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7455 SW BEVELAND ROAD-1 �Yi�l�l�Yflaiii�11Y1r'�fiiiii6`J�iWkoW'+woMMi�WI�I��.UI� `,d�' t►�o#` 'w � i �.�>,.�,-,,...�.„...� V i� CA W CD m ai 0 CL 0 A) CL 745F SV'I Beveland Road w CITYOF TIGARD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2002-00363 DATE ISSUED: 1/30103 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 PARCEL: 2S101AB-01608 ZONING: MUE JURISDICTION: TIG SITE ADDRESS: 07455 SW BEVELANG RD SUBDIVISION: HERMOSO PARK BLOCK: LOT:019 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 20 TENANT NAME: WESTERN PSYCHOLOGICAL REMARKS: Changing from residential use to commercial Owner: WESTERN TIGARD LLC PO BOX 2469 CLACKAMAS, OR 97015 Phone: 503-244-6629 503-659-9371 Contractur:_Sajgan_ati5g PHIL ROSE�r ION 17430 SW VIKING ST ALOHN, OR 97007 Phone: 503-244-6629 503-659-9371 Re #: bW-649-(PM9 649-8359 This Certificate issued 3/6/0.1 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Godes for the group, occupancy, and use under whit ih�- referenced permit was issued. ` BUILDI G OFFI E3UIL$i•31 GG N$ CTO -------- 1AL --- — ---- POST IN CONSPICUOUS PLACE C�r� Y OF TIGARD TEMPORARY CERTIFICATE OF DEVELOPMENT SERVICES __ OCCUPANCY --- '13125 SIN Hall Blvd., Tigard, OR 97223 (503) 639-4171 PERMIT#: BIJP2002-00363 PERMIT ISSUED: 1/30/03 PARCEL: 2S 101 AB-01608 ZONING: MUE JURISDICTION: TIG SITE ADDRESS: 07455 SW BEVELAND RD SUBDIVISION: HERMOSO PARK BLOCK: LOT: 019 CLASS OF WORK: ALT TYPE OF USE: CUM OCCUPANCY GRP: B OCCUPANCY LOAD: 20 TENANT NAME: REMARKS: TEMPORARYOCCUPANCY FOR �-' DAYS FROM ` gk~ Changing frorn residential use to commercial Owner: WESTERN TIGARD LI-C PO BOX 2469 CLACKAMAS, OR 97015 ORIGINAL Phone: 503-628-8508 L Contractor. J __ PHIL ROSE CONSTRUCTION 17430 SW VIKING ST ALOHA,OR 97007 Phone: 503-649-9559 Reg#: LIC 99839 It is understood by the ownerllenant that the issuance of this Temporary Occupancy Permit by the City of Tigard for the use and/or occupancy of the structure located at the site address listed above(hereinafter"structure"),does not grant or convey to the owner or tenant any property right or other protectible property interest in the use and/or occupancy of the structure for ars purpose. It is further understood that this Temporary Occupancy Permit shall only be valid for the number of days from date of issuance listed above and .hat the owner/tenant will no longer be authorized to occupy the structure after the period specified, unless and until all the conditions of approval imposed under the City's or County's Notice of Decision for the project's land use case(s)issued by the City's Development Services Department or the County's Department of Land Use and Transportation and/or the Clean Water Service: and all building and related code requirements and any other applicable requirements have OZ40(filled and complied with to the City's or County's sa Is,action. BUILDING INSOtCTdR BUILDING ICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARI' 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4,71 MST BLIP Received -_ _ Date Requested _. _ �a� AM_�—_ - PM BUP Location -_ _ - MEQ' Contact Person �/ Ph(— ) -2:3 -YO dPLM ,2 -8 d,33 a Contractor - - --- --- - - --_ Ph(----) --- - SWR BUILDING - Tenant/Owner —.-_-`—_ __— _.._— ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain -- — Slab ;;,spection Notes: SIT Post&Bearn - Shear Anchors --- _— Ext Sheath/Shear Int Sheath/Shear -- j•, --- Framing insulation Drywall Nailing Firewall Fire,Sprinkler -- --- — .L:./ Fim Alarm Susp'd Ceiling --------- - Roof Other: Final --------------- --- PASS PART FAIL - PLUMNNG Post&Beam �_— Under Slab Rough-In - Water Service Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain -- — Shower Pan Other: --- -- ---- PART FAIL_ -- ----- ----- VCHANICAL Post& Beam ----- — — Rough-In Gas Line Smoke Dampers Final PASS_PART FAIL _ELECTRICAL Service -- Rough-In UG/Slab _-- --- ----- —_ —.— Low Voltage — —_ Fire Alarm - ---------- — ------------- Final ❑ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE —V - E] Please call for reinspection RE:_ __-- — L Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date ` .— InspoCtor— _____� Ext Other Fir:al DON T REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: 0'503)639-4175 INSPECTION DIVISION Business Liffe: (503)639-4171 MST -eZ 36 Z2 BLIP Received _ Date Requested ___ w AM_*_ PM BLIP Location "Suite MEC Contact Person Ph /o r U PLM 00 3-3 3 Contractor,-----,---- Ph( ) SWR BUILDING _ Tenant/Owner ELC Footing ELC Foundation - 14CCes5: Ftg Drain t_L R Crawl Drain — w --'- Slab Inspection Notes: SIT - Post& Beam Shear Anchors - ------ Ext She Int Sheath/Shear yc►t, dL -aurin cc - A-�� Insufetion VW�.1�lJ►�/I f G -r `p 'Q L ( Ct -eVdUt� `Std Drywall Nailing Firewall Fire Sprinkler Fire Alarm C`�"" t / , ,W,,_(��,\ Susp'd Ceiling L i - Roof Other:-- �- _-- --- ----- ___ Final -- - - - Gam- --- PASS PART FA -_- — ----------- PLUMBING _.".--PLUMBINGLN Post&Beam Under Slab 16 -- - ater Sarvice Sanitary Sewer Rain Drains -- -- __ Catch Basin/Manhole Storm Drain -- Shower Pan b %.ir210 Other — --- W ------------- A_SS PART FAIL - M A_NICAL_ Post& Beanr � �1 _ �� 'r�^ e � Rough-In - LO Gas Line Smoke Dampers -- -_ Final _PASS PART FAIL -- ELECTRICAL `Vo _k l/ - Rough-In UG/Slab - -- - - Low Voltage Fire Alarn, - Final � Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE__ Please call for reinspection RF F] Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Do%-�S"�5"'Ja InspectorEXt Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CI'T'Y OF TIG,A,RD 24-Hour BUILDING Inspection 0.1e: (503)639-41775 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP _ Received ___ Date Re uested . AM_ –__ PM _. BUP Location Suite MEC Contact Person Ph [ O PLM 33 Contractor_-- — Ph( ) SWR _ - -- BUILDING Tenant/Owner -_-_ ELC Footing ELC - Foundation - - - Fig Drain Access Crawl Drain ELF! 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 - -- -r-- ---- - Roof r^ Other: Final -�----- � PASS PART FAIL - -- PLUMBING _ Post&Beam -� S --- - - - Under Slab wamn*". Water Service Sanitary Sewerj --- -- - Rain Drains Catch Basin/Manhole Storm Drain ---- - Shower Pan Other: Final - PASS PAR FAIL __--_-- -MECHa -- Post&Beam ---- - ----- - ----- ---------------- - - Rough-In - --_------ --------- ----- --- Gas Line Smoke Dampers -----.-- ----__-_-- _ --- _-- Final _PASS PARTFAIL --- - - ----- --- ------ ELECTRICAL_ — ----------- Service -- --- --- -- - - ----- Rough-In _ UG/Slab --- _- `-- Low Voltage — —_ Fire Alarm -- ---- -- -_..---- Final F1 Reinspection fee of$ -.-_-required before next Ins PASS_ PART FAIL u I Inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE:- _-.. ❑ Unable to inspect-no access Fire SL-oply line - ADA 6 ApproacWSidewalk Dates- 4 --- -_ Inspector But - Other: _ Final DO NOT REMOVE thin Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Flour BUILDING Inspection line: 156 5)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BLIP Received ___ _ Date Requested__ __�AM PM ___ ___ __ BLIP Location .—Suite----.-.----------- MEC --_-_- ----. Contact Person Ph(— ) -_--— PLM _3 3 Contractor ----� ___—_------ ---- Ph(_—_-) ----------- _-- SWR BUILDING_ Tenant/Owner -_ ----- ELC _ Footing — Foundation ELC Access: Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT — Post& Beam Shoat Anchors - - -- Fxt Sheath/Shear Int Sheath/Shear Framing - -- -— ----- --- -- - Insulation Drywall Nailing --- Firewall Fire Sprinkler - - - - - ------ _ -_._____ ___.____-- Fire Alarm Susp'd Ceiling — -- — --- Roof Other: -- Final _PASS PARTFAIL PLUMBING ---- _ Post&Beam � — ��• Under Slab ---- -------- --- �iougTS-R'i Water Service Sanitary Sewer -------. ____.-- - ---- -_--- - -- Rain Drains --- - - Catch Basin/Manhole Storm Drain ---- -- — — Shower Pan Other: Final _PASS PART F IL MECHANICAL -- Post&Beam Rough-In --- -----— - ---- Gas Line Smoke Dampers ---- -- - ------ ---------- -- Final PASS_ PARTFAIL ---------- .�. — -- - ----------r r_ ELECTRICAL_ Service Rough-In ----------------- ---- —_—.__._...._ UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$-__.._..... —_—_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART _FAIL SITE _ _— LJ Please call for reinspection RE: _ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk /late - InspA-,tor t. _-- Ext Othor: _ Final DO NOT REMOVE this Inspection record front! the Job site. PASS PART FAIL--j ��U�� K�7FU��&�� 24-Hour � ��_417� CITY` ~~^ ~ ~~~^ - '-- Inspection �`'n»� ' MST �� B i epsL�e�' \^uD)�3�4171 -------- ��;�� U�»�� um n BU9 __- ----------� Received8UP sted '3 AM PM -----� Suite e ----'--'---�----- Location ___--�-�Z � --' -) -� 9LY� �� -�-----(_---__-) Contact Person Ph on __--____-__------'-==--------- . �VVA Ph/------\ ---------' � ---- ---- ----------'- Cnnkra�u/ _'__--_-_-__-____--__�__--_-_ ` �--- ELCPost& Beam ----�------- -I 6ING Tenant./Owner ELC Fig Drain Crawl r inspection Notes: SIT � Shoat Anchors � .. ---h'—' Int Shpatr/Shear" taming Drywaii Nailing Firewell Fire Sprinkivr Fire Alarm Root Final � Under Slab Water Service "Raih Drains Catch Basin I Manhole Storm Drain ShowerPan ; PART FAIL CH Post&Beam Gas Line Smoke Dampers Final pAss PART FAIL C,ervice ME A416 Low Voltage Fire Alarm next inspection. I iy at City Hall, 13125 SW Hall L;Ivd. Final [j Reinspection fee of$ rr-quired before pAsS —PART FAIL Please call for reinspection RE� [j Unable to inspect-no access SITE Tir��u, ply Line Ext ADA Onto Inspector Other: DO NOT REMOVE this Inspection record from the job site. Final FAIL pASS PART - -- ----- CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 — BUP Received Date Requested 3 — AM ___ PM _____ BUP Location ___._ :z 4921ta �41__ Suite _ – MEC Contact Person ._- �. -- -. Ph ( _ ) 3 ' / ( O PI-M Ph( } ---- SWR -- BUILDIN Tenant/Owner ____-- _—_—_. ELC Foundation ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT -3 " }� Fust& Beam -----____-- — --- Shear Anchors - Ext Sheath/Shear Int Sheath/Shear ----- ---- Framiny ------ - ---� Insulation Drywall Nailing -- Firewall Fire Sprinkler - / -- Fire Alarm dz U Susp'd Ceiling Roof Other: PASS .EAPT FAIL BIN - ------ _.--- sT` eam- __-..