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10220 SW GREENBURG ROAD STE 125-2 IJ I,J C s n r•: C '7 ?Q a IJ 'll 10220 SNN' Greenburg Rd 125 A CITY I�� �� ������ _ ELECTRICAL PERMIT _ \ PERMIT#: ELC2002-00185 DEVELOPMENT SERVICES DATE ISSUED: 4/25102 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S135AB-01002 SITE ADDRESS: 10220 SW GREENBURG RD 125 SUBDIVISION: THREE LINCOLN-TOWN OF METZGER ZONING: R-12 BLOCK: LOT : 009 JURISDICTION: TIG Proiect Description: Demo misc. electrical 3 branch circuiis _ RESIDENTIAL UNIT _ TEMP SRVC/FEE_DERS MISCELLANEOUS 1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION: EACH ADI:r'L 500SF: 201 400 arnp; SIGN/OUT LINE LTG: LIMITED Efvti<„Y: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/F EEDER _ BRANCH CIRCUITS _ _ ADD'L INSPECTIONS 0� ?00 amp: W/SERVICE OR FEEDER: — PER INSPECTION: 201 400 amp: 1st W/O SRVC- OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD't_ BRNCH CIRC: 2 IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 1000+ amplvolt: >=4 RES UNITS: > 600 VOLf NOMINAL: _Reconnect onlySVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: SP'EKER PROPERTIES L P CAPITOL ELECTRIC CO INC 10260 SW GRE FNBURG RD 12810 NE AIRPORT WAY SUITE 100 UNIT 1 PORTLAND, OR 97223 PORTLAND, OR 9723C Phone: Phone: 255-9488 Reg #: LIC 048748 SUP 3132S ELE 26-4960 _ r FEES Required Inspections` Type By Date Amount Receipt Ceiling Cover PRMT CTR 4/2.5102 $60.15 27200200001' Wall Cover Llect'I Final 51DCT CTR 4/25/02 54.81 2720020000( -- Total $64.96 This Permits issued subject to the regulations cAntained in tie Tigard Mun cipal Code. State of OR Specialty C(des 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 ATTENI ION 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 copes of these rules or direct questions to OUNC at(503) 246-6699 or 1-800-332-2344 Permit Signature: 1 /' Issued By: _OWNER INSTALLATION ONLY _ The installation is being made on property I own which IF not Intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: —_ CONTRACTOR INSTALLATION SIGNATURE OF SUPR. ELEC'N: '_ ��- C— ------- DATE: LICENSE NO: — Call 639-4175 by 7.00pm for an inspection the next business, aay Electrical Permit Application — -- Dale received: UL- I confit no.; (�.7L-k'I� -GYJ r I'rojeissuedspire dale: City of'Tigard nate issuedit,4 Receipt no.: OF TIGARI) Ad-Jress: 13125 SW HALL BLVD.TIGARD,Oil 97223 Case file rick- CITY . I' tment tvpu: Phone: (503)639-4171 Fax(503)598-1960 Land use approval: O I &2 family dew!ling cr accessory ❑ C'ommcrcial/industrial ❑ Multi-family Ci 'tenant improvement New construction ❑ Addition/altcrttion/ieplaccntetit ❑ Other: ❑ Partial Joh address: 10220 SW Greenbui- R'i _ (1t\: Tigan) I'_te.Nu.: Suite no. I;rs Ifulp/Ing l(It/actmoll no _ Lot: 111lock.. N/A I'll o•ecl name: Electrical Demo )escriplion and location oI wui'I:an premises. Suite 126 in Lincoln Three.Misc Electrical Demo. listimnled clnte of complclion/insPt•ctini r d Joh no: 22-608 l '' Business Name: apito ElectricCo.,Inc. first ri 1lioll (11'. , oil no.insp Address: 12810 NE Airport Way New residential-%Ingle nr nndll-family per City: Portland State: OR ZIP: 97230-1029 dwelling unit. Includes attached garage. Phone: 503-255-9488 1hux 255-9488 F.