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I +T? -L 2.e-- NOTICE: IF THE PRINT OR TYPE ON ANY qI11111111111111111 1 1 i 1Thi 1 11 1-1.1 t i l r Crrl IT7F'l 1 IT iI , i1i ijr j iIiiI1 IMI I1 IMAGE IS NOTAS CLEHR AS THIS NOTICE, 11 1 , i i i t i i Ii li i i r-rwY�•MY cOYVu1• IT IS DUE TO THE QUALITY OF THE No.36 ORIGINAL DOCUMENT --E -T CZ �3Z ' LZ 9Z 5Z �� Z EZ ZZ iZ ---OZ CTI 8 [ _ LT_ 9i - 4T fii ET ZT i1 OT C S --- 9 ___ _ ! , now IIII IIII IIII IIII IIII IIII Ilil IIII IILI Illi 1111111] 11111111 IIII IIII ilk! !IILII111.1� 11ll�illl illl�llll Ilii I I I , �' -pull i ��tl�3w IIIIIII�iIIII�II IIIII ,III�IIIIIIIIIIIIIIIIiIIIIIIIIIIII -lUlllllllllLll. Illi illillllllll ll�l li ll 111lllil�ll . I h . ?faiL104w�X�aWirwwu�wr3�X�w1i�I�W+u«.uWw�s-r,.�w�-WttiM'+.+clll�yn�oYY.¢b,�Mraww'•:,..aau#4:1tn�r�a.�w�aWiYW.giY7wda:exrcw.r,IW�wr,iw e'..d _. _. .:._ ......_.�.._...._ .., .... �..:_......-.,.__ r� H In LT7 0 � (n � � s 0 cn W L1 1 I R� 1 1 R 10250 ST4 GREENBURG ROAD SUITE :10 -- �FRTIFICATEOFOCCUPANCY CITY OF TIOARD DEVELOPMENT SERVICES PERMIT#: BUP2002-00471 13125 SW Hall R!vd., Tigard, OR 97223 (503; 639-4171 DATE ISSUED: 11/6/2002 PARCEL: 1 S 135AB-04500 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 10250 SW GREENBURG RD 110 SUBDIVISION: LINCOLN BUILDING PP1991-055 BLOCK: LOT:001 CLASS OF WORK: ALT TYPE OF USE. COM TYPE OF CONSTR: 2-1 HR OCCUPANCY GRP: B OCCUPANCY !-UAB: C-' TENANT NAk!c: FAMILY HEALTH PARTNERS REMARKS: create a doctors office within an existing Owner: EOP LINCOLN , LLC 10260 SW GREENBURG RD SUITE 100 ppRR gg 2222 P Phone ND503-23d�8G17 Contractor: C SCHIEWE& ASSOCIATES INC 1024 NE DAVIS ST PORTLAND, OR 97232 Phone: :i(13-234-6617 Rey #: LIC 54105 his Certificate issued 1/1412003 grants c)ccupancy of the ahove referenced !►uilding �)r portion thereof and confirms that the building has been inspected for compliance with the State of,Oregon Specialty Codes for the group, occupancy, and tpt� under which there d permit was, ssu d. � � BUILDING INSPECTOR BUILDtNGOFFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST - INSPECTION DIVISION Business Line: (503) 639-4171 B.1P 2 oc7e2 - cc 4Y'71 r ZCJyZ -dQ Received -_-__- ---- ._---__-- Date Requested-/� 0-3 AM_ -- PM _ _ ___. ._-- BUP _ Location �O - C _—��C�tC'�/ U✓ _-----Suite---- MEC �' . Ph (--- ) --� -563 (" 2 00Z- bQ'1Z� Contact Person ___-__._______._ —_______--_____.._-- _ Contractor --_.. Ph(_. ) - SWR -- UI -- Tenant/Owner _---__..._ ------_-__-- ELC — ooting -- - ELC --- Foundation Access. �= >< P "�� 0--' t U'' 1 ELR Ftg Drain o.v 6 fQ2ta, -------- Crawl Drain — ----- — SIT Slab Inspection Notes: -- Post& Beam Shear Anchors Ext Sheath/Shear --L --- - Int Sheath/Shear Framing --- -- ----- Insulation Drywall Nailing -- Firewall Fire Sprinkler Fire Alarm Gusp'd Ceiling _- Roof _- A T FAIL -- G — Post eam Under Slab - - - Rough-In Water Service --- - - Sanitary Sewer Rain Drains -- -- - - Catch Basin/Manhole Storm Drain - Shower Pan Other. -- - _ -- - - - Final A PART FAIL Past& Beam Rough-In - - ---- -- ---- -------- Gas Line Sm ke Dampers --- ---- _ —..__-- S PART FAIL -- --- ELECTRICAL -_ Service Rough-In UG/Slab Low Voltage - ------ - - -- Fire Alarm Final �� Reinspection fee of$ __required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL ---- ---------- SITE [ Please call for reinspection RE: �___ ____.._ --- Unable to inspr ct-no access Fire Supply Line--- -' ADAL/ Approach/Cidewalk OAts �� /_� � � Inspector _"1 Ext Other: Finrrl DO NOT REMOVE this Inspection record from the Job site. "'ASE PART FAIL ELECTRICAL - ERMIT CITY OF TIGARD RE TRICTEDPENERGY DEVELOPMENT SERVICES PERMIT#: ELR2002-00286 13125 SW Hall Blvd., Tiqard, OR 9722.3 (503) 639.4171 DATE ISSUED: 12/10/02 SITE ADDRESS: 10250 SW GREENBURG RD 110 PARCEL: 1 S135AB-04500 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT: 001 JURISDICTION: TIG Proiect Description: Tenant Improvement A.RE31DENTIAL D.COMMERCIAL_ AUDIO & STEREO: AUDIO& STEREO:— INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DA1A/TELE COMM. X NURSE CA'-LS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: EOP LINCOLN , LI_C ONE STAR COMMUNICATIONS INC 10260 SW GREENBURG RD 6915 SW 68TH AVE SUITE 100 PORTLAND, OR 91223 PORTLAND, OR 97223 Phone: Phone: 503-701-5376 Reg#: I Wl.r>77•IIW70 11 1 34-448CEP FEES J Required Inspections Description _ Date Amount_— Ceiling Cover I [I LPRMT) ELR 1'ermit 12/10/02 $i 5.00 Wall Cover Elect'I Final [TAX] 8"..: tntc Tax 12/10/02 Total $81.00 This Permit is issued subject io 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 nilcs are set forth in OAR 952-001-0010 throuc Issued by L�- � Permittee Signature_ _— —_ OWNER INSTALLATION ONLY _ The installation is being made on property I own which is riot intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: _CONTRACTOR 1"TALLATION ONLY SIGNATURE OF SUPR. EI_EC'N 1_ _lit - _ DATE: LICENSE N O ----- �L --- ---- --- — _ ---- -------- Call 63,d-417.5 by 7:00 P.M. for an Inspection needed the next business day Electrical Hermit Application Uaterrxeivrd. 02 p��l- Permit no _ Z City Ol l lgard Projectlappl.no.: Expire date: City of Tigard Address; 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503)639-4171 --- Fax: (503) 598-1960 Case file no.; Payment type Land use approval: U 1 &2 family dwelling or accessory -A2Zommercial/industrial U Multi-family U Tenant improvement ❑New construction U Addition/allerati(in/replacement U Other: ❑Partial YOR S111 VIRMATION Job address: 1 Qa 4 1"" m f �� Bldg.no.: ,utte.nit: Iia Tax ap/tax lot/account no.: Lot I Block: --— Subdivision: I'roJcctname: L Description and location of work on pi- miser_ •'� J� e Z� ✓t _ — Estimated&:lc elf completion/inspection: APPLICATIONi Job no: _��+*'�� __ I'''' Business name: he J't'(4�Wjj__giey lbw �r IkrcripUrm Vh. (ca.) total uo.(nsp -�—� New rcsidenlial-single or multi-family per Address: Ii i'r41_fQ __tJ/7 Q —_—_ dwell(ngunft.tncludcsattactxdgnragc. City: ✓1.(` h.- cl State: #eZIP: 12 3 service Included: Phone: cc a Fax: Ldt r S E-mail: C T��+=p=r+e—l�►�• 0W sq•ft.or less _ 4 CCB ul „ p t{'-0 Elec.bus.lic.no: H+ql t'�'fL—T Each additional SW sq.fl.or portion thereof Limited energy,residential 2 City/metro lic.no.: 314 4y P C E P Limited energy,non-residential 2 Each manufactured home or modular dwelling Signature of supervising electrician(r uired) bale —� Service and/or feeder 2 Sup.elect.name(print) rldf icenseno:/t ei Senicesrreedent-installation, alteration or relocation: PI1OPE11jV OWNER 200 amps or less 2 Name(print): 201 amps to 400 amps 2 - - - - 401 amps to 600 amps 2 Mailing address: _ 601 amps to 1000 amps 2__ City: State: ZIP: Over 1000 amps or volts 2 Phone: Fax: I E-mail: Reconnectonly I Owner installation:The insta'idtion is being made on property I own Temporary services or feedem- which is not intended for Salo,lease,rent,cr exchange according to Installation,alteration,orrelocalion: 200 0111ps or less 2 ORS 447,455,479,670,70I. 201 amps to 4(N)amps 2 owner's Si nature: Date: 401 to 600 amps J 2 - - - Branch elrcalls-new,alteration, or, r extension per panel: Name- A.A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: Slate: ZIP: B. Fee for branch circuit.,without purchase - -1'honc: Faof service or feeder fee,first branch circuit: 2 x: F.-m il: Each additional branch circuit PLAN 11W�IEW(P!"%e check all that apply) W (servlce or feeder not included): U Service.over 225 amps-comms rcial U Health-core facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2 family dwellings U Building over IOdltx)square feel four or Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,orextens on' U Building over three stories U Feeders,400 amps or more *Description. U Occupant load over 99 person U Manufactured structures or RV park Fitch additional Insoedlon over the allowable In any of the above: U EgressAightingplan U Other _ per inspection _ Submit___sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictia,a accept credit cant+.pleaw call lurisdictirar lex mrxe infiKnmGroi Notice:This permit application Permit fee..................... U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ _ _- Credit card number -- —_ .__1_L_ within 180 days aper it has been Sidle urcharge(8%)....