__ Un dr Slab - Rough-In Water Service ---- — Sanitary Sewer Rain Drains - Catch Basin/Manhole Storm Drain - ShowerPan Other ----- - rna WHANPART FAIL -- -� ICAL Post& Beam Rough-In - Gas Line Smoke Dampers --- -- -- - Final PASS PART FAIL --- - - ELECTRICAL Service - ----- ------- --- - --- Rough-In UG/Slab Low Voltage -- ------ ----- - -- Fire Alarm Final PART FAIL-FAIL Relnspecdon fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. P Please call or reins tion E;_ [] Unable to inspect-no access Fie Supply Line DA Approa;,hiSidewalk (Daft v - Inspector � Ext Other: _ fi-_ DO NOT REMOVE this Inspection) record from the job site. ASS PART FAIL. CITY OFTIGARD 24-Hour — BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 OM ST -Dry Received _Date Requeste _ !Z AM PM—_ BUP Location 7=mss Suite_ MEC _ Contact Person _ _ Ph( _—) ��13��_ PLM Contractor _ Ph( ) SWR __.. BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: Crawl Drain ELR Slab Inspection Notes: I SIT Post&Beam Shear Anchors Ext Sheath/Shear GLS Int Sheath/Shear -`— ---� Framing Insulation t/v� w, S _ L T Drywall Nailing 1�.J�_� Firewall ` Fire Sprinkler /� ry ,{` f _ t t7,/-Z-7 Q C l ) Fire Alarm �� L-Q(�Z "T � .�► �-d� 2 Z.(P/o-S / , Susp'd Ceiling Roof 2 G U Other: P��"1 �C)0 U 2- 0 A �1� 1 ` - n 111ASS PART FAI PLUMBING — Post&Beam Under Slab Roug WaterService I l ` S l Water Se — _ � T�^ �V� Sanitary Sewer S -- Rain DrainsL_ Catch Basin/Manhole Storm Drain — Shower Pan Other: Final VA S Q Lfi�1 PASS PART FAIL `/, w ��--�� --�-' --- MECHANICAL _ � O t l Post& Beam C- \ - Rough-In v� Gas Line Smoke Dampers — Final PASS PART FAIL — ----- — -- ELECTRICAL — Service -- Rough-In _ UG/Slab _ Low Voltage Fire Alarm - FinalRein n fee of$___ PASS PART_FAIL �� o required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE — n Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk pab--_ =-6 v _ Inspector_ _. _ Ext_ Other: Final - VO NOT REMOVE this Inspection record from the job site. PASS PART FAIL U i:' OF TIGAIRD 24-Hour BUILnING Inspection Line: (503) 639-4175 tj B INSPECTION DIVISION Business Line: (503)639-4171 ---- UP �'dVJ_36 Received _____ ___Date Requested- ___--_ AM_ __- PM BUP LocationSuite---- __- - --- NfEC — Contact Person Ph( -) . ��j 3 - /G l/ - PLM Contractor ---__ - _-_-- Ph(_---____-) - - SWR BUILDING Tenant/Owner ELC Footing Foundation ELt' Access: Fig Drain ELR Crawl Drain _.-__-�-- Slab Inspection Notes SIT - - Post&Beam - Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing ---- ----- - ------- insulation wall Nat IT, Fi er wall - - Fire Sprinkler ---- ---------- --- - Fire Alarm Susp'd Ceiling — - - -- - - - - -- ----- i -- - Roof Other: -- - ------ S PART FAIL_ _BIN_G -- - - - --� ---- Post&Beam Undor Slab -----_----.__..__ _-- Rough-In Water Set-vice --- - - --- - Sanitary Sewer Rain Drains -- ---_ _-- - _- - --- Catch Basin/Manhole Storm Drain ----- - - - --- --- Shower Pan Other- Final ther Final — PASS PART FAIL - --- - - - - ---- -- ---- --_. MECHANICAL Post&Beam Rough.In - ---- ---_ - - , Gas I.ine Smoke Dampers Fini I PASS PART FAIL - ------- —._._.. --- ------ --------- ---- - ELECTRICAL Service ----- -- -- -------.--_— Rough-In UG/Slab Low Voltage ---- - - - -- -- -- --------- ---- --- - -- Fire Alam Final LI Reinspection fee of$ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd. PASS PART FAIL SITE lJ Please call for reinspection RE. _ _- - -__---._-_-- Unable to inspect-no access Fire Supply Line r'---� ADA � Approach/Sidewalk Date � _SL _ Inspec#or -_--- Ext---- Other: Final _ DO NOT REMOVE thle Insp4.)0Ior?n record from the job site. PASS PART FAIL i ` ft".*"'IT'Y OF T'IGAR® _ SITE WORK PERMIT nh. DEVELOPMENT SERVICES PERMIT# : SIT2002-00*026 -�_ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED : 1/30/03 SITE ADDRESS: 07455 SW BEVEI_AND RD PARCEL : 2S101AB-01608 SUBDIVISION: HERMOSO PARK ZONING : P✓1UF BLOCK: -- LOT: 019 JURISDICTION : TiG CLASS OF WORK: NEW PAVING ?: Y TYPE OF USE: COMRESO. NO: GRADING ?: N VALUE: 18,000.00 EXCV VOLUME: cy LANDSCAPING?: U FILL VOLUME: cy SITE PREP ?: Y ENG FILL?: N STORM DRAINS?: Y SOILS RPT REQD?: N IMPERV SURFACE: 1,409 sf Remarks: S wt.. wmgK,-f o_b J�tu_-r F g*k.,bejAk*„ Owner: -le Q6M"t0JAL- U6£, WESTERN TIGARD LLC F�e�s FEES DARYL QUICK ption Date Amount PO BOX 2469CLACKAMAS, OR 97G15 LS Pln Rv 10/18/02 $86.44 113UPPLN]Pin Ck-Valu 10/18/02 $140.47 Phone: 50,'3.7()4-3'1'K,,3 [BUILD]Prmt Fee-Valu 2/3/03 $216.10 Contractor: [TAX]8%St Tax-Valu 2/3/03 $17.29 [ERPRMT]Erosion Cntl 2/3/03 PHIL ROSE CO ,ISTRUCTION [ERPLN]Ersn Pick-USA 2/3/03 $80.00 $26.00 17430 SW VIKING ST [F,ROSN]Ersn Pick-COT 2/3/03 ALOHA, OR 97007 [WQUANT]Wtr Quant 1 2/3/Q3 $26.00 $275.00 Phone: 503-649-9559 Total $867.30 Reg#: LIC 99839 Required Inspections Erosion Control Insp 846-8444 CUIvert/Catch Basin Final Inspection 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 worts 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 O1-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-6699. Issued y: I'_= 4Ny►ti_�k_L Permittee Signature: v L � z Call (503) 6394175 by 7:00 P.M. for an inspection needed the next business day I i I 1 SITE WORK PERMIT CHECK LIST Commercial, Multi-Family (R-1 occupancy) and Residential: Please complete all items be5w, unless otherwise noted. Excavation Volume: – -- Cu. yds. Grading Volume: _(Soils report required for>5.000 cu. yds.) L54 cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) (i f� cu. yds. Retaining structure? (Check one) U Rock �J CM LJ !J Concrete IJ Other �J *Total new impervious area includ.ng all buildings, sidewalks, and paving:_ sq. ft. Site Utilities Plumbing Work: Complete the `TAN" Plumbing Permit Application for site utilities plumbing work. Plans Required: See "Site Work Permit App:ication - Plan Submittal Requirements" _attached. The followingmust accompany this application: Site Plan with "Vicinity Map showing *Parking (including :SDA) and ADA compliance Lighting an Grading Plan and details *Landscac�F'lan _ _ Erosion Control Plan and details Soils Re ort if re ulned --- — ---- --- p --(- -9 —) Retaining Structures *Does not apply io 1 and 2-family dwellings. -- ------� --+--- — #of Plans TYPE OF SUBMITTAL Required at (Includes New, Additions or Alterations) Submittal Commercial 4 i Multi.-Family R-1 Occupancy 4 One- & Two-Family Dwelling 4 NOTE: Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans E::arniner 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). is\dsts\for;,s\silecheeklist.das 09/24(01 CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00402 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-41171 DATE ISSUED: 1/'30/03 SITE ADDRESS: 07455 SW BEVELAND RD PARCEL: 2S101AB-01608 SUBDIVISION: HERMOSO PARK ZONING: MUE BLOCK: LOT: 019 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: 2 WATER HEATERS: CATCH BASINS: 1 FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 55 ft WATER CLOSETS: WATER LINE: 55 ft DISHWASHERS: RAIN DRAIN: 55 ft Remarks: S111 To Oor)�EA r :�IF -a C&M MUV-1.gt, u6 t FEES Owner: - --- -' Description Data Amount WESTERN TIGARD LLC DARYL QUICK IPLIIMItI I'e-nit Fee 2/3/03 $228.00 PO BOX 2469 II'I.MI'LNI Pian Rcview 2/3/03 $57.00 CLACKAMAS, OR 97015 I r.,\Xl 8 State Tax 2/103 $18.24 Phone : 503-704-3063 Total $303.24 Contractor: PAUL THE PLUMBER 4005 SW 195TH AVE ALOHA, OR 97007 REQUIRED INSPECTIONS Sewer Inspection Phone : 649-3140 Sewer Inspection Reg#: LIC 124083 Water Line Insp 111 AI 34-3811`13 Storm Drain Insp Storm Drain Insp RP/Backflow Preventer Final Inspection This permit is issued subject to thF 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 Issued'By: '` "Mr1 c4 = � Permittee Signature: ' ==` �— CaF (503)639-4175 by 7:00 P.M. for an inspection needed the next business day i ` Plumbing Permit Application ✓ Date received:T'P 0 Permit no... e a City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 -- City ofTigard phone: (503) 639-4171 ProjecUappl.no.: Expi date: Fax: (503)598-1960 Date issued B Receipt no.: _ Land use approval: _ Case file no.: Payment type: �e U 1 &2 family dwelling or accessory 0 Commercial/industrial U Multi-fanuly U Tenant improv_ment U New construction U Addition/alleration/replacement J Ruud sersiCe J Other: Job,address: Description Qy. Fee ea. Total New I-and 2-family dwellings only: [lldg, no.: — Suite no.: (Includes 1000.for each tit ilityconnection) 'T'ax ma /t x lot/account no.: Z5 S1:R t I)hath -- - P k. SFR(2)bath Lor. r Block: Subdivision: Mti Project name: tea„J ►�5...- c c u t V. t w SFR(3)bath _ City/county: Zl Each additional bath/kitchen Description and location of work on premises: She utilities: Catch basin/area drain _ Drywells/leach line/trench drain Est.date of complcticm/inslxctiun: Footing drain(no.lin.ft.) Manufactured home utilities Business name:Ic1 _— Manholes _ Address: st- L`l _ Rain drain connector _ City _QA&_h,� 1 State: ZIP: Ci.7 007 Sanitary sewer(no.lin.ft.) Phone: Fax: I E-mail: *2 Stora)sewer(no.lin.ft.) CCB no.: c Plumb.bus.reg.no Water service(no.lin.ft.) Fixture or Hem: City/metro tic.no.: A _- Absorption valve Contractor's resentative signature: Back flow reventer _ _ — Print name. n Date: - O Backwater valve Basins/lavatory Narne: �,�Eo � [� N,]ti�t2/� Clothes washer — Dishwasher _ Address: K o P x %_ Drinking fountain(s) City: U-% State: ZIP O t5` Ejectors/sum Phone: la'y` o4 566S Fax: I 1 E-mail: Expansion tank Fixture/sewer cap _ Name(print): Floor drains/floor sinks/hub _ I JCI�w Q,, 1 U yrcnd 1 PIU�l Garbage disposal MaHose Bibb City: �Svrv� State: ZIP: tUtS'" Ice maker Phone: ' _ Fax: h e Cf E-mail: Irterce for/grease trap —_ owner installation/resid utial maintenance only: The actual installation Primer(s) _ will be made by or the nintenance and repair made by my regular Roof drain(commercial) employee on eropewn as per ORS Chapter 447. Sink(s),basin(s),lays(s) _ Owner's si amt. C�% ' �- Date: Sum Tubs/shower/shower pan Urinal Name: Water closet ress: AddWater heater City:U��z State: ZIP: � c �S" _ Other: Phone: s._ I Fax: _ E-mail: ----- Total _ Minimum fee................$ —� Not all)uridicNnne accept credit card-,plearc cell)urixdkdon for more infanmtinn. Nonce:This permit application Plan review(a[ %) $ ❑vi+e O MastuCard expires if a permit is not obtained Exp8968 Credit card number: _—_—__— within 180 days after it has been State surehsurcharge(( )....$ _ rce ---- Name or cartMrolder o dawn oo aedlt certl T accepted as complete. TOTAL ......................