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10250 SW GREENBURG ROAD STE 115-1 i � o H N r3 ui rn o ul U G7 x� U I i 1 h 4 10250 SW GREENBURG ROAD SUITE 115 CITYOF T I G A R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2000-00058 13125 SW Hall Wvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 02/24/2000 PARCEL: 1 S135AB-04500 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 10250 SW GREENBURG RD 115y"� SUBDIVISION: LINCOLN BUILDING PP1991-055 FILL BLOCK: LOT:001 CLASS ')F WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 2FR OCCUPANCY GRP: B OCCUPANCY LOAD: 16 TENAw r NAME: RANDSTAD REMARKS: Commercial TI - Final Building Inspection and Certificate of Occupancy Approved 3/30/00 by Torr Plescher, Building Inspector Owner: KNICKERBOCKER PROP, INC XXIV BY NORRIS, BEGGS + SIMPSON 10300 SW GREENBURG RD STE 200 PORTL/,ND. OR 97223 Phone: Contractor: MALIBU PACIFIC 735 NE JACKSON SCHOOL ROAD HILLSBORO, OR 97124 Phone: 693-9797 Reg #: LIC 059045 This Certificate grants occupancy of the above reference" ouilding or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty,G"es for the � p4 occupancy, and use under which the referenced permit was issue ' BUILDNG INSPECTOR BUILDING d . ICTAL POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 1 eup .,ZL°� �CX�aC�.� Date Requested_ 3 Z 1 AM --_-PM C BLD Location i(J kS U 6 �.y� c.�L�� SuiteG /1 S �y p MEC _ Contact person ry-o.l of �� Ph D �.2 / / PLM Contractor Ph SWR __-- UILDI Tenant/Owner ��_/� �/-•�et ELC ------------- Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SON Slab ' Crawl Drain Inspection Notes: � /"1 SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear — Framing Insulation — Drywall Nailing Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling - Root Mise -- ART VAiI_ --.-- ING -- Post& Beam - - --- Under Slab Top Out - Water Service Sanitary Sewer - ---- - ----------------------------�- Rain Drains Final -------- ----- --- - -- PASS PART_''AIL i. MECHANICAL _---------- 'l Post& Beam _.. _---- ---- - - - -- ------ �i Rough In Gas Line -----------_._-_-. — --_. ._. Smoke Dampers Final - - - -----..— _------ PASS PART FAIL. ELECTRICAL -- ---- -----------_—_____--.----------__ -__.--..._._ __ Se'vice Rough In UG/Slab - -- ------- --- ------ Low Voltaue Fire Alarm _-- --------------- ---__-_____-.. _-- Final PASS PART FAIL -- - ---._-_-- -----_------ -SITE Backfill/Grading -- — Sanitary Sewer Storm Drain ( ; Reinsp( 1ion fee of$ -requited before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( )Please call for reinspection RF _ _. ( ) Linable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Other Date �spector,— -- Y Ext - Final PASS PART FAIL DO NO REMOVE this inspection rec,)rd from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -� i3UP - --- _Date Fequested ^ ' AM PM _ BLD Location � � Z�� _ � L) s �r rx � �. Suite JS MEG �----- Contact Person M�r ,41 0� f✓G�,' Ph ��S �i PLM Contractor PI", Z 1( Z�_ SWR BUIL-DI NGTen�Owner ELG �'�� '7 Retaining Wall ELR _. Footing AC Cess. FoundationFPS Ftg Drain ) r��ni e)LA-f`rn a /i G-4i. SGN Crawl Drain Inspection Notes ,,` ^LU ` _ - Slab _ . —._�._ �_-- ---- SIT _ Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing - _-- — ---- Insulation Drywall Nailing ----� - -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- ---- Roof Final PASS PART FAIL PLUMBING Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post& Bearn Rough In Gas Line - Smoke Dampers Final PASS PART FAIL ECTRIC Service Rough in UG/Slab _. Low Voltage Fire Alarm Fi AASV PART FAIT_ Ifff- Backfill/Grading — y' Sanitary Sewer Storm Drain [ ]Reinspection fee of$_ _ ,required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE. [ ]Unable to inspect-no access Fire Supply Line --- ADA Approach/Sidewalk Date _ Ext Other -- Final PASS PART' FAIL 0 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ Date Requested -� ,AM PM _,_— BLD Location_ I� :,z 4: (.) re !•(/t _ Suite MEC — '~ Contact Person —_ J Ph 2-2-j-2- Lf L CPLM Contractor Ph SWR BUIL[31NG i Tenant/Owner ELC Retaining Wall ELR Footing Access. ^-- — Foundation FPS Ftg Drain ---- SGN Crawl Drain Inspection Notes --- ---- ---- Slab SIT Post& Beam - Ext Sheath/Shear Int Sheath/Shear -- ---- --- " ---.-___ Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc. - - - ----------- Final PASS PART I All Post& Beam Under Slab Tap Out � ---------------_-- ----- Water Service Sanitary Sewer R ',i Drains PART FAIL MECHANICAL �-- Post& Beam Rough - --- - - Rough In Gas Line -- Smoke Dampers Final -.r--------------- —_ _ ---- PASS PART FAIL ELECTRICAL Service RoughIn - ------- -------_.._ _-___- __ — ._------__ UG/Slab Low Voltage Fire Alarm - Final _ PASS PART FAIL ----- ---- --- - - ._ —__. .