Loading...
10200 SW GREENBURG ROAD STE 365-1 'r I _ Relocate Sink location 2'•0" to left of existing location Reconnect to existing drain/vent/water l er su Pplies I I New 6-gallon water heater to �I ,� _Li i � replace point of use water heater T--t �, Scope of Work: p;p(( New Dishwasher * ... 1 . Relocate (1) existing sink to new location x= „ ( I °; `� '"-� i - (E! ) Floor penetration 2. Relocate (1) drain to new location j I I I L_4., _ r 3. Replace point of use water heater with new 6-gallon water heater 4. Install (1) new dishwasher 5. Install new cold water supply to ice maker/ water cooler New Ice Ma er G - ew cold water supply to water cooler p) w 3 i r, ,4' � '1• ,♦ 1 ,� �� l�µ�' r?i�Lµ'l� .�� 1 ' N"t ,' � � �n ❑ ... G .�) I I 1 ..._ M .. .. � I o � � , XI ;� I w C I y J Cr I O I r ca CDN J ❑.. . _.., �L_J Q n, rn .... fcERCY MAGOAENT 1 8 III ,. 1 � � ' 7EG110N 1vx �IIII _' �.1�.'•`+{k{l. ,•, ✓ae \ ( I - •' I�'� I ., ' �. . :V� r : I ! IJNS TP. A L & .1woracr701Yl r m 'C a MECHANICALI v , AND CONTRACTORS l 5400 N.E. COLUM&A BLVD ? I PORTLAND 'OREGON FO ` ZZI-39ce i I (tT1 I ri's'�uMMyy�i.t{aL���M•y v-. �I t 't� I I �1` — _ f iY it ii • ._ I —. M �yol l� =I 9 � I �1EGl�D 1^. J j I� DATE I rmrl cc- it L HVAC Plumbing Tenant Improvement Plan Plumbing TI (Drawing not to scale) ----PI -- P-1 NOTICE: IF THE PRINT OR TYPE ON ANYll � iiil � li ililil � lililiii � I � I � II lig ill � �� i�1 r1 ��T r_I_r � I�_ � 1 � .�.. i � � , lr1 � 111 11 < < 11 IIS � l � i � � l { , X11 111 ) I I l ( I ' ► I t I I I I I I I I I �- r, I I I I I I I I IMAGE IS NOT AS CLEAR '7LI I I I { I I { ( 1 1 { 1 { 1 { { AS THIS NOTICE, 1 2 I I I _ __-- -- _ ___ _ 6 7 g _ Dt, G o0 IT I - - — — _ ___ _ 9 10 11 12 � � S DUE TO THE QUALITY OF THE — — - -- -- -- -- ORIGINAL DOCUMENT l 5 T 3 I I Z I T T .'Ill 6l. '1111,1u, L 9 9 I i' E Z IIII ILII IIII IIII IIII ILII ILII II{lill{ 11{IllliI111111{ 11111(I1L111. 1�11till. Illillllllii11111111IIIlII11I11111IIII{III111 .1111 IIII IIII IIII IIII IIII IIII IIIIIIIII IIIIII� I IIll .il .d I I I I I I I 1 11. 11.111111111!1111 (.I_I f 1 i _ (Ni -rrzdasc'�.e.�~ )N� j I ! I; ! - � � • r1�t..�1CAL�.. �i2���5 >y.r�D ��u�. � Lj INI� ' (NJ I[�J(Na 77, r ai..■ c; r f �)(tv l G r ,---__ - e—*4 �---� -4 _ I / X 5 ti5T�� Zo 'R ru c 1�:,2 'll- p r� l i I E 1 –_ —:rte. r: o -- - 1�Av )' I 1.141) ) _ 1 (N =4TH OF - _ i—=-- - — — I• fi -- EGRE55 j' ( r 170 L EL-3F-ou ii �I $ Uj LL- - I❑ • ❑ ' C ❑ ❑ , ❑ ❑ y7 __ - _ .. �X1�T ► �� 'I'� I MA nl El ON ... ON ON ------ �:-� 0= x E) ' h ( ) H.�.A C.• NG. 11J 8sN G X >' E1 >'. N >c� I E ) n a F?IEtC7 dlwAcE�+T '- 1, l 14 �l� I l l a 91RE P40TEC'ION cw ow TR r 7 — ?Rt11'3C.'70N' ► /� •.','u MECHANICAL �IGNEE RSA l` MI ,1 �`J >c' D ZON7RAC70RS 5400 4.E. �LUAIEIA K70 QRE� PORTLAND, t _� N I t p'rin FAX (547) 331-8906 J Z.(D 19-11 Z — _._ I ' I' .'.d'r`•,` FPB � _ - - '> U f`1 1 l (..�1 • � � � LAS . DRAWN 3Y: 20�KZDI TTY�tJs -'�, `> -wicc- it �czt�c� G � �� c•1 ��uL�.D 7-IEFT: +. '�,' s oil . Jill NOTICE: IF THE PRINT OR TYPE ON ANY r1 � � � � � Iil � � i � � � I � ! � . ! ilil ) i ! il � ! ) ) ! ) I ) I �r�r�r ) ! �� .� �- i �r11 ) ill i ! ) ili ) ! i ) ! � Ali ) ; t ) I � ) li ) I ) ) I ) r-p rj-r l-i r.-I1- .� MAGE SNOT AS CLEAR AS THIS NOTICE 1 2 �1 I I I I I I 1 ! III . T IS DUE TO THE QUALITY OF THENo.36 ORIGINAL DOCUMENT' - E J 6Z 189 Z Z TZ OZ 6T 8T LT 8I t 9T �T F C ZT TT i 6 8 L 8 9 Z T �Itl13w I , ILII IIII�IIII IIIIIIIII .III IIII IIlIIIII111111!! !�J_11.11llLlllll.11lLlllllll Il�. I1.1ll�ll .11.�lllll IIIIIIII !Ili !1!! !!!! 1!!! !1!IIIIII I!!� III!!!!!! III! I ►I � � ) - ! ; I I i i i x 4 i v 10200 CREENBURG Rn 365 CITY OF TIGARD CERTIFICATE Or.OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BLIP?004-00093 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/10/2004 PARCEL: 1 S135AB-00900 ZONING: (--P JURISDICTION: TIG SITE ADDRESS: ".0200 SW GREENBURG RD 365 SUBDIVISION: FIVE LINCOLN BLOCK: LOT: CLASS OF WURK: ALT TYPE OF USF COM TYPE OF CONSTR: 2FR OCCUPANCY GRP: B OCCUPANCY LOAD: TENANT NAME: AMERICAN EXPRESS REMARKS: TI: Demo and new walls enlarge suiie. Owner: EOP LINCOLN, LLC 10260 SW GREENBUR G RD SUITE 100 P$�TLF•ND OR o/"23 PP one: 234-661 r Contractor: SCHIEWE +ASSOCIATES 1024 NE DAVIS PORTLAND, 1 )R 97232 Phone: 234-6617 Reg #: LIC 54105 'This Certificate issued 6/2R/2004 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for r mpliante with the State of regon Specialty Codes for the group, occupancy, l nd us undeiAhick a of .rjenced permit w iA BUlh G SPECTOR 2UILnIN 7FFIrIAL POST IN CONSPICUOUS PLACE crry OF TIGARD 24-Hour BUIL.DING Inspection Line: (503)639-4175 INSPECTION DIVISiN Business Line: (503)639-4171 MST � BUP 15 RPcaivedDate Requested __ -__ AM_ —�_/-PM,�_—___ 13UP Location ��UL� L,E�/�tc Com___ Suite _ MEC Contact Person ___ __-_ �-� Ph (____-___) � � _ PLM Contractor - ----- _ Ph( ) -- SWR - 18UILDING _ Tenant/Owner _ ELC Footing —� - Foundation ELC Access: Ftg Drain ESR Crawl Drain Slab Inspection Notes: �) �-, . r SIT Post&Beam __ �1�� � • _ Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - - Firewall Fire Sprinkler - - -- Fire Alarm SusP d Coiling - - --- --- - - ------------------------- RoofI Other. SASS PART FAIL , - -- -- — ING Post& Beam U,ider Slab - -- - ---- -- - Water Service - - Sanitary Sewer i Rain Drains --- Catch Basin/Manhole Storm Drain - - - -- Shower Pan Other --- --- - - - _ Final PASS PAR'(_FAIL -- MECHANICAL Post& Beam Rough-In - Gas Line Smoke Dampers - -- Final PASS PART FAIL _.— --- —--- ---- - ---- ELECTRICAL Service ---- ---- .- ___._ Hough-In UG/Slab Low Voltage Fire Alarm Final u Reinspection fee of s- required before next inspection. Pay at Cit,,Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 1 Please call for einspecbon RF _--__ ___- -___ _ F1 Unable to iispect-no access Fire Supply Line ADA Approach/Sidewal'c Date -_- _ Inspector - East Other- Final DO NOT REMOVE this Inspection record from the job site. PASS PAR-r FAIL CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2004-00216 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/14/2004 SITE ADDRESS: 10200 SW GREENBURG RD 365 PARCEL: 1S135Ab-00900 SUBDIVISION: FIVE LINCOLN ZONING- C-P BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: Al.T GAPBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: _ FIXTURESLAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Fixtures: add d.w., and ice maker. Move floor drain and break sink, replace w.h. Other fixtures: ice maker FEES Owner Description Date Amount EOP LINCOLN, LLC — -- 10260 SW GREENBURG RD I I'LUMl3J I'rrmit I cr 5/1412004 $83.00 SUITE 100 I I'AXJ 8'%o Statr tiurclwrj 5/14/2004 $6.64 PORTLAND, OR 97223 Total $89.64 Phone : Contractor: MCKINSTRY CO 5400 NE COLUMBIA BLVD PORTLANE OR 97218 REQUIRED INSPECTIONS Rough-in Insp Phone : 331-02:34 Top-out Insp Reg #: LIC 40981 Final Inspection 1'LM 17-22f B This permit is issued subject to the regulations contained in thq 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 160 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires yoke to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952.0001-0100. You may obtain copies of these rules or direct gkiestions to OUNC by calling (503) 246-6699. Issued By: _�_G� Permittee Signature: Call (503) 639-4175 by 7:00 F.M. for an inspection needed the next busine S06 -Oc la i'lumbMna Permit Aullfficatiula �/ City of Tigard �. O p EF' I lt (7 'ennrtI t 125 SW I fall Blvd..'