10220 SW GREENBURG ROAD STE 300-2 t �
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DEPARTMENT OF LAND USE 4 TRANSPORTATION
LAND DEVELOPMENT SERVICES DIVISION
WASHINGTON k
155 NORTH FIRST,HILLSDORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415 .
OREGON ;:XXXXX,KXX---> 640-3470
Page 1 of 1
Date 05/19/95
Time 07 : 31
Permit 'Type Commercial Electrical Permit Permit # 0506'/900
Permit Status : AL'PRUVEaU Applied : Uy/19/95
Situs Address 10220 SW GREENHUNG RL) '111 issued 05/19/w:- •
vermit 'Title JACOBS S,LRRINE - LV Completed
Permit Leser. JUt3 '/6287 LINCULN TOWER SUITF' 300 To Expire 11/15/95
Project 'Tittle : JACOBS SIRR1NE - LV Project # P0050118
Project Uescr .. JUt3 '16287 * EROSION * •
Parcel N t,,ber 261'1'.1 - Land Use District
Vaivation 0
l Legal Descr , •
owner IN.bPECTI 0N - 'XIGARL) Construction : U'PH gt
Applicant Name ELECTRICAL CONSTRUCTION CO Classification 900
Al.yplicant Addr. : P. U, BOX 10286 Occupancy
PURTLAND, OR 9'/L10 Valida' ed by : PH
Applicant Phone: 124--3511 Inspector Area
!''ce description Units Fee/Unit Ext fee Data
Limited Energy/Alter ./Extension 1 40 . 00------ - __.-__
40 . 0(t
Subtotal Electrical Fees- 4U . 00
State Surcharge of 5% 2 . 00 �
Total Electrical ec:trical t''ees : 42 . C'U
*** r'ees Required 1.** *** Fees Collected & Credits ***
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___-_------_ --------------------- ----------------------------
A Method
-__---_-.._-____--_. _-----------------._- -_---
Method Check # Receipt No. Date payment �
C.M. 4493 05/19/95 42 . 00
'1`U'TAL TH.I DATE; *****x*** 42 , 00
Fees : 42 . 00
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Adjustments: , UU 'Total Credits : . UU
Total Fees : , 42 , UU 'Total Payments : 41. . UU
Balance Due : , 00 '
NOTICE: This permit becomes null and void If the work or construction for which It Is Issued Is not commenced within 180 days. Once construction has started, t
the permit be.omes null and void If construction Is Interrupted for a period of 180 days. I certify that the Information presented by the applicant and Y
hl*agent or agerMa In support of this permit In true and correct to the best of our knowledge. I acknowledge that the Buioding Department's reliance
upon false and misleading Information may Invalidate this permit. All provisions of applicable laws and ordinances goveming the construction and use
of this building or structure will be co r lied with whether or not speelfled nn the plans or noted on the plane correction sheets. I acknowledge that
the granting of a permit does not grant adthorlty to sccesP -!vete property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my callh a Inspections at various times during the process of construction and the building
Inspection staff verifying compliance with the various code,. Jae or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy is revocable until all Inspection requirements are satisfied and
approval Is given by tho Building 7111clel. I further acknowledge that a Ilan may be placed on the title of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements.