$ $ _ ----CardMdrkc rianaturt ,_ Amount 440-4616(6MCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: �� FIXTURES individual CITY eat_ AMOUNT (includes all plumbing fixtures In PI RICE TOTAL 1 Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT 6.60 for each u!IIIV connections 1 Lavatory One 1 bath — $249.20 -rub or Tub/Shower Comb. 16.60 Two 2 bath $350.00 Shower Only 16.60 Three(3)bath_ $399.00 - _ --- Water Closet — 16.60 SUBTOTAL _ Urinal — 1660 — _8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL - - 16 60 TOTAL -- - _ Garbage Disposal _ Laundry Tray 16.60 Washing Machine v 16.60 iloorDrain/Floor Sink z' - 16.66 - PLEASE COMPLETE: 3" 1660 _—Quantity b Work Performed__ Water Heater O conversion O like kind 16.60 Fixture Type: New Moved Replaced Removed/ Gas piping re quires a separate mechanical Capped permits_ -_.— MFG Home'law Water Semico 46,40 Sink _ Lavato MFG Home fvew San/Storm Sewer 46.40 - - Tub or Tub/Shower Hose nibs — 16 60 Combination Roof Drains — 16.60 Shower Only -- - 16.60 Water Closet Drinking FounWln _�- Urinal -_.-- Other Fixtures(Specify) - 16.60 Dishwasher - - _ - -Garbage Disposal Laund Room Tr2j WasMachine Floorr Drain/Sink: 2" Sower-1st 100' 55.00 3° Sewer-each additional 100' —4640 ^— 4" ---_ Water Service-1st 100' 55.00 s5 co _Water Heater __ Other Fixtures Water Service-ea,:h additional 200' 46.40 Storm 8 Raln Drain•1st 100' — 55.00 Storrn 8 Rafn Draln-each additional 100' 46.40 --- ---- Commerclal Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 1660 (�.to C — Inspection of Existing Plumbing or Specially 6250- Requested!!LcE�ctions pe,fnr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 _ - Grease Traps 16.60 - - QUANTITY TOTAL T __— Isometric or riser diagram is required if t]uantit Total Is >9 "SUBTOTAL -- 8%STATE SURCHARGE "'PLAN REVIEW0/60F SUBTOTAL Reqrired onl ly t fixture qty total isy9 —_ J TOTAL E D; *Minimum permit fee is w725o•8%state surcharge,except Residential sarkflnw Prevention Device,whir a$sa 25 f 8%state surcharge "*All New Commerclai swidings require 2 sad of plans with Isometric or riser diagram for plan review. I\dsls\formstpim-fees.doc 12/26/01 i i I I __ CITYOF TIGARD BUILDING PERMIT PERMIT#: BUP2002-00363 DEVELOPMENT SERVICES DATE ISSUED: 1/30/03 13125 SW Hall Blvd. Ti and a , OR 97223 (503) 639-4171 PARC • 2 7 EL. S101AB 01608 SITE ADDRESS: 0 45,5 SW BEVELAND RU SUBDIVISION: HERMOSO PARK - ZONING: MUE BLOCK: LOT: 019 JURISDICTION: TIG REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: 1,288 sf N: S: E: W: TYPE OF USE: COM SECOND: 1,288 sf _ PROJECT OPENINGS? _ TYPE OF CONST: 5N sf N_ S: E: W: OCCUPANCY GRP: B TOTAL AREA: 2,576 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 20 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: Y MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGH"r: ft FIR SPKL: N SMOK DET:N DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDI(;P ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING: VALUE: $ 50,000.00 Remarks: Cat44tAT 4iG" Owner: Contractor: WESTERN TIGARD LLC PHIL ROSE CONSTRUCTION PO BOX 2469 17430 SW VIKING ST CLACKAMAS, OR 97015 ALOHA, OR 97007 Phone: 503-628-8508 Phone: 503-24.4-6629 Reg #: 1303-659-g909339 FEES 503g q- 6N_E_D INSPECTIONS Description Date Amount Framing Insp 111UPI11,N) Pin Rv 8/26/02 $306.02 Roof naiing Insp [FLS] FLS Pin Rv 8/26/02 $188.32 Shear Wall nso Gyp Board Inca (BUILD]Permit Fee 2/3/03 $470.80 Final Inspection [TAXI R State Tax 2/3/03 $37.66 (additional fees not listed here) Total $1,252.80 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 accordanoe, with approved plans. This permit will expire if work is not started within 180 days of issuance, or if worm is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopteJ by the Oregon LRility 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 questions to OUNC by calling (50�1-746-6699 or 1-800-332-2344. Issuersy: -,a t Permit tee Signatnrp �~ (a-�) -------- -- Call 639-4175 by 7 p.m. for an inspection the next business day f Building Permit Application � City of Tigard Date received: S�' �/ p- Permt ng.p b r;a G Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: City of%igurd Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503)598-1960 _ Case file no.: Payment type: Land use approval: DD,:- UOC)CX� 1&2 family:Simple Complex: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Addition/alteration/replaceinent U Tenant improvement U Fire sprinkler/alarm U Other: .1011 SITE 1 1 Job address: y s C�yUC'LIc}�! r _ Bldg.no.: Suite no.: Lot: Block: Subdivision: _ Tax map'tax lot/account no.: Project name: — - — Descripgon and location of war on premises/special conditions: k(S T'(K C. _int S. rTfLlw tµ� Name: P Ast_yG I L k Mailing address: 1 &2 family dweWng: City: State: ZIP: Valuation of work Phone: Fax:-- E-mail: _ ........................................ $ No.of bedrooms/baths....................... _ -- i Owner's representative: Total number of floors Pttonc^----- Fax: - is-mail: New w ( ........................... dwellingarea sq.ft.) .......................... UVAI Garage/carport area(sq.ft.)......................... Name: P41 t v E Covered porch area(s ft.) q. -- --- Mailing address: e, Ale, tetra Deck area(sq.ft.) ........................................ City: _ State: Z Other structure area(sq.ft.)......................... Phone: Fax E-mail: CommerelaUlndustrlaUmulti-family: alp Valuation of work........................................ $ -t—!—— Business name: l_ C Existing bldg,arca(sq. ft.) .......................... Address: u .SW l kl G T New bldg.area(sq. ft.)................................ City: Q t=1�V'W1-'t7) State: 62, ZIP: l op- Number of stories........................................ _ Phone: Fax: q-g; Type of construction.................................... to`�Q'41 S` c1 E-mail: Occupancy group(s): Existing: CCB no.: ��g ,�_ _ __-- --_ New: City/metro tic.no.: Notice:All contractors and subcontractors are required to he r licensed with the Oregon Construction Contractors Board under Name: (, v>r U A-rU K provisions of ORS 701 and may be required to be licensed in the Address: c( jurisdiction where work is being performed.If the applicant is City: Z 'A-AVJ -4 tate:G2. ZIP: q'1 exempt from licen-ing,the following reason applies: Contact person: VF Plan no.: — Phone:2 _ 2 Fax: E-mail: -� Name:R(:yCM KlAotA. Contact person: Fees due �ih.(o. I� � upon application ........................... $ Address} () )A4� G"V VL' k tk<• Date received: City:AA.I State: ZIP: Amount received ......................................... $ _ Phone: q' ( I Fax: .. -qrl( I E-mail: Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit cards,please call Jurisdiction for more information attached checklist.All provilions of laws and ordinances governing this U Visa U Mastercard work will he complied with;wActher specified herein or not. Credo card number: V Expires Authorized signature:_ _- Date: _ 0 Z-� Name o(carxFolder as shown on credit card Print name:,_ T' katt_. '(Zo 5E cardholder alprnwe --- S Amount Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-461 a(6ffiWoM) rl-� 3aU C 1 F�5 )3: "9 ,, `� January 28, 2003 r ' Dave Norton CITY OF TIGARD 11321 SW 6`h Ave. Portland, OR 97219 OREGON Re: Daryl (wick Office Conversion Occupancy: B 7455 SW Beveland Construction Type: BUP2002-00363 Occupant Load: 2.0 Stories: 1 w/basement I Dear Mr. Norton, The City of Tigard Building Division has performed a plan review for the above referenced project. This review was performed under the provisions of the State of Oregon Structural Specialty Code (OSSC), 1998 edition and the Uniform Fire Code (UFC) as amended by Tualatin Valley Fire & Rescue. The plans are approved subject to the following conditions. 1. Two exits are required from the basement level and are required to be identified with exits signs with graphics in accordance with OSSC 1003.2.8.3. Signs shall be internally or externally illuminated and have a power source in accordance with OSSC 1003.2.8.4 and 1003.2.8.5. 2. Inspections by the City of Tigard are required fur the structural upgrade submitted by Benchmark Engineering prior to covering any such portion of the work. 3. Handrails shall be provided on at least one side of the stairways not less than 34 inches or more than 38 inches above the nosing of the treads. Handrails shall extend at least 12 inches bp,c;id the top and bottom risers. OSSC 1003.3.3.6. 4. Provide a minimum 2A,10BC fire extinguisher for each floor in accordance with UFC Standard 10-1. 5. A copy of the approved plan shall be kept on the site and made available to the City of Tigard inspectors for inspection purposes. 6. A final inspection and certificate of occupancy is required prior to the intended use of the structure Sincerely. Gary ?ampella Building Official C. Hap Watkins, Supervising Inspector File 13125 SW Hall Blvd., Tlgard, OR 9722.3 (503)639-1171 TDD(503)684-2772 Commercial Plan Submittal Requirement Matrix City of Tigard 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* 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" technicians. I:\dsts\forms\GCM-matrix.doc 9/24!01 - wwanww+w�MM Y�wiitw+irr..+.w,,..,._........,n,....,.....r.w.w.w.ulYWWgWr+wast.c+.:.•.wNM.u�rur....... ..w...w............ September 4 2002 ,— a 7 CITY OF TIGARD Dave Norton "�. 11321 SW Viking St. OREGON Portland.OR.97007 RF,: 7455 SW Beveland Tigard, Or. The City of Tigard Building Division has reviewed the submitted building plans for the above referenced address in accordance with the Oregon Structural Specialty Code (OSSC), 1998 edition and the 1999 Uniform Fire ('ode as amended by'rVFR. Plans have been submitted and reviewed for a change of occupancy permit to convert a residential home (R3) into a Doctors office(B occupancy). The following items need to be addressed. 1) Current structure meets the definition of a two-story structure. First floor is elevated greater than 4 feet above grade fir more than 50%of the perimeter. Second story has an occupant load greater than ten, (10)and reuuires two means of egress. Plans show a back door out the kitchen and a staircase to the together. I'.xits shall be separ be minimum 36"x 80". ` s shall not pass 2) Required exi ll t ha 3) Providr fire extinguishers pr 4) Plans show a new enclosure provide combustion air to th Plans show two handicap restro Are both restrooms existing anc comparison. Please submit revised plans slit) If you � ve any questions regar Since el !)t lugs Plans Fxaminer CC: file of Post-it Fax Note 7671 ag }— Date �� pages To � From Co.iDept —(1[��T — Co Phone M Phone a V10- Fax n�� Fax a 1312.5 SW Hail Blvd., Tlgard, OR 97223(503)639-4171 TDD (503)684-2772 ----- —� .H',':\:.Yf Y6iriY1+r6alW1YiYYMYYWWLY6r,�Yw—.... rrwrr r..wlr•.