!7gard,OR 97223 an ken,w fPhone 5036394171 Fax: 303.598.1 ��' ` ether Permit No 24-Hour Inspedion Line: 503.619.4175 'Wate kcsdyA v 1in1 0 see Page l for Internet: www ei.tigard.or.us otified/MethoJ r�G Supptementatlnformallan "O' FEE* SCHEDULE ❑New construction ❑Demolition For ig(nrM&*R use cherkbit _ - -- Description _ -- T15 y. I Na.-Trial ®Addition/alteration/replacement ❑Other New I-2-family dweWmRe(includes 100 ft.for each utility connecron) CATEGORY OF CONSTRUCTION SFR(1)beth 249.20 ❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath -_ 35b'10 ❑ SFR(3)bath 399.00 Accessory building -- --- [IMulti-family _ --- -- -- Each additional bath/kitchen 43.00 ❑Master builder ❑Other j - -. - Fire sprinkler(._aq.R.) - -- Page 2 JOU SITE INFORMATION AND LOCATION we triffities Job site address: 10 Z CC) 5 V V PEE N t3 L 1` ll_ Catch basin or a,ea drain 16.60 City/State/ZIP: PG RTL_ W I) Q11-- Drywell,leach line,or trench drain 16.60 linear ft.: Page 2 drain(no Footing . Suite/bldg./apt.no.: g(�5 Project name: AM C P I(_/A N% E X hal:`>-S - --- - Manufactured home utilities 110.00 Cross street/directions to job site: --- -' _ Manholes 16.60 �•,I N L L IV C_E N Tt-2 ' P'I v(_ 1__.I N UJ i- Q Rain drain connector 16.60 Sanitary sewer(no.linear ft.: Page 2 S'o,m sewer(no.linear fl.: Page 2 - -- Subdivision: Lot no.: Water service(no.linear ft.:_) Page 2 -- - -- - - - ------ Fixture or Nem Tax map'parcel no: - -' Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 - ►Z��C�rtt' E><I�T IIV�SINK. IT 2hIN� RUQ Backwater valve 16.60 IA)IkT%tZ CQCAZ--IZ WATt2 LILAC, V-t.PCNCL-1-01WI o Vr'C_- Dishwasherothes 16.60 VJM4 1TN L- 1,I\t_L LA-4LIiM Zti'�,T- LL f\)&-ti l�1•�AkW1kSAe Dishwasher 16.60 tj PROPERTY OWNER ❑ TENANT Prinking fountain _ 16.60 - Ejectors/sump 16.60 Name: („ U I l V OF(--I Lt PR-UPG Iz T-I C - - Expansion tank - 16.60 Address: I C)-LCX) SU,) 1:72 E C-Q (3,C lzL_ Fixture/sewer cap 16.60 City/Ste, .ZIP: POR TL-KN b k- - Floor drain/noor sink/hub 16.60 Phone ( ) Fax:( ) Oarbage disposal 16.60 ------- --------� - APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: I�C 1 j j IZY Lei• hterceptor/greme trap 16.60 Contact name: C.L 1 F H 1\?-L AJMedical gas(value:S ) Page 2 Address: C L Y\( 11 I�,L-1J1� -- - Primer - 16.60 City/Stata/Z[P: 7(j TLA Ub, 02 97zfrl� - Roof drain(commercie) 16.60 Fax::(SV ) 'basin/lavatory 16.60 Phone:(7U3 31,0L3 - Tub/shower/shower pan 16.60 E-mail: Urinal 16.60 - Water closet 16.60 _-- Business name: rA L IC I_N`STP-� CC). - Water heater, 1 y , 16.60 (1 6 ---U Addrosa: 5400 NL LU LUMBI l\ Ifs City/State/ZIP: ISTL_ANL� '] � / - ---- : $72. 0 -- �- �..LIiG.� - Minimum permit fee: 572.30 Z FAX:( C Residential backflow minimum permit fee: 536.25 W5. Phone:(sa3) 33 f. Q 3 S0� 331.(, t. Plat review (25°b of permit fee) CCH Lic.: (� Plumbing Lie.no.: , t2z-P(3 -" State surcharge(11%of permit fee) Authorized signature: ll (n1 - _ TOTAL PERMIT FEE 9 . (s Print name: N '�_ � Date: �y-(>4 Thht permit application etplrea If a permit Is not obtained within 181)days after It has horn accepted as rompletc. •Fee methodoloev set by Iri-Count\ Iluildine Industry Service!kwd. SEE 35MM ROL.. .L# 23 FCR LA-R...UE DOCUMENT 11111-25-2004 15 08 MCKINSTRY CO 503 331 6906 P.02 Building Dh ision Applicant Request to Cancel Permit :it °f TAY-� T0; CITY OF TIGARD, BUILDLNG OFFICLAJ, 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 51)3.598.1960 FRnm ApplicantName: f 1C.� -- M61ing Address: C4rc rA A3 . City/State/zip: VO D Phone No.: PLEASE CANCEL PERMIT APPLICATION AND MFUND PI:RMU FEES, IF ANY, FOK TKE FOLLOW2;G: Type of Perrrit: Site. Address: SlubCilvis10n Lot No.: -�( 'LANATION: ?RQJELr _Vh0 LZ) K.tTukEr`1Sie!�JE ic-cre-aE.P,1 iLGt'lA L16ULaD vYl Rj_&tZ aN i0 'it��f7L AM1t7 laG►JT U NES G a f'P Z 41� t'�l l 11E� 1�17r_ ►� w w% 12 R-Vw(U). 4:0(Tu rr_p_ f_hUOT C1.EMAW\5 Vblift , TOb l_u' MAT LA A.% Ex_ISTI LA(� . 'Print Name; F'.ab- �4uL au v Y FOR OFFICE USE ONLY Route to Admin.: Date. _ B Permit Canceled: __Date: By: Rafund Processed: Datc: - _J By: _ i;Nl.uitdteglmms\ c4C=ctlPamit,�oc O 103 CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2004-00142 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 DATE ISSUED: 5/14/2004 SITE ADDRESS; 10200 SW GREENBURG RD 365 PARCEL: 1S135AB-00900 SUBDIVISION: I IVF. LINCOLN ZONING: C 11 BLOCK: LOT: _ _ JURISDICTION: 11(, _ TENANT NAME: AMERICAN EXPRESS USA NO: FIXTURE UNITS: 3 CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .2 EDU increase. Owner: FEES _ EOP LINCOLN, LLC Description Date Amount 10260 SW GREENBURG RD SUITE 100 1SWUSAJSwrConnecti( 5/14/2004 $480.00 PORTLAND, OR 97223 1SWUSAJSwrConnecti, 5/14/2004 $0.00 Phone: _ J Total $490.00 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 tota! 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, tha 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" Permit and the Agency will install a lateral 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 throug R 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-669 . Issued by: —� Permittee Signature: Call (503) 639-4 i75 by 7:00 P.M. for an inspection needed the next business da Accumulative Sewer Tally Parcel# 1S135AB-00900 _ Tenant Name: American Express This SWR#2004-00142 Site Address: 10200 SW Greenberg Rd., Suite 365 This PI-10# 2004-00216 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off#s court # value #S values Baptisery/Font 4 0 0 _ 0 0 0 Bath-Tub/Shower 4 0 0 _ 0 _ 0 0 -Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash- Each Stall 6 0 0 1 0 0 0 - Drive through 16 0 0 0 _ 0 0 _ Cuspidor Water Aspirator_ 1 0 _ 0 0 0 _0 _ Dishwasher-Commercial 4 0 _ 0 0 _ 0 _ 0 - Domestic 2 0 0 1 2 1 2 Drinking Fountain 1 0 0 0 0 _ 0 Eye Wash 1 0 _ _ 0 0 _ 0 0 Floor Drain/Sink-2 inch _ 2 1 0 0 0 0 0 3 inch 5 0 0 0 '0 0 4 inch _ 6 _ 0 _ 0 _ 0 0 0 Car Wash Drr 6 0 0 0 `0 0 Garbage Disposal Domestic(to 3/4 HP) 16 0 0 0 0 0 Commercial(to 5 HP) 32 1 0 0 0 0 0 _ Industrial(over 5 HP) 48 0 0 0 _ 0 0 Ice Machine/Refrigerator Drain 1 0 0 _ 1 v 1 1 1 _ Oil Sep(Gas Station) 6 _ 0 _ 0 0 _ 0 0 Rec.Vehic a Dump station _ 16 __.___0 0 _ 0 0 0 Shower-Gang (per head) 1 0 0 0 0 0 -Stall 2 0 0 0 0_ 0 Sink -Bar/Lavatory 2 0 0 0_ 0 _ _ 0 Bradley 5 0 0 0 0 0 Commercial �3 _ 0 0 _ 0 0 0 -Service 3 0 0 _ 0 0 _ 0 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes _6 _ 0 _0 0 V _0 0____ Water Extractor 6 0 0 _ 0 0 0 Water Closat-Toilet 6 0 _ 0 0 0 0 _Urinal 6 0 _ 0 0 0 0 — Previous EDU Count 0 0 Capped EDU Credit 0 T OTALS I 1 0 1 0 1 0 0 1 2 1 3 1 2 3 Current Fixture Value 3 divided by 16 = 0.1 Current EDU 1 FDU = $ 2.400 Previous Fixture Value 0 divided by 16= 0.0—Previous EDU Change 3 divided by 16 = 0.2 over (under) $ 480.00 Enter EDU Change Here 0.2 Notes. Signature: .,� t Date: i �!'