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APPLICANT'S SIGNATURE
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WASHINGTON COUNTY ELECTRICAL PERMIT'
Department of Land Use & Transportation
Electrical Inspection Section
155 North First Avenue, 11350-12 APPLICATION 0
Hillsbor.., Oregon 9712.4
Information: (503) 640-3470 Fax: (503) 693-4412
Permit
PLEASE PRINT Number -h U u' O� _ Date j Please
complete4. Complete Fee Schedu:e be;ow
1. L -r.,atlen of installation _ Number of Inspections pea permit allowed
Add __ 10220 5W.W. GWENBURG ITM - Service included: Items Oost(ea.) Sum
Buildingg A. Residential-per -'nit
City PORT1,� Suite N0. SUITE 300
Tenant Name � � l000 sq.n.or leas 4-_ $110.00 _ a
Tenant
J11iT 35 SIRR3NE Each additional 500 sq.ft
-- ---- or poilion thereof $25.00
Limited Energy $25.00 1
Map No Tax Lot __ - Each Manurd Home or Modular
T;iomas Map Book: Pay
Dwelling Service or Feeder __ $68.00 2 ti
�e�:_ Section:
Directions._ LINQ21�1_1SWER_____ B. Services or Feeders
Installation,alterations or relocation
200 amps or less $60.00 2
i Commercial Residential 201 amps to 400 amps $80.00 _ 2
401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 - 2
2a. Contractor installation only: Over 1000 amps or volts $340.00 2 ,
Electrical ContractorEel RIICAL ODNSTRUCI'ION OCMPANY Reconnect only $50.00 2 1
p
Address ,�Hc7X 10286, PORrLAM, OR 7210
City ___ State_ ZIP C. Temporary Services or Feeders
Date_ 05117125_ Job Number 76287 Installation,alteration or relocation #
Property Owner_ _ 200 amps or less $50.00 2
Contractor's License No. 26-45C _ 201 amps to 400 amps $75.00 -_ 2
401 amps to 600 amps $100 00 2
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Contractor's Board Reg. No. - _ -_ Over 600 amps to 1000 volts see'B'above
Signature of Supr. Elec'n _ D. Branch Circuits
License No. 2986S Phone No. 2 _ Now,alterntion or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder lee.
Each branch circuit $5.00 _ ___ 2
b) The fee for branch circuits without
Print Owner's Name - one o, purchase of service or feeder fee.
Address - - --' First branch circuit _-_ $35.00 2
Each add'nl branch circuit _ $5.00 _ _ 2
city - fate---- - E. Miscellaneous (Service or Feeder riot included)
Each pump or irrigation circle $40.00 _ 2
The installation is being made on property I own Fach sign or outline lighting $40.00 2
which is not intender.) for sale, lease or rent, signal chcuit(s)or a limited
energy panel,alteration 1 40.00
+vner's Signature or extension $40.00 2
F. Each additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection _ $35.00
Per hour $5500
Please check appropriate Item and enter fee In section 58. In Plant __ $55.00
__-_4 or more residential units in one structure 5. Fees
__Service and feeder, 800 amps or more
__System over 600 volts nominal A. Enter total of above fees $ 40-00_
-_Classified area or structure containing special 5% Surcharge (.05 X total fees) $ - 2.00 _
occupancy as described in N.E.C. Chapter 5 Subtotal $ 42.00
0. Enter 25% of 1''e A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $ ---
above apply. Not required for temporary construction Subtotal $ 42.00
services. ( [] Trust Account $
J Balance Due � 42.00
For Inspections call
This permit becomes null and veld N the work authorized by the permit Is not commenced
640-3561 or 693-4415 within 169 days from date of Issuance of such permit or It the work suthorhW is
suspended or abandoned at any time after worts Is commenced for a period of 169 days.
24-hour recorder, one working day in advance of need Electrlul permits are non-refundable and non-tranaferable.
t1/94 l
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CITYOFTIIFARD
CTTYOF TWA' RD
' COMMUNITY DEVELOPMENT DEPARTMENT olnao�a
13126 BW FWI ahrd. P.A.Brno 23347.T*M.Oregon 77223(603)634.4176
PLUMBING PERMIT
PERMIT #. . » ,. » . . : PLM93-0026
639-4171 DATE ISSUED: 02/25/93
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;SITE ADDRESS. . . : bW GREENBURG S RD #MELH11 PARCEL: 1S135AB-01004
SUBDIVISION. . . . : ZONING: •
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . » . . .
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CLASS OF WORK. . :ADD GARBAGE DISPOSALS. . : MOBILE HOMESPACES. a------ _
TYPE OF USE. . . . :CO01 WASHING MACH. . . . . . . : BACKFLOW PREVN'TRS. . : 1
OCCUPANCY GRI". . :B2 FLOOR DRAINS. . . . . . . s TRAPS. . . . . . . . . . . . . . s
STORIES. . . . . . . . :5 WATER HEATERS. . . . . . : CATCH BASINS. . . . . . . a y
F'IXTURF --_.__________._ LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . . :
SINKS. . . . . . . . . . : URINALS. . . . . . . . . . . . a GREASE TRAPS. .
