10300 SW GREENBURG ROAD STE 100-2 r
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10300 SW C11tEVNgt11 G RD 100
CITYOF T I G A R D CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: BUP2003-00008
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/7/03
PARCEL: 1 S135AB-01003
ZONING: C-P
JURISDICTION: TIG
SITE ADDRESS: 10300 SW GREENBURG RD 100
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L
BLOCK: LOT:
CLASS OF WORK: ALT --------------_____
TYPE OF USE: COM
TYPE OF CONSTR: 2FR
OCCUPANCY GRP: B
OCCUPANCY LOAD: 17
TENANT NAME: TRIAD TECHNOLOGIES
REMARKS: TI
Owner:
EOP LINCOLN, I.1 C
10260 SW GREENBURG RD
SUITE 100
P%16 ND59f-A42-IR17
Contractor:
C SCHIEWE& ASSOCIATES INC
1024 NE DAVIS ST
PORTLAND, OR 97232
Phone: 503-234-6617
Reg#: LIC 54105
This Certificate issued 2/28/03 grants occupancy of the above referenced
building or portion thereof and confirms that the building has been inspected for
compliance with the State of Oregon Sper.ialty Codes for the group, occupancy,
and use under which the referenced permit wa
L
BUILDING IIJSPECTOR E3111LD1 G FICIAL
POST IN CONSPICUOUS PLACE
CITY OF T I GA R D -- BUILDING PERMIT
PERMIT#: 13UP2003-00008
DEVELOPMENT SERVICES DATE ISSUED: 1/7/03
13125 SW Hal! Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 1S135A1301003
SITE ADDRESS: 10300 SW GREENBURG RD 100
SUBDIVISION: LINCOLN ONE/RED '.OBSTER/CASA L ZONING: C-P
BLOCK: LOT: 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 CORST: 2FR sf N: S: E: W:
OCCUPANCY GRP: 6 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCN 'LOAD: 17 BASEMENT: sf AREA SEP. RATED:
STOR: 5 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZ-Z?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORK: PARKING!
VALUE: 4 of V, Dxj, 00
Remarks: 11
Owner: Contractor:
EOP LINCOLN, LLC C SCHIEWF & ASSOCIATES INC
10260 SW GREENBURG RD 1024 NE DAVIS ST
SUITE 100 PORTLAND, OR 97232
PORT'.AND, OR 97223
Phone:
Phone: 503-234-6617
Reg#: LIC 54105
FEES _ REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
I BUILD] Permit Fee 1/7/03 $235.30 Electrical Permit Required
ITAX]89r6 State"Tax 1/7/03 $18.82 Framing Insp
13UPP1.N Pin IRv 1/7/03 $152.95 Gyp Board tion
nsp
I 1 Final Inspection
I FLS] FLS Phi Rv 1/7/03 $94.12
Total $501.19
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 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: �],j.(.!_ ! [_ _ 7 L _—
Permittee
Signature: --
ZCall 639-4175 by 7 p.m. for an inspection the next business day
Building Permit Application
Date received: ---] -O Permit no.: ?-U(Jc
City of Tigard -
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date:
City of Tigard Phone: (503) 639-4171 Date issued: By: G Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: I&2famjly:Simple Complex:
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Addition/alteration/replacement ATenant improvement U Fire sprinkler/alarm U Other:
11 SITE INFORMATION
Job address: c)?00 SW Greehbu►� va bldg.no.UNOo&N Suite no.: 5i�
R d
Lot: __ Block; Subdivision: _ _�x map/tax lot/account no.:
Project name: 'rri ati I t.,C�Ytti(oal tom___ —__---
Description and location of work on premiscs/special conditions; Tenant I»tnn vemeAt(I loodphin,septic capsell v,%olai,etc.)
Name: Lei�IT`{ oFFtcE PRvPER7tEs
Mailing address: 10260 5W Gp. t-31114.0 Ft-0 SUITE 100 1&2 family dwelling:
City: FoRTLP+JD State:Op. ZIP; 97223 Valuation of work........................................ $
Phone5o1l $92-25oo Fax; E-mail: No.of bedrooms/baths................................. _
Owner's representative: I'�7 N. GLu/r- t3pD k�rcbtitectr Tnc Total number of flours.................................