$ _ Expires accepted as complete. TOTAL . $ _ Name c older u rhown on c u cord - S Cardholder sisaature Amoanl 440-4615 MWCOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: (Complete Fee Schedule Below: RPE OF WORK INVOLVED RESIDENTIAL Restricted Energy Fse... $78.00 Number of Insspections .er ermit allowed (FOR ALL SYSTEMS) Service included: [terns Cost Total Check Type of Work Involved: Residential-per unit 1000 sq ft.or less _ $111 b 15 _ 1 ❑ Audio and Stereo Systems' Fach additional 500 sq.ft or portion thereof _ $33.40_ 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ❑ Garage Door Opener' Dwelling Service of Feeder $90,90 Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocaVon 200 am s or less $00.30 __ 2 EJ amps to 400 amps $106.85 2 Vacuum Systems' 401 amps to 600 amps _ $160.60 2 ❑ 631 amps to 1000 amps $240.60 2 Other_ Over 1000 amps or volts $454.65 2 Reconnect only —� $66.85 V 2 Temporary Services cr Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less _ $66.85--- 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. F] Audio and Stereo Systems Branch Circuits ❑ New,alteration or extension per panel Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $665 v_ 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit __ $4685 Each additional branch circuit $6.65 — ❑ HVAC Miscellaneous ❑ Instrumen!atlon (Service or feeder not included) Each pump or Irrigation citcie $5340 Each sign or outline lighting $53.40 _ F-1 Intercom and Paging Systems Signal circult(s)or a limited energy panel,alteration or extension $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) — $125.00 _ Medical Each additional Inspection over ❑ the allowable In any of the above ❑ Per inspection $62.50 Nurse Calls Per hour $6250 In Plant _ $73.75 J ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ ❑ Other 6%State Surcharge $ .—_— _v Number of Systems 25%Plan Revievi.ee See"Plan Review"section on $ No licenses are required licenses are required for all other installations front of application Fees: Total Balance Due $ n - — Enter total of above fees i �J Trust Account# 8%State Surcharge i Total Balance Due All New Co:nmerclal Buildings require 2 sets of plans. 0dsts\fbrma\elc-fees.doc 08/30/01 CITY OF T I G A R.D ELECTRICAL PERMIT — DEVELOPMENT SERVICES DATE IS`UIED: 9/102'2-00489 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 102.50 SW GREENBURG RD 110 PARCEL.: 1 S135AB-04500 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT : 001 JURISDICTION: TIG Project Description: Electric derno: 1 branch circuit. RESIDENTIAL UNIT _ TEMP SRVC/FEED,ERS MISCELLANEOUS 1000 SF OF LESS: 0 - 200 an,p: PUMPilRP.IGATION: EACH ADD'L. 500SF: 201 - 400 amp: SIGNIOUT LINE LTG: LIMITED ENERGY: 401 - 600 amp. SIGNAL/PANEL: MANF HNI/SVC/FUR: 601 ramps - 1000 volts: MINOR LABEL (10): _ SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS____ 0 - 200 amp: WISERVICE.. OR FEEDER: PER INSPECTION: _ 2011 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 4011 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: — —_ _ PLAN REVIEW SECTION 1004+ amp/volt: >=4 RES UNITS — _ —> 600 VOLT NOMINAL: _ �^ Reconnect only: _ SVC/FDR >= 225 AMPS: --_— CLASS AREA/SPEC OCC: —_ Owner: Contractor: EOP LINCOLN , LLC CAPITOL ELECTRIC CO INC 10260 SW GREENBURG RD 12810 NE AIRPORT WAY SUITE 100 UNIT 'l PORTLAND, OR 972.23 PORTLAND, OR 97230 Phone: Phone: 255-9488 Reg #: LIC 048748 SUP ; t 32S ELE 26-496C FEES i—_ _ Required Inspections__ Type By Date Amount Receipt Rough-in PR^.;T CTR 9/19/02 $46.65 2720020000( Elect'I Final 5PC:T CTR 9/19/02 $3.75 2720020000( Tota! $50.60 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws. All wink will bil 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 ATTFNTION Oregon law requires you!o follow rules adopted by the Oregon Utility Notificarion Center. These rules am set forth in OAR 952-001.0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246 f 69q or 1 800-332-2344, Perm t Signa!ure: '_ �� _� / Issued S 7-7- -t .zt/�L d t OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNE=R'S SIGNATURE: _ DATE:__.—._, _ —. CONTRACTOR INSTALLATION ONLY_____ SIGNATURE (IF SUPR. ELEC'N: 7% / � e 7_}��0 _YJ.I�� DATE: LICENSE NO: �� 7f:) � Call 639-4175 by 7:00pni for an inspection the next business day Electrical Permit Application Dutereeeived: F,-, P �� clnlitnu..._ y — I Project/appl.n : Expire date: City of Tigard ��o ` Y Date issued: o. f3 CITY OF TIGARD Address: 13125 SSV IIALL BLVD,TIGARD,OR 972113 1 C 2002 Case file no.: Payment type: -�� Phone: (503)639-4171 Fax(503)598-1960 S -P 1 U ; Land use approval: ❑ 1 &2 family dewlling or accessory ❑ Commercial/industrial ❑ Multi-family ❑ 'Tenant improvement M New construction [j- Addition/alteration/reply cement [] Other: C7 Partial Job address: 10250 SW Greenburg Rd City: Tlyard [tldg.,o.; Sunc n 110 Tax rnap/tax lot/account no.: Lot: 131,,1, N A I - Project name Suite#110 Description and location of work 3n premises: Electrical Benno Estimated date of con)nletion/inspection: -- lob no: L.1-1100 Frr 11ns. Business Name. ap to ElectricCo.,Inc. Description Vr> (ea.) [,,w no.insp Address: 12810 NE Airport Way New rest Jentlal single or multi-family per City: Portland State: OR ZIP: 97230-1029 dwelling unit. Includes attached garage. Phone: 501-255-9488 Fax: 257.7121 ]F-mail: darrellce dx com Service Included: ('CB no.: 48748 jElec.bus.lic.no: 26496C 1000 sq,it,or less $ 14515Qj& t nitro lic.no.: N/A Each additional!00 sq,Il or portion thereof _ f 11.40 9111102 I.imited energy r,:sidential S -rc telt Stgnetttre of supervising electrician Imyuocd) Date Limited uiergy,non-residential c 45(x) Sup.elect.name(print): Clairell McNeel I I,ense no.: 3132-8 Each man ifactured home or modular dwelling Setvice ar d;or lceder 1 90.90 Name(print): Equity Office Properties Services r r feeders-Installation, Mailing,adthcss. 10260 SW Greenburg Rd alteratior or relocation: City: Tigard State: OR 71P: 97223 200 amps or less S e0 30 Phone: 503-892-2500 Fax: E-mail: 201 amps to 400 amps __ S 106.85 Owner lnstallarinnr: the installation is being made on property I own 401 amps to 600 amps S 160,6.1 ,vhich is not intended for sale,lease,rent,or exchange according to 601 amps to 1000 amps S 240,60 ORS 447,455,479,670,701. Over I OW amps or volts S 454.65 2 (Aener's signature: Date: Reconnect only Y S M1M1.85 1 Temporary ser,ices 0r feeders- Iv 1me: Intalla Ion,alterations,or relocation: A(dress: — 200 amps or les) S 66.85 1 Ci}: --- State: LIP: 2()l am sto400amps —� - S 100,30 2 Ph„ne: lar: il: 401 am,e to 6021 amps S 133.75 2 E-maltranch circuit-i-new,alteration, ❑Service over 225 amps-commercial []llcalth-,an•facihl; or exte ision ps r panel: ❑See vice over 320 amps-ratin t or Ik: [I Hazardous location A. Fee for branch circuits with purchase of fent ly dsveiiings ❑Building over 10.000 square a.four or service of Ncder fee,each hranch circuit $ 6.65 ❑Svstrm over 610 volts nominal more residential units in one structure H. Fee for branch circuits without purchase C Build nn over three stories ❑Feeders,400 amps or n• of servic,o feeder fee,first branch circuit 1 S 46.85 46.85 2 ❑Ocrup mt laid over 99 pers,,m ❑Maturecturcs stnrenues or OV Park I ach additional branch ci•cuit S 6.65 ❑ligremlishting pian ❑Other: %lase.(Service or feeder Included): Submit sets of flans with anv of the ahose. Each pump or irrigation circle $ 53 40 2 The above err not applicahi, a iemporar3 conshdcdon ser%lce. Each sign or outline lighting _ S 53.40 2 Signal circuit(;)or a limited energy panel. alteration,or;xiension• 75.00 , 'Description: - Fach additional inspectiun, if,allo,sahle m am of the ahme II Per inspectimi r�s 02,50 I Imestigmion far �__ Q Visa ❑ MasterCard -------- Permit fee........ .... .. 5 46.85 Cte it .td number. - / Notice::this pf rmit application Plan review ( ) S °P1t8 expires if a parrlit is not obtained Stare Surcharge 81/6 ) S 3.75 Name nl cardholJer as rM�vT no rr it card -_ S velthing 180 days after It has been TOTALL.................. S 50.80 Cedhotdersignature 'gym.-I aocapted as romulete "'" CITYOF T I GA R D - BUILDING PERMIT PERMIT#: BUP2002-00471 DEVELOPMENT SERVICES DATE ISSUED: 1116/02 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639.4171 PARCEL: 1 S 135AB-04500 SITE ADDRESS: 10250 SW GREENBUPG RD 110 SU13DI'VISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: _ _ LOT: 001 _JURISDICTION: TIG _ REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 2-1 HR sf N- S: E: W; OCCUPANCY GRP: B TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 61 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _R_EQDSETBACKS __ _ REQUIRED_ _ FLOOR LOAD: psf LEFT: �ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y BEDRMS: BATHS: IMP iURFACE: PRO CORR- N PARKING: VALUE: $ 220,000.00 Remarks: create a doctors office within an existing Owner: Contractor: EOP LINCOLN , LLC C SCHIEWE &ASSOCIATES INC 10260 SW GREENBURG RD 1024 NE DAVIS ST SUITE 100 PORTLAND,OR 97232 PORTLAND,OR 97223 Phone: 503.23,-6617 Phone: 503-234-6617 Reg #: LIC 54105 FEES _ REQUIRED INSPECTIONS Description Date Amount Electrical Permit Required [13U1LD] Permit Fee 10/25/02 $1,212,30 Sprinkler Permit Required ['TAX]8%State'Tax 10/25/02 $96.98 Fire Alarm Permit Re uirecPlumbing Permit Required [BUPPLN]Pin Rv 10/25/02 $788.00 Framing Insp [FLS]FLS Pin Rv 10/25/02 $484.92 Gyp Board Insp Tota! $2,582.20 - Su.sp Celing Insp Final Inspection This permit Is issued s,jbject to the regulations contained in the Tigard Municival Code, State of OR. Specialty Codes and all other applicable law. All work will be done In accordance with approved plans. This permit will expire if work is not started within 180 days of issuarice, or if work is suspended for more tha,i 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 OAF 952-001-0100. You may olxaln a copy of these rules or direct questions to OUNC by calling (503)246-669 r 1-800-332-2344. Issued By: !