--- -------SITE Backfill/Grading ---Sanitary Sewer Sewer Storm Drain [ [Reinspection fee 0$_ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin i [P' ;e call for reinspection RE: -_ [ ]Unable to inspect-no access Fire Supply Lire ADA Approach/Sidew31k Other Date Inspector 1 i Ext: Final PASS PART FAIT- 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION Ms,r 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — — BUP Date Requested AM —PM BLD Location �� V _ Suite MEC _— Contact Person S S Ph f, � —(�� PLM Contractor Ph SWR - BUILDING _ end Owner � /, �. (ELC Retaining Wall E Footing Access: — Foundation FPS Ftg Drain --- SGN Crawl Drain Inspection Notes: -- -- .._ - Slab _ �.—_-__--._-__-- SI Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation L Drywall Nailing — -.--_- -----C- - - -J[J Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Mlac:_ --------------- -- - ------ —------------ Final --- ,----- PASS PART FAIL --- -- --------- _—__-_-._ -- PLUMBING Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final - PASS PART FAIL. MECHANICAL Post&Beam --------- ---..— —.__-- _ Rough In Gas Line - - — -- --- --------- Smoke Campers Final ------- PASS PART FAIL Service Rough In UG/Slab Low Voltage Fire Alarm 9AART FAILSITE Backfill/Grading -- -- --- _ — Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE [ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk �-�-t Other Date _7_ Inspector Ext Final % PASS PART FAIL DO NOT REMOVE this inspection record from the job site. �►RC� ELEC'T'RICALPERMiT CITY OF TIG PERMIT#: ELC2000-00114 DEVELOPMENT SERVICES DATE ISSUED: 03/172000 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-04500 SITE ADDRESS: 10250 SW GREENBURG RD 115 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT : 001 JURISDICTION: TIG Proiect Description: Installation of easch sign or outline lighting. ----�aRESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS 1000 SF CSR LESS: 0 -200 amp- PUMP/IRRIGATION: EACH ADD'L 500SF- 201 - 400 amp: SIGN/OUT LINE LTG: 1 LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amr+s - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER _ BRANCH CIRCUITS ------ -- -. _ ADD'L INSPECTIONS _ 0 200 amp: W/SERVICE OR FEEDER: + PER INSPECTION: 201 •• 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: __ PLAN REVIEW SECTION_ _ 1000+ arnp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only. _SVC/FDR >=225 AMPS: ,CLASS AREA/SPEC OCC: Owner: Contractor: KNICKERBOCKER PROP, INC XXIV TUBE ART DISPLAYS BY NORRIS, BEGGS + SIMPSON PO BOX 34333 10300 SVV GREENBURG RD STE 200 SEATTLE,WA 98124-1333 PORTLAND, OR 97223 Phone: Phone: 223-1122 Reg #: LIC 00070956 SUP 366SIG ELE 37-554CLS FEES V^ Required Inspections Type By Date Amount Receipt Elect'. Service PRMT GEO 03/17/200( $42.75 0000767 Elect'/ Final 5PCT GEU 03/17/200( $3.42 0000767 ORIGINAL Total $4E,17 This Permit is issued subject to the regulations contained in the Tgard Municipal Code, State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire if work it not started within 180 days of issuance,or ff 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 V 952-001-0080 You may obtain copies of these rules or direct qu stions to OUNC at(503) 246-1987. PERMITTEE'S SIGNATU ISSUED BY: OWNER INSTALLATION ONLY The installation is being ma 6 property I own which is not intended for Sale, lease, or rent. A OWNER'S SIGNATURE_: DATE:-,- CONTRACTOR INSTALLATION ONLY r� SIGNATURE OF SUPR. ELEC'N: � v' DATE:. J /Ze5,,f) LICENSE NO: �__ 3. Call 639-4175 by 7:00pm for an inspection the next business day i CITY OF TIGARD Electrical Permit Application Plan Recd By Date 13125�W HALL BLVD. Date Recd 'TIGARD OR 97223 Date to P E� Phone(503)639-4171, x304 Date to DST Inspection (503)639-4175 Print of Type Permit Fax(503) 598-1960 Incomplete or illegible will not be accepted Called 1. Job Address: ^� 4. Complete Fee Schedule Below: Name of Development —I�.�[ Number of Inspections per permit allowed Name(or name of business) Service included: Items Cost Sum Address — -,)n , __ 4a. Residential-per unit Ci /State/Zi t, 1000 sq.R.or less $ 117.75 _ _ 4 ry P Each additional 500 sq.ft.or portion thereof $ 26.75 1 Commercial Residential ❑ Llmi'ed Energy $ 60.00 — Eac i Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder S 72.75 2 (Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders Information for COT data base Installation,alteration,or relocation Electrical Con tact r 200 amps or less $ 64.25 2 Address �- 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps $ 126.50 2 City GJCtI G State Oe 601 amps to 1000 amps $ 192.50 2 Phon NO. - Over 1000 amps or,olts $ 363.75 _ 2 .lob No. _ _ Reconnect only $ 53.50 2 Elec.Cont. Lice No. r Exp.Date /0 Da 4c.Temporary Services or Feeders OR State CCB Req. No.