-mail: darrell ce dx con Service Included: CCIt no.: 48748 l;lcc. iks lic.no: 26-496C Inns sq,ft.or less _ $ 14515 _ _Wi04nW.qo lic.no.: N/A Hac1 additional.500 sq.Il nr portion Ihct-col % 114o iALL 4/22/02 Limited energy residential It 7500 _ Signature of su crvismg clr(triciun Ireyuired) Date I united energy,non-icsidenuul f 45 nn Sup elect nntnc(Print) Darrell McNeal License no.. 3132.3 Pach manufactured home or modular dwelline Service and/or feeder Name(print►: Equity O,'fice Propertie,, Services or reeden-inshlllation, — — Ma ling address: tdlerallon or relncnlion: city: _ State: Y.II': 'nn amps or less I'hc Fax: P.-maiL' 2111 amps to 400 amps nu.ss _ 2 Owner ltrstallation: 'I'hc rostallntinn is being mode on pnlperty I awn 401 amps to(100 amps v b 160 60 which is not intended torr sale,lease,rent,or exchange cccording to 601 amps In 1000 amps _— s :u _ ORS 447,455,479,670,701. liver V)00 amps ar volls -- S I`1 (Ju'ner's siganrru•o.; Date: Reconnect only Temporary services or feeders- Name: installation,alleratlons,or relocntiml: Address: 200 amps or less City: State: ZIP: 201 amps to 400 naps Phone: I is I -nt,il tai amps to 600;11111,s Brunch circuits-new,alteration, E)Service aver 225 mnps-cnnanercial ❑nenhh•nur 6lvilils 111'exIe115Ir1n per panel: ❑Service over 320 mnpe•rmiug of 1&, ❑1lazanlom Incatim, \ I cc for branch circuits with purchase of fanny dwellings ❑nodding over lytta square if lino tit xrk'W'Or feeder Re.each branch circuit r,6s ❑Syelem over 6011 volts nominal more residential unite in rnm structure 11 I ee for hrancli mein.,t ilhoul putrhme ❑nuilding over three stoles L7 feeders.On amps m more of sett ice or heeler ice.I first htnnch cucun 1 b 4(,85 16 a5 ❑nccupanl load over 410 persons ❑Alrnmfactureti atrucnues or R\'I'n,k Tach additional branch Vocal s o 0 11 ui ❑fgttres/hriliing plan ❑Other \Ilse.(Se"'Ice or feeder nut Included): Sulnlit sets of plans w1111 aey of the nhnve. I ach pump nr inigntion circle t 51•1' the above are nal appli;nMe to temporary ci,noruclion service. Inch sign or outline lighting Signal circuilts)or n united energy panel, alteration,ar cxtensinn• 5 'Description v_- P.ac,additional inspectionover th allowable In any of the�above-�— Per inspec•ion Imes111"Ileo h fee (Rhcl ❑Visa ❑ MasterCard Permit lee. .. .......... 1 60.15_ u•dit,and number / Noticeth•s permit application Plan review 1 ) ! �— �''""" expires if a permit is not obtained State Surcharge 806 1 1i 4.81 Name al cmdholder m sham on credll curd wlthing 180 days after it has been � f'O'I'Al....... ........... x sass (ardhn,dev xinmmote accepted as complete. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)6:,9-4175 MSf INSPECTION DIVISION Business Lina: (503) 639.4171 5UP Received ___ _- __ -.---,-- Date Requested `_� 3 AM__ PM _ EUP Location ---__-- �r7 l �� -� Z.Q/V Suite---- MEC Contact Person _ Ph ) _ PLM _- Contractor ___ Ph( ) c�x.5.5 _ �4`Q SWR �-- BUILDING _ Tenant/Owner ___ _.