\ Permittee Signature Cakk`6�399--4175 by 7 p m. fur an inspection the next business day i i Building Pcrinit Application -- r -� ---� t)atc received: p �p`Irj..pL Permit no,!a)?gQQ. p c f � City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire6,te: — i(y /Tigard Phone: (503) 639-4171 Datcissued: B � Recti trio.: y` �� Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: t&z family:simp►c C mple;t: 1 U I &2 family dvlelling or accessory U Commercial/industrial U Mifti-family U New construc,ion U Demolition C.1 Add ition/al terau,)tdre placement Tenant improvement U Fire sprinkler/alarm U Otho __--_________ 11 1 1 Job address: �5S W Gvere+.l��a� 131d;.no. G uitc I 10.: lib Lot: I Block: Subdivisi(n: —�?ax map/tax lot/account no.: Project name: 't ly Hea k eri. Description and location of work on premises/special conditions: ifilasit rv_+�o►vvej�►i __-- _ __ !1aftfi ' 1 ' 1 RName: UQUITY OFFICE PRoPER-1IEs 'Mailingaddress: l0UP0 SW Gp t=EN�ugb P-D SUITE f00 family dwelling: City: POP-TLP00 Statc:Of. L[P: 9 7223 Von of work........................................ $ Phonc5c'5 892- .500 Fax: E-mail: Nbedrooms/baths................................. Owner's representative: "*Y fL. GLv_P-LGlbD Arcbtt'tee'ty Irke-4 Total number of tloors................................. Phone5t>3 22 -9to5fp Fax: IE-mail: New dwelling atea(sq.ft.) .......................... _ Garage/carport area(sq,ft.)......................... — Name: GI3d Art1t {ec't J�rt Covered porch.area(sq.ft.) ......................... — ---- Suite 4.000 Deck arca(sq. ft.) ........................................ Mailing address: 1320 Zvi 2>-PA aventrs --._ --—� Other structu'a area(sq.ft.)......................... city: Port l State:0 7.IP: 9720 - `—_ a'^ _- -R __.��--- — Commercla'Jirtdustrial/multi-family: Phonc5G3 Valuation of work ....................... :b 22-0,0r10.00 Existing,b1 Jg.area(sq.ft.) .......................... _.__0_9-4--NSFt Business name: C, Sck i et,te C vk i5_ ., New bldg.area(sq,ft.). Address: l t)'L Ne V"Ivi s St. City: ptrt a� State: ZIP: -332.2,?. Number of stories. _ PType of construction.................................... Phane$o3 23 fo�17 Fax: E;mail: _ Occupancy group(s): Existing: -- CCB no.: 5 Off— J—_ New: 1!> Cityhmetro lit no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: cArt j provisions of ORS 701 and may be required to be licensed in the Address: - ---�`- -�----- - jurisdiction where work is being performed. If the applicant is ---- - :— exempt from licensing,the following reason applies: City: State: ZIP: _-- Contact person: Plan no.: Phone: I ar: 1.-mail: Name: ICtnnact poison: Fees due upon application ....:...................... $ Address: Date received: City:- State: ZIP: Amount received ......................................... $ Phone: Fax: E-mail: Please refer to fee schedule. hereby certify I havee read and examined this application and the Nor aft iurir6c6ow aaept credit cardr.r4eme cvt}ur4dicuon(or more fnrormatien. attached checklist.All provisions of laws and ordinances governing this U Visa U Mastercard work will be complied with,whether specified herein or not. credit card camber:_ -- ___r.L� r Authorized signature: Date:J!VWZ er eider m rhown on credo card- s Print name: 2_ Y F_. v - --- cardhotae�ai`nuwe�_— amount-- Notice:This permmiltapplication expires if a permit is not obtained within 180 days afteCit has been accepted as complete. 4404613 t6MCOMt 01(VT. UP-•3FLA,0 ��cdlvt Qld9 -s�� tr 110 Accessibility: Barrier Removal Improvement Plan City of Tigard REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation,alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may he deemed disproportionate to the overall alteration when the cost exceeds twenty-five per-cent(25%). VALUATION: of all renovation, alteration or modification being done o0 excluding painting,wallpapering. [110-201000.r-201000- multiply: 25% Barrier removal requirement. •25 BUDGET FOR BARRIER REMOVAL [21 $ 5'5COp pv In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking lo"t re,siyibp% II I I 1 !- II 1 A / II►e. ,I�i I � II . I, I ��► �.� III ► . I CITY OF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT AU 13'125 SW Hall Blvd., Tigard,OR 97223 (50?)639.4171 PERMIT #. . . . . . . : BUF1197--001 E DATE ISSUED: 01!14/97 f='ARCEL: 1 S 135AB- O45OO 91TE ADDRESS. — : 10250 SW GREENBURG RD #110 SUBDIVISION. . . , : Z ON I IVIG:C.-P BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . r7EISSUE: FLOOR AREAa -__.._..___...___ EXTERIOR WALL. CONSTRUCTION-. F;LASS OF WORK. :F IS FIRST. . . . : 0 sf N» S. E: W: TYPE OF' USE. . . :COM SECOND. . . : 0 s PROTECT OPENINGS?-.---•-.------- TYPE OF CONST. :E:FR 0 sf N: S: E: W: i7CCLJPA'�ICY r,!34-,. :B TOTAL_ - --- -: 0 s f R00F C 0 N 6 T; h T RF RF-1 OCCUPANCY LOAD: 0 BASEMENT. - 0 sf AREA SEF. RATED: `,TOR. » 0 H'T » 0 f-1 G✓rRAGE. . . : 0 s f OCCU OEP. RATED-. BSMT?: MEZ Z?: REDD SETBACKEi--..--..--.-.--- --------- F 1. OOR LOAD. . . . : 0 psi` LEFT , 0 -Ft RGHT : 0 f•t F T R SPIRL :Y SMCIK DET. . DWELLING UNITS: 0 F'RNT: 0 ft REAR: 0 ft FIR ALRM»Y HNDI.CID ACC: BEDRM S: 0 B('aTH5: 0 IMP SURFACE- 0 PRO rGRR: PARKING: 0 VALUE. $: 540 Remar,[(s : F=irp suppression system rlwnpr-. ___.____.____._.__.___..______ ____________._...__._..._--__-___ FEE -___________._.... 1140P3TS BEGGS SIMPSON type AId0IATI : by riatP r-ecpt ! W:00 SW GREENSURG ROAD PRMT $ 25. 00 B 01/06/97 97-26845..3 FIR'1 $ 10. 00 B 01 /06/97 97--EHR453 1 1GPRD OR 97223 5PCT $ 1.. 25 B 01/06/97 97-2811453 Phone #» 1-rJntr-c1C'tor-- --------------------------------- FIRE __._.__---------------.--.__—__— FTRE SYSTEMS WEST, INC. 19 F•RONTAGC: RD. N #B PACIFIC WA 98047 1-1-)cine #: 3260-69 • -`39O6 $ :36. R5 TOTAL.. Reg #. . 049732 REf;UIRED INSPECTIONS This permit is issued subject to the regulations contained in the Sprinkl.er- Rough- Tigard Municipal Coda, State of Ore. Specialty Codes .rcl all other C;pr ,i.nk 1 er• Final applicable laws. All wor4 will be done in accordance with _,•�.__,� __, _— __-.._�.�__ approved plans. This permit will expire if work is not started within 188 days of issuance, or if work is suspended for more th„n 181 days. 0 r rmi.ttee `a a. „ tr•e : �, ti(', T S s��e ri tx y : 1•��l�N'��i.;1(i!"�.._._..�..____.._..._._..._.._.._.....�.. Call fur inspection - 639-4175 ire Protection Permit Application PlanCheckal OF TIGARD .f�A� Commercial or Residential Recd By ,�RD, OR 972-3 Print )r Type Date to P E. -q 639-•x171 Ext. 304 Incomplete or illegible applications will not be accepted Date to DST nermd a Called Name of Development/Prolect Type of System (Complete A or B as applicable) Job I-1iJ Cc:>LJ C_w_J-Y'c_rz I c c, —� -- -- '.ddrs3S Address �,�,/y A.) Sprinkler Wet Dry ❑ rLStandpipes Name ri r ( Hazard Group M Owner Mailing Address Additional L_.I C tylSlate Zip Phonal Information Den`ity — Design Area Name t l lr, C tD FJ L..C7 �ocupant Mailing Address K. Facto ~� Sprinkler Project Valuation $ �� City/state Zip Phone COT Business)ax or Metro Er_. + B.) Fire Alarm �— NameSubmittal Shall Include Battery Calculations YES C] ntractorIRt✓ -T , Individual Component YES r] rinkler or Mailing Address Cut Sheets Alarm (0 c,a t-�Ii fL t "T'I r-1 F_ p-�/~- 3� —Fire Alarm Project Valuation $ ampany) Cityrstate Zip Phone ttach Copy State Const. Cant. Board l.ic.0 Exp.Date Project Valuation Subtotal (A or B) $ cfl Of etq'132- — �- Ct-rrent L/ � COT Business ax or Otto 0 Exp.Date Permit fee based on valuation $ t{carr ses� — An{" ' rip (see chart on back) �_-- M t W_ `?_1F `L_ Name - S% Surcharge S I z c:� •i,rchitec4 Ma iin�Aad�ess — FL.S Plan Review 40% of Subtotal $ ( o 0 C,tyr'State Lp Phorr� TOTAL $ _ ——�escribe worts A.)New 0 Addition 0 Aftration/ PLANS MUST BE SUBMITTED,approved and a pemut issued prior to mstailatron. Three sea-f plaits and site part(and vrctnrty map)reduned whrrh shows iontlon of Ce dr,ne: Repair O nearest hvdrinL 6.) Basement O HoodNent O Spray Booth O 1 rem"acx:owtedge mat 1 nave read cors anpuratrort.:tat the information given is Completed Partial O Exrtway 0 correct,that i arm"owner or aurhonted agent of the owner,and that plans submitted j are in Compliance with Oregon State laws ,ldltlonal Description of Worts: --. —_ l.O c-,-rg—' 4 JI C- gnature of Owner/Agent Date 1 '(ulJ J a.�/ ♦tion Ll.� l_.d 7 u V - A.)In Existing Budding New Budding ❑ Contact Person Name Phone 1�uilding 01. 1 t-1 A. 9 r a-n_ "3 (a n c�9`> 110 t, Data p•) Commerval X Residential ❑ FOR OFFICE USE ONLY: Plat ft --��- Map[T'L*. No.of stones. Sq Ft: Notes Occupancy Class Type of Construction __J — ----- -- --- iresupr.doc CITY C'F T1GAR0 TOTAL PLAN STA A i c BUILDING V,ALr rA T ICN PERMIT FLS REVIE'N TAX PERMIT -'F PRCJEC- F-c=S (40e0i (651'0) 5?la FEE 3) WAME 1-1,500 CO 10.00 16.25 1.25 52.50 1.50'-1,500 ::5.50 SO.:J 17.231.23 3 55.80 1.501-1,700 Z9.CO 11.20 18.20 1.40 58.80 1.:01-1,800 29.:0 11.90 19.18 1.48 61.96 1,901-1,5C0 31.CQ 12.40 20.15 1.53 65.10 1,501-77,'!CO 32.50 13.CO 21.13 1.63 68.25 2.001-3,1.1C0 38.50 15.40 25.03 1.93 80.86 3,C01-4,000 44.50 17.90 28.93 2.23 93.46 4,C01-S,CCO 50.50 20.20 32.83 2.53 106.06 5,C01-6.000 56.50 2260 36.73 2.23 118,66 6,001-7,OCC 62.50 25.00 40.53 3.13 131.25 7,COI-8,CCO 68.50 27.40 44.50 3.43 143.85 8,001-9.000 -d4.!: 29.80 48.43 3.73 156.46 9,C01-•10,CCO 80.50 32.20 52.3.E 4.03 169.06 10,C01-11,CC0 86.!0 34.30 56.23 4.33 181.66 11,CO1-12,CCO 92.SO 37.CO 60.13 4.53 194.26 12,C01-i3,CCO S8.