energy panel, alterationBusiness Name: tL,X S E Ll-:L.Trl.1,L Description: extension _ pa 2 2 Description: Address:q qnj, S Er 2 0 Tort rZ 0 — Clt /Slate/ZI :rn 1 L A �L V (� Each additions Inspection over the allowable In an of the 2.5-0 1_ —� Per inspection per hour(min. I hour_ 62.50 PhoneS�b S14-7 21 L Fax: Investigation I'cc CCB Lic.#: - Z_ Lic. #: Other: —Supervising electrician ,L - Electrical Pertnit Fees* P B L J L V SSubtotal S I/(,. signature required: Plan Review(25%of Permit Fee) S _ Print blame: Lic.#: - L �' _ State Surcharge 8%of Permit Fec S 5 - _ TOTAL PERMIT FEE S '_(��' Authorized w Notice: This permit application expires If a permit is not obtained within Signature: Date:elt14116-3 180 da�c after It has been accepted ac complete. •Fac nrcthoilolop -et by Tri-Corinth Building Industry Service Board. RaA&aa --�Plcrint na 444=0J:Jase — i:\l)ststPermit FormslElcPermitApp.doc 01103 Electrical Permit Application -City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems..............._.......................................... $75.00 ('heck Type of Work Involved: Audio and Stereo Systems* Burglar Alarm Garage Door Opener* ❑ Heating,Ventilation and Air Conditioning System* aVacuum Systems* ❑ Other - —�--. _--- COMMERCIAL WORK ONLY: Nee for I high system.......................................................... 75.00 ISGI;.OAR 918-260-200) Check Type of Work Involved: Aud o and Stereo Systems Boiler Controls SY3:;:= Data Telecommunication Installation Fire Alarm Installation HVAC CJ Instrumentation n Intercom and Paging Systems L� landscape Irrigation Control* Medical Now Calls I Outdoor landscape Lighting* Protective Signaling Other_5 Z11 0 N 41` R L Number of Systems * No li:enses are required. Licenses are required for all other installations i\Dsts\Permit Forms%Ek;PermitAppPg2.doc 01/03 SY MONS 12805 S.E. Foster Road ENGINEERING rILE C Portland, OR 97236 CONSULTANTS, Inc. (503)760-1353 FAX 762-1962 MEMO V , TO: � Hap Watkins DATE: November 14, 200 FIRM: City of"Tigard Building Dept. 13125 SW Hall Boulevard I Y44 Tig�-rd, OR 97223 F'RONI: Dan Symons PROJECT: Our Redeemer Lutheran Church PROJECT NO: 22002 This memo is to certify that based on our observations, sitework for the above referenced project has been completed in substantial accordance with the approved civil plans, specifications, and modifications issued by this office, except as noted below: This certification assumes that all pertinent plumbing inspections were perton-ncd by ('ity of Tigard personnel with satisfactory results. Our final site visit was done on October 17, 2003 and permanent erosion control measures were being installed at that time. Establishment of permanent ground cover and maintenance of sedimentation control measures and structures will continue to be an ongoing necessity. I N 16091 r� cmcot✓ ��l Y 21, �4N E. SYMpy� CC: Zaik Miller Associates 3��y� G&P Obrist Excavation, Inc. RECEIVED NOV z 1, 2003 .A—I Y C,r Ti0- ARL a1 nt r11N(, nIVISID� CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPFOTION DIVISION Business Line: (503) 639-4171 BUP - -- _ Heceived __ Date Requested___ � AM__._ PM - __._ BUP Location �3 0 ( r Suite _ MEC Contact Person _ - — Ph( ) a-3 `it - "7..3 3 1 PLM _ Contractor _ Ph( ) SWR BUILDING _ Tenant/Owner --- -__-_ - -_ ELC Footing Foundation ELC - Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT - Post& Beam ---- - ---- - - - Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing - -- - Insulation Drywall Nailing - --- - - - - - Firewall Fire Sprinkler - - - -- --- - - Fire Alarm Susp'd Ceiling - -- Roof Other: - -- - -- - - Final PASS PART FAIL PLUMBING_ Post&Beam Under Slab -- Rough-In Water Service - -- — Sanitary Sewer Rain Drains — Catch Basin/Manhole Storm Drain -- - - Shower Pan Other: --- Final PASS AT FAIL - - -- - - ---- - MANIC L Rough-n Gas Line — Smoke Dampery -- -- - - ------ - __. -- ------ ------ - — Fin PART FAIL E CTRICAL _ Service - Rough-In UG/Slab - - -- - - -- ----- -- L ow Voltage -- ---------- Fire,alarm Final Reinspection tee of$_ -_required before next inspection. Pay at City Hall, 13125 SW Hali Blvd. PASS PART FAIL SITE C] Please call for reinspection RE: _ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Data-- - /D ,L- Inspwctor--- J--------- _ -- ---- Ext—_— Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL FILE COPY Apri l 11, 2003 CITY OF TIGARD i Dave Curtis OREGON Yorke&Curtis / 4480 SW 101"` Beaverton, OR 97005 RE: OUR REDEEMER, BUILDING EXPANSION Dear Dave: Project Information Building Permit: BUP2002-00425 Construction Type: VN Tenant Name: Our Redeemer Lutheran Church Occupancy Type: B/A-3 Address: 13401 SW Benish Street Occupant Load: 706 Area: 11.440 Sq Ft Stories: 2 Sprinkled: NA Alarms: NA The plan review was performed under the State of'Oregon Structural Specialty Code(OSSC) 1998 edition, and the 'Tualatin Valley Fire & Rescue Ordinance 99-01 (TVFR99-01) 1999 edition. The plans were reviewed by Winstead and Associates. The submitted plans are approved subject to the following. • As noted on sheet CS. Phase 2-4 will not be done during this permit project. The drawings shown on the plans are for reference only. Special Inspection: Special inspection is required for items listed on sheet S,I. The special inspection agency of record, Northwest Testing, shall furnish inspection reports to the Engineer of Record, Berry-Nordling, the General Contractor. Yorke& Curtis, Inc. and the City of Tigard, Building Division, attention Hap Watkins. All discrepancies shall be brought to the immediate attention ofthe general contractor lbr correction. The special inspector shall submit a final signed report stating whether the work requiring special inspection was, to the best ofthe inspector's knowledge, in conformance with the approved plans and specifications and the applicable workmanship provisions ofthe code. 1701.3 OSSC American with Disabilities Act (ADA): It shall be the responsibility of the Architect, Engineer, Designer, contractor, Owner and Lessee to research the applicability of the ADA requirements for the structure. The City of Tigard reviews the plans and inspects the structure only for compliance with Chapter 1 1 of the OSSC which may not include all of'the requirements o1 the ADA. 13125 SW Nall Blvd., Tigard, OR 97223 (503)639-4171 TDD (503)684-2772 — Live Loads Posted: The live loads for which each floor has been designed shall be conspicuously posted by the owner in that part of each story in which they apply, using durable j metal signs, and it shall be unlawful to remove or deface such notices. The occupant of the r building shall be responsible for keeping the actual load below the allowable limits. 1607.3.5 OSSC Approved Plans: 1 set of approved plans, bearing the City of Tigard approval stamp, shall be maintained on the.jobsite. The plans shall be available to the Building Division inspectors throughout all phases of construction. 106.4.2 OSSC Certificate of Occupancy: No building or structure shall be used or occupied until the Building Official has issued a certiiicatc ofoccupancy 109.1 OSSC Premises Identification: Approved numbers or addresses shall be provided for all new buildings in such a position as to be plainly visible and legible from the street or road fronting the property. When submitting revised drawings or additional information, please attach a copy of the enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and proce 'ng the documents. Respect ' rian Bl Senior ans Examiner BUIDIN: r�ERMiT CITY OF