Phone5o3 224-065f6 Fax fi-mail: New dwet,ing area(sq.ft.) ..........................
Garage/tarpon area(sq. ft.).........................
Name: &BD A-rckitec'tl, Inc Covered porch area(sq.ft.) .........................
s ft.
Mailing address: 1)20 SW 3� avenue st�j tt 4-000�o� Deck area( ) .......................•.............•..
City: Porta State:n 'LIP: 9720 Uther structure area(sq. ft.).........................
Phone5O3 22�} 9tr; , Fax E-mail: Commercial/industrial/multi-family:
00
Valuation of work........................................ $ 'LOFUOo,
Existing bldg.area(sq.ft.) .......................... 0
Business name: G Sr j e•W e h 5 New bldg.area(sq.ft.).
Address: S S Number of stories........................................
Cit �—'r State: ZIP °) Z''.�2
y_—.�2 �� 'Type of construction.................................... _----
PhoneSot, 2 Fax: I E-mail:
-- Occupancy group(s): Existing:
CCB no.: S41oC' _-. New: D'
City/metro lic.no 7Noflee: contractors and subcontractors arc required to be
h the Oregon Construction Contractors Board under
Name: P%MIE APF jI( rf ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing,the following reason applies:
Contact person: Plan no.:
Phone
Name: lContact IM-sun: Fees due upon application ........................... $
Address: Date received:
City: State: ZIP; Amount received ......................................... $
Phone: Fax; E-mail: _ Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not alt jurisdictions wcepr credit cods,please call junsdiction for more inf"ation.
attached checklist.All provisions of laws and ordinances governing this U viae U MasterCard
work will be complied with,whether specified herein or not. cmtu cold"amtxr._-- Expires
Authorized signature:_— l2..lfi`�___ Da'e: 1 ?•02 --iaame cardholder a drown on credit card
p�� ar $
Print name:-`-1L VY — Cdholder ntur
alpe Amount
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 40013(6MCOM)
Trlad �ecv�vtU(u JieS
703
Accessibility:
By •rier 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 be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: of all renovation, alteration ur modification being done 00
excluding painting, wallpapering. Ill $ 2 �•—
MulgplV: 25% Barrier removal requirement. 25
BUDGET FOR BARRIER REMOVAL (2l $ 157,
a.�00
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:
. t7U
(a) Parking lett res�iFpi ,a'tt.e b„ork rel8+1n 'ti $�•_
:.Ccec-r 616_ ,-Met,ac�PSriW,Far4-i�^9 + =i,JN�p.
(b) An accessible entrance: 1 J $
(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
i\dsts%fomus Accessibility.doc 09/24/01
CITY OF TIGARD BUILDING INSPECTION (DIVISION
MS'T
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
Date Requested_ 5 I AM_ PM BLD ~
Location— Suite lU0 MEC _
Contact Person rDPh _ PLM
Contractor, l,V(I ��IC/ Ph G, 2 ?� 3 SWR
BUILDING Tenant/Owner �1'��Q/-►',J t���`-�t=_� ELC � ' OU —
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain 1IL�X �L C l/ `�� — SGN
Crawl Drain nspection Notes: rt --
Slab 'r S��f' SIT
Post&Beam -------- ---
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - —� ___ 411
—
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling —
Roof Q ,
Misc: --- /
Final -^
PASS PART FAIL - ------ -- --
PLUMBING
Post & Beam
Under Slab
I uh chit
Water Setvicee
Sanitary Sewer --- —
Pain C>rar�s
Fincl --------__ -__
PASS PART FAIL_
MECHANICAL _
Post& Beam --
Rough In
Gas Line - -- - - - - -- ----- -—
Smoke Dampers
Final -- _ -- -- --
PASS PART FAIL
keffTRIC
Service ------ --- _—_
Rough In
UG/Slab
-------
Low Voltage
Fire Alarm
in
PART FAIL
IT
Backfill/Grading — -
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ _required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE [ ]Unable to inspect no access
ADA
Approach/Sidewalk Date -yg�--1 ._(51&f - -_ Inspector Ext
Other --
Final
PASS PART FAIL DO NOT REMOVE this irispectiori record from the joh site.
n, IPERMITCITY OF TIGARD ELECTRC:
ELC99-017
DEVELOPMENT SERVICES DATE ISSUED: 03/05/99
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171
PARCEL: 1S135AP--01003
SITE ADDRESS. . . : 1O3O0 SW GREENBURG RD #100
SUBDIVISION. . . . !L.INCOLN ONE/RED LOBSTER/CASA L 7.ONING:C—P
BLOCK. . . . LOT. . . . . . • . . . . JURISDICTION: TIG
Project Description: Installation of 6branchcircuits. Job No. 50.