- _ ELC Footing ELC — Foundation Access: Ftg Drain ELR Crawl Drain _—_ Slab Inspection Notes: SIl Post&Beam Shear Anchors - --- Ext Sheath/Shear - — Int Sheath/Shear Framing - Insulation G� Drywall Nailing - — -- '1 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -- — ------ -... ----- - -- Roof Other. -- Final PASS PART FAIL — PLUMBING Post& Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: First PASS PART FAIL MECHANICAL_ Post&Beam Rough-hi ------ - ----- Gas Line Smoke Dampers ---- Final PASS PART FAIL �- ELECTRICAL. ...Service ------ Rcugh-In -- - - UG/Slab _} Low Voltage -- F' larm �• Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hail Blvd A S PART FAIL SITE —�_ Ll Please call for reinspection RE:__ Unable to inspect-no access Fire Supply Line ADAC Approach/Sidewalkcfi - Inspector, t�.'� Ext— Other: . Final DO NOT REMOVE this Inspection record from t/job sift. PASS PART FAIL CITYOF TIGA,RD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#- BUP2002-00344 f ♦ 13125 SW Hall Blvd.,Tigard, OR 97223 (503 639-4171 DATE ISSUED: 8/8/2002 g PARCEL: 1 S155P 3-01002 ZONING: R-12 JURISDICTION: TIG SITE ADDRESS: 102.20 SW GREENBURG RD 125 SUBDIVISION: THREE LINCOLN-TOWN OF METZGFR BLOCK: LOT:009 GLASS-0 F WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 2N OCCUPANCY GRP: B OCCUPANCY LOAD: 37 TENANT NAME: SPEC SPACE REMARKS: TI Demising walls for future restooms Owner: SPIEKER PROPERTIES L.P. 10260 SW GREENBURG RD SUITE 100 P9QeND2W69W3 Contractor: C SCHIEWE +ASSOCIATES 1024 NE DAMS PORTLAND, OR 97232 Phone: 234-6617 Reg#: LIC 5,4105 This Certificate issued I1/6/2002 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the Sta of Oregon Specialty Codes for the group, occupancy, and u under which a eferenced permit w BUIL GINSPECTOR BUII_D1NG O r/ POST IN CONSPICUOUS PLACE CITY O F T'G A R PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT-#: PLM2002-00341 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/30/02 SITE ADDRESS: 10220 SW GREENBURG RD 12.5 PARCEL: 1S135AB-01002 SUBDIVISION: THREE LINCOLN-TOWN OF METZGER ZONING: R-12 _u BLOCK: _ LOT: 009 JURISDICTION: T13 CLASS OF WORK: ALT GARBAGE DISPOSALS- MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH ' ASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVA i"ORIES: OTHER FIXTURES: 2 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replace with new fixtures: 1 sink, 1 w9ter heater. Other fixtures: 1 hub drain, 'I primer. Per John Oberg, these fixtures are replacing fixture that were capped by others No sewer permLLegiiired__� Owner: _ FEES 5PIEKER PROPERTIES L.P. Type By Date Amount Receipt — 10260 SW GREF_NBURG RD PRMT CTR 8/30/02 $72.50 27200200000 SUITE 100 5PCT CTR 8/30/02 $5.80 27200200000 PORTLAND, OR 97223 _ Total $78.30 Phone 1: -- --- Contractor: POWER PLUMBING CO P O BOX 23144 TIGARD, OR 97281 REQUIRED INSPECTIONS Phone 1: 244-1900 Rough in Insp Reg #: LIC 52378 Top-out Insp PLM 34--150PB 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 work is not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: 1 ,' t 1. lI r /e. Permittee Signature: Call(503) 639-4175 by 7:00 P.M. for an inspection needed the next business day HUG 27 2002 13 15RM HP LASERJET 3200 Mf-'!t`i- i • • Phimb><ngPernut Apphcat><on s / r-r Daterece[ved. •�/ Pernod City of Tijald Sewer permit no.: Building permitno,; ss: i 3125 SW Hall Blvd,TigaM,OR 97'23 R- iW .. _" (503) 6394171 Projtxt/appl.no.: -- _- Expircdatey -- V(503) 598-1960 Vateissucd: SY: tno.: AUG ? 