� _ Building Division Note The property owner shall retain the ORIGINAL sewer tally record If credits exist, this document will serve as a voucher hich must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges_— OBuilding\Sewer Tel ly\SewerT aIlySheet.xls 11/19/03 TLL-14-2004 09-26 MCKINSTRY CO 503 331 6906 P.L12 M*Mkk**+*+**wr* -C01'IM. .T[N.MbWL.- ****,rrurr***+k,****** DATE W(-In-200d *r*** TIME VA:30 ******o* MODE - MEMnRY TRANSMISS1ON START■MPY-18 08:2.9 ENIIFMNY-IU 06130 FILE N0.-54, STN LOMM. rK-T000)'i STATIQ4 NAVE/TEL N0. PWAS DLI*TInN r4 1. RBBB Nr). 001 ON s 951i359B1"jG0 003/003 Ofd'M MCk IN'.TRY CO - J ram*w** > *,w+M*r *a*x**+luw�*r - rrs;r •- 503 S31 6J�J6- * rrwir bJ 5400 NE Golu"Oks DIM. �r ►orsJa.,d.00. tr218 ■ 509331.0'L74try r (� Of Yw Relid1'f facsimile transmittal To' CIT`l 6F -Tt6ARD Attn: 6ARCSAT-A b-AT1.F..2 From: Earl Solobury Phone Pages: Fac Sa3 SQ h I q G,O PM h,CA1.1 E xp(fess ��'dtrl 11- � F'lM 'ISO 4 •CJ1'?s t.. uw1t O vor v. w ❑���+Cam meet ,. Plaaee y F SI�1R 2na-ej -on147_ Gommrxrtov FL-i LL.A-:- - �.L.�►_�k I'1�1,auclwca_t�l�¢cal4WAaACL-A&W_1_ Ras��t,�np144� kC.�}'S�LILE�-t.utcn R13Ta&^1e I -SINk "1r , - z,►Ta1u Ica .►Lsrcc►c��7�_7�7wa os+l I�u �c ,may IIJL-1.1 -'004 09:26 MCK I NSTRY CO 503 331 6906 P.04 rattimb.Lin Permit &WH alio - City of Tigard 11age 2 - Supplemental Information Fee Schedule: REsidential Fired ression SysteruF: _ Fee(as) Tout S uare Foota e: Permit Fee: Site(Jtilitieo �'' --� -- - - - Footutg diatn• 1" I(Nl' --- 5500 0 to 2,000 5115.00 2.001 to 3,600 S 160.00 Footiagdrain•each additional 10f1' - 46,40 3,601 to 7,200 220.00 __- Scwcr- tat 100' 55•00 7,201 and girtalter S304.On Sower-each additional 100' 46.40 water Service•tai too' 55.00 Medical Gas Systems: weter Service-each additional 100' 46.40 Valuation•, �Mini-- �fee ' _ Storm k Rain Dram•Ilit 100' 55.00 $1.110 to 55,000.00 2,50 Storm 9z Rain Drain-wch adduional l0U' 46.40 $5.001.00 to 510,000.00 S72 50 for the first 55.000.00 and$1,52 fur each Qry ken Icel foatl F1Xture or Item additional 5100.00 or fraction thereof,to and _ includin SIQ0000(I. _ Comtrremol Back Flow Prec'cmion Device 46 40 510,001.00 to 525,000.00 3149,50 for the riot$10,000.00 and$1.34 for - - - -- each additional S100.00 or fraction thereof,to Rcsidential Bacldlow Prevention Device and includin 525 000.00 (minimum tcm,it fae$36.25) ./5S -- - _ - �` 525,001.00 W 550,000,00 5379,50 for the first 515,(100.00 and 51.45 for R.nn fr,iui.Single family dwelling �`' each additional$100.00 or frar_tion thereof,to Irsprt unn ol"exianne plutubing or - _ - and including$50,000.00 s oc�all jcquc.stcd ins crunns- er hour ___ $50,001.00 and up $741.00 for the tilat Ssupoo,t10 and 51.20 for Subtotal: each Odditignijil$100.00 or button thereof. Fixture Work: A //X Are you capping,moving or replacing existing fixtures? IfY "yes",please indicate wurk performed by fixture. Failure to v ' accurately re ort fixtures could result is increased sewer fees*. ;+ + •i, {'''' ,al! tiaetl to14e �rtiet+ane� '! �;�r 4d+>. +'fit ? ! " r r gid. � l R,' Comments regarding fixture work: hl 's /Font --- -— Bath -TuhlShower •.lacu22i/Whtr of _ _ - ---------.._.--•- _..._ c er Wash •Each Stall - -Drive Thtu -- Ciw.ridorWater Asointut - - Doshwasher Corrwicrcial -Dotnc�tla - --- --- Ikinkin Ftntntain -- - _-- 1- r Wash - Floor Dmiwsink -2" _ Car Wash Drain _-- --_- t9arbase -I?emeslie Diapoaal Canrmercial - ''lute: if the tistut r work under this permit results in an •industrial increase of sewer F.bUs, it sewer permit Fill be issued and Ice Macb.Rtefnt.-Drains fees nssesred iur the sewer iucrease mnct hr paid before the 0115 aratat t0aa Station - plumbing permit can be issued. Roc Vehicle DUMP Stallion Showrr -Gang _ - Siak •Barli:ivatery _ uaDti Total -Braaten Isometric or riser diagram is required it fixture quantic: •Comrorrcc+l _- - --- total is>9. S Pool Filter _-- --_- WashS Clothes Water Extractor WaterClohet-Toilet _-_ -_ Plan review la required if fizhtrr yunnrity total is>Q. UritW -- - Otber Fixtuter _ -- JIJ1_-14-2004 09:27 MCKINSTRY CO 503 331 6906 P.05 Accumulative Sewer Tally Parcel# TeaantNeme: A44erVU AN EApg. $ • S�%' 3(057 This SW R# Site ACIdreSs; 102.oa G J R This PLMP L•IN�I.N tvE New I i�ture value Previous Previous Credits Capped Firture FiaGure New I total 0value capped off value added added total count off as count tr value 03 values Haptise /Foul a O _ tdath•-rub/Shower 4 O �.�auzA,A hirlpuol 4 O — Ga—rWash_-Each Stull 6 _ .Drive through 16 _Cuspidor/Water Aspirator _ 1 Dishwasher.Commercial 4 Domestic 2 1 1 + Drinking Fountain 1 Eire Wash ? 1 Floor Drtaln/Sink-2 Inch, 2 Z 1 s - -I inch S a inch 6 Car Wash DiT 6 - _Garbage Disposal Domestic(to 3/4 HP) 16 Commercial(to 5 MP) 32 _�-Industdat over 5 HP) 48 Ice Machine/Retrige-Mr Droin 1 { r 1 Oil Sep(Gas station) 6 _Rec.Vehicle Dump station 18 Shower-clan (per head) " .Stall 2 Sink-Beril.tivalory 2 Brodlev S -commercial 3 -Service 3 Swimming Pool Filler 1 Washer-Clothes 6 Water Extractor 6 Water Closet-Toilet 6 _ Urinal 6 — Previnus EDU Count Capped EDU Credit TOTALS 1 EDU S 2,400 Current Fixture value divided by 18= Current EDU Previous Fixture value_ divided by 18= Previous EDU Change divided by 16= "~ over (under) Enter EDU Change Here Notes: Name: Date:_ �UlldinA Divi�bn _L The property owner shall retain this recordfor sewer credit purposes. In the event of a credit, tris ent stamped"ORIGINAL"shell serve asa credit voucher and must be submitted to the City Of®uildin Division to r®deem credit towards future system development charges. TOTRI_ P.05 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST i4 l/ BUP Received 'r Date Request —7 _ AM _ PM BUP — Location Suite— 1 MEC _ Contact Person — A lop _ __ ( ) PLM —. Contractor Ph(� ) a �"'?'.? SWR —_—_ BUILDING Tenant/Owner __ ELC Footing Fr undation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT _ Post&Beam Shear Anchors Ext Sheath/Shear _ Int Sheath/Shear Framing —_-- --� Insulation Drywall Nailing Firewall Fire Sprinkler -- —• Fire Alarm Susp'd Ceiling - - — Root Other: — Final ~^ PASS PART FAIL '-- PLUMBING Post&Beam - -- -------_----�� -- Under Slab _- Rough-In Water Service — ------_ __ Sanitary Sewer Rain Drains — —Catch Basin Basin/Manhole Storm Drain - — --— Shower Pan Other. Final PASS_PART_FAIL_ — _ --- - MECHANICAL Post&Beam ------ �— -- -- - -- Rough-In _— Gas Line Smoke Dampers --- — - -- ---- - ---- — - Final PASS PART FAIL R L Sery ce ------ Rough-In — — UG/Slab - ---- —___-_ arm Fin Reinspection fee of$ required before next inspection. Pay at pity Hall, 13125 SW Hell Blvd. Nil PART FAIL SITE Please call for reinspectlo RE: Unable to inspect no access Fire Supply Line ^,:1A Approach/Sidewalk Date _ Inspector < _ Ext )then. Final DO NOT REMOVE this Inspection recor from t ob one. PASS PART FAIL ELECTRICAL PERMIT - CITY OF TI CARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00062 -- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/10/04 SITE ADDRESS: 102.00 SW GREENBURG RD 36: PARCEL: 1S135AB 00900 SUBDIVrSIC'N: FIVE LINCOLN ZONING: C-P BLOCK: LOT: JU 'ISDICTION: TIG Proiect Description: 1 cnanl Improvement A. RESIDENTIAL _ _ B.CCMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: ACCESS COPi X TOTAL#OF SYSTEMS: 1 Owner: Contractor: EOP LINCOLN, LLC ADT SECUR11-Y SERVICES, INC 10260 SW GREENBURG RD 2815 SW 153RD DR SUITE 100 BEAVERTON, OR 97006 PORTLAND, OR 97223 Phone: Phone: 503-469-7244 Reg #: LIC 59944 ELE 16-209CLE FEES _ Required Ins,lections �— Description _ Date Amount Ceiling Cover �I I I'11�11 I I k I'rrnur 3/10/0-1 — --- $75.00 Wall Cover Elect'I Final I �� "o til;ur tiurcl a1, 311,(/04 $6.00 Total $81.00 This Purmit 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 Cregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issued by YY �, _ Permittee Signature c=����'' i CWNER 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 IN STAL!_ATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: ------ Call 639-4175 by 7:00 P.M. for an inspection needed the next business day o3/10/2004 11: 13 FAX 15094897110 ADT SEC('RITY [a 001 Electrical Permit Application y�- -- petort�ceivea Pemit no CD 0City of TlardREGEIYE idi kF'rojcct/app!.no.. - --- Elcplre 4ttti: ------- - ChyajTJgord Address: 13125 SNV!tall Blvd,Til3urd,OR 97223 Dntciasued: BY: Rcnoiptno-; Phl:=; (5(.3) 639-4171 MAP Fax: (503) 598-1 n6o Case file no PAymenitype: Land use approval: Or OF nGAFD _- --- rIU7-� &2 family dwelling or accessrny *21 C:rtnunen:i:rl/industn:tl .l Mul(i-family U,reriant imI1wVerne-'nl LJ New construction 0 A(if lit ion/alinratiurf/n;piarcinr::! U Other U Partial Job address: v - Rid - _l_ p/ 1 s. �y �iT- �.no,: Sults uo,: Tax ma tax IoU�t punt no.: Lor: Block: Subdivision: J - Project name Description and loca[ion of wank on ptemitles: -N � Bodmated date f campletio�na xwtion: _ Job no: - �?. �.�:L�1.��.-_ U� pry arae — [snaps r Easiness Warne_ Qt . at Total ua,len �- Nrtrr r..tr4nlW-slatrk or nwlf�farnily per AddCC9s_����.i�r��� dntilinpnnk 4rdn�4+vttachal�rraKn. City: State.Qx ZIP: t4nnlrxtrrcilsart Phoneme & .?jl Ft'K• �.� mall 100_0 aq it or less 4 s T Zi Erh od ill0 sq fl cr prntion thcrwf _ �— CCB no.: "1 !viae.bus. lie.no Unutm"ergy,re.Acrida 2 City/mta lic.no - '1 J_ Eimltrdtnrsgy,eonresidentl 2 1c6f 1 Ls�� Each rnanuf,cturedhomrormndularJwelling Signa r,_... ry oloctrictnn(ra ulree� to Sorvlu atxwur tnxier 2 _ ..__•_fr- -i__5--) Or --- --- Sup.dectname rinq• 6A1 KRAUS Uoaluano:l�g381 �nictskeden—lrhn��wlion, is teratloa at reloanrien: Lei I it f[[Zam 200 amps or Irm j Name / _p — �,_�L �1 _� 'l�L ►J Y �lXl 1 401 _— nrtAteSa: , 401 angry to 6fN1 amps � - --- _.--__ _ 601 amps to 1000 amps 2. City: State: 7JP: - ---- _ - _- - • s, _ ovy 1000 ramps or rylts 2 Phone- Owner hone Owner installation- The installadon Is being made oa piYpetty I own Tem oimrse�tceorfeeders _ witich is not intended for sale,lease,rent,or exchange according to 1-M-Al Alon,alteta0on,urrnlorntlnn: ORS 447,455,479,670, /01. 2M AuyA n,1699 2 1(I I Amps to 400 snips —2 - —_ -- — Owner's signature; Date: aul 1nsunamps ' i- p1 Ifranrh tircaits-nen,alt6rnnon, or extension per panel: Name A Prr far branch cirrulu with purchaz:of Address: Frrvicr,nr frederfea each branch circuit 2 City: State: 713?!: If Fee for btanrlr cirruits withm!t purchose of srrvireor feeder fee,first branch chcult: L Phuue: Fax: $-mail: - -- ------- .. Each addiunnnl branch circuit: Misc.(.Serrice of fader not included): UService over 225omps-commerrinl !Ilienith•carafac(lity bachpump orinigadoncircle 11 Service over 320 amps rating of 1 dr2 U Nuzsrdous locolon Each sign or outline lighting famllydwellings Qduildioguver1(1,000square leer ratiror Signal cirn'il(s)oralimitedenergyprrrl, —/•� _�r� USysternover60Uvoltsnonrinal mom residential units in onestmcmre tltaration,orextension, C1 Building over threr.etorins U Frwdars,400 amps or morn , — I)cscri •Oceunant load ova 99 persons O Manufncturrd atrurulres or R V put U RgtessAightingpim r-Other glen adenal InrpMloe overr9 the alleable In any of fire above: _ tlltlt- Nsi- o tion -LT" — Au6nilt-__-__seta of plata r''h arty orthe above investigation fa The above are Itof appf"Cabr• po rt' .u. 1'A eorurtrnclloda•r�lc:e. ocher Nm oil Jedsdlcdms*VW crodil cards,pleat cd!JudeAlnlrn,ver morn tnfa ti- Notice:Tuts reffnit ap,•t,cation Permit fee...... .... .... - U Viso Q Ma.ete'rGro explits if n pemtit is not obtained flan tcview(Ai 4:,r.111 tern sumhrs, _ _._ L� wi rhir I Aa dpv9 Aficr it tins Iwrn Stale t;ln-charge(840) ._. $ .W ne nccepied os Complete. l OTAJ. .................... .$ uema'7rnn hp tae-FlowsA rn envi't cud____- _ s '•anthol r r nature - Amount 410161!(NODCOM) CITY 4F TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP��2� Received __ '9 Date Requested ZEE, •�" 2 � AM _ PM BLIP Location _-- _. G to © � MEC —_-- — Contact Person _ Ph(10.ZL �I Z PLM Contractor — --___ Ph(�) (L > 5 — ��� SWR _-- BUILDING Tenant/Owner -___ zt441, ELC Footing ELC Foundation Access: —� Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam _ -------- _ Shear Anchors -- Ext Sheath/Shear Int Sheath/Shear Framing 4 Insulation Drywall Nailing Firo all _ Ire Sprinkler ---- --- — - - Fire arm Roof usp'd Ceiling �o n � � R �` _�_t"— - /IPAPS.,/PART FAIL _)PIL411VIBING — Post& Beam Under Slab - - Rough-In Water Services -- Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain - Shower Pan Othei: --- — - Final PASS PART FAIL --- — MECHANICAL Rost&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$_ _--- requiied before next inspk­;tion. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL r, SITE ❑ Please: u all for reinspection RE:__ Unable to inspect-no access Fire Supply Line 7 /fl .> ADA � �� ( � c, Approach/Sidewalk Date Inspector '_ -_— -- Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL �I TY OF T I G A R D _-- BUILDING PERMIT PERMIT#: BUP2004 00096 DEVELOPMENT SERVICES DATE ISSUED: 3/10104 13,125 SW Hall Blvd., Tioard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-00900 SITE ADDRESS: 10200 SW GREENBURG RD 365 SUBDIVISION: FIVE LINCOLN ZONING: C-P BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRU_CTI.ON CL:,SS .11: WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? _ TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS _ __ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: vft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEURMS: BATHS: IMP SURFACE: PRO CORR: Pk.I (ING: VALUE: $ 900.00 Remarks: Fire protection: add 3 heads and relocate 6. L__ -- — ---------- Owner: Contractor: EOP LINCOLN, LLC AFP SYSTEMS INC 10260 SW GREENBURG RD 19435 SW 129TH SUITE 100 TUALATIN, OR 97062 PORTLAND, OR 97223 Phone: Phone: FAX-692-1186 Reg #: MEW)92-9060083459 -- --� FEES ^-� LIC REQRI INSPECTIONS-------- Description Date' Amount Sprinkler inspection 10'll 01 I'milit I-ce 3/10/04 - $62.50 Final Inspection 1 I'AX1 811%State Surcharl 3/10/04 $5.00 Total $67.50 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 wot k 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 fallow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain a copy of these rules or direct questions to OUNC by calling X503) 246-6699 or 1-800-332-2344 Issued By � �Gl i•- G,C-� — -- Pe nnittee Signature: ' ( ' ----- — AL Call Call 639-4175 by 7 p.m. for an inspection the next business day MAR-0' 02:OOPM FROM-Automatic Fire Protection 5036821186 T-889 P 003/005 F-723 Received Building . bate/By'J� J/l/L� � '.