-=O 39.:0 61.03 4.93 206.86 13,CO1--,4,CCO 104,50 41.¢0 67.93 5.23 219.46 1-1,C01-13,000 1'10.50 44.^0 71.83 5.53 232.06 i 5,x01-i 6,CCG 116.?J 46.:7 75.73 5.93 244.66 15.CC1-17,CCO 122.50 79.9-1 a i ,,001-i8,CC0 129.:0 31.;0 83.53 v.d3 269.86 13.001-i9,nC0 134.-x0 53.30 87.43 6.73 282.46 ;9,001-20,CC0 140.5:0 5.5.20 91.33 7.03 295.C6 =1,CC0 i=6. t) 58.:0 S5 7.33 •� '•• .�� 307.56 152. 51.50 59.13 7.53 320.25 ,�C _3.000 153.:1 53.=Q 103.03 7.93 332.86 15•:.5.0 5.5.8Q 1Ca".=38.23 345.45 2... _ ._. :c3... . 8.53 388.06 0'-__._53 17 5.50 70.00 112.75 8.7 30"7.50 _G i r _.53 71?C 110'.68 8.53 27,Z'C 1 3. 3 84.^,0 7=.5J t7 9.27 ^;$6.40 3,c0i-=a.rCJ iP?.:O i 5.-'0 i2?-=? 9.13 398.85 irr.21 405.30 s .":u,cC;-3i'CCO 197.50 79.00 ;29.38 _.88 414.76 -',CG1-32.'�C0 502.:0 ao-zo 13 i.;.a 1G.;Q 424.20 _ra._•3 22.90 15'.23 1�.33 412.56 3.00;-:',c�a 2 i i.CO L--.=(7 1:7.'15 '�. .: AA3.10 _ X01-_ -CJ 21�.SJ c'�.=� 1-C.c3 10.73 452.55 SEE 35MM ROLL # 20 FOR ONrERSIZED DOCUM,ENT CITY OF T I G A R D _ ELECTRICAL PERMIT PERMIT #: ELC2002-00594 DEVELOPMENT SERVICES DAT;_: ISSUED: 1113102 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S135AB-04500 SITE ADDRESS: 10250 SW GREENBURG RD 110 SUBDIVISION: ZONING: C-P BLOCK: LOT : 001 JURISDIC110N: TIG Project Description: TI Relocate service panel and approximately 10 existing branch circuits, add approx. 10 branch circuits. RESIDENTIAL UNIT TEMP SRVC_/FEEDE_RS _ MISCELLANEOUS 1000 SF OR LESS: _ 0 200 amp: — PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 • 600 amp: SIGNAL/PANEL: MANF Hh1/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS _— _ _ ADD'L INSPECTIONS 0 - 200 amp: 1 W/SERVICE OR FEEDER: 20 PER INSPECTION: 201 - 400 amp: 1st W10 SRVC OR FDR: 0 PER HOUR: 401 - 600 amp: EA ADG'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ _ __PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: —__ SVC/FDR>=225 AMPS:i _ _ CLASS AREA/SPEC OCC: Owner: Contractor: — �— EOP LINCOI-N, LLC WII-LAMETFE EI-ECTRIC INC 10260 SW GREENBIJRG RD PO BOX 230547 SUITE 100 TIGARD,OR 97281 PORTLAND,OR 97223 Phone: Phone: 624-2938 FAX _ Reg #: 6e1;-:5631 34-283C FEES - Description Date Amount' Required Inspections [ELPItM1']ELC Pcnrnt I I ,ti 02 — $213.30 --- --- ------ [TAX[8111,Stag"I $17.06 Elect'I Service ——- Rough-in Total $230.36 Elect'l Final 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 9 work is suspended for more than 180 days ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules ordireci questions to OUNC at(503) 246-6690 or 1$032-2344 Issued By: Permit Signature:x' / , 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 INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: -- DATE: (CENSE NO: ___ J(,1 �_ — ---- --- — Call 639-4175 by 7�00pm for an inspection the next business day Ll-ectricai Permit Application _ '— –""— kDoj,,,rec'c,,ved:� _ _U� Pcrmtt no.city of Tigarti ect/ pl.no.: Expire date: CiryajTigard Address: 13125 SW Hall Blvd,Tigaid,OR 97223 bate issued: By:L-e I Receiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: �® 1 U I &.2 family dwelling or accessory U Commercial/nulu.;tnal U Nlultt-terms) Ai Tenant improvement U New construction U Addition/alteration/replacement U Other: U Partial li SITE IMFORMATION Joh address c J _ �. Bldg. [,,,� Suite no.: / Tax map/tax lot/account no.: Lor. Block: Subdivisidt: Project name: I Description and soca ion of work on premises: Tj _r+ Aj Estimated date of completio inspection: !�; CONTRU70111 APPLICATIONSCHEDULE Job no: 3 z ti _ Fee Max IkccrlprGm Qt). (ea.) 101.11 no.ince Business name: 1st 1 I. r �(,y„ c i r� _ New midenrial-single or multi family per Address: 26 __ doellinguuit.lncludesaltachedgarare. City: SIdtC:Qy-_ ZIP: `/�2F'/ Seri Ice inc luded: Phonc:�Ll S1 / Fax: 4'l4•lel 9 I E-mail: Itwusq.ft.orless _ _ 4 Each additional 500 sq.ft.or portion thereof CCB no.: Elec.bus.lic.no: Limited energy,residential 2 City/m•tro lic.no.: /S 9,, Limned energy,non-residential 2 E:.cl-manufactured home or modular dwelling Signature of supervisi r electrician(required) _ Dale 5ervics and/or feeder 2 snp.elect name(print, ! , r License no: /�/ "J Services or feeder—Installation, alteration or relocation: ga PROPERTY OWNER . 200 amps or less t S L 2 Name(print): _ 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps _ 2 City: rStat ZIP: Over 1000 amps or volts 2 Phone: Fax: E-mail: Reconnect only I Owner installation:The installation is being made on property I own Temporary services orfeeders- which is not intended for sale,lease,rent,or exchange according to Installation,allerat Ion,or relocation: 2 ORS 447,455,479,670,701. _ 200 amps or less 201 9rnp5 10 41w amps 2 it (.Owner's si wature: Date: 401 In rk)o ams 2 ( Branch ch-culls-new,alteration, or extension per panel: 7mle: A. Fee for branch circuits with purchase of service or feeder fee,arch branch circuit �L 2 yl Stale: 7IP: B. Fee for brunch circuits without purchase r--- of service or feeder fee,first branch circuit. 2 _ Phone: Fax: E-mail: Each additional branch circuit: Misr.(Service or feeder not included): U Service over 225 amps-commcmial U Health-care facility Each pump or irrigation circle 2 •Service over 320 amps-rating of I llr2 U Hazardous location Each sign or outline lighting 2 familydwellings U Building over IOJW square feet four or Signal circuit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension* 2 U Building over three stories U Feeders,4(X)amps or more *Description: _ U Occupant load over 99 persons U Manufactured structures or RV park )each additional Inspection over the allowable In any of the above: U EgressAightingplan U Other �— Perms ection _ Submit_vets of plans with■ray of the above. Investigatipn fee I The a'sove are not applicable to temporary construction service. Other --- Permit fee.....................$ —2,13,3c' NM aII jtmsdl fi,;% reel"credit card,,llraw call jurisdiction rex nwxe information. Notice:This permit application U visa U MasterCard expires if a permit is not obtained Plan review(at _ 96) $ i r.rd namtr_r _L_L._. within ISO days after it has teen State surcharge(8%)....$ I �,C Expires accepted as complete. TOTAL, ........ ..............$ Name of crdhoWr as shown on credit card �_, — Cardholder sigrtalurt — s Amours 440-4615(610WOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEEZ: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY (� Restricted Energy Fee...................................................... $75.00 Nurnher of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less _ $145.15 4 Audio and Stereo Systems" Each additional 500 sq.it or portion thereof $33.40 1 Burglar Alarm Limited Energy __ $75.00 _ Each Manul"d Home nr Modular ❑ Dwelling Service or Feeder $90.90 2 Garage Door Opener' Services or Feeders F—] Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $8030 —, 2 201 amps to 400 amps _ $106.85 u 2 LJ Vacuum Systems 401 amps to 600 amps $1d0 bq 2 —..._�. —--- 601 amps to 1000 amps 3'[•10.60 2 Other Over 1000 amps or volts i $45455 2 Reconnect only $66.85_ 2 Temporary Services or Feeders 'TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system. 200 amps or less __— $66.85 _ 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100.30 — 2 401 amps to 6nO amps — $133.75 2 Check Type of Work Involved: ' Over 600 amps to 1000 volts, ` -;00"b"shove. n Audio and Stereo Systems / Branch Circuits New,alleratioi or extension per panel Boiler Controls a)The fee for branch circuits with purchase of service or Clock Systems feeder fee. Each branch circuit _ $6.R5--_ 2 Data Telecommunication Installation b) The fee for branch circuits without purchase of service orfeeagrfee. Fire Alarm Installation First branch Circuit _ $46.85 ❑ Each additional branch circuit $6.65 HVAC Miscellaneous Instrumentation (Service or feeder not included) Each pump or irrigation circle _ __ $53.40 _ Each sign or outline lighting $53.40 _ �� Intercom and P�ging Systems Signal circuit(s)or a limited erergy panel,alteration or extensio 1 — $75.00 _ Landscape Irrigation Control" Minor Labels(10) $125.00 _ Each additional Inspection .,ver Medical the ahowable In any of the above Per inspection $62.50 Nurse Calls Per`your _ $62.50 r� In Plant $73.75 U _ __. _ Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ Other C%State Surcharge S _ __Number of Systems 251n Plan Review Fee See"Plan Review' m c ion nn $ Nr licenses are required i icenses are required for all other installations front of application �.._- -- --- Fees: Total Balance Due $ Enter'otal of above fees $ Trust Account f - 91,e State Surcharge $ Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i:\dsts\forms\eIc-fccs.doc OM/70/01 CITYOF T I G.A R C) SEWER CONNECTION PERMIT DEVELOPMENT SERVICE'S PERMIT#: SWR2002-00300 DATE