7 iOU Land use approval: ,— ._ _ _.�- (:ase file no.: Payment type: 3111111111111111111 �[CJJ "c.o,.,t,.Wun lima!ofaccessory U Conunercial/industrial U Multi-family New `S�Addition/altemtion/mplacemea: U Food service U Other: ._ 308SIMINIVICNIATION Job address Ucwcri an Qt . Fee ea. Tutnl - -- New 1-and 2-fwdly dwelthipa on1r. (Foclndex100 ft.for eacLodayconnectlon) Tart reap/tax lot/account no.: SPR(1)bath LotBlock.: Subdivision -- —_ SW(2)hath -- — Project nttme: _ SFR(3)bath -- -- -- - _City/county: _ ZTP ��.�.� Fach additional badAkRchen A_ Jr- Deacripti n and ocadop of work on psee: _ Skeratllltics: Ich basin/arca dein — — t.date of comple.1ir xitinspu:tiuu: rywclldrai- h li.hn. nch drain - - Fcx>dng drain(no.lin.ft.) ManufmAuted home utilities _ Dustiness name: QX1i.df�l�_�_-_ M iolcs es --- _— — -Addrs: fa L / Rein rltnin connecter - CAty:: State: ZIP: _2-FU Sanitary sewer(no.lin.ft) Phone: 1944,) Fax: - yam' E-mail: Storm sewer(no.lin.ft.) CCB no.: .� — Plumb.bus.reg.no: Waw service(o m.it) FIxturr or ken: Ab. tion valve Contract es mrresentative signature: Rick flow lireventea - — Print narne:46A/ 0 Date: Backwater valve- 1 Basins/lavatory --, - Name: � - VV'L— Caotlucs washer�� �_. Address: j] Drinki ng fountain(s) — City: _�Stalc:(�y' 'LIF': .1 -Faectors/sump __— Plione: pv Pax: "-atail: ExpwLsion tank AM rrxturrlScwer cap _—� .- —_ _Name(print): floor drainVfloor sinks/hub !. address: -- - Garbage die o�sal 3 11 - Hose Bibb ty_ U State:Qy ZIP:_Q 7�� TIce MWC-r -Phone: 5 - I ax: l mail -Uor trap Owner installatitx>lresidential rnaintenance only: The actual Installation Primers) will be made by me or the maintenance acrd tepair made by my regular Raif drain(commereiil ) employee on the property I own as per ORS Cliap(er 447. Si s),basin(s),lava(a)Ab, oivtiet's signature:. ----,— -- _ Dale: Summa_ l T ibs/showed�Tvmr pan Urinal Water clo9a Address: __- Water Ixater • City: Phone: Fax: ---�� Hrtnail: 7' u Nd as�at.drtlam aca4t credit cads.panes call)crud cdoo oar nae k Onn'tim Notice:This permit aprhmtfon Plinllan reemurn vievie fee............9E,)) $ U Viae U Maatt2VArd expires if a permit is not obtained w(at — S --] -.1— within 180 days after it tins leen State surcharge(8%) Fxphez accepted as complete. TOTAL .......................S --�taam of cardhatda'�ce u:d _ $ _ f'a<daotdm elpunae -- AraoUot 4404616(6=K-'DM AUG 27 2002 8: 15RM HP LASERJET 3200 �p p' 2 3• ,r ' r 1 e�..-r1t �,y • 16.60 (� $249.20 51nk t vatory One 1 bath 3350.00_ _ Tub of Tub/3hower Comb. 16.60 - T�2)bad f $399.00 16.60 Three(3)bath Shower Only SUBTOTAL ' - 16.60 Water Closet 8y,6TATE SU GE r Urinal it 6n PLAN REVIEW 25%OF SUBTOTAL 16.60 7isltwasher 7 + - 1660 ago Disposal Garb „ ---� 16.60;�: �f 1+� A.Mundry Tray r+ t(P� ku • Fr f rr• Washing blechlne - 16.60 Floor Orli Floor Sink 2• PLEASE COMPLETE: :. ; 3" d- - 16.60 10.60 Wa1cr Heater O cnrrversloll Ilk@ kind Gar; fin r vires a separate mechanical - �ermiL 46.40 Sink MFG Nome New Water Service_ Lavalay _ - 46.40 MFTub or 1 utt/lihovvCr C Home Now S;rVS.tonn Sewer _ - -• 16.60 Combinatkn__Y-.