- _ Permit No, City offTigard L• f, PlanningApprO oOther Date/8y; Yorrrtlt No.: 13125 SW Hall Blvd. t j t�`1 i Plan Review othcr Tigard, Oregon 97223 M``Il 1 o-i"y — Permit No.: Phone 503.639-4171 Fix: yr5,9&1'91�D�{l, Posr•Raview [,and Usc 1 1 DatrJE3y Casc No Internet: www.ci•ti ard.Qr•ut ON g �� Contact )uric,; sit Poke?far 4-hour Inspection Requestt',*Q-19-4t75 Name/Method: J Supplemental Information J -- TYPE OF WORK AREQUIRED DATA: New constnicuon Demolition_ 1&2 FAMILY DWELLING Addirion testi eplacement �rher: - — — j CATEGORY OF CONSTRUCTION Note Permit fres'are based on the total value of the work performcd indicate i [moi & 2-Family dwelling 0 erel—alladustrial the value(rounded to the nearest dollar)of all equiprncnt,matcria5,labor, i overhead and profit for the work Valuation_,,,, ndicated on Uiis application ❑Accessory BuildingEl Multi-Family Master Builder L Other: • •. .....• JOB SITE XNFORMATION and LOCATION No.of bedrooms- _ No.of baths: Job site address: I OZM S. 1 (grtt�y'�JQi�h1� Total welling offloots................•...............,..,. _ y New dwelling area(sq.!t.)........................••,,,, Shite#: J � rt,l;- L Garage/carport area(sq. ft.)............................ Project Name: Covered porch area(sq.ft.)............................. Cross streev`tlir .ffs toq Deck arca(sq. fr-).......................................••••• Other structure Brea(sq.R.)........... ............... REQUIRED DATA..— a COMM:EReW,-USE CEEC�LIST Subdivision: Tax map/parcel#: Note: Permit fees'are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollor)of all equipment,materials,labor, —o, overhead and profit for the work indicated on this application Existing building area(sq.ft.)- I � _.— ---- New building area(sq. ft.)......... ................... -^ Number of stories............................................JQ _ PROPERTY OWNER TENANT`- Type of construction........................................ _ i Occupancy group(s):1, r Existing: 1 --- New: -� Address_ C_it�/State/Zip _1��•r. -9-1 ZSR--- --- I Phone: Pax: NOTICE: All All contractors and subconnactors are required to be APpT;j phf'h CONTACT PERSUIV licensed with the Oregon Construction Contractors Board under — provisions of ORS Tal and may he required to be licensed in the Business Name: `(jSv ` �_ C • jurisdiction where work is being performed. If the applicant is exempt Contact Name: t ,% fir u.SC -A from licensing,the following reason applies: Address:City/State/Zipt_61-z - 11Phone: ax: ' p - g[riL:D1NGPERMrrFEW, ` -•mall: :#144wi fertolee sc]ledule. _ _CON MACTOR.. — r Business Nannie.: �lS t.l_S� Fees due upon application.............•................ S �c1 •5� Address: 1 Ci iState/Zi j t� p��� Amount received....... . .......•..... __........... S_ —• Phone: -(p '�- Pax: S�- - pate received: CCB Lir.Authorized ? O �/� - Notice: T (si per-mit application expires ira ptrmit it not obtain.•d within Signature: _ �— Date: J• 1 W 180 days after it has been accepted as rompletr. % l 5 O 41 "Fee methodology set by Tri-County Building Iadusw Service Board. (Please print namcl i �Usu�PerrtitForms�BldgPermit.4pp.dnc oUo3 ___ BUILDING PERMIT CITYOF TIGARD PERMIT #: BUP2004-00093 DEVELOPMENT SERVICES DATE ISSUED: 3/10104 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-00900 SITE ADDRESS: 10200 SW GREENBURG RD 365 SUBDIVISION: FIVF LINCOLN ZONING: C-P _ BLOCK: _ LOT: JURISDICTION: TIG REISSUE. FLOOR AREAS _ EXTERIOR WALL C014STRUCTION CLASS OF WORK: ALT FIRST: sf PI S: V E: W: TYPE OF USE: CUM SECOND: sf PROJECT_OPENINGS? TYPE OF CONST: 2FR st N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT': ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ'?: _ REQD SETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT:, ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: Remarks: TI. Demo and new wails, enlarge suite. Owner: Contractor: EOP LINCOLN, LLC C SCHIEWE + ASSOCIATES 10260 SW GREENBURG RD 1024 NE DAVIS SUITE 100 PORTLAND,OR 97232 PORTLAND,OR 97223 Phone: Phone: 234-6617 Reg #: LIC 54105 S=EES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require Electrical Permit Required I(3UILL)J Permit Fee 3/10104 $470.80 Plumbing Permit Required I13U13PLNJ Pin Rv 3/10/04 $306.02 Framing Insp IT AXI 81%State Surcharl 3/10/04 $37.66 Gyp Board Insp IFLSI FLS Pin Rv 3/10/04 $188.32 Final Inspection Total $1,002.80 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 accordance with approved plans. This permit will expire if work is riot started within 180 days of issuance, os if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-6699 or 1-800-332-2344. U Issued By: �(,;� Z t -- ��. �-t✓ Pe nn it tee Signature: Call 639-4175 by 7 p.m. for an inspection the next business day I Buiddine Permit Application FOR OFFICE 0SE ONLY. Received Building Date/By: _ Perron No.. r `1 CityCit of Tigard Planning Approval Other g Datc/ny: _— Pem,it No.: _ 13125 SW Hall Blvd. Plan Review Other _ Tigard,Oregon 97223 Date/By. 3' 0-Oy aSD Permit No.:-- Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Date/By: Case No. Internet. www.ci.tigard.or.us Contact Juris see Page 2 for - 24-hour Inspection Request: 503-639-4175 Name/Method: LSup Icmental loforrnallon TYPE O; WORK REQ UIIt1;D DATA: New construction Demolition 1 &2 FAMILY DWELLING Addition/a I teration/rcp lacement I F1 Other: - ---- ---------- --- CATEGORY OF CONSTRUCTION Note. Permit fees*are based on the total value of the work performed. Indicate ❑ I &2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, - - - Accesso� F�uildinMulti-Family overhead and profit for the work indicated on this application. _ _ � _ _ Master Builder ❑ Other: Valuation........................ ................................ 5 JOB SITE INFORMATION acid LOCATION No.of bedrooms: No.of baths:`_ Job site address: 10 Zoo SW Greenbur (io Total number of floors-..... ..................... ....... _ New dwelling area(sq. ft.) ............ .. ............ suite #: 3 G 6 BI d ./A)t.#: 'J fredn Garage/carport area(sq. ft.)............................ Project Name: { rler t c E?�pire.r., Covered porch area(sq. 0.)............................. Cross street/Directions to job site: Deck area(sq.ft.)............................................ Other structure area(sq.11.)............................ REQUIRED DATA:: --_. —.-- Subdivision: Lot#_ -- COMMERCIAL-USE CHECKLIST _—� _ _ - Tax_!n #: _ Note: Permit I'ecs•are based on the total value of the work perfommd. Indicate DESCRIPTION f1F WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, T overhead and profit for the work indicated on this application.ey+an't Irm�ro�erneht_ __— _-__- Valuation........................................... ... ......... $_5_ cm,"o -- Existing building area(sq. R.)......................... USF — --- -- --- New building area(sq. A.)............................... — _ Number of stories............................................ SEVEIJ PROPERTY OWNER TENANT _ Type of construction....................................... Name: EQUITY OFFICE P(tOPERTIe-& — Occupancy group(s): Existing: D^— Address: One SW Golvw bi a 5ui to Sim New: Cit /State/Zi ort a��- 272Z8 ----- — - -- Phone:503 12-QUO Fax: NOTICE.: All contractors and subcontractors are required to be -13 APPLICANT' CONTACI'PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Name: GJD At' iteA5,IhG, _— jurisdiction where work is being performed. If the applicant is exempt Contact Narie: Fl-ay (-. Glor from licensing,the following reason applies: Address: IIZo NW Couck St. Sete 300 — -------- ---- - Cit /State/Zip: for a OFS — -------- ------ - ---- -Phone:501 224-9w'o6Co Fax: ----� --- E-mail: - ------ �. `t71'' r1��. ,:��::=, ; _ I - BUslness Name: C- -Scklewe aks-J-o c T t .1Y1 c. Fees due upon application.................. ........... $ _ Address: rDG15 'SW 111 t-'Venom City/State/Zis'\ferrbvvl Df l-. 9- C)oA Amount received.................... ... .................... $ Phone:503 6 rob Fax: — gate received CCB Lic. #: S 05 ------------------- -- ---- Authorized Notice: This permit application expires If a permit is not obtcined wilLin Signature: - �� -- Date:_3 —R. Glut 180 days after It has been accepted as complete. -- •Fre methodology set by Tri-County Building Indus'ry Service Board. (Please print name) i\Dsts\Permit Fnmts\BldgPermitApp.doc 01/03 CITY OF TIGARD _. ELECTRICAL PERMIT PERMIT#: ELC2004-00103 DEVELOPMENT SERVICES DATE ISSUED: 3/4/04 13125 SW Hall Blvd-Tioard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-00900 SITE ADDRESS: 10200 SW GREENBHR(, hl) 'i65 ZONING: C-P SUBDIVISION: FIVE_LINCOLN BLOCK: LOT . JURISDICTION: TIG Project Description: Electric TI, (18)branch circuits. Job No. 572 RESIDENTIAL UNIT TEMP SRVCIFEEDERS — _ MISCELLANEOUS 1000 SF OR LESS:— 0 200 amp: PUMPIIRRIGATION: 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): SERVI-,E:/FEEDER — —_BRANCH CIRCUITS _-- ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION- 201 - 400 amp: list W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 17 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: LOP LINCOLN,LLC WILLAMETTE ELECTRIC INC 10260 SW GREENBURG RD PO BOX 230547 SUITE 100 TIGARD,OR 97281 PORTLAND,OR 97223 Phone: Phone: 603-624-3631 Reg #: LIC 75059 Still 1965S _ FEES Description Date Amount Required Inspections I I.I'IZ\I I I L( 1'cinnt t ! )'l $159.90 r I \ h S)'wc Surcharge l u1 $12.79 I Rouyh•in Elect'I Final Total $172.69 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR - 010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or 1-8red 344 _d Permit Signature: �( C Issy: L!� ____-- -- 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 ATE:CONTRACTOR INSTALLATION ONLY GDATE: SI(:�NATURE OF SU FIR. ELEC'N: s:�=� _� �6 �.('��� ------ 1 C E N S E N O: __. .------- — ---- ---- --- Call 639-4175 by 7:00pm for an inspection the next business day Elea ical Permit Application "atc/Br Electrical Permit No City of Tigard Planning pproval Sign D -- ate/e/Hv:v: Permit No.'. 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 nate/By: Permit No.: - -__-_- Phone: 503-639-4171 Fax: 503-598-1960 Yost-Review Land Use Date/By: Case No. internet: www.ci.tigard.or.us Contact Juris.: See-fa-up-2 far 2A-hour Inspection Request: 503-639-4175 Name/Method: Suhplentental Information.- u «r u. • �,_, t �_`.— —�. li e C BC �I New construction_ _ r— Demolition Sctcice over 225 atnps- Health-care facility commercial ❑Hazardous location Ade'ition/alteration/re lacement Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, r ;i s'. 1&2 family dwellings four or more residential units in 1 &2-Familydwellit CummercialilndustTial System over 60o volts nominal one structure ❑Building over three stc--s ❑Feeders,400 amps or more Accessory Building _ Multi-Family ❑Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder Other: ❑Egressnighting plan ❑Other: — « S I �yo � � I y u Submit sets of plan%with any of the above. Vii ' The above are not al) Iicahle to tent ornry construction service. Job site address: /0 z 51- S Bld �+ Number of ins ectlans er rermit allowed Project Name: / - Suite#: � n S•/A t�p • '� 5� � - -----__ 7 r- t e / ��f r Description Qty Fee(ea.) Total �dwvelllnit residential-single or multi-fandly per Cross street/Directions to Job site: uit.Includes attached garage. ice Included: 0 sq.A.or less 145.15 4 Each additional 500 sq.ft.or portion thereof 33.40 I - -- J— Lot#: Limited energy,residential _ 75.00 2 Subdivision: Limited energynon residential 75.00 2 Tax ma /parcel 0: Each manufactured home or modular dwelling "TJ sen•ice and/or feeder 90.90 DESC�i Ser Ices or feeder-In%tallaHon, / alteration or relocation: [_ --�- - 200 amps or less _ 80.30 2_ --�__—_--- _ -- -- ------- 201 amus to 400 amps 106.85 2 401 ap'p's to 600 amps 160.60 _ 2 601 amps to 1000 amps — -_— 240.60 2 Ovcr 1000 amps or volts 454.65 2 Name: -- _--- Recomueat only �- --�—— 66.85 2 Address: Temporary�ervlces or feeders-In%tallatior alteration,or relocation: City/State/Zip: -- _— 200 am sp or less _ 66.85 I Phone: Fa}t', _12Lamstn 400�s 100.30 2 vw 401 to 600 amps 133.75 2 Branch circuits-new,alteration,or Name: extension per panel: A.Fee for branch crcuits with purchase of Address: _ _ service or feeder fee,each branch circuit 6.65 _ 2 City/State/Zip:/State/Zl B.Fee for branch circuits without purchase of t �— ----_,- — -- service or feeder fee,first branch circuit 46.85 ��6 2 Phone: _ _ FaX: Each additional branch circuit 17 6.65 13-0) 2 — Misc.(Service or feeder not included): 1 -mall: Each pump or ori !tion circle _ _ 53.40 2 Each sign or outline li htinlL53.40 _ 2 Job No: s 7 Z Signal circuits)or a limited energy panel, alteration,or extension Pae 2 2 Business Name: u- az„�t/( t. �Pr l',•c r. t: Description' -- — Address: – V _Each additlnnal inspection over chic allowable in an of the above: —_ Cit /State/Zi :a �� Z Per ins %tion per hour(min. l iw� Phon ,'j L'f 371 FaX: 1 '3 t`� yJ Investi scion fee: '-- CCB Other.#: 075�� 5 Lic.#: 3 y- Zt�� _-_ Supervising electrician k -- Subtotal $ / S-9+ 90 Signature required: TTS _ Plan Review(25%of Permit Fee) S _ Print Name: r2er f< Lic. #: /9 91 s - State Surcharge(8%of Permit Fee S I z 7 S — — TOTAL F9 �I Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 days after it ha+been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. (Please print name) iADsts\Permit Forms\ElcPetmitApp.dnc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems............- .......................................... $75.00 Check Type of Work involved: Audio and Stereo Systems* I� Ilurglar Alarm (iarage Door Opener* El Itesting,Ventilation anc'Air Conditioning System* ElVacuum Systems* Other.---- COMMERCIAL WORK ONLY: Fee for each system.......................................................... $75.00 (SEE OAR 918-260-260) Check Type of Work Invol ved: Audio and Stereo Systems Boiler Controls Clock Systems Data Telecommunication Installadwi Fire Alarm Installation HVAC Instrumentation 0 Intercom and Paging Systems 0 Landscape Irrigation Control* F1 Medical Nurse Calls ! ! Outdoor Land—toe Lighting* El Protective Signaling Other _Number of Systems * No licenses are required. Licenses are required for all other installations iADsts\PermitForn.'Etc PermitAppPg2.doc 01/03 CITY OF TIGARD 24-Hc BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 -- - 4 // //� BLIP - -.. .- --- - Received .._..____�� ��� ..- Date Requested `7�"Z�v 5�__- AM__ ______- PM__..