—'1Q�Exp.Dat� P Installation,alteration,or relocation CO F Business Tax or Metro No. S O _Exp. ate� 7 200 amps or less $ 53.50 2 I 201 amps to 4C0 amps $ 80.25 2 Signature of Su f. 401 amps to 600 amps $ 100.00 2 9 P Over 600 amps to 1000 volts, see"b"above. License No. 1 _Exp Date _ `// �_ 4d.Branch Circuits Phone No. New,alteration or extension per panel a!The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owners Name _ Each branch circuit $ 5,35 Address _ b)The fee for branch circuits without put-chose of service City State Zip _ or feeder fee. Phone No. _ First branch cira4t $ 37.50 Each additional branch circuit $ 5.35 The installation is being made on property I own which Is not 4e.Miscellaneous intended for sale,lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42 75 Owners Signature Each sign or outline lighting $ 42 75 Signal circuits)or a limited energy panel.alteration or extension $ 6000 3. Plan Review section (if required): Minor Labels(10) - _ $ 10000 Please check appropriate item and enter fee in section 58. 4f.Each additional Inspection over 4 or more residential units in one structure the allowable In any of the above -- Per inspection $ 5000 Service and feeder 225 amps or more Per hour _ $ 5000 System over 600 volts nominal In Plant $ 5900 Classified area or structure containing special occupancy as described in N F C Chapter 5 5. Fees: 2-7 i Sa.Enter total of above fees $ Submit 2 sets of plans with application where any of the above apply. 8%Surcharge 108 X total fees) $ _ �L Not required for temporary construction services. Subtotal $ Sb.Enter 25%of line So for NOTICE Plan Review If re uq ired(Sec 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust.Account p AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ % I\dsls\lirrms\cicctric doc ELECTRICAL PERMIT- CITY OF TIGARD RESTRICTED ENERGY DEVELOPMENT SERVICES — PERMIT#: ELR2000-00050 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 03/08/2000 SITE ADDRESS: '10250 SW GREENBURG RD 115 PARCEL: 1 S135AB-04500 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT: 001 JURISDICTION: TIG Proiect Description: Data telecommunications system A. RESIDENTIAL _ B.COMMERCIAL _ AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: B''RGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS:.___1 Owner: Contractor: KNICKERBOCKER PROP. INC XXIV MICRO ELECTRIC VOICE + DATA BY NORRIS, BEGGS + SIMPSON SERVICE 10300 SW GREENBURG RD STE 200 24501 S BARLOW RD PORTLAND, OR 97223 AURORA, OR 97002 Phone: Phone: 503-266-584( Reg #: l_iC 131543 ELE 3-447CLE FEES _ Required_Inspections_ Type By Date — Amount Receipt Elect'I Service PRMT BON 03/08/200( $60.00 000520 Elect'I Final 5PCT BON 03/08/200( $4.80 000520 Total $64.80 ORIGINAL 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, orf 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 952-001-00 10 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. (� Issued by �` N�(��'eV,�.+; r -- Permittee Signature_ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD RESTRICTED ENERGY EL ECTNICAL APPLICATION Recd by: 13125 SW MALL BLVD Date Recd TIGARD OR 97223 PRINT OR TYPE _` //�� V- 503-639-4171 X304 Permit#: 1�- 1 IMI—74-74W F - 503-598-1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS CUSt Call-'d: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL ONLY , / Restricted Energy Fee........................................ 560.00 (FOR ALL SYSTEMS) JOB Street Address A� Ste# ADDRESS /Q" j-0 � Check Type of Work Involved C.ty/State Zip Phone# ❑ Audio and Stereo Systems 72Z3 Name rCn,i/vi-/ a,� fr ❑ Burglar Alarm OWNER Mailing Address ❑ Garage Door Opener' C it 3UfW 5 ;ryw R� L ] Heating,Ventilation and Air Conditioning System' ir ity f- L1W 7a Z 3 Phone# Name U Vacuum systems- /V Flee,-roe. C] Other - ---- CONTRACTOR Mailing Addres —� 300 ,S, /4Q TYPE OF WORK INVOLVED -COMMERCIAL ONLY (Prior to issuance a City/Sta a Zip Phone# Fee for each system.............................................. $60.00 copy of all licenses L-o+7 C9r -X8"11 (SEE OAR 918-260-260) are required if Oregon Contr Brd Lic.Of Eup.Date expired in C O T f 31 Check Type of Work Involved: data base) Electrical Contr.Lic.# Exp.Date Q-*:�- RE r Xopz ❑ Audio and Stereo Systems C.O.T or Metro Lic.