ISSUED: 11/22/02 1:125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S135A6-04500 SITE ADDRESS; 10250 SW GREENBURG RD 110 SUBDIVISION: ZONING: BLOCK: LOT. — JURISDICTION:_ TENANT NAME: FAMILY HEALTH PARTNERS USA NO: FIXTURE UNITS: CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: 3.8 EDU increase. Previous EDU:--26 for a total of 416 fixture values. Addition of 61 fixture values, for a new total of 477 fixture values =29.8 current EDUs. Owner: — _ FEES _ EOP LINCOLN , LLC Description Date Amount 10260 SW GREENBURG RU — SUITE 100 jSNJ ISAJ Seer C„nnccr 11/22/02 $8,740.00 PORTLAND, OR 97223 -- —— Total $8,740.00 Phone: -- Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with ali the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the Nide sewer laterals. J the sewer is not located at the measurement given the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" 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 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. j r Permittee Si, nature:• Is�Ued by: _� q Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day` Accumulotive :sewer Tally T onant Name gamily Health Partn ars _ fhis SWRA 2002-00300 Site Address: 10250 SW Greenhuro Sto. #110 This PLM# 2002-00427 Fixture Value Previous Previous Credits Capped Fixture Fixture New New 4 value capped off value added added total total count off as _count # va,u_e #S _ values__ Haptisery/Font 4 0 _ -0 0 U _0_ _ Bath-Tub/Shower _ 4 _ 0 -- 0 _ 0, 0 _0 -_ Jacuzzi/Whirlpool _4 _ 0 _ - 0 _ 0_ 0 0 - Car - Each Stall_ - 6 - 0 —1 0- _ _ 0 0 _ 0__ _ -Drive through _ 16 � 0 0 -D 0 0 Cuspidcr/Water Aspirator 1 �- 0 _ 0 0 - 0 0 Dishwasher-Commercial 4 _ 0 1 4 1 '4 0 _ 0 --� -Domestic 2 0 0 _ 0 0 0 _ Drinking Fountain 1 v _ 0 0 _0 0_ 0 _ Eye Wash 1 0 0 _ _- 0 0 0 - Floor Drain/Sink-2 inch _ 2 0 1 1 2 _1 - - 2 U _ 0 _ 3 inch _ 5 0 0 - 0_ _ 0 _ 0 4 inch _ 6 0_ 0 13 0 1 0 Car Wash Drn 6 U 0 �0 _ 0 _ 0 G3rbage Disposal _ Domestic(to 3/4 HP) 16 0 0 0 0 _ 0 - - Commercial (to 5 HP) 32 0 0 -0 0 0 _-- Industrial(over 5 HP) - 48 0 0 0 0 0 ICI? Machine/Refrigerator Drain 10 _ _0_ 0 0 Se Oil GStation) 6 - -� v 0 - ^0 0 �_ a.,_—.� 0__. _-- -- 0 0 -- - Rec.Vehicle Durnp station 160 0 0 v 0 0 Shower_-Gang (per head) 1 0 _ -� (' 0 o.- G, - '�- _ - -Stall _-_- _ 2 _ 0 - 0 � 0 0 fl Sink Bar/Lavatory 2 - -_0 _ 0 - 2_ 4 2 4 - Bradley__-- 5 -- -U _-- - 0 _ -- --_0 0 �0 _Commercial _ -- 3-_ -_�_0 -1 3_ 14 42 13 -Service --^ 3 -0 0- -- 0 0 _0 Swimn ing Pool Filter 1 0 v0 _ _ 0 _0 0__ Washer-Clothes _ 6 _ 0_ 0_ 1 _ 6 _ 1 _6 Water Extractor _ 6 0 _0 __-0 _ 0 0 Water Closet-Toilet -� - 6 D 0 2 12 2 12 Urinal 6 — - 0 --_ -0--- _--^_-^ _0 0 Previous EDU Count 26 446 - - 416 Capped EDU Credit 0 TOTALS U 416 3 J 21 70 18 477 Current Fixture'Value 477 divided by '6 = 29.8 Current EDU 1 EDU = V,300.00 Previous Fixture Value 4 16 _ divided by 16= -_26.0 Previous EDU Change 61 _ divided by 16 = 3.8 over (under) _$_ _8,740.00 - Enter EDU Change here 3.8 - HISTORY Notes: _ PLM# EDU# SWR# EDU count of 26 taken from _ PLM# T`T EDU# - - SWR#_ -- yellow files PLM#� -_ -----�-- EDU# ------ --------- SWR# - �-------- Name:� ' �: ��CdlA:� Date. __c�CJ- CMZ Signature of person that calculated this tally sheet and date perfromed is nequlntd CITY OF TIGA RD - -- PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00427 13125 SW Hall Olvd., Tigard. OR 97223 (503) 639-4171 DATE ISSUED: 11/25/02 SITE ADDRESS: 10250 SW C;REEi IBURG RD 110 PARCEL: 1S135AB-04500 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: 'r`!PE OF USE: COM WASHING MACH: I BACKFLOW PRE'VNTRS: 1 OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES —� LAUNDRY TRAYS: SF RAIN. DRAINS: SINKS: 15 URINALS: GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: 2 Tog/SHOWERS: SEWER LINE: it WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Plumbing TI: Other fixtures: 1 expansion tank, 1 primer. Owner: _ —_ FEES —"- —"'—' EOP LINCOLN , L[.0 Description nate Amount-- — 10260 SW GREENBURG RD IPLUMR] Permit Fee 11/25/02 $461.40 SUITE 100 [PLUMB] Permit Fee 11/25/02 $0.00 PORTLAND, OR 97223 ITAX] 8°/,State Tax 11/25/02 $36.92 [TAX] 8%0 State Tax 11/25/02 $0.00 Phone 1: [PLMPLN] Plan Rcview 11/25/02 $1'5.35 Contractor: [PLMPI NJ Plan Itc\-ic%\ 11/25/02 $0.00 ASSOCIATED PLUMBING CO Total $613.67 P O BOX 301362 PORTLAND, OR 972.30 REQUIRED INSPECTIONS Phone 1: 331-0582 UnderflaoriUnderstah Top-out Insp Reg #: MET 00001881 RP/Backflow Preventer IIC 57890 Final Inspection PLM 26-412PB 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 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: f_' Permittee Signature: Call (03) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application � ,a. ;I Permit Cit nt l Tigard igaru 5cwa IKrTnit no.. Building permit no.. Arldtess: 13125 SW Hall Hltd,Tir,u l l rh ' +7'' \. CirvnJTigrtrd Phone: (503) 639.4171 11 ' 1'rojalappl.no.: ti> date, _ C G + Fax:(503) 598.196(1 F'LA^1P ',i _ ()steicuod: *,,19 1 ReCeiptno: Land use approval: ease[t a no.: Payment type: I - -- M-- - U 16c 2 family dwelling or accessory ;»CommerciaVindustn� Ll Mutt-fanuly XTrnani iniMivetrrnt U New(x,netnrction :J AddiNotJalteratiotdreplxcement U� FtxA servire IJ(hhet , ^ MW _ ___ _ )10 _ De,,cr�on (n Fee. ea.). 11'atal Jot)Id-g-. o-.- --f,,- SW;�-G rec,l 'S611 no.: �t��: NeN I as '--fanjily dell ngs oily: - Bldg,ao.:Lmp n 13U,I�I1s T'S 61 no.: Ito Tax map/tax lot/accountno.: - (Inchs(1)be ft. 5FR(1)beth Lot. Black: Subdivision: - SFR(2)bath me Project na : q QA w SFR(3)bath _ City/county:-nor ZIP: qy AA3 Each addit unal hatWkitchen Description and ocation cif ark on(irremises: Site uH1lHmms: Ttg =ma(0.yemt.r - Is F)oo^ 59 rorntr Catch bask/area drain Est.date of compledoolinspcction: -2 bt/tcs Dry el ach lineitrench drain _ 1 Forting drun w.lin.11L) _ Manufactu•ed home utilities Business name: _ A 0 iI�c Y� ,lanholes Address:PO &A 3v34,4_ P nen counectur City' qr 'q _ State4bg 7.1p: 72 - 6 Sanitary sewer(no.lin.ft.) hhone:503 33) 056A I r 310 9) Email: Storm scWvt(no.tin. UV CCH no.: M90Plumb.bus.mg.no. 'gj,�-f��_ ater se"'cc(no lin.ft.) City/metro lie.no.: Teel 26R%ture or Rem: Contractor'sm resentative sin urr —Abso—�tion valve--- r------- p g -- -- Back flow )rove Iter Pt t- '`U ^C� Print name: ( k ylag Date:11 -ol Backwater valve - 1 b asins/law tory 2 11 t� Name. Crack �U yYlQrin CI� of es washer - - 'sh ,was r Address: Qp ( 3c1)b Drinking f�wtain(s) Clty:P0� An �stateOR ZIP:g7Z91t-`I3 Ejectors/surnp Phone:5o) 331 65Fz_ Fax; 331 0561 L-mail: -- Expansion tank _ Fixture/sewer cap Name(pent): rJ u, p ,f T Floor drain/floor sinks hub ----t-- Garbage di tpcncaj Mailing address: osc bibti City: - p�,� Estate: Z[P: c1�213 lee maker Phoac:50) Y��5ao Fax:V�V �Gmaii _ recce gyrase trap — Owner insiallation/residential r inintenance only: The actual installation Ptimer(s) 1 will be made by me or die:a+iv*,nancc and repair made by my regular Roof drain(commercial) employee on the rniperty I own us per ORS C7tapter 447 Sink(s),ba.in(s), ays(s) Owner's si nature Date: Sum Tubs/show:r/shmyu pan _ Name: N A rinal Addm ,;s: _ __ Watcrhab:r �- City: State: TIP: `Phone - _ Fax: I Email -"— . .. Vm OU ialdetlota 1nqx"t&Ealf trrdt,*M4 cdl)unlAltllm(of nom WamNba. Notice:71r1s permit eppl cntivn Minimum fee ... .... a U vlu USteterC'rJPlan review(at __ ' ) 5 expires it's permit is rmt rtttaineJ State sort hul,e(R%l s within 180 da%%after i11•es ta.•crl ----- -- -- rr�r,r 113 o t TOTAL ........ .. .. i �� 6 7 uw ei ac a�M e�n1N�.vJ rl r t M1� 011 Y OF TI GARD BUILDING PERMIT — DEVELOPMENT SERVICES PERMIT#: BUP2002 00496 DATE ISSUED: 11/25/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10250 SW GREENBURG RD 110 PAPCEL: 1S135AB-04500 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P : LOT: 001 r---- BLOCK-- JURISDICTION: TIG _ REISSUE: _FLOOR AREAS A EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: ` TYPE OF USE: COM SECOND: si PROJECT OPENINGS? TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GA.IAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _ REQD SETBACKS __ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SRL: — SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 2,935.00 Remarks: Add (1.2)new pendent heads and relocate (21) pendent heads. Owner: Contractor EOP LINCOLN , LI-C DELTA FIRE INC 1 '60 SVV GREENBURG RD 14795 SW 72ND AVE SUITE 100 PORTLAND, OR 97224 PORTLAND, OR 97223 Phone: 620.4020 Phone: 620-4020 _ Reg #: MET 001000gq1934 _— FEES LIC REQ6g4IRED INSPECTIONS Description Date Amount Sprinkler inspection (BUILD] Permit Fee 11/13/02 $72,10 Sprinkler Final ITAXJ 8%Statc Tax 11/13/02 $5.77 (I I.Sj FLS Pln Rv 11/13/02 $28.84 Total $106.71 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if worl, is suspended for more than 180 days ATTENTION: Oregon: law require3 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 3r direct questions to OUNC by calling (503)246-6699 or 1-300-332-2344. Issued By: Pennittee Signature: Call 639-4175 by 7 p.m. for an inspection the next business day Fire Protection System � ( t � 6.L Building Permit Application ID!tereceived: City of Permit no.: i 'Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: xpire te: City of Tigard Phone: (503) 639-4171 Dale issued: r B y1(,Pb Receipt no.: Fax: (503) 59R-1960 Case file no.: Payment type: Ladd use approval: I&2 family:simple Complex: n ❑ 1 &.2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition Add itionial teration/repl acement U Tenant improvement U Fire sprinkler/alarm U Other: 3011 SI 11, INI ! 