---RESIDENTIAL UNIT---- -----TEMP SRVC/FEEDERS---- -----MISCEL.LANEOUS----
1000 SF OR LESS. . . . : 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 5O0SF. . . : 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 40.1 — 600 amp. . . . . . . : 0 SIGNAL./PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 6O14-amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
----SERVICE/FEEDER----- ---BRANCH CIRCUITS------- ---ADD' L INSPECTIONS---
0 — 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 — 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 •- 500 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 5 IN PLANT. . . . . . . . . . . : 0
601 — 1000 amp. . . . . : 0 ------------------PLAN REVIEW SECTION-------------_____
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner,: __-_________.____—__.__________.__.____—____.__.-..___._.___._. FEES
KNICKERBOCKER PROP, INC XXIV type aMOIAnt by date recpt
BY NORRIS BEGGS 8 SIMPSON PRMT $ 60. 00 DEB 03/05/99 99-313465
10300 SW GREENBURG RD STE 200 SPCT $ 3. 00 DEP 03/05/99 99-313465
PORTLAND OR 97223
Phone #:
Contractor:
WILLAMETTE ELECTRIC INC $ 63. 00 TOTAL
PO BOX 230547
-- - REQUIRED INSPECTIONS
--
TIGARD OR 97281 Ceiling Cover Elect' l Service
Phone #: 624-3631 Wall Cover- Eler_t' l Final
Reg #. . : 000750
This permit is issued subject to the regulations contained ir. the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in acrardance with approved plans. This permit will eM ire if work is not started within 188
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon requires to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAP, 952-901-80 through OAR 952 1-1987. You may obtain a copy
of these rules or direct questions to Ol1NC by calling (503)246-1987,
Flermittee Si gnat .rr,e: Iss�.red By: 6 6z __.
INSTALLATION ONLY-----------------
The installation is being made on proper-ty I own which is not intended for-
sale, lease, or^ rent.
OWNER' S SIGNATURE - _Y _ _ DATE:
INSTALLATIO ONLY
^IGNATURE O 5UPR. CLEC' N: �,��'�:.. Df1TE:
LICENSE NO: 1 9p��
+++++++++f++++++++++++++++++++++++++++++++++.f-+++++++++++a-++++++++++++++++++++-�+
Call 639-4175 by 7:00 p. m. for- an inspection needed the next bi.rsiness day
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++i-++++++++++++++++++
r
RECEIVED
CITY OF TIGARD Electrical Permit Application Plan eck# _
13125 SW HALL BLVD. MAR I ��)`.l ReA By
TIGARD OR 97223 r�^' Date Recd
COuiFfiUC'(ITY DfVELO.+.,.�'' Date to P.E. -��-
Phone (503)639-4171, x304 Print or Type Date to DST T-
Inspection (503) .;39-4175 Incomplete or illegible will not be accepted Permit# £ =o/cri7
Fax (503)684-7297 Called-
1. Job Address: 4. Complete Fee Schedule Beloli
Name of Development Oat (_,A c i 1- _ Number of Inspections per permit allowed --
Name(or name of business) F,'I . Ce-,i a Service Included: Items Cost Sum
Address C • t- 1 4a. Residential•per unit
1000 sq.ft.or less $110.00 _
City/State/Zip 1,Sj.A_�_ UA } I-L � (� Each additional 500 sq.It.or
Commercial® Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manut'd Home or Modular
Dwelling Service or Fender $66.00 ,
2a. Contractor installation only
(Attach copy of all current licenses) 4b.Services or Feeders
r' Installation,alteration,or relocation
Electrical Contractor_ f I .u� ti, Pc��r •�
200 amps or lase $60.00
Address, 2 7o ;-q 7- 201 amps to 400 amps $80.00 _ 2
City_ /a •�Y1_State Zip 401 amps to 600 amps $120.00 2
Phone N0._ 4 Z - 3 L S/ � 601 amps to 1000 amps $180.00 2
Job No._ 1t^ D Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 711- 7 S 3 Exp.Date /U/, let 5 Reconnect only - $50.00 2
OR State CCB Reg. No. ?5-C Exp.Date &/_`a� 4c.Temporary Services or Feeders
CAT Business Tax or Metro No. /)'5 c Exp.Dat �� Installation,alteration,or relocation
'00 amps or leas $50.00
201 amps to 400 amps $75.00
Signature of Supr. Elec'n 401 amps to 600 amps $10000
Over 600 amps to 1000 volts,
License Nr- /�1G S=� Exp.Date ,0 1 c see"b"above.