# Exp Date Boiler Controls Owner's Name ❑ Clock Systems t,,;IYNER - Mailing Address APPLICANT [� Data Telecommunicetion Installation City/State Zip Phone# ❑ Fire Alarm Installation This permit is issued under')AE 918-320-370 This applicant agrees to make only restricted energy installations(100 volt amps or less)under this ❑ HVAC permit and to do the following ❑ Instrumentation 1 Only use electrical licensed person:to do installations where required. Certain residential and other transections are exempt from licensing. ❑ Intercom and Paging Systems These have asterisks(") All others need Incensing; ❑ Landscape Irrigation Control' 2. Cell for inspections when installation under If is permit are ready for inspection at 603-639-+1175; ❑ Medical 3 Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls inspection when the inspector is out to Inspect under this permit, 4 Assume responsibility for assuring that all corn ctions required by the ❑ Outdoor Landscape Lighting' inspector are done,and; ❑ Protective Signaling 5 Assume responsibility for calling for a final inspection when all of the corrections are completed ❑ Other Permits are non-transferable and non-refunable and expire if work is not started within 180 days of issuance or If work is suspended for 180 days _— __,_Number of Systems The person signinn•--, ;I„s N„ifnit must be the applicant or a person No licenses are required t icenses are required for all other installations authorized to bind the applicant. FEES: n Signature ENTER FEES M SURCHARGE(.05 X TOTAL ABOVE) S t Authority if other than ,'Applicant _ TOTAL i\dsts\formsireseie doc 3iC 1 CITYOF TIGAR® _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00040 13125 SW Hall Blvd.,Tigard, CR 97223 (503) 639-4171 DATE ISSUED: 03/0212000 SITE ADDRESS, 10250 SW GREENBURG RD 115 PARCEL: 1S'135AB-04500 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT: 001_ JURISDICTION: TIG TENANT NAME: RANSTAD USA NO: FIXTURE UNITS: 41 , CLASS OF WORK: ALT DWELLING UNITS: 1 TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: Add a commercial sink for tenant improvements. Owner: FEES _ KNICKERBOCKER PROP, INC XXIV Type By Date — Amount Receipt BY NORRIS, BEGGS + SIMPSON — — --- 10300 SW GREENBURG RD STE 200 PRMT BON 03/02/200( $2,300 00 0000400 PORTLAND, OR 97223 Total $2,300.00 Phone: -- - — Contractor: Phone: Reg #: Required Inspections ORIGINAL This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall 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 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued by: !J• TNI� L- —_—_ Permittee Signature: �,vt�-�.ce `1 Can✓�li� Call (503) 639-4175 by 7:00 P.M, for an inspection needed the next business day CITYO F T I G A R D ELECTRICAL PERMIT PERMIT#: ELC2000-00086 DEVELOPMENT SERVICES DATE ISSUED: 03101/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S'i35AB 04500 SITE ADDRESS: 10250 SW GREENBURG RD 115 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT : 001 JURISDICTION: TIG Proiect Description: Install 8 branch circuits in existing commercial building. RESIDENTIAL UNIT TEMP SRVC/FEEDERSMISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: _ PUMP/IRRIGATION: EACH A001 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY- 401 - 600 amp: SIGNALWANEL: MANE FIM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER_ BRANCH CIRCUITS _ _ AbD°L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: —^PER INSPECTION: 201 400 amp: 1st WIO SRVC OR FDR: 1 ER HOUR: 401 600 amp: EA ADD'L BRNCH CIRC: 7 IN PLANT: 601 - 1U00 amp: PLAN REVIEW SECTION 1000+ amp/volt: >-4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >_225 AMPS: CLASS AREA/SPEC OCC: _ Owner: Contractor: KNICKERBOCKER PROP, INC XXIV CHRISTENSON ELECTRIC INC BY NORRIS, BEGGS + SIMPSON 111 SW COLUMBIA 10300 SW GREENBURG RD STE 200 STE 480 PORTLAND, OR 97223 PORI-LAND, OR 97201 Phone: Phone: 241-4812 ORIGINAL Rey#: LIC 000458 SUP 3289S PLM 24685 ELE 26-34C FEES _ _ Requires. Inspections--.------- Type By Date Amount Receipt — Elect'I Service PRMT KJP 03/01/2000 $74.95 0000351 Elect'I Final 5PCT 10P 03/01/200C $6.00 0000351 - - �-- Total $80.95 _- 'This Permit is issued subject to the regulations contained in the Tigard Muniapal Code, State of OR Spedalty Codes and all other applicable laws All worts will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance or rf work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952.001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246-1967 PERMITTEE'S SIGNATURE �1 (�4� ISSUED BY: _ OWNER INSTALLATION ONLY The installatiin 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: ci��yf �" -�,2a�`� _ DATE:_ LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Plan Check# 1341-25 SW HALL BLVD. Electrical PermitApplicationl:ec'd By_ _ RECEI�� ecd TIGARD OR 97223 Date Date RR P E Phone (503)639-4171, x304 