TIGARD PERMIT#: BUP2003-00323 DEVELOPMENT SERVICES DATE ISSUED: 6/5/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL.: 2S104AB-04700 SITE ADDRESS: 13401 SW BENISH ST SUBDIVISION: ZONING: R-4.5 BLOCK: l-OT: JURISDICTION: TIG REISSUE: _ FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ACS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N_ S: E: W: OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 3 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: 10 ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED__ FLOOR LOAD- psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR AL-RM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORK: PARKING: VALUE: $ 16,329.00 Remarks: New stor&ge shed. 672 sq. ft. Owner: Contractor: OUR REDEEMER LUTHERAN CHURCH OWNER 13401 SW BENISH ST TIGARD, OR 97223 Phone: 503-524-6646 Phone: Reg#: FEES REQUIRED INSPECTIONS Description Oate� Amount Electrical Permit Required 1131!11.1)1 Permit Fcc 6/5103 $206.50 Foot/Found Insp I A� 8"�Statc Tax 6/5/03 $16.52 Framing Insp I I Shear Wall Insp 1131'PPI NI Pln Rv 6/5/03 $134.23 Final Inspection JV1 S)FLS Pln Rv 6/5/03 $82.60 Total $439.85 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 worts is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopt 3d by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct question:, to OUNC by call 7dBy 3-)246-6699pr 1-800-332-2 . 4. ISSI : Q f Permittee Signature: Y Call 639-4175 by 7 p.m. for an Inspection the next business day U r ' Building Permit ATpplic,ation FOR OFFICE - Received 1Sw1ding � Date/By: t. Permit No.�L'tjQ�� -C7L>3 City of Tigard Planning Approval Other —- Dale/B : Permit No.: 13125 SW Hall Blvd. Plan Review. Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 `''' Post-Review land Use Internet: www.ci.tigard.or.us Date/By: Case No. Contact Juns.: 10 See Page 2 for 24-hour Inspection Request: 503-6394175 Name/Method: t Supplemental Inrormation _ TYPE OF WORK --- REQUIRED DATA: New construction Demolition_`- I&2 FAMILY DWELLING Additiondalteration/re lacement Other: —_-- CATEGORY OF CONSTRUCTION Note: Permit fees'are based on the total value of the work performed. Indicate 1 &2-Familydwelling Commercial/Industrial the value(rounded to the nearest dcllar)of all equipment,materials,labor, ccesso BuildingMulti-Family° -�--� overhead and profit for the work ind.cated on this application. • IV I H Other: valuation......................................................... $ JOB SITE INFORMATION and LOCATION No.of bedrooms: No.of baths: Job site address: 13q 0 1 5 w J c Nt$14- Total number of floors..................................... New dwelling area(sq. fl.)... .......................... Suite#: Bld ./A t.#: Garage/carport area(sq. ft.).................. _ - Project Name' L) 'Z t F EZ b Covered porch area(sq. R.I .... ...................... Cross street/Directions to job site: Deck area(sq.ft.).......... ... ... .. ._.. ......... J K` + LOG\ L N -+ T 7c D.J i i' Or Other structure area(sq.ft.)........... .... ..... . .. REQUIRED DATA: COMMRRCIAL-USE CHECKLIST Subdivision: TLot M. Tax map/parcel#: _ Note: Permit fees*are based on the total value of the work performA. Indirate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. C--- Valuation......................................................... $ _ Existing building area(sq.ft.)......................... — New building area(sq. fl.)............................... Number of stories............................................ 