Phone N,
4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circults with
purchase of service or
Print Owner's Name feeder tee.
Address Each branch circuit $5.00 2
b)The fee for branch circuits
City__ State Zip without purchase of
Phone N0._ _ service or feeder lee. 7 C'
First branch circuit t $3500 1^_ _2
The ins!allation is being made on property I own which Is not. Each additional branch circuit $5.00 ? 2
intended for sale, lease or rent. 4s.Miscellaneous
(Service or feeder nr ick:dod)
Owner's SignatureEach pump or irrigation circle �- $40.00 p
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):" Signal circult(s)or a limited energy -
panel,alteration or extension $40.00 2
-
Please check appropriate Itern and enter fee In section 5B. Minor Labels(10) $100.00
_ 4 or more residential units In one structure 4f.Each additional Inspection over
Servile and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00 _
Classified area or structure containing special occupancy Per hour $55.00
as described In N.E.C.Chapter 5 In Plant $55.00
`Submit 2 setts of plans with application where any of the above apply. 5, Fees: / r
Not required for temporary construction services. 5a.Enter total of above fees $ (o
5%Surcharge(.05 X total fees) $
-NQILQE Subtotal $ -----
Sb.Enter Review
of line
ie q for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review Iflf ie un fired(Sec 3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY r-I
TIME AFTER WORK IS COMMENCED. LJ Trust Account#
S J
Total balance Due
I%DS 1ELC%. APP Rev WN
CITYnF TILARD — ELECTRICAL PERMIT
ll'�� PERMIT#: ELC2003-00617
DEVELOPMENT SERVICES DATE ISSUED- 10/8/03
Ilk 13125 SW Hall Blvd., Tictard. OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GRt -NBURG RD 100 ZONING: C-P
SUBDIVISION: LINCOLN ONEIRED LOBSTER/CASA I_
BLOCK: LOT: JURISDICTION: TIG
Project Description. Relocate(2)contractors. Job No.6599
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 200 arnp: PUMPIIRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+arnps - 1000 volts: MINOR LABEL (10):
_ SERVICE/FEEDER ` _ _` BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp- WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OF: FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: I IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION-------- —�_—....— --
1000+ amp/volt- -4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
EOP LINCOLN,LLC NEW TECH ELECTRIC
10260 SW GREENBURG RD 1400 NE 48TH AVE.
SUITE 100 HILLSBORO,OR 97124
PORTLAND,OR 97223
Phone: Phone: 503-648-1900
-, Reg #: LIC 41868
SUP 2113s
FEES_ ELE 26-41S,
Description Date Amount
_ _ Required Inspections
I I_PRIvIT) ELC•Pemrit Io 8 of $53.50 - -----_ --
I I AX I X"s State'rax 10 S u t $4.28 Rough
Elect'I Final nal
Total $57.78
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 18b daya ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth i AR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246.6699 or
1-80 332-2344.
Isau d By: ( c� i` ' I t� JI C t1�e i Permit Signature: � � t
_ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended far sale, lease, or rent.
OWNER'S SIGNATURF- DATE:__
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ 1' .. -- �e—_ DATE: --
LICENSE NO: --
Call 639-4175 by 7:00pm for an inspection the next business day
10/06/03 MON 19:50 FAX 503 648 31.31. NEW TECH ELEC 001
Electrical Permit Apnlieation Rrocivea �� � Electrical
Pcr ttNol•- L` *X � -c'Cel 2
Plo,mtng Aptxnvt+ Sign
City of Tigard M + w.i �' - "�--- _ __ _ Permit No.