1 Job address: pZ ,� 1C '� Bldg.no: Suite no.: 116 Lot: I Block: Subdivision: Tax map/tax lot/account no.: Project name: /C-o (Q, Description and location of work on pre ses/special condit ns: OWNtER FOR SPECIAL INFORMITION Name: � (Floodplain, solar,fle J Mailing address: 1 &2 family dwelling: j City: I State: ZIP_ Valuation of work........................................ t _. Phone: Fax: G mail: No.of bcdmoms/haths................................. ' Owner's representative: Total number of floors................................. I " Phone: Fax: E-mail: New dwelling area(sq.ft.) .................... ..... Garage/carport area(sq.ft.)......................... Name: �•- Covered porch area(sq.ft.) , Mailing address: iei � Deck area(sq.ft.)........................................ . Cit y:l State: ZIP: C Other structure area(s •ft.)......................... _ Phone: (� Fax: r. ;,ad - Commerr-ial/industrial/multl-family: Valuation of work........•............................... �yL Business name: ( �� Existing bldg.area(sq.ft.) .................•........ Address: C _ _j�J �, New bldg.area(sq.ff.)........................•....... City:r-7.r_ Start ZIP - Number of stories ........................................ Type of construction.......... ... Phone: 0 ZJ Fax: E-mail: "no.: Occupancy group(s): Existing: C��!!7`� New: no.: C. Notice-All contractors and subcontractors are required to be . CMZ= licensed with the Oregon Construction Contractors Board under Name: 7CC - provisions of ORS 701 and may be required to he licensed in the Address: �` ) - C jurisdiction where work is being performed. If the applicant is City:r Stated ZIP: C exempt from licensing,the following reason applies: Contact person• Plan no.: Phone: -- Fax NOF ft 10' Name: ('untact perstm Fees due upon application ........................... $ Allccl 71--- Address: tate received: City: State: Z.IP: Amount received ......................................... $ Phone: I;ax: E-mail: Please refer to fee schedule. I hereby certify i have read and examined this application and the Not all jurisdictions accept credit raals,gleam call judxliction for more information attached checklist.All provisions of laws and ordinances governing this Q 19sa U Ma.,tercard work will he complied with whether sp •ified he in or not. credit card number: _ -_LI 1 1 —+ fspircs Authorized sign tuj[a!- 2 (! Uate: !/-.-6.;l' None of cstrdholder et shown nn credit crud � - S Print name: c.rdnider.lsnuurc" _ mm Notice:This permit application expires if a permit is not obtained within 180 days ager it has been accepted as complete. aatAu tturacoMt Fire Protection Permit Check List A.) ❑ New Q Addition Ul Alteration ❑ Repair B.) Modification to sprinkler heads only: Describe work to 1. 1-10 heads: No plan review required. be done: 2. 11+ heads: Plan review required. Number of sprinkler heads: Additional description of work: Koo(11L) j �,eNo0�T r*a.o.cS 064-05 Typeof System (Complete A, B or C as a . Ip icable : _ A.) Sprinkler T Wet W Dry ❑ Standpipes -- Additional Hazard, Group Information Density . 10 Design Area %s_p K. Factor 5.610 _Sprink!`err ect ValValuation: $ B.LType I - Hood Fire Suppression S sty em Hood Project Valuation C. Fire Alarm_ Submittal shall BattCalcufations include: Individual Component Yes ❑ Cut Sheets Fire Alarm Pro ect Valuation: $ _ Project Valuation Subtotal A, B & C): $ Permit fee based on valuation see chart : $ 8% State Surcharge: $ _ FLS Plan Review 40% of Permit: $ _ TOTAL: $ Plan review requires a completed application and 3 set< of plans at submittal. Pian review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. OdstsVormsTPSchecktist.doc 11!21/01 BUILDING PERMIT CITYOF T I G A R D PERMIT#: BUP2002-00496 DEVELOPMENT SERVICES LATE ISSUED: 11/25/02 13125 SW Hall Blvd.,Tiaard. OR 97223 (503) 639-4171 PARCEL: 1S135AB-04500 SITE ADDRESS: 10250 SW GREENBURG RD 110 ZONING: C-P SUBDIVISION: LINCOLN BUILDING PP1991.055 JURISDICTION: TIG _ BLOCK: _ LOT: 001 REISS:JE: FLOOR AREAS — EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE- CUM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONT: sf N: S: E: W' OCCUPANCY GRP: H TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: GARAGE: sf OCCU SEP. RATED: STOR: HT' ftREQD SETBACKS REQUIRED BSMT?. MEZZ?: - FLOOR LOAD. psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: WELLING UNITS: FRNT,: ft REAR: ft FIR ALRM : HNDICP ACC: D BEDR W BATHS: IMP SURFACE.: PRO CORR: PARKING: VALUE: $ 2,935 00 Remarks: Add (12)new pendent heads and relocate (21) pendent heads. Contractor: Owner: EOP LINCOLN , LLC DELTA FIRE INC 10260 SW GREENBURG RD 14795 SW 72ND AVE SUITE 100 PORTLAND, OR 97224 PORTLAND,OR 97223 Phone: 620-4020 Phone: 620-4020 Reg #: MET 0000100741934 --- ----- FEES LIC REQUIRED INSPECTIONS- -- --� Description Date —Amount _— Sprinkler inspection 1131JILI�1 1'ennit FccA 11/13102 $72.10 Sprinkler Final TAXI 81/o State'Tax 11/13102 $5.77 1171,S]hLS Pln Rv 11/13/02 $28.84 — Total $106.71 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 1 his permit will expire if work is not s'.arted within 180 days of issuance, or 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. Issued By: - Permlttee / ) Signature: 1�— --�/ r t✓ ----- C'all 639-4175 by 7 p.m. for an inspection the next business day CITYOF TI GA R D VIECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2002-00546 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/13/02 PARC t.L: 1 S 135AB-04500 31TE ADDRESS: 10250 SW GREENBURG RD 110 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR TURN: f_VAP COOLERS:� TYPE OF USE: COM UNIT HEATERS: VENT FANS: )CCUPANCY GRP: 3 VENTS W/O APPL: `DENT SYSTEMS: STORIES: BOILERS/COMPRES_S_ORS _ HOODS: FUEL TYPES _ 0 - 3 HP: DOMES. ING'IN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS?: J-0 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + Hp: WOODSTOVES: FURN < 100K BTU: _AIR HANDLING UNITS CLO DRYERS: FURN >=100K BTU: r<= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Mechanical tenant improvement Owner: FEES _ FOP LINCOLN , LLC Description Date Amount 10260 SW GREENBURG RD — SUITE 100 IN11'r'111 I'crmit Ice '12/13!02 $133.30 PORI-LAND, OR 97223 1 i'AX] W. titatcTax 12/13/02 $10.67 1N1FCPI.N1 Plan Rev 12/13/02 $33.33 Phone: — Total $177.30 Contractor: — PROTEMP ASSOCIATES INC 9788 SE 17TH AVE PORTLAND, OR 97222 REQUIRED INSPECTIONS Phone: 233-6911 Mechanical Insp Final Inspection Reg #: LIC 38868 This permit is issued subject to the regulations oontained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work Wil be done in accordance with approved plans. This permit will expire if worts is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 00 Issued By: /,,; . , Permittee Signature: Call (503) 639-4175 by 7.00 P.M. for inspections needed tfe nex usiness day Mechanical Permit Ao, s 400ji Date received: Permit no.: i •DO'Sy City of Tigard DEC 0 4 2002 ProjecVappl.no,; date: CM of i„ I'd Address: 13125 SW Hall Blvd,Tigard OR 97223 Phone: (503) 639-4171 CITY OF TIGARL) Date issued; Hy Receiptno.: Fax: (503) 598-1960 -- n��GING,D VISION Case rile no.: _ Payment type: Land use approval: Building permit no.: AllaTYPE 01PERMIT U 1 &2 family dwelling or accessory �omme.cialhndustrial U Multi-family cnant improvement U New constniction U Addition/alteration/replacement U Other: _ Job address: ;r T Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ 3 OCA Lot: Block: Subdivision: *See checklist for important application information and Project name: c eT AR7-1,C0jurisdiction's fee schedule for resid-mtial permit fec. City/county: ZIP: 77 C2,;L t Description and location of work on premises: _ t /-✓4 - iF44Q1CA .2 466 v ree(ea.)I Tota! Est.dale o complciiort/inspecti Ih,cription _ Qty. Res.only Res.only, 'tenant improvement or change of use: Is existing space heated or conditioned'Lf�Ycs U No 7Ai,ha, nit __ ng(silc phin required)Is existing space insulated9Ja�es ❑No terauon ofcxistingjl C system stem — - - iNeer/compressors Business name:14,77� ,yl p S & State boiler permit no.: — HP --Tons BTU/H Address: 97E E S� ,a, ire smok�ampers uctsmo a detectors City: j p _ State.: T IP:� eat pump(siteplan required) Phone: / fax: ?Js.g747 Email; nstalVrep ace furnace urner / CCB no.: --- ---_- Including ductwork/vent liner U Yes U No — lista replace re ocale eaters-suspende , City/metro lie.no.: U53`� wall,ur floor mounted Name(pleaseprint): Vent,forap iance other than furnace Refrigeration: Name: / Absorption units_ HTU/I I _�rres�t�1, LAI -. Chillers__ __ HP Address: Com ressors Hp Y State: ZII Cit - Environmental ex aust an ventilation: ' Appl iance vent Fhone _-- T=:,. _ E-mail: IiryercxTauet " Hoo s,Type 1/res. nc IeN azmat — hood fire suppression system _ Name. Exhaust fan with single duct(bath fans) Mailing address: x au t s stems art fr,. heating or AC City: St Ise: 7,IP: -+ lie p p ng and distribution(up to 4 outlets) - -�'--` Type: ." LPG NG Oil Phone: I; I?