-....-... ._. _..,,. • September 4, 2002 -� Y OF -nGAR CRD Dave Norton 11321 SW Viking St. OREGON Portland,OR.97007 RE: 7455 SW fieveland 'Tigard. Or. i The City of'Tigard liuilding Division has reviewed the submitted building plans for the above referenced address in accordance with the Oregon Structural Specialty Code (OSS('), 1998 edition and the 1999 Unilbrm Fire Code as amended by TVFR. Plans have been submitted ;and reviewed for a change of occupancy permit to convert a residential home(R S) into a Doctors office (13 occupancy). The following items need to be addressed. 1) Current structure meets the definition of a two-story structure. First floor is elevated greater than 4 feet above grade 16r more than 50% of the perimeter. Second story has an occupant load greater than ten, (10) and requires two means of egress. Plans show a back door out the kitchen and a staircase to the first floor, the staircase location rind the exit are too close together. Exits shall he separated a minimum ofhalfthe diagonal (28 feet). Exit doors shall he minimum 36"x 80". 2) Required exits shall not pass through kitchens. 1) Provide fire extinguishers per floor, near the exits. 4) Plans show a new enclosure around the water heater, and furnace, please show how you will provide combustion air to these appliances. Plans show two handicap restrooms on the first floor with an occupant that only requires one. Are both restrooms existing and we are just relocating a wall? Please provide existing plan for comparison. Please submit revised plans showing compliance with codes. If yo ve any questions regarding this review, please contact me at (503) 369-4171 ext. 2436 Since el Da Jo es Plans Examiner CC: File nt Post-it Fax Note 7671 NIvz Toi Fro Co Dept Cn Phone q Phone q Fax p —Q-- F� — L_/ 13125 SV/Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503)684-2772 l a SEWER CONNECTION PERMIT CITY OF TIGARQ - --- DEVELOPMENT SERVICES PERMIT#: SVVR2003-00006 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 1/8/03 PARCEL: 2S 101 AB-01608 SITE ADDRESS; 07455 SW BEVELAND RD SUBDIVISION: I IFRMO SO PARK ZONING: MUi: BLOCK: LOT: 019 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection. Reimbursement district#15 paid. Owner: — - FEES _ WESTERN TIGARD LLC Description Date Amount DARYL QUICK -- -- — PO BOX 2469 1SWUSA]Swr Connect 1/8/03 $2,300.00 CLACKAMAS, OR 9'7015 1SWI ISA I Swr Ccmncct 1/8/03 $0.00 Phone: 5113-704-31163 1SWINSPI Swr Inspect 1/8/03 $35.00 iSWINSP] Swr Inspect 1/8/03 $0.00 Contractor: --- --- -- Total $2,335.00 Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total arnount paid will be forfeited if the permit expires. The Agency does not 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 2. Permittee Signature: Issued by: ��- __ Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day _a--_&-enWLAp lication div ) Plumbing Permit No.: Planning Aovro•,al Sewer City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review other Tigard,Oregon 97223 Date/By _ Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 I?ate/By: Case No: Post-Review Land Ilse Internet: www.ci.tiga`d.or.„s Contact Juris.: See Page I for 24-hour Inspection Reyu,;st: 503-6394175 Name/Method: Supplemental Information. TYPE OF WORK FEE*SCIIEDULE(for special information use checklist) New construction Demolition. Description Qh. Frc(ca.) Tutal i. New 1-&2-family dwellings Addition/alteration/replacement ❑Other: includes 100 ft.for each utility connection CATEGORY OF CONSTRUCTION SFR(1)bath M249.201 &2-Family dwelling _(Commercial/Industrial SFR(2)bath RAcccssory Buildin* [ Multi-Family SFR 3 bath Master Builder Other: Each additional bath/kitchen JOB SITE INFORMATION and LOCATION Fires rinklcr-s .ft.: Site Utilities Job siteo address: Suite tBld ./A tp #• Catch ba^in/arca drain 16.60 Dr well/leach line/trench drain _ 16.60 Pro'ec� t Name: Footing drain(no.lineal ft _ Page 2 Cross street/Directions to job site: Manufa-ured home utilities 110.00 Manholes 16.60 — Rain drain connector 16.60 Sanitary sewer no.linear ft. _ Pae 2 Subdivision: — Lot#: wft Storm seer(nu.linear . Pa e 2 --� Water service no.!incar fi. Tax map/parcel#: _ Fixture or Item _ DESCRIPTION OF WORK _— Absotion valve 16.60 _Backflow prevcnter Page 2 Backwater valve 16.60 — T -- ---- Clothes washer 16.60 __— --.------- ----- — Dishwasher 16.60 __ __ __ Urinkin fountain 16.60 PROPERTY WNER T ANT r Ejectors/sump _ 16.60 Name: I ___ Expansion tank 16.60 Address: S Fixture/sewer cap 16.60 Floor drain/floor sink/hub 16.60 -- Cit /State/Zl Garbage alis osal _ 16.60 — Phone. _ Fax: _ Hose bib _ 16.60 PPLICANT _ CONTACT_P_ER_ SON Ice maker 16.60 Name: - Interceptor/grease tra 16.60 —f Medical gas-value: 5 Page 2 Address: a -'`� In”] — Primer _ 16.60 _ �City/State/Zlp: Roof drain cottvnerC!91 _ 16.60 Phone: t77�3_ _� Fax: _ Sink/basin/lavatory 16.60 Tub/shower/shower pan 16.60 E-mail: 16.60 CONTRACTOR Urinal -- _---- Water closet 16.60 Business Nanie: 1 _ — Water heater _ 16.60 Address: ^ other. — Cit /State/Zi ------_—__-. _ Others �777_ aX: _ Plumbin Permit Fees* Phone: __.________� — sub;utal 5 CCB Lie #: umb. Lic.#�_ Minimum Permit Fee$72.50 S Authorized Residential Backflow Minimum Fee$36.25 Signature: _ _._._ _ Date: Plan Review(25%of Permit Fee) 5 State_Surcharge S%of Permit Fee 5 ------ _ — (Please print name) _ _ TOTAL PERMIT F_EE LS _. Notice: This permit app'!•ation expires If a permit Is not obtained within All new commercial buildings require 2 sets of plans with isometric or Igo de,}x aflrr it has been accepted as complete. riser diagram for pian review. *Fee methodology set by Tri-Count; Building Industry Service Board. is\Osla\Permit Forma\PlmPermit.�pp.doc 01/03 Plu.mbinp.Permit_Apilicatiot� - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential FireSur ression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: tooting drain-I"100' 55.00 0 to 2 000 $i 15.00 _ Footing drain-each additional 100' 46.40 2,001 to 3,600 -_ $160.00 _ 3,601 to 7,200_ _ $220.00 Sewer- Ist 100' 55.00 7,201 and greater $309.00 Sewer-each additional 100' 46.40 Water Service-Ist I(V 55.00 Medical Cas Systems' _ Water Service-each additional 100' 46.40 Valuation: _ I Permit Fee: Storm&Rain Drain-Ist 100' 55.00 $1.00 to$5,000. Minimum fee$72.50 Stom.&Rain Drain-each additional 100' 46.40 S51O01.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.51 for each additional 5100.00 or fraction thereof,to and Mixture or Item Qty. Fee(ea) Total including$10,000.00. Commercial Back Flow Prevention Device 4040 $10,001.00 to$25,000.00 5148.50 for the first$10,000,00 and 51.54 for Resi lentioi Backflow Prevention Device each additional$100.00 or fraction thereof,to (minimum permit fce$36.25 27.5.5 and including$25,000.00 Rain Drain,single family dwelling 65.25 525,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof,to Inspection of existing plumbing or and including 550,000.00. specially requested inspections er hour -72.50 _ S50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping, nerving or replacing existing fixtures? If "yes",please indicate work perforated by fixture. I allure to accurateiv report fixtures could result in increased sever fees*. - - uanllt b Fixture Work Perfnrin"l Comments regarding fixture work: Fixture Type: Replace _New Ninved Exlxtln __Carped Baptistry/Font - Both -Tub/Shower _ -Jacuzzi/Whirl pool _ (Car Wash -Each Sm11 - -Drive Thru _ --- Cuspid or/Watot Aspirator _ Dishwasher -Commercial - ----- -Domestic Drinking Fountain Eye Wash -- Floor Drain/sink 2" _ 3„ -- Car Wash Drain -- *Note: If the fixture work under this permit results in :ul Garbage -DorrlestiC Disposal -Commercial _ increase of se « aa seer EDUs,a sewer permit ill be isscd nd Industrial fees assessed for the sewer Increase must be paid before the Ice Mach./Refri .Drains plurlibing per'n11t can be issued. Oil Separator Gas Station) Rec.Vehicle Dump Station Shower -Gang _ _ -Stall _ Sink -Bar/Lavatory -Bradley -Commercial -Service Swimming Pool Filter _ Washer-Clothes _ Water Extractor Water Closet-Toilet _ Urinal_ _ Other Fixtures: _ __ i:\Dob\PermitFonm\PlmPermitAppPg2.doc 01/03 ELECTRICAL PERMIT CITY OF TIGARD PERMIT#: ELC2002-00410 DEVELOPMENT SERVICES DATE ISSUED: 1/30/03 13'!25 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S101AB 01608 SITE ADDRESS: 07455 SW BEVELAND RQ ZONING: MUE SUBDIVISION: HERMOSO PARK LOT: 019 JURISDICTION: TIC BLOCK: Project Description: CCr 4LAr-,6f vVt�.ft-ro 04HNegGNi 1151- ^— _ RESIDENTIAL UNIT TEMP SRVC/FEEDERS __MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: SIGNIOUT LINE LTG: EACH ADD'L.500SF: 201 - 400 amp: LIMITED ENERGY: 401 - 600 amp: OR LABEL 0 L: MANF HM/SVC/FDR: 601+amps -1000 volts: MINOR LABEL T.I _ SERVICE/FEEDER _ BRANCH CIRCUITS ADD'L INSPECTIONS W/SERVICE OR FEEDER: PER INSPECTION: 0 - 200 amp: 1 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L.BRNCH CIRC: IN PLANT: PLAA REVIEW SECTION 601 - 1000 amp: - >600 VOLT NOMINAL: 1000+amp/volt: >=4 RES UNITS: Reconnect vo SVCIFDR>=225 AMPS: CLASS AREA/SPEC OCC: _ Yom_. Owner: Contractor: WESTERN TIGARD LLC ECONO ELECTRIC PO BOX 2469 5420 N MICHIGAN AVF CLACKAMAS.OR 97015 PORT LAND,OR 97217 Phone: 503-62.8-8508 Phone: 735-4705 Reg#: LIC 67212 ELF. 34-195C FEES SUP 21465 Description Date Arnount Required Inspections IELPRM•l'j ELCPermit $93.60 �yii $'7.49 Elect'I Service [TAX]R-S State Tax - Rough-in Total $101.09 Elect'I Final This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 riot started within 180 days of issuance,or 4 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 it R 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rides or direct questions to OUNC at(503)246-6699 or 1- -332-2344. IQI_ ued By: a/ ___ Permit Signature: � rc tc.lF _ OWNER INSTALLATION ONLY -- The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATtON SIGNATURE OF SUPR. ELEC'N: -�+°�� DATE:-- LICENSE NO: — Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application "Datercceived: / Permit n�� die i , City of Tigard Project/appl.no.: Expire date: Cityof Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: ❑ I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement U New construction U Ad(lition/alteration/rcplarcmt•nl U Other: U Partial J09SITEINF-611MATION Job address: ,? y 5T St4i C-,f.L,, k31dg. no.: Suite no.: Tax map/tax I(Taccount no.: Lot: 131ock: Subdivision: --- Pro act name: Description and location of work on premises: _ Estimated date of com letion/ins eciion: — 1 Job no: Business name: 4t-C&f46 LL ts:-t _ Description Qty. (ea.) 