E'ER li Date to DST Inspection (503) 639-4175 Print Of Type Permit#��, ZoGt�-006dJo Fax (503) 598-1960 Incomplete or illegible will not L�� a' vt(("",I; Caned 1. Job address: 4. Complete Fee Schedule Below: Name of Development. LINCOLN BUILDING Number of Inspections pe_�r _permit allowed Name(or name of business) RANDSTAD Service included: Items Cost Sum Address 10250 SW GREENBURG RD SUITE 115 4a. Residential-per unit City/State/Zip TIGARD OR 1000 sq.ft.or less $ 117.75 4 MAL 1 1W PALLFIC GENERAL, CTR portion thereof $ 2625 t Each additional 500 sq.ft.or — [`� Commercial Residential ❑ Limited Energy $ 6000 QUESTIONSICONTACT ROSS CROSBY 245-1965 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72 75 2 (Prior lu permit issuarco.applicants must provide contractor license 4b.Servicrs or Fe-dem Information for COT u-,ta base). Installation,alteration,or relocation Electrical Contractort;HR I S'I'ENSON ELECTRIC INC 200 amps or less $ 64.25 2 Address 1 1 1 SW COLLIMBIA,SUITE 480 201 amps to 400 amps _ $ 85.50 _ 2 City PORTLAND State OR Zip97201-5886 401 amps to 600 amps 128.50 2 � $601 amps to 1000 amps S 192.50 2 Phone No. 241-4812 Over 1000 amps or volts $ 363.75 2 .lob No. 62-09470 Reconnect only $ 53.50 2 Elec. Cont. Lice. No, 26-34C Exp.Date_ 10 00 4c.Temporary Services or Feeders OR State CCB Reo No. 458 Exp.Da 03 ` Installation,alteration,or relocation COT Business Tax or Metro No. /46 E D 12100 200 amps or IEss $ 5350 z 201 amps to 400 amps $ 8025 2 Signature o Si tf Su r. Elec'n 401 amps to 600 amps _ $ 10700 z g p -- Over 600 amps to 1000 volts. / see"b"above. License No.�� _Exp Dale _I 0 U l Phone No 241-4812 4d.Branch Circuits — --------------- New,alteration or extension per panel a)The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit _ - $ 5 35 2 Address_ _ V b)The fee to branch circuits without purchase of service City State _Zip _ or feeder fee. Phone No First branch circuit 1 S 37 50 37.50 Each additional branch circuit 7 $ 5 35 '17-45 The Installation is being made on property I own which is not 4r,.Miscellaneous intended for sale, lease or rent. (Service or feeder not Included) Each pump or irrigation circle S 42 75 Owner's Signature Each sign or outline fighting $ 42 75 Signal eircuit(s)or a limited energy if required):" panel,alteration or extension $ 6000 3. Plan Review section Minor Labels(fo) $ 10700 Please check appropriate iters and enter fee in section 58. Q.Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Per Service and feeder 225 amps or more Perhour hourourion $ 50 00 S 5000 System over 600 volts nominal In Plant $ 5900 —Classified area or structure containing special occupancy as described in N E C Chapter 5 5. Fees: lid.Enter total of above fees $ 74.95 Submit 2 seta of plans with application where any of the above apply. 5%Surcharge(05 X total fees) 87 $ -- M— Not required for temporary construction services. Subtotal $ 80.95 Sb.Enter 25%of line Ba for NOTICE Plan Review if required(Sec 3) $ _ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ — IS NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS LJ Trust Account# AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ 80.9 5 i\dsts\forms\elcctric.doc CITYOF TIGARD _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: /3/00 0-00060 3 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/3/00 PARCEL: 1 S135AB-04500 [ITE ADDRESS: 10250 SW GREENBURG RD 115 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK.: LOT: 001 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES _ LAUNDRY TRAYS. SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Reoi+i ks: Add one commercial sink for tenant improvements _FEES Owner: Type By Date Amount Receipt KNICKERBOCKER PROP, INC XXIV PRMT KJP 3/3100 $50.00 0000430 6Y NORP,IS, BEGGS + SIMPSON 5PCT KJP 3/3/00 $4.00 0000 .30 '10300 SW GREENBURG RD Sit 200 _ ----- PORTLAND, OR 97223 Total $54.00 J Phone 1: Contractor: DETEMPLE CO INC 1951 NW OVERTON ST PORTLAND. OR 97209 REQUIRED INSPECTIONS Phone 1: 503-227-2641 Rough-in Insp Final Inspection Reg #: LIC 00002510 PLM 26-25PB ORIGNAL 1-his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Citi. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plan::. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for morE than 180 days. AT fENTION: 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 copip f these rules or direct questions to OUNC bycall' (503) 246-1987. Issued By: i _ ��- -rt-�J Permittee Signature /��,/y�`�1/ _ a J Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Accumulative Sewer Tally Tenant Name' ",vik" v This SWR# w000 -r-tN`1 Address:Ld:,r` �;t,,> This PLM#:a000 -r-xX51VO Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value Capped off value added# added #s total Count off#s count value values- Baptistry/Font 4 Bath -Tub!Shower 4 _ -JacuzziMhitlpool 4 Car Wash - Each Stall 6 _ - Drive Thr3ugh~ 16 _ CusptdorNVater Aspirator 1 Dishwasher- Commercial _ 4 _ - Domestic _ 7. Drinking Fountain �1 EYe'I s `y 1 Floor Drain/sink-.2 inch 1 2 _ - 3 inch 5 4 inch 6 Car Wash Drn _6_ Garbage-Disposal 16 Domestic(to 3/4 HP) T Commercial (to 5 HP) V32 Industrial (over 5 HP) v 48 Ice Machine/Refrigerator Drains 1 Gil Sep(Gas Station) 6 — Rec.Vehicle Dump Station 16 Shower-Gang (Per Head) 1 - Stall _ _2 _ Sink Bar/Lavatory _- 2 — _ Bradley 5 Commercial 3 _ Service _ 3 _ Swimming Pool Filter 1 - Washer- Clothes 6 _ Water Extractor 6 _ Water Closet - Toilet �6 Unnal —- - 6 - — - --- ---- --- TOTALS 7n 7 .7 VAI Total fixture values y/<) `___-divided by 16 = ! (e 3 EDU Ore"',,i HISTORY _ r PLM#/ - otie?FB'EDU# as SWR#/4;K- PLM# _ EDU# SWR# PLM#9d_. r-63y,? EDU_#_a_,� SWR# jU_ �' ,-a�/ PLM# EDU# SWR# PLM# EDU# _ _ SWR# PLM# _ EDU# _S_WR# PLM# ^ EDU# SWR# F'L.M# EDU# SWR# rtdsts�swnaly doc CITY OF TIGARD Plumbing Permit Application Plan Check#_ i 13125 SW HALL BLVD. Commercial and Residential Recd By TIGARD, OR 97223 Date Recd (503) 639-4171 Date to P.E. Print or Type Date to S Incomplete or illegible applications will not be accepted Permit#, c/�r� ' U Related SWR#*000 "60 Called ?�7�""_`��_ 5Po c_ �J S A.��✓ 7;3�s►�r Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job Kiak,I z S',A a 1 1 - 'I � A t i dy, Sink - -- 11.50 Address Street Address Suite ') Lavatory -_ 11.50 tof,16'.Lt tM I Tub or Tub/Shower Comb 11 50 Bldg# City/State M Zip Shower Only 11.50 C1 Water Closet -- -- 11.50 Name - lk,N61 C C. " �V l l Tl E Urinal - ,1.5U Owner Nailing Address Suite Dishwasher 11 50 i U A," SL r� I?i' Garbage Disposal 11.50 City/State ZIPC,, Phone Laundry Tray 11,5C Name Washing Machine 11.50 Floor Drain/Floor Sink 2" 11.50 Occupant Mailing Address Suite 3" 11,50 J>�i-✓Llf ,. ,1.50 City/Stale Zip Phone -- Water Heater O conversion O like kind 11.50 Gas piping reqvires a separate mechanical permit. Nam MFG Home New Water Service 32.00 �L> ,, I C �rF Co I - Contractor Mailing Address Suite MFG Home New San/Storm Sewer 3200 `1( 1 Hose Bibs 11.50 Prior to permit City/Staler� I Phone Roof Drains 11 50 issuance,a copy �'0r i t 5�� Drinking Fountain 11.50 of all licenses are Oregon Const Cont.Board Lic.# ExP.Date Other Fixtures(Specify) 15.00 required if .4&to ';�S/(-) expired in COT Plumbing Lic # Exp Date -� database 1- S �/3 Ci 6V Name Architect __ Sewer-1st 100' 38.00 Or Mailing Addrres3 Suite Sewer-each additional 100' 32.00 Water Service-1st 100 38,00 Engineer CltylSlate Zip Phone g Water Service-each additional 200' 32.00 Describe work to be done ^� Storm&Rain Drain- 1st 100' 3800 New`o Repair O Replace with like kind. Yes O No O Storm&Rain Drain-each additional 100' 32.00 Residential O Commercial Q _ _ Commercial Back Flow Prevention Device 32.00 Additional description of work: ; '^ --- I-l Residential Backflow Prevention Device' 19.00 Catch Basin 11.50 Are you capping,moving or replacing any fixtures? Insp of Existing Plumbing or Specially Requested 50.00 Yes O No D Ins ectior.s _ per/hr If yes, see back of fore,to indicate work performed by Rain Drain,single farnily dwelling 4500 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. -' QUANTITY TOTAL I hereby acknowledg-,that I have read this application.that the information Isometric or riser diagram is required if Ouantrty Total is >9 given is correct,that I am the owner or authorized agent of the owner,and 'SUBTOTAL th submdt,,d are in c9fliotiance with Oregon State Laws _ [J SI e o OvmnerlA antF Date --- - -� B%SURCHARGE 'I _ `7 F44nillctAm6n Name °hone — �1ti,, 1I X74'G I1 "PLAN REVIEW 25%OF SUBTOTAL 1:iATH HOUSE=178.00 Required o ly d fixture qty total is>S —TOTAL u 2 BATH HOUSE$250.00 S 3 BATH HOUSE$285.00 -- - (This fee Includes all plumbing fixtures In the dwelling and the first *Minimum permit fee is$50+8%surcharge,except Residential Backflow Fievention 100 feet of sanitary sewer%form sewer and water service) Device which is 325+8%surcharge **All New commercial Buildings require plans with isometric or riser diagram ind Gia,renew I bsteVormMplumapp doe 12117196 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink — Lavatory — Tub or Tub/Shower Combination _ Shower Only Water Closet _Urinal Dishwasher Dishwasher — Garbage Disposal _Laundry Room Tray _ Washing Machine Floor Drain/Floor Sink 2" Water_Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: t 1d3le""1\ KW,nrP d- tat IN" BUILDING PERMIT