13125 Cw Hail Bled. Plan Review otII
lot—amY ._-- Pamrit No._
Tigard,Oiegon 97223 Post-Review --- Umd Use
Phonr.: 503-639-4171 Fax: 503-598-1960 OatrJH _-.-- Case No.
Internet: www,ci.tigard.or.us Coir-actIuri . T�,Sea Page 2 for
24•l,ntlr ITlspectinn R,-qutst. 502-6394175 _Nan,rJMethod„ �,_ l_SJrplemental lolormation.—
MEN
New eonstmetion Demolition Service over 225 amps [j Nea`�tl 1:a,r tar.,hty
comrr,ernial location
Addition/alteration/17 lacement Service over 320 amps-ruins of ❑building ever 10,000 squart feet,
I &2 family dwellings four or more residential units to
❑system over 600 volts nominal onr.stntcture
1 &2-Famil dwellin Commereia iduftttriixl Building over three atones LI Feeders,4DO amps of roore
Aec�uildingL_ Multi-Family 0 ocr.upant load over 99 peril” []Manufactured struc:nrrs or RV park
Other: ❑Egress/lightingplan C](lthrr__ --
Matstef Builder Submit_.seta of Plans with any of the above,
y {
Then are not a IIca I I to Ism,eroY COnskruCtlOn service-
.0", `1
job site address: z v ScJ ,ccnlour�`_ '�'
Suite#: Bld ./� Apt.#: _ __ __� ____._Number of inN CCti2 er ertnit allowed
--- — - -
� Description
city Pee(n.) 'tool
Project Name: -- New rrsidendal etnEle ur multi famlly per
�;r(Iss Streetroirecihons to job site: dwe,liog unit.Includes sheered earaye.
Sera;^.i Included: 4
1006 .ft or leas 141.15 _
Foch additional 500 sq.IL or ion
• ------ .- - Limited seer r residMtla)
75.00 Z
SubdiVl6ion: I tit • Limited energy non tiaidenda� ___ •
--Z —
'Tax ma ltercel#: Each rnanufsctu"A home or modular dwelling 2
.•--� � service arid/ xdc� �.�
Srrvkca er feeders-la,ttdlutbn,
r � alteration or ralurattua:
9(10 2
200 armor less ,
201 an, s a AM nm j4454.65
.a5 2
---- -- -
-.- . 2
601 MUL11 w 1000 a --� .60 2
�► *� 2
Over loon a npc or valta •--
Name: s es 2
- Temporary servicesor feeders•InstdlaUoer
Address: — - - alteratiou,or reloratlon:
ci ►/State/7.i : — _ 200La less
201 simps to AM s_rr __.- .30 2
Phone: 13'03 G 2 0y99 Fax: 401 to 600 amla 13 ,75 2
111111111lit grim 171VIRtmilY u� � _ - Branch cirrolte-new,alteration,or
e t »
ah
Name: - --._ A-Fee
per,ta circuits
_. - A.Fee for branch eirruits with pwchne of 6,65 2
Ad&es9: __. -- Service m feeder-each branch cimuit —
_ .. -._
CIt /Sta�te; T- — A.Fe-,for bench circulta without purohasc of 46.85 ��L `e13 2
�_ �- .__ _..._ _. s,rrvice or feeder f � t branch circuit
t 11'ax; 13achadlitionallrrytchcircuit 6,65 a
1<honey_ . --ax �_ _. -
Mi z.(Servir*or teeAtt not included) 53.40
1
E-mail: t'` e
Euh rump r irritation circle _
' :, _ Foch ai or euuh,c li bun 340 2
Job No; e{roiifs)or ua limited energy pawl. Pa 2 - 2
-- ■Iteration of ertenaion
Business NaI11e: �(y_�(L�[ -
Addrr,+:_Q01_II2Each additional Ins_Lection ever the allowable In a_n of the above:
Ci �t% i
, j,Q 2 Per im_ �ion�ar tour�in.I hourL 62,50 -
y k Fax: other._33_1
CCB Lic.#: y/8 8 Lic.#: .e - y/06 _.5,�-
Supervising electrician subtotal s
Si nature re Uil ed: _-__ Plat Revlr:ty 25%of Penn it Pee S
1?rint Neme: Lic. #_ 'y2 fs' S sotto surclwge(ee�of Pt tn�it Ftse _s __�'' -
TOTAL PERMIT FEE
Autherired Nottee; This permit applleation er<pir•es If a permit b not ehtalneo cruoa
Aut Date: -- I!0 days agar it has been accepted an romplete
^Fee methodology set by Tri-County Building Industry Service Board.