'total no.fusp - - NervmAdc-inial-sipgleormullifamilyper Address: N _ dNclling rill.Inclutirs attached garage. City: v) IMate:6it, I'LIP: -LI-7 %enicclnclnded: Phone: I E-mail: 1000 sq it.or less 4 CCB no.: Elec.bus.lie.no: Each additional 500 sq.ft.or portion thereof Z. Limited energy,residential 2 City/metro lie.no.: Wt 11VM5 Limited energy,non-residential 2 Each manufactured home or modular dwelling Signature of supervising electrician(required) Date Service and/or feeder 2 Su elect.name((print): Services or feeders-installation, P• P License na: alteration or relocation: 200 amps or less �� 2 Name(print): DtwL 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: State: ZIP: Over 1000 amps or volts 2 Phone: Fax: E-mail: Reconnect only — 1`— Owner installation:The installation is being made on property 1 own Temporary services orfeeders- which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation: ORS 447,455,479,670,701. _200 amps or less 201 amps to 400 amps — - Owner's signature: Date: 401 to 600 amps — --- — — --— Branch circuits-new,alteration, — Name: or extension per panel: --- A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 12 City: T Stale: 1P., B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: Phone: I n° r-mail: _ _ Each additional branch circuit: Mlsc.(Service or feeder not Included): U Service over 225 amp!.(ommereial U I lealrh care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous location Foch sign or outline lighting 2 familydwellings U Building over 10,000 square feet four or Signal circuit(a)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,orextension• 2 U Building over three stories U Feeders,400 amps or more •Ucscri non: _ U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the alcove: U Egress/lightingplan U Other: Per inspection Subsalt—_sets of plant with any of the above. Investigation fee r-T I— The above are not appllc�.ble to temporary construction service. Other Not all jurisdictions rccepr credo camfi,please call jurisdiction for more Inrormation. Notice:This permit application Permit fee.....................$ _ t7 U Visa U Master:udfres p it'a permit is not obtained Plan review(at — %) $ ex Credit card number.—_ within ISO days ager it has been State surcharge(8%)....$ 7•� t x re' accepted as complete. TOTAL $ D NW4--of cardholder as shown on credit card S Cardholdr r ilptanae — Amount 440-4615(fiMCOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEE:. : 1 TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service Included: Items Cost Total Check hype of Work Involved: Residential-per unit 1000 sq ft.or less $145.15 4 Audio and Stereo Systems' Each additional 500 sq.ft.or portion thereof $33.40 1 ❑ Burglar Alarm Linflied Energy $75.00 Each Manuf'd Home or Modular Garage Door Opener' Dwelling Service or Feeder $90.90 _ 2 Services or Feeders C7 Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $80.30 2 Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps _ _ $160.60 _ _ 2 __j601 amps to 1000 amps $240.60 2 Over 1000 amps or volts _ $454.65 2 Reconnect only $66.85_ 2 Temporary t o or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Fee for each system.......................................................... $75.00 Installation,alteration,or relocation 200 amps or less $66 85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $13375 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see"b"above. Audio and Stereo Systems I Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)The fee for branch circuits wl(h purchase of service or ❑ Clock Systems feeder fee. t�I Each branch circuit Y $6.65 _ 2 L 1 Data Telecommunication Installation b)The fee for branch circuits wrthern purchase of service (�] Fire Alarm Installation or feeder foe. F irst branch circuit _ $46.85 HVAC Each additional branch circuit $6.65 _� ❑ Miscellaneous ❑ Instrumentation (Service or feeder not Included) Fach pump or Irrigation circle $53.40 ❑ Intercom and Paging Systems Fach sign or outline lighting $53.40 Signal ciroiit(s)or a limited energy panel,alteration or extension _ $7500 U Landscape rrigation Control. Minor Labels('10) _ $125.00 Each additional Inspection over F-1 Meo cal the allowable in any of the above Nurse Calls Per inspection $62 5U Per hour $62.50 __ In Plant $73.75 �- _ ❑ Outdoor Landscape Lighting' Fees: Protective Signalinq Enter total of above fees $ -_ r Other 8%State Surcharge $ —_ Number of Systems 25%Plan Review Fee No licenses are required Licenses are requirnJ for all other Installations See"Plan Review"section on $ front of application Fees: Total Balance Due $ Enter total of above tees ❑ Trust Account#___.____ _-..- F%State Surcharge S_ '— Total Balance Due $All New Commercial Buildings require 2 sets of plans. i ldstsVbrnu\cic-fees.doc 08/30/01 CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2002-00365 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/30/03 PARCEL: 2 S 101 AB-01608 SITE ADDRESS: 07455 SW BEVELAND RD SUBDIVISION: HERMOSO PARK ZONING: MUE BLOCK: LOT: 019 JURISDICTION: 1IG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VEN r FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: 1 BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 • 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTL,: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: C�o0tok, ,rokD of,4r l��e,Dt�cE n2 Owner: CcH FEES WESTERN TIGARD LLC Description Date Amount PO BOX 2469 _ -- iMl�( III Permx it I� 2/3/03 $72.50 CLACKAMAS, OR 97015 ITAX 8°,,StateTax 2/3/03 $5.80 Phone: 501-628-4508Total $78.30— — Contractor: B +S HEATING 67396 CRANEIBUCHANAN RD BURNS. OR 97720 REQUIRED INSPECTIONS Phone: 503-250-0558 Mechanical lnsp Final Inspection Reg#: LIC 45838 This permit is issued subject to the roqulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All wo 1' will be done in accordance with approved plans. This permit will expire it work is not started within 180 days of issuan .e, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted i„ the Oregon Utility Notifica'ion Center. Those rules are set forth in OAR 952-001-00 Issued y: f� � Permittee Signature: Call (503) 639-4175 by 7:00 P.M.for inspections needed the next business day MechanicalPermit Application --- Date received: City of Tigard Project/appl.no.; Expiredatc: City ofTrgard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: — Phone: (503) 639-4171 Fax: (503) 599-1960 Case file no.: Payment type:_ Land use approval: S D/Z X001--Oct OC}9 Building permit no all W 7.U &2w cfamily dwelling or accessory U('omnuercial/industrial U Multi-family U Tenant improvemrnl onstruction U Add ition/alteration/ieplaccnicnt U Other:_- ---- - t � t Job address: EVE%c.+�tvt 0 'T j&# O A?, Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: value of all mechar teal materials,equipment,labor,overhead, Suite no.: i profit. Value$ Tax map/tax lot/account no.: _ Lot: Block: Subdivision: *See checklist liar important application information and Project name: _ jurisdiction's fee schedule for residential permit fee. I � I City/county: tA/l L7.IP: Description and location of work on premises: IK41,74 IVA I N A IWAI kil 110A I AI Fee(ea.) Total F.st.date of completion/inspcetion: Ikscriplion (ply. Rts.onh Rts.only Tenant impro,,emcnt or change of use: Air handling unit = CFM Is existing space heated or conditioned?Q(Yes U No it con itioning(site plan—required,) Is existing space insulated?Q4 Yes U Notetati no of existingT7iVACsystem Mir/compressors S State boiler permit no.: Business name: HP Tons BTU/N Address Gw 9 #&}-— j_ Fir smo a amper, t sr oo sec -e electors City: klk-�)5 00-N cat pump(�itc p an requu•e ) Install/replace urnace/nurner---gFUJft- PonFax: E-mail: h $ Including ductwork/vent liner U Yes U No _ CCB no.: y�cp SX nsta I/rep ac re ocate eaters-suspense , City/met tic.no.: — wall,or floor mounted _- ant ora lance other than furnace Name(please print): —� a C 5 e prAt on: Absorption units-.-- BTU/H Chillers HP — — — --.. Com ressors— HP Address: 1 -7 y�jU ,LT) � amenia exhaust an ventilation: City: t State:(�`' ZIP:' `� Appliancevent -_ Phone: - ''15 Fax: c.tj 3 E-mail• Drycrex aust oo s,Type If I 1fres. its en nzmat hood fire suppression system --- - Name: (✓ Q"�(L k Exhaust fan with single duct(bath fans) — -F taunt s stem a art Coro isatin or AC Mailing address: :see pip nK an diorlblation(lip to out ets) City: State: I ZIP: Type: ---1,T6 NG Oil Phone: Fax: E-mail: sec .i in each addition over 4 outlets s rocessp rtng(schematicrequire ) _ Number of mullets Name: OtTiei stet app ance or eq— ment: Address: Decorative f irepince City: ----- =s Ta ZIP: nsert- type -- _ — oo stov pe et stove Phone: Fa E-mail: Utl-icr: Applicant's signature: �- Y_ Date: Name(print): X41 L- P-S — Permit fee.....................$ _ — Not all)utiufictims accept credit ends,please call luriuhction for mnm infonnmim Notice:This permit application Minimum fee................$ U Visa U MasterCard expires ifs permit is not obtained Plan review(at ".� `�) $ Credit card ntunher: -------- % within ISO days after it has been — C- p State surcharge(996) ....$ tete.aCCd Near•of cardholder u a awn o�c t cent ted BS complete.p TOTAL ........... .........