CITY OF TIGARD PERMIT M BUP2000-00058 DEVELOPMENT SERVICES DATE ISSUED: 02;24/2000 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-04500 SITE ADDRESS: 10250 SW GREENBURG RD 115 SUBDIVISION: 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: 2FR 1,930 sf N_ S: E: W: OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 16 BASEMENT: sf AREA SEP. RATED: STOW HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IlYrr SURFACE: PRO CORR: PARKING: VALUE: $ 39,000.00 Remarks: Commercial TI Owner: Contractor: KNICKERBOCKER PROP, INC XXIV MALIBU PACIFIC BY NORRIS, BEGGS + SIMPSON 735 NE JACKSON SCHOOL ROAD 10300 SW GREENBURG RD STE 200 HILLSBORO, OR 97124 Pq�'JjneAND, OR 97223 Phone: 693-9797 Reg#: LIC 059045 FEES ^^ _ REQUIRED INSPECTIONS — Type By Date Amount Receipt Framing Insp PRMT KJP 02/24/200C $357.25 00-321839 Gyp Board Insp Susp Ceiing Insp PLCK KJP 02/24/2000 $2.32.21 00-321839 Final Inspection 5PCT KJP 02/24/200C $28.58 00-321839 FIRE KJP 02/24/200C $142.90 00-321839 Total $760.94 '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 parmit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days, ATTEI!TION: Oregon law requires you to fellow 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) 246-1987. Pennitee signature: OR r GINA L Issued By: �-`� - Call 639-4175 by 7 p.m. for an inspection the next business day Ct'. Y OF�TIGARD Commercial Building Permit Application Plan checks 13125 SW HALL BLVD. New Constructign and Additions Recd By Date Recd _ TIGARD, OR 97223r Date to P.E. (503) 639-4171 r�. Date to DST Z 1-ZA1 :ID Print or Type G Permits Incomplete or illegible applications will not be accepted Related SWO s _ Called_ Name of Development/Project Job Llrtcoln Genter' — Existing BuildingV New Building ❑ Address Street Address — suite BJ IOQ� SW GreenburJc P–d il5 I.IriGO�n �iidlN Building Bldg* Ctty/State Zip Data a.Itt. a �-I n co�h Cep v' WI Gol_nl o hand bFti . 97223 pING P ►' - � Existing Use of Building or Property: Name [�.f',�I Ct✓ Property (<n ickel bucker f'roPerti er, In c�R7V Owner Mailing address Suite Proposed Use of Building or Property: lo3Do SW Green6 o!r. N, 2.00 C)ff ice City/State zip Phone N9 Qf Stories Porti II~d t . 9-1223 4.52-59C)C) (20 Th ree - Occupant Name Sq. Ft, Of Project �'.V,4st.ad lg 3+ -- Name Occupancy Class(es) Contractor Mal Abu Pac'J i c 1�1 Prior to permit Mailing Address Suite Types of Construction Issuance,a copy �3� NE Jacks.- . _ I Hr of all licenses — are required If City/State zip Phone Will this project have a Fire Suppression System? expired InG.OT' N(IIs6Dr°,OF97124 693 979 — Yes _ No database Americans with Disabilities Act(ADA) ��1Y` Oregon Const.Cont.Board I.lc,# Earp.Date J I__�,//.k 059045 2�Ig�oca Valuation X 25% = $ 9,750,00 Participation yt'o Complete Accessibili Form Name Project $ pp Architect �'['�� YN• I Accts' Inc ' Valuation 9,OC�U Mailing Address r� Suite 92C) SW Avenue 4000 Plans Required: See Matrix for number of sets to submit City/State zip Phone on back fortl�na , C>P` 9720e ' 224 -96E4o — --- — — Fnglneer Name given hereby acknowledge that 1 have read this application,that the information given Is correct,that I am the owner or authorized agent of the owner,and Mailing Address Suite that plans submitted are In compliance with Oregon State Laws. Signature of Owner/Agent Date d City/State zip Phone _ �G��. �. 2 '2 T 'n0 Co ct Person Name Phone F-2 1°�. Gl ur 2,24 -9,65;6 Indicate type of work: New O Addition O t*molitinn O _-- ------ Acc:esso(y Slnictuie O Foundation Only O Alteration)!!( _ _ Repair O Other o T_ FOR OFFICE USE ONLY _ Description of work: Map/TL# Land Use: TP►'A�� j rnProVPY►1P�tt Notes: ------ Parks: Estimated R of Employees TIF If the above figure Is not supplied at the time of application,the city will calculate the fee based upon the number of parking spaces. Note: Site Work Permit Application must precede or accompany Building f armlt Application klsts\formslcomnew doc 5/10/99 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX :Klan Review is dependent upon submittal of BOTH plans AND a COMPI:ET; "iapplication. For an electrical 'submittal, the application: must contain t. signature of the supervising electrician beton: plan review will be con After plan review approval, Plans Examiner will contact the applicant tq``r :additional plan sets for distribution purposes. (Copy,,,p ContraGtr . ` Washington County County, Tualatin Valley Fire & Rescue):' Total #of TYPE OF SUBMITTAL glans KEY: .