(Please print namr.) -
i.\r)sa\Permit Fomu\BlcPerrnitApp,doe 01103 A LC-dV r --
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: 03)639-4171
Reecelved _3`�L r�Da ,Requested �Q ¢ — AM___ PM BUP
Location —suite., MEC _
�.�. �%
Contact Person �. �� __ Ph (__ _} PLM
Contractor_ - h; ) __ SWR
BUILDING Tenant/Owner C ELC d3 ^/��7/y'
Footing L -00 2 /
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: } SIT
Post&Beam -� _-
Shear Anchors -- �
Ext Sheath/Shear
Int Sheath/Shear
Framing - - --------- - - ---
insulation c.
Drywall Na!ling - - --- -
Firewall
Fire Sprinkler — - ------ -- - — --
Fire Alarm
Susp'd Ceiling
Roof
Other: --------- -.._—.�---------
-
Final
PASS PART FAIL
PL --�----�-- ---- _-----_ _.._ ,�
UMBING _ - ----f- --_-�_- __T ,__--
Post&Beam
Under Slab
Rough-In
Water Service _--
Sanitary Sewer
Rain Drains - -----_ . .. _--_-
Catch Basin/Manhole
Storm Drain -------- --
Shower Pan
Other: ----- — - - -- -- - ---
Final
_PASS PART FAIL -
MECHANICAL
Post&Beam 1 , �
Rough-In �' -- ----
Gas Line
Smoke Dampers - -- - - -
Final
P RT FAIL ---
EC L
Service _�•r - � U �
Rough-In
UG/Slab
Low Voltage
F' arm
15b- I 1leinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd,
S
g_ Please call for inspeption RE: - Unable to Inspect-no access
Fire Supply!
1 (
ADA dab !c� '� Iy Ins r �-'� fFatt
Approv - -
Ot�
I DO NOT REMOVE this Inspection record fr the job Ite.
rMh�
CITY OF TIGARD 24-Hour
BUILDING Inspection Line; (503)639-4175
MST
INSPECTION DIVISION usiness Line: (503) 639-4171 _—
BUP —
Received _._ __�r _Date Requestedp �� _. _ AM- _. __ PM BUP
Location
L� �.f� I�'��� -- - -- Suite _ MEC -.. - ------
��.
Contact Person — Ph( ) __ PLM --___-
Contractor__. — Ph —) ____ SWR
BUILDING_ Tenant/Owner .___ v ELC
Footing ELC
Foundation Access:
Fig Drain EL.R — -
Crawl Drain
Slab Inspection Notes: \ FrLSIT
Post&Beam
Shear Anchors �-
Ext Sheath/Shear
Int Sheath/Shear
Framing - - -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm �� C, 1�� �' ��
Susp'd Ceiling '�h�
Root \J `
Other:
Final
PASS PART FAIL
PLUMBING _ —
Post&BeamYVI
I \
Under Slab ---- ----
Rough-In
Water Service -- --- ---�
Sanitary Sewer
Rain Drains — — -- —
Catch Basin/Manhole 1
Storm Drain -
Shower Pan
—_ -- �j y, / I A A cL4,av
Other:
�—
Final
PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In -----
Gas Line
Smoke Dampers --- - —
Final
PASS PASR TRICA FAIL
Service
Rough-In
UG/Slab
Low Voltage L —__— __ -- ---••—-
Fire Alarm
Final �_� Reinspection fae of$— —required before next inspection. Pay at City Hall, 13125 SW Hall Biva.
PASS PART FAIL
SITE [� Please call f9r reinspe ion RE: Unable to Inspect-no access
Fire Supply Line �, 1
ADA f
Approach/Sidewalk Date ��L - - Inure ^—��� "c d--,- _ KXt
Other:
Final DEQ NOT REMOVE this Inspection record trom th ob site.
PASS PART FAIL