-mail Ivc i in I eac additional over outlets -" rocessp p ng(schematic required) Name; Number of outlets AI',Ure3l1: ter app lice or equipment., - - _ Decorative fireplace City: A State: ZIP: --- nsert -type _ Phone: _ B mail; oo stove/p-e et stove —— Applicant's signatures Date: Other. —` - Other': Name(print): • Nd all jurisdictions accept credit cattle,pleas;call jurisdiction ror muse olonn+tion Permit fee........... .........$ U visa U MasterCard Notice:This permit application Minimum fee................$ t redit card narrtber: expires if a permit b not obtained - -rL L v:ithin 190 days atter it has been Plan review(lit ` %) $ Na,ne or c r u shown on c t card - - accepted as complete. State surcharge(8%)....$ s TOTAL . ................. ...$ ----- Crdttold'or signature — -- Amount 4434617 t6ltla/COM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code _ aty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the-first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each;additional$100.00 or including ducts&vents 14.00 fraction thereof,to and including 2) Furnace 100,000 BTU+ _ $10,000.00. _ Including ducts&vents 17.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or Including vent 14.00 fraction thereof,to and including 4) Suspended heater,wall heater $2500000 or floor mounted heater 14.00 $25,001,00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included In appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and Including 6) Repair units _ $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof, footnotes below. Comp •• Minimum Permit Fee$72.50 SUBTOTAL: 7)<3HP;absorb unit 7, to 100K BTU _ 14.00 8%State Surcharge a 8)3-15 HP;absorb '7 unit 100k to 500k BTU _ 2560 �- 25%Plan Review Fee(of subtotal) a9)15-30 HP;absorb Required for ALL commercial permits only7,7 , 7 unit.5-1 mil BTU 35.00 _ TOTAL COMMERCIAL PERMIT FEE: $ unit 301.7 mil absorb � 2 unit 1-1.75 mil BTU 52.20 11)>50HP:absorb unit>1.75 mil BTU _ 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 C;=M -- Value Total 10.00 13)Air handling unit 10,000 CFM+ Description: O Ea Amount _ 17.20 Furnace to 100,000 BTU,Including 955 14)Wn-portable evaporate cooler ducts&vents _ 1000 Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct ducts&_vents 6.80 Floor furnace Including vent 955 - Susp9nded heater,wall heater or 955 16)Ventilation system not Included In floor n_ounted heater appliance emtit 10.00 17)Hood served bmechanical exhaust Vent not Included In appliance 445 y xs srmlt 10.00 Repair units _ 805 18)Domestic incinerators <3 hp;absorb.unit, 955 17.40 to 100k BTU 19)Commercial or Industrial type incinerator 3-15 hp;absorb.unit, 1,700 G9.95 101k to 500k BTU 20)Other units,Including wood stoves 15-30 hp;absorb.unit,501k to 1 2.,310 10.00 mil.BTU 21)Gas piping one to four outlets 540 _ 30-50 hp;aLsorb.unit,v 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU _ 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: >1.75 mil.BTU $ Air handling unit to 10,000 cfm 656 8%State Surcharge Air handlingunit>10,000 cfm 1,170 a Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: 5 Ventt fan connected ed to a single duct _448 Vent system not Included in 656 _a liance ermit -�-- - - --- PP._`__-- _Hood served by mechanical exhaust 656 Other Inspections and Fees:_ t Inspections outside of normal business hours(minimum charge-two hours) Domestic inGnerator 1,170 $62 50 per hour. Commercial or Industrial Incinerator 4,590 1 _ 2 Inspections for which no fes is specifically Indicated (minimum charge-half hour) Other unit,including woad stoves, 656 $62.50 per hour Inserts,etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas piping 14 outlets _ 360 charge-one-half hour)$62 50 per hour Each additional outlet 63 "State Contractor Boller Certification required for units>200k BTI. TOTAL COMMERCIAL $ ""Realdentlal A/C requires site plan showing placement of unit. VALUATION: All New Commercial Buildings require 2 sets of plans, i:\dstsNformsVnech-fees.doc 02/11/02 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 iNSPEC-i10N DIVISION Business Line: (503) 639-4171 MST _- BLIP _ Received -_____ _ Date Requested 3 �_ AA4-_-- _-- PM—. --_-__ BLIPLocation _ _ b Z �_ Suite Y, - MEC _ Contact Person __ _ Ph( ) PLM Contractor_ �aLl _-L x� Ph( )) 1 a — SWR BUILDING Ter.ant/Owner ! y� Footing - -- - Foundation ELC) Fig Drain Access: ELF! Crawl Drain -- --- - Slab Inspection Notes: �-• // Ir-2 �0 SIT Post& Beam / !► Shear Anchors Ext Sheath/Shea- 1... .r Int Sheath/Shear Framing T Insulation s 2 0O /7 -�/T"- p Drywall Nailing OV 0 ° L J�+1'" l LI r `" !� . . Firowall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: - Final - --- -_---- PASS PART FAIL PLUMBING ------ - - � C� �-- Post A Beam Under Slab _ Hough-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 Fi iai PASS PART FAIL EL C RI A_L --- SetVi_e -- - --- Rough-In UG/Slab ----- _� Low Voltage _.�_ Fir Alarm nQ.1L{�e --�f d— - ---- -- AS PART FAIL L__1 Reinspection tee of$_— —_required before next inspection. Pay 3t City Hall, 13125 SW Hall Blvd. SITE W �� Please call for reinspection RE: FJ Unable to inspect- no access Fire Supply Line ADA Date — -�✓-- C. OvZ Approach/Sidewalk — _ Inspector .(�� Ext Other: --- --- Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDI,:G Inspection Line: (503) 639-41'5 MST INSPECTION DIVISICN Business Line: (503) 639-4171 BLIP Received -- --Date Requested /�Z.1'.-1�—.- AM-- -- —PM BUP — Location _- 1Da�-.-_`L �� SuiteMEC -- f Contact Person e r��c�t Ph( 2 ) _�?��_ PLM _ -- td� -- Ph( ) — SWR — Contractor ___, Tenant/Owner --9i-� � � � ELC - — Footing ELC Foundation Access: EL - -- Ftg Drain C ---- rawl Drain - SIT Slab Inspection Notes --t& Beam --- --- - Shear Anchors Ext Sheath/Shear ^- Int Shnath/Shear Framing - --- - -- --- . . -- Insulation Drywall Nailing --- -- Firewall Fire Sprinkler — ✓'': SJ �C. /V _ Fire Alarm Y Susp'd Ceiling Roof Oteffher:, S Y �✓ �� l PASS PART FAIL _PLUMBING__ ___ - _ ---------- - Post&Beam Under Slab -- - - -- Rough-In Water Service u Sanitary Sewer Rain Drains _ Catch Basin/Manhole Storm Drain - __- ` - 17 - Shower Pan ` Other: - -- Final ----- --— -- --- - PASS PART FAIL--- MECHANICAL - Post&Beam Rough-In - -- - Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough-In UG/Slab I.ow Voltage -- - - - ----------. -------- Fire Alarm f anal PASS PART FAIL_ jReinspection fee of$_.___...____--required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE F-] Please call for reinspection RE: Unable to inspect-no access Fire Supply Line �7 ADA Date A?APIX)� Insper or - Approach/Sidewalk Other: _-_- Fine! DO NOT REMOVE this Inspection recur from the Job site. PASS PART FAIL CITY OF T I G A R D ELECTRICAL PERMIT- RESTRICTED ENERGY t DEVELOPMENT SERVICES PERMIT#: ELR2003-00012 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 1/17/03 SITE ADDRESS: 10250 SW GREENBURG RD 1'10 PARCEL: 1S135AB-04500 SUBDiVIS:ON: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT: 001 JURISDICTION: TIG Proit:ct Description: Low voltage: Protective signaling. A. RESIDENTIALB.COMMERCIAL AUDIO & STERFO. AUDIO & STEREO: _ INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENED: CLOCK: MEDICAL: HVAC. DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: _-_..TOTAL#OF SYSTEMS: 1 Owner: Contractor: EOP LINCOLN , LLC PROTECTION ONE ALARM MONITORIN 10260 SW GREENBURG RD 15500 SW 72ND AVE SUITE 100 PORTLAND, OR 97224 PORTLAND, OP. 97223 Phone: Phone: 624-0244 Reg#: EI E 34-428CCI I LIC 116325 _ FEES Required Inspections _Description — Date—__ Amount Low Voltage Inspection 1 �ELPRMT] ELR Permit 1/17/03 X75 (�0 Elect'I Final (TAX) R"a. State Tax 1/17/03 $6.00 Total $89.00 This Permit is issued subject to the regulations contained ii ., $drd Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accor,,ance with approved plans. This permit will expire if work is not started within 180 days Of issuance, or if wor< is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oreg,n Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952.001-0100 You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 Issued by �..xa.�. ,C�Com- j _ U_ ', Permittee Signature OWNER INSTALLATION ONLY ( / flip installation is being made on property I own which is not intended for sale, lease,-of rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLA i ION ONLY SIGNATURE OF SUPR. ELEC'N GATE: I ICE14SE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day r Electrical Permit Application FOR OFFICE _--_ _------ Received ME,11-1 I[Iccuncal Date/By: I - 1 .� - O Permit No.:�jx_�(kj City of Tigard Planning Approval sign t)ate/By: Permit No.: 13125 SW HrU Blvd. Plan Review— Other Tigard,Oregon 97223 Date/By! Permit No.: Phone: 503-639-1171 Fax: 503-598-1960 Post-Revicw Land Use Internet: www.ci.ti;ard.or,us Date/By:— _ I Case No.: Contact Juns.