$ Ca $ ---- Cardholder aiRnatrne - Amount 440-4611(NOO/COM) i MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 _Minimum fee$72.50 Table 1A Mechanical Code _ Qty (Fa) Amt $5,001.00 to$10,000.00 $72.50 for the first$5.000.00 and 1) Furnace to 100,000 F3'fU $1.52 for each additional$100.00 or -including ducts 8 vents 14.00 fraction thereof,to and including 2) Furnace 100,000 BTU+ _ $10,000.00. including ducts 8 vents _ 17.40 $10,001.00 to$25.000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace 14.00 $1.54 for each additional$100.00 or _including vent _ fraction thereof,to and including 4) Suspended heater,wall heater $25,000.00. or floor mounted heater _ _ _ 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and including 6) Repair units _ $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond _ fraction thereof, footnotes below. Comp •' Minimum Permit Fee$72.50 SUBTOTAL: 7)<31-113;absorb unit s to 100K BTU 14.00 8•/.State Surcharge a 8)3-15 HP;absorb 25.60 unit 100k to 500k BTU -30 25%Plan Review Fee(of subtotal) a 9)unit .5-1 HP;absorb _ Required for ALL commercial permits only .5-1 mil BTU 35.00 TOTAL COMMERCIAL PERMIT FEE: $ unit 301.7 mil absorb 52.20 unit 1-1.75 mil BTU 11)>50HP;absorb unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: - 12)Air handling unit to 10,000 CFM 10.00 Value Total 13)Air handling unit 10,000 CFM$ Description Qt (Ea) Amount 17.20 Furnace to 100,000 BTU,including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace> 100,000 BTU Including 1.170 15)Vent fan connected to a single duct ducts&vents 6.80 _ Floor furnace Including vent _955_ 16)Ventilation system not included in Suspended heater,wall heater or 955 appliance permit 10.00 floor mounted heater -- 17)Hood served by mechanical exhaust Vent not Included In appliance 445 10.00 permit 18)Domestic incinerators Re air units _ 805 _ 17.40 <3 hp;absorb.unit, 955 19)Commercial or Industrial type incinerator to 100k BTU 69.95 3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 101k to 500k BTU 10.00 _ 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil.BTU _ Air handling unit to 10,000 cfm 656 - 8%State Surcharge $ Air handling unit>10,000 cfm 1,170 Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system net Included In 656 app Ilance ermit Hood served by mechanical exhaust 656 Other Inspections and Peed: 1 170 1 Inspections outside of normal business hours(minimum charge-two hours) Domestic Incinerator $82.50 per hour. Commercial or Industrial Incinerator 4,590 _ 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour) Other unit,Including wood stoves, 656 $62.50 per hour Inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas piping 1 4 UUUets 360 _ charge-one-half hour)$82.50 per hour Each additional outlet 63 - ---- 'State Contractor Boiler Certification required for units>200k BTU. TOTAL COMMERCIAL ''Residential A/C requires site plan showing placement of unit. VALUATION: _ All New Commercial Buildings require 2 sets of plans. 1:\dsts\forms\me ch-fees.doc 02/11/02 .►4w.ra W.MYr ww.Y�r..�•.. -� CITY OF TIGARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: S 01103 00046 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 1/330103 NARCE L: 2S 101 AB-01608 SITE ADDRESS; 07455 SW BEVEL.AND RD SUBDIVISION: IIt.RMOSOI'ARK ZONING: N11IF BLOCK: IAT: IIID JURISDICTION: 11c1_ TENANT NAME: WESTERN PSYCHOLOGICAL_ SERVICES USA NO: FIXTURE UNITS: 17 CLASS OF WORK: NEW DWELLING UNITS. TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: 1.1 £nti �acA�.R6L• PRtJiomc,tY feSeti A* 14 F,xruQt: 'JRcetEs rok R w Qes,nE�J�f.. Conldark Tb doNNE��.fii u5f. /7 Natohxru t-4h1.BEs AOL 4A" 61rnL or IbF,xM4f 44LutS Owner: _ FEES WESTERN TIGARD LI-C Description Date Amount PO BOX 2469 - CLACKAMAS, OR 97015 1SWUSA) Swr Connect 2/3/03 $2,530.00 1 SWUSAJ Swr Connect 2/3/03 $0.00 Phone: 503-628-8508 Total $2,530.00 Contractor: Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not 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 put chase a "Tap and Side Sewer" Perm Iss d by: �Q � Permittee Signature: — s ness da Call (503) 639-4175 by 7:00 P.M.for an inspection needed the next bu y Accumulative Sewer Tally TenanLName: Western Psychological Services _ This SWRA2003-00046 Site Address: 7455 SW Beveland St This PLM# 2002-00333 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off#s count # value #s values Baptisery/Fant 4 0 0 0 0 A0 Bath-Tub/Shower _ 4_ 0 0 1 4 1 4 -Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash-Each Stall 6 _ 0 0 0 0 0 - Drive through 16 0 0 _ 0 0 _U_ Cuspidor/Water Aspirator 1_ 0 0 _0 U _U Dishwasher-Commercial 4 0 _ 0 0 0 0 Domestic 2 0 0 1 _00 0 Drinkinq Fountain 1 _ G_ 0 i 0 0_ 0 Eye Wash 1 _ 0 0 0 0 _ 0 Floor Drain/Sink •2 inch 2 0 0 0 0 0 3Inch 5 0 0 0 0 0 _ 4 inch 6 _ 0 vW 0 0 0 0 Car Wash Dr �6 0 0 0 0 0 Garbage Disposal Domestic(to 3/4 HP)_ 16 0 0 0 0 U �=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 Sep (Gas Station, 6 0 0 0 ^0 0 Rec.Vehicle Dump station 16 _ 0 0 0 _ 0 0 _ Shower-Gang (per head) 1 0 _ 0 _ _ 0 0 0 -Stall 2 _ 0 _ 0 1 2 1 2 Sink-Bar/Lavatory _2_ 0 _ 0 Y 3 6 3 6 Bradley 5 0 0 _ _ 0 0 0__ Commercial 3 _ 0 _ 0 _1 3 1 3 _ Service _ 3 _ 0_ �0 1 0 0 0 Swimming Pool Filter_ 1 0 0_ 0 0_ 0 Washer-Clothes 60 0 0 0 0 _Water Extractor 6 v _ 0 _ 0 _ 0 0 _0 Water Closet-Toilet 6 _ 0 _ 0 3 18 _ 3_ 18 Urinal 60 0 _ 0 0 0 Previou. )i1 Count 1 _ 16 16 Capped EDU Credit 1 16 TOTALS 0 16 1 0 0 9 1 33 9 33 Current Fixture Value 33 divided by 16= 2.1 _Current EDU 1 EDU = $2,300 00 Previous Fixture Value 16 _ divided by 16= 1.0_Previous EDU Change 17 divided by 16- 1.1 _ over (under) $ 2,530.00 Enter EDU Change Here 1.1 HISTORY Notes:Stru tore was rev SF. PLM# N/A EDU# 1 --�� SWR# SWR2003-00006 _ fixtures repl3ced,no add'I PLM# EDU# _ SWR# fixtures added. Credited for _R M# EDU# SWR.# fa me: i ] LLDate: __ gnature o person that calculated this tally sheet and date perh+otned Is required CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: "LM2002-00333 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/30/03 SITE ADDRESS: 07455 SW BES/ELAND RD PARCEL: 2S 101 AB-01608 SUBDIVISION: HERMOSO PARK ZONING: MUE BLOCK: LOT: 019 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS: STORIES: 1 WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS 0 URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: CDiNA*p�T vF _F0 6-4H1-It Q1,4 . W6E- "i Pule�Zi) S,Ak,6)�-A�,U)wA 0.eeoSEr _ FEES Owner: -b,Az. - --- -- -- Description Date Amount WES-FERN TIGARD LLC PO BOX 2469 1I'I UMBI I'crmit Fee 2/3/03 $72.50 CLACKAMAS, OR 97015 ITAXI 8 S1atc Tax 2/3/03 $5.80 Total $78.30 Phone : 503-628-8508 — Contractor: PAUL THE PLUMBER 4005 SW 195TH AVE ALOHA, OR 97007 REQUIRED INSPECTIONS Phone : 649-3140 Top-out InspFinal Inspection Reg#: LIC 124083 [,I'M 34-381 P13 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 Issued By:(, _ Permittee Signature:,, A,1 A.A.47'j— Call (5011639-4175 by 7:00 P.M. for an inspection needed the next business day Building Fixtures Plumbing Permit Application Date received: ' Permit no.:Pt D -t 33 City of Tigard `J b Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of Tigard phone: (503) 639-4171 Projecdappl. no.: Expir,date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: SD11Z - ;?60-2-t)0-0 1 Case file no.: Payment type: TVPV OF PERMIT U 1 &2. family dwelling or accessory U Commercial/industrial U Multi-family O Tenant impro ement U New construction Ll Addition/alteration/replacement U Food service J Other: JOB SITE INFORMATIONrt special Info t Job address: -7 '1 S5 5 N/ IrUl9... %lo Description Qly.IPee(ea.) Total Bldg. no-: Suite no.: New I-and 2-family dwellings only: (Includes 100 ft.for each utility connection) Tax map/tax lot/account no.: SFR (1)hath _ Lot: Block: Subdivision: _ SFR(2)bath Project name: --_ _ _ SFR(3)bath _ City/county: 'r ZIP: Z Each additional bath/kitchen escription and location of nrrork on r mi s: t Siteutilities: 1 1-00) 1J WhTt4G.os#,r �C1� $1&AA,_^ — Catch basin/area drain Est.date of completion/inspection Drywells/leach line/trench drain _ 1 ' 1 Footing drain(no.lin.ft.)PLUMBING _— Manufactured home utilities Business name: Fout_ TG_K 6t,tvt�j.ti� Manholes _ Address: Yd0$ S KI I TS131 AVV, Rain drain connector City: _ State:OX. I ZIP: 17-7c.)0-7 Sanitary sewer(no.lin.ft.) Phone: '(_q- 1 go Fax: I E-mail: I Storm sewer(no.lin.ft.) _ CCB no.: 12s'{O8�_ Plumb.bus g.no: •3`t-59T Water service no.lin. fl.) Fixture or Item: City/metro lie,no.: Contrm;toes representative signature: Absorption valve — Back flow preventer Print name: I Date: Backwater valve PERSONBasins/lavatory _ Name: l,LClothes washer Address: Dishwasher ( 1 '{;o W u& — Drinking fountain(s)— City: (,,e fv N State: QA ZIP: 9 700 Ejectors/sump Phone: (, _Q t y Fax: ! 1 E-mail: Expansion tank ' Fixture/sewer cap Name(print): j y(ft L „�,c i l.I� Floor drains/floor sinks/hub - - -- - Garbs--e is asst _ Mailing address: Hose bibb City: _ State: ZIP: Ice maker Phone: Fax: E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date- _—_ Sump _ Tubs/shower/shower pan Urinal O _Name: _. _—__-- Water closet t Address: Water heater City: --- State: Z[P: Other: -— Phone: Fax: E-mail: Total Nd all jurisdictions accept credit cards,pleas call jurisdiction far mare intbrmulon. Minimum fee.•..............$ 1 1 Notice: This permit application plan review(at— %) S _- U Visa U MasterCard expires if a permit is not obtained State surcharge 8% r Credit card rwmber:. __ __ L within 180 days after it has been 8 ( )"' $ Expires _— -- p accepted as complete. TOTAL.............•..........S �_ Name or ardhalder a shown onitere t c* S Cardholder si{nature -- — Amount — "0.161E(QOM) i PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual) QTY ea _AMOUNT (Includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (Na) AMOUNT Lavatory -18,60 — for each utility connection __ _ $249.7..0 , Tub or Tub/Shower Comb. 16.60 Two(2)bath __— $350.00 Shower Only_ — 16.60 — Threes bath _ $399.00 - Water Closet— — _ _ 16.60 —� -- - — -- SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _ TOTAL Garbage Disposal 1660 --- _ — - - Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 - -- 16.60 PLEASE COMPLETE: Water Heater O conversion O like kind — 16.60 Quantit b Work Performed` Gas piping requires a separate mechanical Fixture Type: New Moved Roplaced Removed/ ermit -- ^- — — Capped MFG Home New Water Service 46.40 Sink — MFG Home New San/Storm Sewer — 46Lav ,40 ato ry -- — —------- _ Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains — 16.60 Shower Only Drinking Fountain _ 16.60 Water Closet Other Fixtures(Spectry) 16.60 Urinal _ Dishwasher Garbage Disposal Laundry Room Tray -- - Washing Machine Floor Drain/Sink: 2" Sewer-1st 10 0' 55.00 3„ Sewer-each additional 100' 46.40 4" Water Service-tsl 100' 55.00 Water Heater_ Water Service-each additional 200' 46.40 Other Fixtures _ (Specify) Storm&Rain Drain-tat 100' 55,00 Storm 8 Rain Drain-each additional 100 46.40 — Commercial Back Flow Prevention Device 46.40 --- -- — — - —"— Residential Backflow Prevention Device' 27.55 ----- Catch Basin 16.60 —` --- -- — _-- Inspection of Existing Plumbing or Specially 62.50 Requested Inspections _ per/hr _— COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps — -- — 16.60 _J.