- Hese liths 116.60 Shower On ::�ppAr++r•I ROM Drains Walel Cioeet :rN •, 1 18.80 Urinal Drinking roll 18.60 -- Other Fixtures(Spectly) Ulsewesher Garba2!�Di osal �L- Laund Room Tra _ Washln Machine _ - - Flour Dr2in� - 3 sewer-1st 100' _�� 4' Sewer-oacl additional i00 ,. 56.00 Water l•leeter / a.rK��-,p• 6vater service, 13t 100 Other FiXhlreS A;; .. -- 464 . S Wator Service-each additional 200 . 46..00 0 _! t N A 65 Storm 3 Rsln Dr -1st 100' wk C t." r 1 SlOrm b Rab'`'1h-each additioonal '100' _ Corrlrrmrdal[?; .40 co Preventktrt tkhvloe_ 27.55 ResldenLal Hack(iow Pmvenllon Device . _ _ --•-� 16.60 Catch Basin ABOVE: 22.50 . - ' Inspection of kxlstilsp Plumbing«Specially dhr _--- COMM6'NTS REaARDINt3 [jested Inc�acllons - -65.75 ------- - Rain Drain,single family dwelfing - ------�-- - 16.60 — Grease 7 mrd; -- -� — -QUANTITY TOTAL Ixnm-Aflr of riser dingrsra is rc�*Jred K .'� MrT.L�•' — --- -------— �,_.-- —---__—.-- ---- •SUBTOTAL ----- e% STATE SURCHARGE LAN REVIEW 25%OF SUBTOTAL +' r7rrrlulredx4yIfIlxturugt2tsdle?9 TOTAL ��— 'minimum psrmn fw"$77 ell•S%el7Ae surd+=2e.exoWReskle"PsddhvN prnwnM,n(7mAr.0,which Is$36.25•8%slut@ sud+arvs' —All New Cor„mercl@I Buildings reallm PLOns wilih uonh@lncc or Ater dt19rs17+@M (Aa,l revl,--n' I:\dststtem,qWlm-fees.doc 10/10100 CITY OF TIGARD - BUILDING PERMIT PERMIT #: BUP2002-00401 DEVELOPMENT SERVICES DATE ISSUED: 9/12102 13125 SW Hall Blvd., Ti4ard. OR 97223 (503) 639-4171 PARCEL: 1 S135AB-01002 SITE ADDRESS: 10220 SW GREENBURG i'D 125 SUBDIVISION: THREE LINCOLN-TOWN OF METZGER ZONING: R-12 BLOCK: LOT: 009 JURISDICTION: TIC; REISSUE: _FLOOR AREAS EXTERIOR WALL CONSTRUCTION__ .;LASS OF WORK: FPS FIRST: 3f N: S: E: W: TYPE OF USE: COM SECOND: sf _PROJECT OPENINGS?_ __— TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RAI FD: GARAGE: sf OCCU SEP. RATED: STOR: HT: ft BSMT.?: MEZZ?: R_ EOD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: —ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIP ALRM : HNDICP ACC: BEDRMS. BATHS: IMP SURFACE: PRO CORR: PARKING. VALUE: $ 450.00 Remarks: Plug 3 sprinklers. Owner: Contractor: SPIEKER PROPERTIES L.P. AFP SYSTFMS INC 10260 SW GRE ENBURG RD 19435 SW 129TH SUITE 100 TUALATIN, OR 97062 Pq�TLAND, OR 97223 Phone: 503-692-9234 one. Reg #: UC 67534 FEES REQUIRED INSPECTIONS _--____- Type By Date Amount Receipt Sprinkler Final PRMT CER ` 9/12/02 $62.50 27200200000 Final Inspection 5PCT CTR 9/12102 $5.00 27200200000 Total $67.50 This permit is issued subject to the regulations con,ained 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, or if work is suspendFd 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 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-66$9 or 1-80��32-2344. Permittee Signature: 1 Issued B Call '39-4175 by 7 p.m. for an inspection the next businc3� day Building Permit Application gi: 14— -- r City of Tigard Date received: ?rL Permit no.. U�, Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: Cit)of Tigard Phone: (503) 639-4171 