____, 71;�) -- -_-_ Location ___ _�Q_2s1� -_ !`�''a.�0 -- ---_soite��?i�P_ Contact Person __ _ _. � P Ph �W. T7_0_5�k_ PLM Contractor _ _--_-__ ... -__ -,--- - -_-- Phi(--__) _---- _-- SWR BUILDING _ Tenant/Owner � ELC Footing Foundation ELC --__-- _ Ftg Drain Access: Crawl Drain _ — - Slab Inrpection Notes: ' SIT Post&Beam Shear anchors - Ext Sheath/Shear Int Sheath/Shear - Framing - - - Insulation Drywall Nailing --- --- - Firewall Fire Sprinkler -- --------- -- - - ---. Fire Alarm Susp'd Ceiling Roof Other: Final - ASS PART FAIL PLUMBIIVQ Post& Beam _"------------ ---- Under Slab - Rough-In --- _ Water Service - ------ Sanitary Sewer Rain Drains - ---- - — Catch Basin/Manhole Storm Drain --- Shower Pan Other: -- -- - - -- - -- - ---- ----------- ----__ Final PASS PART FAIL MECHANICAL _ Pc••+R Ream Rough-in __— ------------ Gas Line R ja ampers - -------- - --.—_.._._---- — —__---- ART FAIL ELECTRICAL-� Service -._— ---------- _ --- -__ �- ---- ----- ---------- Rough-In ------ ---- --.. -- UG/Slab Low Voltage Fire Alarm ,-- Final Reinspection fee of$_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. _PASS PART FAIL_ SIT n Please call pr reinspection RE: Unable to inspect-no access Fire ADA Date Line / Approach/Sidewalk D�t� / r - !"Specter Ex! Other,- nal ther:nal DO NOT r4EMOVE this Inspection record from the job site. L PASS PART FAIL CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2004-001;, 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATA;_ ISSUED: 3/26/04 PARCEL: 1 S135AB-00900 SITE ADDRESS: 10200 SW GREENBURG RD 365 SUBDIVISION: FIVE LINCOLN ZONING: C-P BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FLRN: FVAP COOLERS: TYPE OF USE: GOM UNIT HEATERS: VENT FANS: OCCUPA14CY GRP: B VENTS WIO APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: _ FUEL TYPES 0 - 3 HP: DOMES. INCIN: 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 BTU: <= 10000 cfm: GAS OUTLET S: > 10000 cfm: Remarks: Mcchanicul'I'I, relocate ducts& grillc,, Project Valuc: $14,535 Owner: FEES ^' EOP LINCOLN, LLC Description Date Amouat 10260 SW GREENBURG RD I Vl c III Permit I-cc 3/26104 $292.25 SUITE 100 I \\Is".,siate surchal i 3/26/04 $23 38 PORTLAND, OR 9722.3 _ Total $315.63 Phone: — Contractor: MCKINSTRY CO 5400 NE COLUMBIA BLVD PORTLANn, OR 97218 REQUIRED INSPECTIONS Phonrz. 331-0214 Mechanical Insp Final Inspection Reg#: LIC 40981 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rales adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 } .i Issued By: �` _ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for Inspections needed the next business day Mechanical Permit Application City of Tigard 1tXllv.:. ,„ 1 , Peruui r, s' 13125 SW Hall Blvd.,Tig„rd,OR 9723 flax Review Phone: 503.639.4171 Fa. :03.59N,1960 Date It),: t cher Pcnnn Inspection Line: 503.639.4175 — Intemel: www.ci.figard.ot.us Notified RdMelhy: ® Sec PaRe'.for g Nntilicd'Melhod: Supplemental Inkirmanoa f--- TYPE OF WORKi_ COMMERCIAL FEE* SCHEDULE - USECHECKLIST El New construction ® Additiomalterution replycement Mechanical ennit fees*are based on the va ue of the work I performed.Indicate the value I namckd to the nearest dollar)of all ❑ Demolition ❑Other: mecham_cul materials,equipment,labor,overhead,and�ftt. CATEGORV OF CONSTRUCTION '- VnlucS 14 S35.O/t - ❑ I-and 2-familydwelling Cumrncrcia iindustrial RESIDENTIAL EQUIPMENT/SYSTEMS FEES* b ® ❑Accessory building Fo special injomnotion ust c-hecklist ❑Multi-family ❑Master builder ❑Other: Description —=ny. 1 Ea. Total JOB SITE INFORMATION AND LOCATION I Heatinil/cooling _ Jot,cite address: 10200 SW Greenburg Rd./Lin.:nln Five Air conditioning ite plait hi hent pump (requires site plan ehowin placement) 14.01 City/State-ZIP:97223 Furnace 100,000 BTU(ducts vents) 14.00 Suite/btdg..apt,no.:Suite-165 _ Project name:American Express Furnace 100.0001 BTU(ducts vents) 17.90 Gas heat pump 14.00 Cross street/directions to job site- Duct work 14.00 H dronic hot water system 14.00 Residential boiler(radiator or h dronic) 14.00 --- — Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 10.00 Flue/vent for any of above 10.00 Subdivision: - Lol no� Other: 10.00 Tax map/parcel no.: Other fuel appilences _ — DESCRIPTION OF WORK Water heater - 10.00 Gas fireplace I0 HVAC Tenant Improvements ~- t10 Flue vent for water heater or gas fire 3lace _ 10JO ----------- ---- ----- Log lighter as 10.00 _ Wood- ellet stove 10.0(1 - ----- ---�-�----� ----- Wood fireplace/insert 10.00 ® PROPERTV OWNER L` ❑ TENANTO - ther. yiliner'llucivcnt 10.00 Other. 1001 Name:Equlty Office Properties Environmental exhaust and ventllatloo Address:One Columbia Street/Suite 300 a ui mRange a tx)iother kitchen _ -- -_-�_-_- mt -----_ — 10.0(1 City/State/ZIP:97258 Clothes dryer exhaust ------ --- --- Single-duct exhaust(hathmoms, Phone:( ) Fax:( ) toilet compartments.utility mules) 6.80 ❑ APPLICANT ® CONTACT PERSON Atticicmwlspace fans 10.00 Business name:Mckinstry Co. Other _ 10.00 Fuel piping _ Contact name:Earl Salsbury $5.40 for flrst four;51.00 for each additional Address:5400 NE Coumble Blvd Furnace,etc. -_ --- - - --- Gas heat punk City/State/ZIP:97218 _ _ Waftsuspended,unit heater _ Phone:(503)331-2465 Fax::(503)331-6906 Water heater — - -- — Fireplace E-mail:earls(a-,mckinstry.com Rangy -- CONTRACTOR Barbecue _ Business name:McKlnetry Co. Clothes der as)_._ -- -- ---- Other: Address:5400 NE Coumbla nlvd MECHANICAL PEPS -F1'.S* City/State/ZIP;97218 _ ___ ;+i t►total Phone:(503)331-0234 Fax:(503)331-6906 —Minimum permit fce(572.50) _ Plan review(2!%(if permit fee) CCB lic.:40981 State surcharge Wil of permit fce) 7.OTA1.PEP.1141T FEE This permit iy,)plleanon expires If a permit Is not obtained aithln 1110 Authorized signature: ^ daps dire It has been accepted as complete. Print name:Earl-alsbury — D :03/24/04 Fee methodology set by Tridbunty Building Industy Service Board r Building Pemiin MEC-PennitApt,doc 12 01 44046!?T(11 02 COM AIER) SEE 35MM RdLL# 2 3 FOR LARGE DOCUMEIITT CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639.4175 �- INSPECTION DIVISION Business Line: (503)639-4171 MST — , �3�, �� BLIP Received �� —Date Requested 31 -- AM._ � ! BUP Location ��Zy v �` __�r. �= ff e%6 _ ,C S'n MEC _ -- r Contact Person (6-A C - - Ph( PLM Contractor _ — _-� -- Ph( ) — SwIrl — BUILDING TenantlOwner z / ✓��-- — EL'S —-— — Footing - �- ELC ----- -- Foundation Access: Ftg Drain 10L oy - Crawl Drain - Slab Inspection Notes: SIT - ----- - -- Post&Beam - --- -- _ _---__ Shear Anchors Ext Sheath/Shear — - Int Sheath/Shear Framing1'. K/E 1 Insulation y�I�..` W�� — �/` r'16 -- -- - Drywall Nailing Firewall 67 (�` Fire Sprinkler "� -- -- Fire Alarm Susp'd Coiling Root Other: .-. --__ - -- --- - - -- - - -- ----- ----- -- - Final -------- - -- - / --- ----- --- — PASS PART FAIL PLUMBING - ------ --� - ——------- --_-- Post Beam Under Slab ----- ---- ---�-- rtl -" ---- - ---__ --- Rough-In Water Service - ----- `- - -- Sanitary Sewer Rain Drains ,------- Catch Basin/Manhole Storm Drain -- - - Shower Pan Other: - -- ---- Final - PASS PART FAIL MECHANICAL - --- Post -Post& Beam Rough-in -- -- - Gas Line Smoke Dampers - - - -- -- Final P T FAIL -- - - --- - L_ECTRICAL _ Service - Rough-In ---- iw Vol - -- ---- - -------- --.