—_ — ------- -- - - QUANTITY TOTAL --- Isometric or riser diagram Is required if Quantity Total is >B -- "SUBTOTAL -- — - -- 8%STATE SURCHARGE — -- —-- -- —"- "PLAN REVIEW 25%OF SUBTOTAL _ Requlrp,d only If fixture ly.total Is TOTAL - Minimum permit fee is$72 50-B%state surcharge,except Residential Backflow Prevention Device,which Is$3e 25*N%state surcharge *'All New Commercial Buildings require t sets of plans with Isometric or riser diagram for pian review. I:\dsts\forrns\plan-f?es.doc 12/26/01 (CITY OF TIGARI]► 24-Hour BUILDING Inspectir•- ' ' re: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MS r' -� ' � BUP _ r' Received _ Date Requested__—__ _ APA___ PM_ ___ BUP -- Location _—. T _ —_ � -� �f�-� _Suite MEC Contact Person ___.— Ph PLM Contractor_ _ -_ Ph(— ) -- SWR --_—,-- --- FUILDING Tenant/Owner --__ -_ — -_ --___ ELC Footing - Foundation Access: ELC Fig Drain Drain ELR - - ---- - - Crawl Drain - Slab Inspection Notes: SIT --_ Post& Beam ----- -- ---- -- - ------ ------ Shear Anchors - - - Ext Sheath/Shear Int eat ear Insulation Drywall Nailing ------- - ----- Firewall 3,(/ Fire Sprinkler Fire Alarm Susp'd Ceiling -- ----- - - --- ------ Roof Other:. - --- -�— -- __ � -- --- - -- Final PASS PART FAIL ----- - —-- - PLUMBING �-- Post& Beam ' Under Slab � - -- - - - ---__._.--_------ ----- Rough-In --___..------------- Water,Service ---- Sanitary Sewer Rain Drains --- --- - _ — --- ----- - -...- -- Gatch Basin/Manhole Storm Drain ------ Shower Pan Other. -- Final PASS PART_FAIL MECHANICAL_ Post& Beam Rough-In ---- ---- Gas Line Smoke Dampers --- Final PASS PART FAIL -- - -- ---- ---- - -- -- ---. - -- ------ - ELECTRICAL Service --- - ---_-- Rough-In UG/Slab Low Voltage Fire Alarm Final E] Reinspection fee of$ required before next inspection. Pay at City Hall, 19125 SW Hall Blvd. PASS PART FAIL SITE _ --- Please call for reinspection RE: - Unable to inspect-no access Fire Supply Line C� ADA De Q� InspeApproach/Sidewalk ctor - �C._ Ext _--- Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARL 24-Hour BUILDING Inspection Line: (503)639-4175 MST rNSPECTION DIVISION Business Line: (503)639-4171 — _ BUP �iv-d ---_..__�__�--Date Re ested _ a 7 AM PM BLIP Suite—_—__ _ _ MEC Person ._ �� __ Ph PLM ,ontractor___ --- Ph( ) —..__.--------- --._._-_-- SWR BUILDINU —� Tenant/Oivner -__ -_-_ ---_ ELC _ Footing Foundation ELC Access: Ftg Drain ELR - - ----- -- Crawl Drain — Slab !nspection Notes: SIT Post R Beam _—___ Shear Anchors Ext Sheath/Shear Int Shoath/Shear Framing ----- - ul rywall Nailing Firewall Fire Sprinkler --- - ------ — Fire Alarm � �__S•p ,^�� •�-�s � �/ Susp'd Ceiling -- Roo! r -, ri Other:- _- - Final PASS A FAIL PLUM_8!N Post&Beam .—.—_ ------... ----- ------ Under Slab ----- - -- -- --_-- Rough-In Water Service Sanitary Sewer Rain Drains ------- - - Catch Basin/Manhole Storm Drain — Shower Pan Other: -- - Final --w - PASS PARTFAIL MECHANICAL Post& Beam Rough-In Gas Line Smoke Dampers --- __ - --- -- — -- — Final PASS PART JAIL - _- -- ---- - - ELECTRICAL Service --- Rough-In UG/Blah Low Voltage Piro Alarm - ----- _-- Final Reinsh,?ctinn kora o! $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL_ _ SITE _ — Pleas?call for reinspecUc n r�! -_w___ —_ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date Inspector _- _Ext Other: Final 1)0 NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION �� ,;u'.:_ ",ie: (503)639-4171 --- �� c� BUP Received ____ Date RequestFd___-- 2�Z o AM_—_—_ PM .__ BUP Location —_—__ Suite—_______-_ _ — MEC Contact Person —__ � Ph(.__.-_—) � ��/d_ PLM Contractor--- - -------_ ��_D- _ Ph =�� ) _ _ �� SWR BUILDING _ Tenant/Owner - ------- ELC o� d-D q10 _____ Footing Foundation Access: ELL; Fig Drain ELR Crawl Dain --- ---- slab inspection Notes: SIT Post&Beam Shear Anchors -- Ext Sheath/Shear Int Shoath/Shear Framing Insulation ^� Drywall Nailing - --- - - . - ---- --- ---- Firewall Fire Sprinkler --- _- --- ---- Fire Alarm _ Susp'd Ceiling - — _ ------- — — Roof - Other:__ - --- ------- — — — Final PASS PART FAIL - -— ---- — -- - PLUMBING Post& Beam Under Slab Dough-In ------__---_ __ Water ServiceA— Sanitary Sewer --------—----- Rain Drains --- - Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL - - ---- MECHANICAL_ Post& Beam -_-- Rough-In Gas Line Smoke Dampers Final i�AS��- ART FAIL --- - -— - - -- — -�oegfi-In UG/Slab --- --- - Low Voltage Fire Alarm IASS PART FAIL Reinspectlon fee of$� required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. IL SITE Please call for reinspection FSE:._. -_ _ [] Unable to inspect-no access Fire Supply Line j ^ AD,1 Approach/Sidewalk Dab ✓ ` r � - Ins sp.� �r� � _- Ext - Other! ---------- / Final DD NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST iNSPECTION DIVISION Busing Jae: (503)639-4171 BUP -- -- --- - Received .-- — _ Dale requested_ 1;1 _(2- AM---__-.-- PM —_-- BUP - -- Location 7 Ll,_Sx.10-4 _Suite—___.. _-.._._.__ — MEG ---_- Contact Person _ Ph PLM Contractor— -- -_—_— -- Ph(---- - ) --- SWR BUILDING, Tenant/Owner —_ - --- —___-- --.-. ___.---_.--- ..- ELC CI-2- Foctiny -- Foundation ---- ELC Access: Ftg Drain EL.R Crawl Drain Slab Inspection Notes: SIT Post&Beam --_--- ------.._.-_ Shear Anchors - ----- - -- --- - Ext Sheath/Shear Int Sheath/Shear Framing --- � --_- -- --- Insulation Drywall Nailing - ---- Firewall Fire Sprinkler -- --- - -- - - --- — Fire Alarm Susp'd Ceiling - - - - ----- --- _ -- ---- H )of Other: ----- - _ - Final PASS PART FAIL -- PLUMBING Post& Beam------ Under Slab --.- -_-_- - -------- - Rough-In Water Service - ---- -- ---- - Sanitary Sewer Rain Drains ------ ----- --- Catch Basin/Manhole Storm Drain ----- -- ------- _�___.__.._-_ Shower Pan Other: - — ---- -- --- -- -- - Final PASS PART_ FAIL ---- --- ---- - --- -- - - MECHANICAL Post&Beam Rough-In - - ------- -------- Gas Line Smoke Dampers --- - ------ --- __---- -�..- --- --- Final _PASS PART FAIL - --- _- - - --------- -- - - - --- --- -... _ --- -- ELECTRICAL Service----- -- .____ ------- - ------- __----- --- - -- Rough-In --------- --- ------------- ------- ---- -- -- UG/Slab L.ow Voltage -- ---- --- -- -- ------- - ------ - Fir_e Alarm PASS PART FA- L Reinspection fee of$ _-_ _-__required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE _ �� Please call for reinspection RE: _ ___-_—. -_ L] Unable to inspect-no access Fire Supply Line ADA Dab _! _.. ~� C_f Insp L3 Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the jdb site. PASS PART FAIL_J CITY OF TIGARD 24-Hour BUILUING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Busing -.'-.ie: (503)639-4171 BLIP Received Date Requested -2- AM---.---__-- PM BLIP ':SV_V—C-C — Suite MEC Location LG Contact Person Ph PLM Cont actor Ph(-----) SWR BUILDINGTenant/Owner ...... ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain SIT Slab Inspection Notes: Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm I L L %e' Nle- Susp'd Ceiling Root foll Other: Final kc, Jl' PASS 9& PART FAIL PLUMBING -Post&Beam Under Slab Rough-in Water Service W( Sanitary Sewer . Rain Drains Catch Basin/Manhole C'o Storm Drain ShowerPan Other: Final PASS PART FAIL _WE_dW_AN1dWL Post& Bearn Rough-In Gas Line Smoke Dampers Final PASS PART.- FAIL F�LRCTRICAL Pough-In UG/Slab I ow Voltage Fir larm in ❑ Reinspection fee of required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. SS PAR( FAI SITE F] Please call for reinspection RE: ❑ Unable to inspect-no access Fire Supply Line ADA C)__01 Lfe Approach,,Sidewalk Date Insl Ext___ Final DO NOT RFMOVE this Inspection record from t job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST - --- ------- INSPECTION DIVISION Busines. ..,e: (503)639-4171 � BUP Received ______ Date Requested--___— _— AM__-___--PM —__ BUP _-- Location -___—__� Suite MEC __-- Contact Person Ph(— ) 7 CJ 3 �L'/4 PLM ContractorPh SWR ll// BUILDING Tenant/Owner .—___- _ -- ELC Ile T� U Footing — ELC Foundation Access: :tg Drain ELR -- Crawl Drain -- - Slab Inspection Notes: 51T Post&Beam Shear Anchors - Ext Sheath/Shear ----- -- Int Sheath/Shear Framing Insulation Drywall Nailing --�---- Firewall Fire Sprinkler — Fire Alarm Susp'd Ceiling � '� -��- �- Roof -___-- Other: --- --- T- Final � _PASS_ PART FAIL r PLUMBING ___ - ---- - ----- -- ---- -- Post& Beam Under Slab y Rou h-In Water Service --��--� 1` � 1 e10 - - -- Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain --- --- —-- -- - - Shower Pan -- Other: Final - PASS PART FAIL MECHANICAL _ _ __. _ ------- ------ - - --- Post& Beam - Rough-In -- -- ----- -- - - - ---- Gas Line Smoke Dampers --- --- -------- `- --"— - Final PASS PART FAIL - --- -- - —- --- ELECTRICAL -------- --- --- Service ) L Rough-In L� - ------ ------- ----- - ---- UG/Slab Low Voltage - ----- - - - -- --- ---- -- - - -- Fire Alarm Final Reinspection fee of$___.__- _ required beforo next inspection Pay at City Hall, 131'_5 SW Hall Blvd. S _ PAR_T FAIL -SI T -� Please call for reinspection RE'- ____- __________- -� Unable to insFect no access Fire Supply Line ADA - �'] Approach/Sidewalk Da -.- Ext to Other Final DO NOT REMOVE this Inspection ree6rd from the Dob site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection I Vine: (503)639-4175 INSPECTION DIVISION (? ( Busines, ..,e: (503)639-4171 MST BLIP Lt Received __ e_Date Requested a`— AM _.__--___—__ PM _--- BUP Location ._ _ __— Suite MEC Contact Person _ _ _ /"Q Ph( ) -1�_ PLM Contractor-_- --_-__-- Ph(--_-) _-__-- - SWR _--- BUILDING , - Tenant/Owner _ - ELC l rooting Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing - -- - - � Firewall Fire Sprinkler -- ` ,-** '' -- J --�1- Fire Alarm -J 1 ti J - -� (-.LY ' 7 �1- Susp'd Ceiling --- Roof Other: — - --- - --. -_�- Final ` PASS PART---F-AIL -- ------ _PLUPWRING _ - Post& [;,-'am Under Slab —..-------- Rough-In -- - - ---- --- - - --- Water Service, __-- Sanitary Sewer Rain Drains --_---_ -._._.- Catch Basin/Manhole Storm Drain — - - — ------- - -- Shower Pan Other: - --- - - -- -- Final PASS PART FAIL -- - --- ----.. __ -.