2ROPER.TY OWNER TENA T Type of construction....................................... Name: Ou( r - - /7L ujtki/);ZZ -' Occupancy group(s): Existing: Address: U 15 Gk) > ti New:t 5 i — Cit /State/Z,i .'T NZ 0 G (Z 22, -S -- - Phone: _S"2`{- x: NOTICE: All contractots and subcontractors are required to be PPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Name: _ jurisdiction where work is being performed. If the applicant is exempt Contact Name_— — _ S 66DW G�,Z,• from licensing,the following reason applies: Address: City/State/Zip: — --- ---- Phone: �— -- - Fax: ---- — ------- — — --__ E-mail: BUILDING PERMIT FEES* - CONTRACTOR Please refer to fee schedule. ---- Business Nanle: Fees due upon application.............................. g Address: &hu1.�J4��6-)u C L City/State/Zip: Amount received............................................. S Phone: Fax: Date received: CCB Lic __ --- Au00 thorized Notice: This permit application expires Ira permit Is not obtained within Signature: _ ) � a d tit.�..s� Date: +lam 3 P PP P IC �/ \ IFO days ager It has been accepted as complete. --�+ S - i5' "cam.11f2'`1 *Fee methodology set by Tri-('ounty Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 Plan Submittal Requirement Matrix ConinierOal & Multi-Family Cit,of Tigard New, Additions or Alterations TYPE OF SUBMITTAL # of Plans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 2 Building 1* I Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" ter.hnicians. \Buliding\Forms\PlanSubMatrix.doc 04103 03 �Ui SYNIONS 12805 S.E. Foster Read ENGINEERING Portland, OR 97236 CONSULTANTS, Inc. (503)760-1353 FAX 762-1962 MEMO FILE COPY TO: Hap Watkins DATE: November 14, 2003 FIRNI: City of Tigard Building Dept. 13125 SW Hall Boulevard Tigard, OR 97223 FROM: Dan Symons PROJECT: Our Redeemer Lutheran Church PROJECT NO: 22002 This memo is to certify that based on our observations. sitework for the above referenced project has been completed in substantial accordance with the approved civil plans, specifications, and modifications issued by this office, except as noted below: This certification assumes that all pertinent plumbing inspections were performed by City of Tigard personnel with satisfactory results. Our final site visit was done on October 17, 2003 and pennarcnt erosion control measures were being installed at that time. Establishment of permanent ground cover and maintenance of sedimentation control measures and structures will continue to be an ongoing necessity. P IN 16091 ORMIGON SYM��S CC: Zaik/ Miller Associates /3y/ G&P Obrist Excavation, Inc. �� RECEIVED NOV z u 2003 61TY OF TIGAHU sJJll ING DIVISION CITY OF TIGARD 24-Hour BUILDING Inspection Line--(503)63 INSPECTION DIVISION Business Line: (503) MST —_ ReceivedDate Requested_ 7_ _ AM PM_ BUP Location — � /� �� Suite_ MEC Contact —_ Contact Person _-_ _ _-.- Ph(-_—) _— v Contractor —. Ph(— ) SWR BUILDINGS Tenant/Owner .�j�►LL� ? — ELC Footing ELC _ Foundation Access: Fig DrainELR _- Crawl Drain Slab Inspection Notes:-�� / _ _ SIT _ Post Beam Shearr U Anchors - Ext Sheath/Shear _ _ Int Sheath/Shear Framing Insulation r,, �I O 06 / I (x Drywall Nailing �L [�C./ l� l� , 1 Firewall Fire Sprinkler - -- --- Fire Alarm Susp'd Ceiling -- -- — Roof Other.- - ------- - &al -------------- P. AIT FAIL ----- - - INS Post 8 Beam ------ ------------ Under Slab Rough-In Water Service --- ----- --------- — —� Sanitary Sewer Rain Drains I Catch Basin/Manhole -c.-.------ i Storm Drain ----'--_--- ---- — - Shower Pan 7 Other: Final -- ----- -- • _PASS PART FAIL - -----`-- - -- MECHANICAL _ __ -10000 Post& Beam Rough-In --- --- --- Gas Line Smoke Dampers --- --------- - -- Final PASS PART FAIL - --- --- -- - ELECTRICAL' Service Rough-In UG/Slab I.ow Voltage Fire Alarm Awl Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE [] Please call for reinspection RE: _- Unable to inspect-no access Fire Supply LineAA �� Approar /Sidewalk Dat* _LL_--- Inspector-_- �'�� Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL SEE 35MM � ROLL# 22 FORA LRGE DOCUMENT i