Date issued: 9 y: I6 I Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: - - I&2 family:Simple Complex: TYPE OF PFRM11'1* U 1 &2 family dwelling or accessory JdlComincrLuu/industrial U Multi-family U New construction U Demohlion U Addition/alteration/replacement WWI enant improvement (Fire sprinkler/okw U Other: — JOB SI 11 INFORMATION Job address: _ Bldg.no.: Suite no.: �C Lot: Block: Subdivision: _ Tax map/tax lot/account no.: _ Project name: L _ Description and location of work on premises/special conditions:-71AA-- 07 WVIA OWNER Foil SPECIAL INFORMATION, Name: tj ' solar, Mailing addr ,s:I D Y ro Q LIWA - 1 &2 famlly dsielling: City: State LIP: Valuation of work.................................... ... $ Phone: - J x: C-mail: No.of bedrooms/haths.............................. . Owner's representative: 'rota)number of floors............................... . Phone: Fax: E-mail: New dwelling area(sq. ft.) .......................... Garage/carport area(sq.ft.)......................... Name: Covered porch area(sq. ft.) ......................... - - - -- Deck area(sq. ft.) ............. . Mang address: _ City: "_ Slate: ZIP:'jam tri lure area(sq. ft.) ........................ Phone: I ;t E-mail: (ommereli lindustriallutulII-fanilII: -. tuatiun of work........................................ F Existing bldg.area(sq. ft.) .......................... T� Business name: Address: - ty- New bldg.area(sq. ft.)................................ City: Slide zip: Nurr tier of stories........................................ qVid 'Z1_ Phone Fax: TMJ is mail: fypeofconstruction......................'..........'. _ -- - ----- Occupancy group(s): ^� Existing: CCB no.: �7 - - •---- _- - - - --- --- New: Cil;/metro lie no.: Notice:All contractors and subcontractors are required to he licensed with the Oregon Construction Contra,tors Board under Name: provisions of ORS 701 and may be requireu to he!icensed in the Address: _ jurisdiction where work is being petforned, If the aF,nlicant is City: State: ZIP: exempt from licensing,the following reason applies: Contact person: Flan no.: — ---- ---- I'hone: Fax: E-mail: Name: Contact person: Fees due upon application ........................... $ - Address: _ Date received: _ City: State: ZIP: Amount received ....^............................... g Phone: I E-mail: Please refer to fee schedule, I hereby certify I have read and examined this application and the Not all JunWictions accept credit cards,please call jurisdiction for more information attached checklist. All provisions of laws and ordinances governing th, Uvisa U MaslcrCard work will he complied tit,whetherZ'--cifred herein or not. CmAlI card number_—_— -- -.--�-1 - r•.Kpne« Authorized sittatUte: Dale: q__ Name of ardholder as shown on credit card Print name._ -- s — Cardholder signature Amount Notice:'flus permit application expires• a permit is not obtained within 190 days after it hos been accepted as complete. 