-- Fire Aliam Fi Reinspection fee of$___- _- required hefcre next inspection. Pay at City Hall, 13125 SW Hall Blvd. A88 PART FLAIL _– S -` P19ase call for reinspection RE: —._ _____. - [� Unable to inspect-no access Fire S!!pply Line ADA Dots 2.� Ilnspootor - � ��� ��i Fact-- Approach/Sidewalk Other:._ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL .r CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639.4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP Received —._ f3� �� .D- Date Requesteid _ AM__ PM _-__--.— BLIP - - Location �r��� -Q�- - --- Suite -- MEC -- -- Contact Person Ph PLM ------------- _ Contractor P SWR --- _---- BUILDING Tenant/Owner _ _. _ _.___ ELC — --.—_ Footing EL����� Foundation Access: Fig Drain ELN _--- Crawl Drain —— SIT Slab Inspection Nates: Post&Beam ----- - - --- Shear Anchors Ext Sheath/Shear •- - - -- -- int Sheath/Shear Framing - - Insulation Drywall Nailing --- — --- -- ---- - - Firewall Fine Sprinkler ��—____------ ------ - -- Fhe Ale.rm S jsti a Ceiling Roof - --- 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 -- - 161ECHANICAL ---- Post _Post& Beam - Rough-In - Gas Line Smoke Dampers ---------- --- __ _. Final PASS PART FALL - - - --ELECTRICAL Service Bou h- L _"J"11t -- -- UG/Slab - -----.-.-- Low Voltage Fire Alarm Final n Reinspection fee of$ r9quired before next inspeot:on. Pay at City Hall, 13125 SW Hall Blvd. 1'"S.)PART FAIL S [] Please call for winspectwn I IF __�-r_- [] Unable to inspect-no access Fire Supply LineADA ' Approach/Sidewalk Date _�* r/ _C i Irsipe Ext Other: Final DO NOT REMOVE thls Inspection record firthe Job Ito. SASS PART FAIL CITY OF T I GA R D ELECTRICAL PERMIT- RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00076 13125 SW Hall Blvd., Ticiaro. OR 97223 (503) 639.4171 DATE ISSUED: 24/04 SITE ADDRESS: 10200 SW (ARF ENBURG RD 365 PARC`L: 1S'135AB-00900 SUBDIVISION: FIVE. LINCOLN ZONING: C-P BLOCK: LOT: JURISDICTION: TIG Project Description: Install limited enargy for voice/data. ----- - Jot) No. 0465:4A A.RESIDENTIAL _ B.COMMERC:IA_I AUDIO & STEREO: AUDIO & STEREO: -- INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DA'rA1TELE COMM: x NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL #OF SYSTEMS: 1 Owner: Contractor: EOP LINCOLN, LL_ DRYER ELECTRIC INC 10260 SW GREENBURG RD PO FIOX 86369 SUITE 100 PORTLAND, OR 97286 PORTLAND,OR 97223 Phone: Phone: 503-771-5667 Reg #: Et L•' 26-11420 LIC 153466 SUP 28765 REES Required Inspections Description — Date �~ Amount Low Vollage Inspection �I 11IRM I I LLR Permit 3/24/04 $7500 f=lect'I Final 1 A\18",.State Surchart 3/24/04 $6.00 Total $811.00 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 folluw rules adopted by the Oregon utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Isued by a�4L�l 0�pc Permittee Signature• 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: CONIR ACTOR INSTALLATION ONLY %GNAT'JRE OF SUPR. ELEC'N DATE: LICENSE NO: -- Call 639-4175 by 7:00 P.M. for an insnectlon needed the next business day Electrical Permit Application City (rr rl ►ard lBs, ved Permit No�+ �' I i 12�SW I Inll Illvd. Figard.()1t 97223 tevicsa — I'Itouc 5113.639.4171 Fax: 501 598,19(41 Dale/By Other l'crmit: Inslivown Line503.639.4175 Date Ready/Hy -- tuns ® See Paae 2 for Interne( tt ww ci.tigard.or its Nolitied/Method: Supplemental Information ----._— _TVP►. OF WORK PLAN REVIEW ❑ Ncw construction ti Additi;;,!,illcration/replacement Please check all that apply: ❑1)Ihcr: ❑Service over 225;nips,comm'I []I lai.ardous location F] Demolition _ []Service over 320 amps-rating ❑liuildng ut cr 10,000 sq.It.. CATEGORV OF CONSTRUCTION of I-and 2-11mily dwellings 4 or more new residential ❑ I-and 2-family dwelling ('ummerciul/ittdusu'ial [I Accessory building ❑System over 600 volts nominal units in one structure ❑Flufiding over three storic, Deeders.400 amps or more ❑Multi-tinnily s4.[ lsler builder ❑Otiler. ❑Occupant load over 94 persons ❑Manufasuved stntcuues or JOB SITE INFORMATION AND LOCATION ❑tigress/lighting plan RV park ❑Ileallh-care lilclitty ❑Otiler: .lob no.: a Joh sltc a(Idress: Submit 2 sets fa'plans with any o(the above. - C'ily/Stale/7.11': iT� p I'hc above are not applicable hr temporary construction service. Suite/bidg' I/a tt. no.. Project name: I�}rht�f.«.x It — FEP SCHEDULE .. -- p6t, �1fttl3 Descriptio. r?t>. Mer. caul Cross street/directions tojob site: New residential single-or multi-family dwelling unit. — --- Includes attached garage. 1,000 sq IL or less 145 15 4 Subdivision: —_ -— Lot no.: Ua.add'I 500 sq.it or portion 33.40 1 Limited energy,residential 75.00 2 1 ax ntap/purcel no.: _ Limited energy,non-residential 75.00 2 DESCRIPTION OF WORK Fach manufactured or modular -- dwelling,service and/or feeder 90.90 2 Vol c i IDwtt h �a — Services or feeders Installation,alteration,and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER T ❑ TENANT 201 amps to 400 amps — 106.85 1 --- — --- 401 amps to 600 amps 160.60 2 Name: 601 amp,io 1.000 snip, 240.60 2 Address.: Over 1,000 amp,ui wll, 454.65 2 Rc�_n(nco onk 66.8.5 2 01y Slaw/H, 'I'eniporary services or feeders Installation,alteration,and/or Phone: Fax:l 1 1 relocation - ___ _ — ----- 200 amps or loss66.85 1 ftwner installation: I his installation is being made on property that I own which is not 201 attlps to 400 amps 100.30 2 intended tin-stile, lease,rent.or exchange,according to •I1S 447,449,670.and 701. 401 amps to 600 amps -- 133.75 _ 2 Owner si mature:-- __-- hate: - k -__ _ _ .__. _ branch circuits-new,alteration,or extension,per panel ❑ APPLICIM,t jff CONTAC-11' PF,RSON A.Fee tin hranclt circuits mfth service or Iceder Ice,each 6.65 2 Business name: Dof ifIeef7Gt --,--.---- branch circuit _ _ B.Fee(its branch circuits Contact name: without service or feeder fee. 46.85 2 Address: Q 86 (� each branch circuit f'Oe?f _ _ _—_ 9 Each add'i branch circuit 6.65 2 City/state/%IP: p�2H ,x� z g _ Miscellaneous(service or feeder not Inc;ided) f Pump or irrigation circle 5340 2 Phone:(5V ) 7 s6b : Po; 77#f (ok ) le -- — - ` -( - 1 Fax: 1_ Sign or outline fighting 53.40 2 G-trtt,il: 6 0h w d V Orr tlec+rlt . ton% Signal circuits)or limited- - CONTRACTOR energy panel,alteration,or extension,hescrihe: Page 2 2 Bueincss name: �4 1 edn,'-c — — \ddress: PO of)( 6061 Each additional inspection over allowable In any of the above Per inspection 62.40 I ity_istate/7.11': v(!>ft o g z g 6 Investigation per hour(I hr min) 62.50 Industrial plant per hour 73.75 Ph,mc:(Tb) ►771 - sz6 r --- Fax: Jv3 ►77Y-IoY6 -- _ ELEc-L'RICAL Pa:RMIT FEW 1 It l.ic ' S'3�6(p Electrical Lie.:26_1142 c Supry�l,ic _ subtotal �S Supry. I Ira i man signature,required: Plan review(25"16 of permit fee) — /� State surcharge(11"'n ol'pemtit fee) Print ntttt,e: lit 1 e� 6-4-5 De.5 DA dJ�-�Yw — - -- TOTAL PF:RMTr FEF _91 Authorized signature: �J��...�-. this permit application expires if a permit is not obtained eithin 180 days after it has been accepted as complete Print name: — -- Date. —� I cc methodology set by Ilr('ounn Boildiug Ioduso%Scrsicc Hoard "Number of inryeclions per permit nllowed. Huildmg prnnia.0?L('-Penuit.4pp doe I'•a 440-461'T(In/o2rc'ONInvta