LAVATORIES. . . . . : OTHER FIXTURES. . . . . ..
T'UB/SHOWERS. . . . : SEWER LINE (ft) . . . . a
WATER CLOSETS. . : WATER LINE (ft) . . . . c
DISHWASHERS. . . . : RAIN DRAIN (ft) . . . . a �
- Remarks: �
Uwner. ____________________._._________._________.___.___.._._._._.__._ FEES ------------•----
LINCOLN CENTER/MECH ROOM type amoi_tnt by dale recpt
10220 SW GREENBURG GRIrIT $ 17'5. 00 JH 02/25/93 — s4
TIGARD OR 97223 PCT $ 1. 25 JH 02/25/93 —
Phone #s
Contractors -------_------.-_----------___—_
POWER PLUMBING CO
PO BOX 23144
TI13ARD OR 97281 _-__________________._--------_.—_—
(='hone #: $ 26. 25 TOTAL
Ren #. . - 52378
---- REQUIRED INSPECTIONS
--_._..._......_.
This permit is issued subject to f.he regulations contained in the Top--out Insp
Tigard Municipal Code, State of fire. Specialty Codes and all ether Firra'1 .Inspection
applicable laws. All work will he done in accordance with _
approved plans. This permit will expire if wurk is not started
within 180 clays of issuance, or it work is suspended far more
than 180 days.
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Permittee 5iynati_tre :
Iss:1_terJ By :
Call for inspection — 639-4175
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City of Tigard PLUMBING PERMIT Planck/Rec. #
1?125 SW Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
ORS 814-21-6 10 aTY PRICE AMT
Job � n Oe�,(4�. c s .+h2.c^ I FIXTURES I
Address - 7.50
Lavatory 7.60
r u or u ,owe( -
�. � P Shower Only -- 750
"' Water Closet — O
Owner ';C)220 .3.V.), 4AA,, Je 1 ishwaUier 7.50
-T rrAP Garbage IspoS
7 i 2 c Washing Machine 7.50
loon Drain ,
ITT Water eater � 7, 5.7 •
Laundry Room Tray
OCCIlpanf G'1 S�` � Gf� Unnal 7.50 j
Utttior Fixtures( poci
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C MISCELLANEOUS
Contractor n. y -
1` ap
1 I Sewer 1st 100' 30.00
"' "°" . t'K ,%A r n .n `� Sewer-ea. I. 100'
J 7 I t Water rvi-e 1 st 100' 20.00
reby acknawfoclige that I havp read is ap rcatrrx,,that Via Water Service as.Addit 200' 13.00
infonnatloo given is mrod,that I am the owner or authorized agent of
the owner,that plans submitted are in compliance with State laws,that I Storm 6 Rain Drain 1st 100' 30.00
un registered with the Conshuctiun Contractor's Board,that the number Storm&Rain Drain Addit. 100' 15.00
given is a,rrect (If exon] .from State registrafion,please give reason
befow.j'` a, Mobile Home Space 25.00
Ccwl•fiPrrevention
Device or Anti-Pollution Device 7.50
Any Trap or Waste Not -
`� Connected to a Fixture 7.50
DescnW-WoT new 0 additen a ttembon repair Catch 13as4i 50
to be cone residential 0 non-residents -'(St 40.00
Insp.of E)ist.Plumbing per hr
40.00
Specially Requested Inspections l_per hr
Existing use u. r in Drain,single family
building or property dwelling 15.00
Hesidenaal backflow prevention
Proposed use of dens 15.00
building or property e
'( xcept nest arm ac low
y _ prevenfion devices)
NOTICE *Minimum Fee$25.00 SUBTOTAL „f j
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Sx SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 259 OF SUBTOTAL
COMMFNCFD.
TOTAL
Special Conditions ---- -- -._.—
-- —_���—— Date issued --
4m„n.er++,
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