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method _ Supplemental Information. TYPE OF WORK PLAN REVIEW(Please check all that apply) ❑ New construction _ DemolitionService over 225 amps- L Health-care racility X Addition/alteration/replacement Other: commercial ❑1lazardous location _[0 __ CATE_GORY OF CONSTRUCTION ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, I&2 family dwellings four or more residential units in I & 2-Family dwelling CommercialIndustrial ❑System over 600 volts nominal one structure _ Accessory Building Multi-Famil , ❑Building over three stories ❑Fecders,400 amps or marc ---�.� ❑Occupant load over 99 persons ❑Manufactured struclur-..s or RV part, Mast:r Builder Other:__ _ ❑Fgrcs,7ightin^plan I ❑Other: JOB �SITE INFORMATION and LOCATION Submit_ sets of plans withy o anrthe above. Joh site address:_ ��. ) i� "E�/rf1e��La Thebove are not applicable q temporary construction service. a __ _ Suite#_�T� / Bid FEE*SCHEDULE ./A _ Number of ins ectiouspe"ermit allowed Project Name: R[ K.t` Descrl tion Qh Fee(ea.) Total Cross street/Directions to fob site: New n•sidenlial-sinplc or multi-fan ally per dwelling unit.Inc•'ades attached garage. Senlce Included: 1000 s .11.or less 145.15 4 Each additional 500 sq.fl.or p2iniion thereof 33.40 1 Subdivision:___ Lot#; Limited ene,g ,residential 75.00 2 — -- --- - limited ener ,nonresidential 75,00 2 TJX triap/parcel #: _ Each manufactured home or modular dwelling DESCRIPTION OF WORK — service and/or feeder 90.90 2 Services or feeders-Installation, alteration nr relocation: 200 amps or less 80.30 _ 2 -__"" ---- — 201 amps to 400 amps —" 106.85 2 _ 401 am s to 600 amps 160.60 — 2 PROPERTY OWNE1t—� TENANT 601 ams to 1000 amps 240.60 2 Name: /-- t/ Over 1000 amps or volts 45465 2 � (J Reconnect only 66.85 2 Address: ' T _ Temporary services or feeders-InsWlation, Cit /State/Zi : alteration,or relocation: �/ �� r")' 200 ams or less 66.85 I Phone: "x 201 amps to 400 ams _ CONTACT 1 ERSf1N 401 to 600 amps APPLICANT r 133.75 --- 2 Branch circuits-new,alteration,or Name: _ extension Per panel: Address: A.Etc for hranch circuits with purchase of service or feeder fee,each branch circuit 6.65 2 City/State/Zip: B.Fee for branch circuits without purchase of _ Phone: Y — service or feeder fee,first branch circuit 46.85 2 Bach additional branch circuit — 6.65 2 E-mail: Misc(Service or feeder not included): LGNTRACTOR --E!st2urri2 or irrigation circle _ 53.40 2 I -- Each tip or outline I�hting 53.40 � 2 Job No: Signal circuits)or a limited energy panel, — -- ' alteration,or extension Business Name: 1 _� PAL2 2 2 Description: Address: _ -W- z/ Cit /State/Zi %Zf�/L �! - _ Each additional Inspection oset the a_llow_able In any of the above: Per inspection per hour min. 1 hour _ 62.50 Phone: - ? _ ax: )��' - �� Invest/ hon fee: CCB Lie.#: I - Lic. #: q A,'_ Ck Other: - Supervising electrwt� ' C3 Subtot -L `-Electrics'111'—11 Fees* al $ r)!j signature required. d _ Plan Review(25%of Petrnit Fee $ o Print Name:, Lie. b- �4 State Surcharge(8%of Permit Fee) $ _ TOTAL PER F'EE S Authorized �— Notice: This permit application expires if a permit Is not obtained within Signature: — _ pale;_ 180 days after It has been accepted as complete. `Fee methodology set by Tri-County Building Industry Service Board. (Please print name) i:\Dsts\PermitForms\FlcPemiiiAppdoc 01103 Electrical Permit Application.- City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL.WORK ONLY: ----- ---------- Fee for all systems........................................................... $75.00 Checl:Topa of Work Imolced: Audio and Stereo Systems* Burglar Alarm F] Garage Door Opener* El I Icating,Ventilation and Air Conditioning S)stem* C1Vacuum Systems* Fj Olhr, COMMERCIAL WORK ONLY: Feefor each system......................................................... $75.00 (SNE OAR 919-260-260) Check Type of Work Involved: 0 Audio and Stereo Sys,ems Boiler Controls Clock Systems Data Telecommunication Installation l Fire Alarm installation HVAC u Instrumentation E] Intercoi-i and Paging Systems U Landscape Irrigation Control* DMedical Nurse Calls CJ Outdoor landscape Lighting* Protective Signaling Other------------— --_ _---_Number of Systems * ho licenses are required. Licenses are required fu:all oVter installations i Dsts\l'ernrn Forms\ElcPermitAppPg2,doe.. 01/03 ELECTRICAL - CITY OF TIGARD RESTRICTED ENRIGY DEVELOPMENT SERVICES PERMIT#: ELR2003-00030 13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 DATE ISSUED: 2/5/03 SITE ADDRESS: 10250 SW GREENBURG RD 110 PARCEL: 1S135AB-04500 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT: 001 JURISDICTION: TIG Project Desr;ription: D/L lett-r1 t•� x. l' f. A.RESIDENTIAL _ B.COMMERCIAL AUDIO& STEREO: — AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOii-ER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: X HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL. INSTRUMENTATION: OTHER: -- ^� TOTAL #OF SYSTEMS:_1 Owner: Contractor: - EOP LINCOLN , LLC MI JAY ENTERPRISES, INC. 10260 SW GREENBURG RD P.O. BOX 569 SUITE 100 BEAVERCREEK, OR 97004 PORTLAND, OR 97223 Phone: Phone- 503-632-4103 Reg #: — FEES _ Required Inspections _ Description Date -! -`— Amount Low Voltage Inspection IL:LPRNITJ ELR Permit 2/4/03 $75.00 Elect'I Final TAX)8114.State Tax 2/4/03 $6.00 Total $61.00 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 he 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 fp4cW►Utes_�dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issue y ..�_I Permittee Signature, _ OWNER INSTALLATION ONLY The installation is being made on property I awn which is riot intended for sale, lease, or rent. — OWNER'S SIGNATURE: _ -_ _ _ +_---_ DATE: _._.-. CONTRACTOR INSTALLATION 014LY SIGNATURE OF SUPR. ELS(;'N DATE: LICENSE NO: -- Call 6.'J94175 by 7:00 P.M. for an inspection needed the next business day yJ,lnl 1Lie ctrica�_Pez•tnn�t.f� �litiun ' � clectncal „ City of Tigard RECEIVE pate7,_� X03 -Goo3o Plann.nq k,p, I Sion 13125 Su ?call Blvd. Plun Aevit,v Othar Tigard,Oregon 97223 3 Date By 5( • 761Post•Rc +Ptone: 503-639-4171 FG. . I Lind Use Intennet: Htv w .ci .r. ai_'( r us CITY OFT Case - ---_ Contact - - - iurisi::o. _�- See Page 2 for a 24-hour Itlsreati;,. ry�t.st: 503• f �N(; NameMeUtod 'rupvlcmentgl[nrormation. pD t .- _T.rY.!,—EOF $ trc�u�e�r�2anRp�t QVIEW�lease c eek�all tbttt.A,p..l_��_L____. .___�_....._. - _ Health•caretecitih, �dtlition%alteratiotl'replaceMent _ er.- -` corr,111ccial Nuzardous location Lt ?tn^•ra cce•7iU Qntps-r,.nn �g of build+ng nvc*t 0,o0u CAT>rC.OR AF COV.STf1 lCT1U\ -I 4 2 Patttily dw.titngs four or more reside h. t,,(•cs &22-Fatnily dwellin¢_ C:ommerciabin ustrial�_ ❑''>'ten,over 00 volt nvr�,:nat I ,ne sttactur_ i a'd;lding over,hree stone 1 Fecd.rs a00 amps or mire Acce�sso B-lildin ?�•[ulti-Tamil --� __.. I • �_.,�lt.--- -- ---- 1 Occupant Inad ner99 yeroons a4enufe,aured snvctutce '{'park Prfa6t�r$Uiltier 1 er Egrem'.ighlt4g plan I cruet _ ;TOBfi1T"E tl« JLIKATION and t t)CA7tbti Submit sets nrplans with unt ofthe above. The above are not applieable to t m ar cuestructiun Jar%ite Job site at'dress. - rt"F•SC;aEDL� ___.__ Suitt# — - -� _�� -®® dumber of Inspec er ►hermit aliowtd Pru eq lame: `.�(Grtr3r" Descripilon _ Q� ire(es.) r royal New residrntirlsingle or multi-family per 1'ro ;sxreet�Di.r:ctions to jo cite: I `eYIlius unit.Includes sttanccd tnrn¢e dw �'tce Included: I Tax m3p,parcel 0: _ - Each r ------ _ _DESCR)P IDS OF Wo , . ervi t CSca•., , .,, . ,italla6on. I - C�T' .,L.G,�._. altleatlnnr Iet[,CdU[IL( I 1 !l irmns kr St�U t,,�s _" irj6 A� ..� G r❑r60 60 ' P1tU,'�tZT1 r __....__._ .- ._45a hs Address: Temp,rori Cr kict,o,feeders-in,trdinco . (,RS altergi-on nr ret:,,sr,nn: Phone Fax: j MI411 K _._. j. WTArlPE1tSt ..r anth e6>:uirs•rtew,elft ..time,or I � �•� • " ' 'NdTriC ►rtension per panel: Address: ,<vf hran,.t ,.i,',rs,�;�PurcttaatoP -- r '" I a �a,r ftt r lr.,eec�,�runch circuit _�_ t•.b: ' (.1 State,t ip t',�w r /�� /'_� — d. fr,iran�fi�,c 1ta w,ti,_�purchase of - _ ._ - Fre Phone {� j t• S i ie r, r feeder fee„fu t .u't ._._._.;.,t�.G �_��r.�l..�! Etch ta_tl:'sonal branch ci• s- d L-- - ..........__ ... _•....,. � ( t:r/ceder n:. j C um un toot cu. 5141 Each Sign.ro titin t i4(.,, " V lure 11n 3- -�_.. Job No. MT �A e- e ation,Business Name:— t ti ,or e .� �1�*, �— _tti6°�i._.. Uesrrpa,n Address 8CS s"G 'T Cf rlstatt' �l >rIo n� �[ I Each additional ins Dation t tile•al.o%abir:in en at theaho•,e a Yerins eetic!-%&-our(nan i tour) „�. �i'�r, 1 Phone: 1j�_ t..__ .. 3.s..;�ra 'rf/ Other, Supet•vtstng clec frtcial' sti,Rei t ature re uiteti � ti �✓ P -t,�Ier .� I - Stibicttil r� " print>y'arrle; �,�f 1 ,: ' ®C�3 I �r- - . ✓.`� �*e � to �•ur h3r c,t Permit Tea I , fdTAD ikMI I.1`f E S Authorized _�•rut,cc. This t i!t a Ire•I , P pp:ration ex+J ptrrrdt is out ubtaine.l -'rt 1, SI�T1Qril"e: -. _ --- hitt ds-.s LIM[ it 1,.:5 been arrcptcd cs uumplete. � *Fee method,.:og',, set by Trl-Count, Buildintt tnduum.Sen•ire Board. ODs:a`Perrmtt For•n t. r ,rp dere G1 nS