440" 11 Irroac oMl Fire Protection Permit Check List A. ❑ New ❑ Addition Alteration LlRepair �Modification to sprinkler heads only: Describe work to 1 1-10 heads: No plan review required. be done: 11+ heads: Plan review required. Number of sprinkler heads: Additional description of work: _Type_ of System Com lete B or C as applicable --- - - A.L Sprinkler ___ Wet 0 _ Dry ❑ - Standpi es__ ------- Additional Hazard Group_— _ Information Density K. Factor Sprinkler Pro ect Valuation: $ _ B.)_ e I - Hood Fire Suppression System Hood Pro ect Valuation $ C..)Fire Alarm Submittal shall Battery Calculations Yes_❑ Include: Individual Component Yes ❑ _ Cut Sheets Fire Alarm Project Valuation_ $ Project Valuation SubtotaIAA B & q- _Permit fee based on valuationsi a chart:_ $ __— S% State Surcharge: $ _ - --- - - _ FLS Plan Review 40% of Permit: $ TOTAL: $ Plan review requires a completed application and 3 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon lice ised fire suppression engineer, or NICET level "3" technicians. U (-A-V) "(Cj tie. �/j)u-L 0�+ ` hdsts\fonns\FPSchecklist.dor 11121101 v CITE( OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Susiness Line: (503)639-4171 BLIP Received --- ---. Date Requerred AM-- ----- PM - - BUP - - Location Suite Suite S_ _ MEC ---- - ,� 3� 2- o C, PLM - Contact Person — Ph( ) Contractor Ph( _) — ___ - SWR _ BUILDING Tenant/Owner --_-__ _ ELC Footing ELC --- Foundation Access: Ftg Drain El_R 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 Susp'd Ceiling Roof — Other: Final ---- PASS PART FAIL !� PLUMBING Post_&_Beam Under Slab Rough-In Water Service Sanitary Sewer __— Rain Drains Catch Basin/Manhole — Storm Drain Shower Pan — Other:_ PA PART FAIL, CHANICAL -- — Post R Beam Rough-In Gas Line Smoke Dampers - Final — PASS PART FAIL ELECTRICAL_—___ - — service — Rough-in --- -- UG/Slab Low Voltage _... Fire Alarm Final L Reinspection fee of S_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL iITE El Please callfor reins action RE: ,-- — Unable to inspect-no access Fire Supply Line ADA Date Inspector -- Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the job site. PASS FART FAIL_ CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)6394175 MST INSPECTION DIVISION Busines Line: (503) 639-4171 PUP Received – Z?�b —Date Requested /U-Z2 AM_.__—_PM _ BLIP Location ,T U()SN'Grits•GN""�_ i ,,,._3- -Suite ZL � MEC _ Contact Person Ph 3 _.3-L PLM - - -_ - Contractor _ Ph(__ ) __ SWR BUILDING Tenant/Owner — ELC ,;�2yZ-ud �!h Footing EI C Foundation Access. Ftg Drain ELR crawl Drain : 'ab Inspection Notes: SIT Post&Beam Shear Anchors I - — Ext Sheath/Shear Int Sheath/Shear Framing ------- Insulation rrywall Nailing -_ _ - ------- - --- F-ir,.wall Fire Sprinkler ------------ Fire Alarm Susp'd Ceiling - Roof Other: Final - ---T-- _PASS PART FAIL -- - ---PLUMBING Post 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 -- -- -- ---- --- --- - ----- --- ------------ - -- Ser,ic© _--- ^ough-In UG/Slab Low Voltage Fire Alarm dia PART Reinspection fee of$_- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SOP Please call for reinspection RE:-_- - FJ Unable to inspect-no access Fire Supply Line / ADA 7'i - �-�[ Approach/Sidewalk Date , `�`�� Inspector 44rl C72- �c __ _. Ext Other: tl Final . DO NOT REMOVE this Inspectic,n record from the job site. PASS PART FAIL