-_ MECHANICAL Post&Beam Rough-In Gas Line Smoke Dampers -- ------- - - - _ - - - -- - Final PASS _PART FAIL ELECTRICAL - ------------ Servige Low Voltage Fire Alarm Final Reinspection fee of$_- _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd, PART FAIL ART ------ - Please call for reinspection RE: L .-_-_ ] Unable to inspect-no access Fire Supply Llne ADA 1 Approach/Sidewalk lDatt►_�E- �,.� ---55 - Inspect Ext____._ Other: Final -- - DO NOT REMOVE this Inspection record from thb job site. PASS PART FAIL p� CITY OF T I GA R D ELECTRICAL PERMIT PERMIT#: F_LC2000-00663 DEVELOPMENT SERVICES DATE ISSUED: 12/04/2000 4- 13,125 SW Hall Blvd.,Tloard, OR 97223 (503) 639-4171 PARCEL: 2S101AB-01608 SITE ADDRESS: 07455 SW BEVELAND RC SUBDIVISION: HERMOSO PARK ZONING: MUE BLOCK: LOT : 019 JURISDICTION: TIG Proiect Description: New electrical service drop. Job No. 79351-201 - Lowes Project. f _ 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: SIGNALIPANEI.: MANF HMI SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS _ 0 - 200 amp: 1 W/SERVICE OR FEEDER: _ PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: Recor sect only: SVC/FDR >=225 AMPS: _ CLASS AREA/SPEC OCC: Owner: Contractor: KOBERLEIN, PATRICIA LYNN ELECTRICAL CONSTRUCTION CO 7455 SW BEVELAND RD PO BOX 10286 TIGARD, OR 97223 PORTLAND, OR 97296 Phone: Phone: 224-3511 Reg #: LIC 049737 SOP 2986S ELE 26-45C FEES _— _ Required Inspections _ Type By Date Amount Receipt _ Elect'I Service PRMT CTR 12/04/200C $80.30 272.00000001 Elect'I Final 5PCT CTR 12/04/200C $6.43 2720000000( Total $86.73 I his Permit is issued subject to the regulations contained in the Tgard 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 I 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 copies of these rules ordirect questions to OUNC at(503) 246-1987. PERMITTEE'S SIGNATURE ISSUED BY: _ OWNER INSTALLATION ONLY The installation is being made on property I own which is riot intended for sale, lease, or rent. v� OWNER'S SIGNATURE: __ __, DATE: CONTRACTOR INSTALLATION ONLY - SIGNATURE OF SUPR. ELEC'N: __. ____�_—_ —. _—_ DATE: LICENSE NO: _.._-- ---- - --- ---- -- — ----- - ------- Call 6394175 by 7:00pm for an inspection the next business day BUP - Building Permit _ ELC - Electrical Permit —Inspect—ion -D—escription Date Passed-, — assed_ B Ins ction Description Date Passed B Footing/Setback _ - - Underground cover Foundation walls _ Wall cover Footing drain __— _ Ceiling cover Waterproof bsmtwalls_ _ _ Electrical rough-in Slab _ Electrical service - Crawl drain Electrical final �- i;2 w oti Underfloor insulation �- Post/beam structural -- -- __ - -- Shear walls/anchors_ _ E_LR - Restricted Ener Permit Roof nailing --- - -- - - ___.._._ Inspection Description Date Passed B Firewall Low voltage Tilt-uppanel Electrical final Mason_rr/_Reinforcement --- Framing -- MFG-Structure set-up -- - MEC - Mechanical Permit Insulation --- — Dr wall nailing - Inspection Description- Date Passed By _ -Suspended ceiling ---- _ Post/beam mechanical_ _ -- Engineered soils - Gas line Welding Lab Final -- Mechanical roug in �- Fire dam r _ Concrete Lab Final Bolting Lab Final --- Duct work Fireproofing Lab Final - -- Smoke detector roo - —�--�— --- Mechanical final Structural observation --- Final inspection --------- --� ---- -- ----.-. — �---�- - ------- --- PLM - Plumbing Permit-- BUP ermit _BUP - Fire Protection :System Permit lus ection Descr!tion Date Passed By- _ _ Pe_r_ __ _ Ins Description Date Passed B Plumbing underslab Inspection_ -_ Crawl drain Sprinkler underfloor/slab _ _ Post/beam lumhin Sprinkler rough-in ----p- --g_-- - -- --'- Plumbing top-out _ Sprinkler final --- f� i RP/backflow preventer Fire alarm final Rain drain -- ------ Storm drain _Water service _ SIT - Site Permit _ Sanitary sewer Inspection Description_ Date Passed By _ Culvert/catch basin Footings - _ Pum /fill septic tank - Foundation walls - Plumbing final - _�prinkler sum lines -- Sprinkler underfloor/slab - - Catch basin/Manhole SWR - Sewer Permit En ineered soils _ _ Inspection Description Date Passed By Engineering acceptance _ Sanitary sewer__ _ Final ins action-- — Final inspection — - INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP —_- -- Date Requested 1` 7Z�f) _ AM -PM - BLD — Location 7��'} 5�v lam^ Suite MEC Contact Person Ph .3�3 _7 - 3� �3 PLM Contractor _ _ Ph _ — SWR BUILDING Tenant/Owner ELC 20 Retaining Wall ELR Footing Access: FPS Foundation - Ftg Drain SGN Crawl Drain Inspection Notes — Flab _._ ---- ---------- ---- -- SIT -- Post&Beam Ext Sheath/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 PASS PART FAIL --- MECHANICAL Post& Bearn ------------- Rough In Gas Line - ---- - - --------- -- Smoke Dampers Final _----..---------------- ..."._-- PASS PART FAIT_ -jr,- LEC TRIC er ,ice ----- ---- -- --- - ----- oug In UG/Slab -- ----- - — - - -- Low Voltage Fire Alarm - - -- - --- - ------ Fin ASS PART FAIL -._------------ ---- -- - 5 — --------- Backfill/Grading `- _--"--�------------ Sanitary Sewer Storm Grain ( ] Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch BasinUnable to inspect-no access Fire Supply Lines [ ] Please call for reinspection RE _ _ I 1 P ADA Approach/SidewalkDate �� U ' Inspector— —Ext ,Other _ --- --" Final - PASS PART FAIL 00 NOT REMOVE this inspection record from the joh id t CITY O� �I��D � ELECTRICAL PERMIT PERMIT#: ELC2000-00663 DEVELOPMENT SERVICES DATE ISSUED: 12/04/2000 2001h�+ 13125 SW Hall Blvd„Tigard, OR 97223 (503) 639-4171 PARCEL: 2S101AB-01608 SITE ADDRESS: 07455 SW BEVELAND RD SUBDIVISION: HERMOSO PARK ZONING: M(JE BLOCK: LOT : 019 JURISDICTION: TIG Proiect Description: New electrical service drop. Job No. 79351.201 - Lowes Project. RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELI.ANFOUS 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/FDR: 601+amps - 1000 volts: MINOR LABEL_ (10): SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 - 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: KOBERLEIN, PATRICIA LYNN EL-ECTRICAL CONSTRUCTION CO 7455 SW BEVELAND RD PO BOX 10286 TIGARD, OR 97223 PORTLAND, OR 97296 Phone: Phone: 224-3511 Reg#: LIC 049737 SUP 2986S ELE 2.6-45C FEES — —_+ Required Inspections Type By Date — Amount Receipt Elect'I Service PRMT CTR 12/04/2000 $80.30 2720000000( Elect'I Final 5PCT CTR 12/04/200C $6.43 2720000000( Total $86.73 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 Liles are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at(503) 246-1987 PERMITTEE'S SIGNATURE e,4r . _ G/� YFi� ISSUED BY: OWNER INSTALLATION ONLY fhe installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE:-- CONTRACTOR ATE: –CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _ —_—_ __— DATE:----,-- LICENSE ATE: ---LICENSE NO: r ------- --- --- ----- — --- ----------- --- Call 6394175 by 7:00pm for an inspection the next business day 11/29/2000 14:29 15032953012 E C COWAN',, PAGE 1a7 Electrical]Permit Application Date received: '' 1, Permit no,:EW Zp00"lib�i(e.3 City of 'Tigard W;� ��f� projecUappl,no.: Sxpite date; Cryo Ti ad Address: 13125 SW Hall Blvd � � c^� Date issued: B —- 1 8 Phone: (503) 639-4171 q p {; J Y:Z keaelpt no.; fax: (503) 598 1960 1 1 iN- t rf7 Case file no,: Pavment type Mail CC to: C Land use approval: L4 CJ 1 k Z family dwelling Or accessory YCommerc ial/industnal O Multi-family ]Tenant improvement l7 New construction 0 Add itioMalteration/rr placement U Other: _-_ ❑Partial Job address: rj Bid no. Suite no,: Tax ma /tax Int/account no L it: Block: Subdivicinn- — - , Project name: LAW-S Description and location of work on premises�[K/ CI fY C,f'v1 elidmated date o(compier)on/ins ccUon:tv Job no.,_7 �/ L_ _ Fee htax Business name: �G7 r JL �' ��'�•� � lJescrlptlnn _ (ea) Total no.Ina Address - -1�4 - Me"rveddwtW-a orwuld-fiindly per dwelling unit Include,enter"gsu age. Sit y: `' � Tctate: ZIP: - YrrieeYschldeA Phone. F u_ E-mail: t two cqn.al leas 4 - __ -- Each additional SOO ay.ft,or portion thereof f C13 no_: 1314G.hU5 tic. no: Urnited energy,residential 2 City/melt no' T _ Limited energy,nnn•residenlial 2 Q rich manufactured hnme or modular dwelling OUXUA Signature ni'lijerviiing hlactriaian(rcqui� Ditr. 2 Service and/or feeder - --. -- - S Servlceanrfeadesn-installation, Sup,elect,non»(print): License nn:� alteration or relocation: NO a 7,00 amps nr les, 2 Name(Print): 201 nn s to 400 amps 401 ompe in 600 amps - 2 Mailing address: - -- ---- __ - 2 601 amps tu_1000 amps 2 City: -- -� Slate: ZIP:= Over 10W amps or volts 2 - Phone: �Fax_� Email. Reconneelonly -_-- - -1 Owner installation:The Installation is being made on pruperty I own Tetnporwywrvirmorfrrdera- which is not intended for sale,lease,rent,or exchange according to Inrtau■lion dteiratlat,arreloeatlan: ORS 447,455,479,670,701. 200 amps or less �- _ 2 201 amps in 400 amps 2 Owner's signature: bate: _ 401,,,FW amps -- 2 Branch clrrulte new,alteration, or P.1hr inn Par panel: Nie' A Fn fnr hunch rirruits wlth pumhtsp nr Address: - service at feeder fee,each branch circuit 2 City: Stott: _ ZIP' 8. Fee for branch circuits without purrhaas� - of service or feeder fee,first branch cirruit- 2 Phone: Fax: F. mail; Each additionaihnnchrircuit. Misc.(.Service or he4er not Incladed): O Service mer 225 amps-comartmial 0 Health-rue farili(y sc_h nump 2 or irngrtton circle --8-- - ----- CI Semine over 320 adnps-rating of 1 k2 13 Hauldous]oration Fath sign or outline lighting 2' family dwellings O Building aver 10,000 erluam feet four or Signal cirrultfs)or a limited energy par O System over 60n vnita nominal more residential units In one structure alteration,of exlensiono 2 O Building over three stone L1 Feedets,don amps or more 'Description. -- --- - -- —1 ❑Ckcup,nt load over 99 persons t3 Manufactured+tnir4ures or RV park Fish addltioaal pwpectlen,ser the dlowablc In any*!(he above: C]Egrcaallightingplan ❑Other-, Perinspecticn $ubmlt_tort of pulp with any of the above. Investigation The above are not appUcable to temporuy construction service, Other p -- NS ra ail putedl ylona accept c.erlit,-adds,please call Iuri�AirUun ru rare inrermauen Notice: This permit application Permit fee ......... ......- . .. -_�'- 13 vC• r sa MuterCord expires it a permit is not obtained Plan review(at rad) $ �Credii;Wa rwan,X __. �_ within I An day,after it has been State surcharge -_- �+• `"p11ef accepted es complete. TOTAL ............ ......... f , ra. a 9111 as d own ant h r. Cardholder aignarura Amnani eu>ar15I5AJf��i,�i