__.. Sgl,mt(ed S (Private) 1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt =Alternation to Existing (New , Add) Building *B or B & M (Alt) 1 "8 & M& P(Alt) 3_ "B & M & P & E(Alt) 3 _ T & M & PCif F(Alt) NOTES: 'Shaded areas designate ALT submittals only:. I%dstsVurms\m9trxcom doc 10/30/98 ��a�.dstad T . I , � ��-I►s 2•Z't �Oo SUBJECT: ACCESSIBILITY BARRIER REMOVAL IMPROVEMENT PLAN 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 be deemed disproportionate to the overall alteration when the cost exceeds twenty-five per-cent(25%). VALUATION of all renovation, alteration or modification being done �^ excluding painting, wallpapering. [11$ 39,oCYD-°� multiply_ 25% Barrier removal requirement. .25 BUDGET EOR BARRIER REMOVAL [2)$ 7_'o 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 tot- restr"riprr , net. curb cut-s , $ — side_walks , s ��rao�e and acces.r;l�,le s�allS• (b) An accessible entrance: $ (c) An accessible route to the altered area $ (d) At least one accessible restroom for $ _ each sex or a single unisex restroom: (e) Accessible telephones: $ (f) Accessible drinking fountains: and $ (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL: Shall equal line 2 of Value Computation_ $ Ov i�J,I;V�nn;�a.cc;•.duc CITY OF TIGARD _BUILDING PERMIT _ PERMIT#: BUP2000-00065 DEVELOPMENT SERVICES DATE ISSUED: 02/29/2000 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-64500 SITE. ADDRESS: 10250 SW GREENBLJRG RD 115 SUBDIVISION: LINCOLN BUILDING PP'1991-055 ZONING: C-P BLOCK: LOT: 001 JURISDICTION: TIG REISSUE: f>> FLOOR AREAS EXTERIOR WALL_ CONSTRUCTION K: I CLASS OF WORFIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TAPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _ READ SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: —ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 100.00 Remarks: Lower 1 sprinkler head in existing commercial building. Owner: Contractor: KNICKERBOCKER PROP, INC XXIV FIRESTOP CO BY NORRIS, BEGGS + SIMPSON 9384 SW TIGARD ST ORIGINAL 10pp3RR00 SW GREENBURG RD STE 200 TIGARD, OR 97223 PPhorie ND, OR 97223 Phone: 620-6140 Reg #: LIC 00063846 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Sprinkler inspection PRMT KJP 02/29/200C $5000 00-3212893 Sprinkler Final 5PCT KJP 02/29/200C $4.00 00-3212893 Total $54.00 chis permit is issued subject to We 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 wiii 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 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) 246-1987. Pe nn itee Signature: Issued By: � Call 639-4175 by 7 p.m. for an inspection the next business day Fire Protection Permit Application Plan Check# CITY OF TIGARD Commercial or Residential Roc'd By 13125 SW MALL BLVD. Date Recd TIGARD, OR 97223 Print or Type Date to P.E. (503) 639-4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST-�— Permit# �i-t"L C) CuO(os Galled _ Job Name of Development/Proje Type of System (Complete A or B as applicable) *01V nvz_ Address Addr3ss A.)Sprinkler Wet ❑ C' ry _ /o zsi SuJugv� Name Standpipes Owner Mailing Address A Additional Hazard Group City/Slate Zip Phone Information Density Name Design Area Occupant Mailing Address K.Factor l o7 S-V S I&) _ Cityistate Zip Phone �A.1) Sprinkler Project Vaivation $ _.. T&Al2b Ok 17M /CID_ Contractor Name B.) Fire Alarm (Sprinkler or Alarm company) Malin ddr � �— �r — Submittal Shall Include Battery Calculations YESPrior to permit r issuance,a CitylState Zip Phone — Individual Component YES ❑ copy Cut Sheets of all licenses 1 �E 17113 47o-6 1 Q o _ B.1) Fire Alarm Project Valuation $ — are required if State Const.Cont Board t-ic.# Exp. Date expired In GOT — -- - — — database 3 8 4 e� -- 15 Z004. Project Valuation Subtotal (A & or B) $ Name -- Permit fee based on valuation eL Architect Mailing Address —" _---- __ _ (see chart on backs $ 5 0 "a Surcharge $ ,o FLS Plan Review 40% of Permit $ �– Describe work A.)New O Addition O Alteration Repair O TOTAL $ to be done — B) Modification to sprinkler heads only: I. 1-10 heads=No plans required Plans required. Submit three sets of plans,including a vicinity map and 2. 11—Plan review required the location of the nearest hydrant. _____---_-"__-_/_-------------------- I hereby acknowledge that I have read this application,that the information given Is Number of sprinkler h@ad3: ' corc`c►,that I am the owner or authorized agent of the owner,and that plans submitted are in compliance with Oregon State laws Additional Description of Work Signature of Owner/Agent Date _ " A.)In Existing Building 1K New Building ❑ 1C ; I( Building C ct P o ala Pho e Data gJ Commercial _ Residential ❑ �/'l<<t : I` L �%I`�O ` ( ? (,'- FOR OFFICE USE ONLY: No of stories Plat# MaprrL#: Sq. Ft — --- _ _ Notes Occupancy Class Type of Ci n sIrllctlon is\dsts`,fortns\firesupr.doc 7/2/99