10300 SW GREENBURG ROAD STE 230-1 -10300 S`4 GREENBURG ROAD
ONE LINCOLN, SUITS 230
CITY OF TIGA RD 24-Hour
DUILDINr Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
Received ,5 c
BUIP
-_-Date Requested__-_._ � AM _PM BUP
Location ____ /e ,�C11::�- Suite - MEC
Contact Person Phi — ) PLM
-- --
Contractor _______ � Ph(— ) �� �-_ ���-3L SWR
BUILDING —_� ?ena��UOwner ELC
Footing '-�
Foundation Access: ELC
Ftg Drain
Crawl Drain _ ELR
Slab Inspection rJ�tes - - SIT '
Post& Beam —
Shear Anchors
Ext Sheath/Shear ---
Int Sheath/Shear _
Framing _
Insulation
Drywall Nailing
---
Firewall -
Fire Sprinkler --
Fire Alarm —
Susp'd Ceiling _
Root ---"
Other: - `I
Final __----- — _.—
PASS PART FAIL -
PLUMBING -
Post&Beam -- --
Under Slab _
Flough-In -
Water Service
Sanitary Sewer --
Rain Drains -- - _
Catch Basin/Manhole —
Storm Drain -
Shower Pan - - —
Other:
Final -_-.-
PASS PART FAIL --- ---_ _— -
MECHANICAL
F;ost&Beam -- --- ------_—.� - - —
Rough-In
Gas Line ---------- -----
Smoke Dampers —
Final
PASS PART FAIL
ELECTRICAL
Service - - - — _-
Rough-in
UG/Slab
Low Voltage
Fire Alarm - --- -- -- -- ---- --
MaI Reinspection fee of$
PART FAIL Reins� p _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI Please call for reinspection RE: _ _- Unable to inspect-no access
Fire Supply Line
ADA / _
Approach/Sidewalk Dates Q C�'�._ Insp�tot X7 7 —�"- -7`----_EM_----.
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS MART FAIL
CITY L "'IGARD Inspection spection Line: (503) 639-4175
MST ---------- _ -
INSPECTION DIVISION Business Line: (iO3)639-4171
BLIP —. .
Received _ Date Requested ' — AM F'M -_~ BUP
��- -���
Location � � �G'G �-L�=�'�1-� 's�--Suite MEC —
Contact Person — S7 �t-L�'` Ph( ) "72 f✓ 3L PLM
—
Contractor_— — Ph( ) -- SWR -- -
BUILDING Tenant/Owner — ELC
Footing ELC
Foundation Access:
Ftg Drain ELR -
Crawl Drain SIT
Slab Inspection Notes: -
Post& Beam - ----- -_
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear _
Framing -- -
Insulation
Drywall Nailing (�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --- -_--
Roof
Other --
Final _
PASS PART _'AIL S
PLUMBING_
Post-&Beam
Under Slab -- - --
Rough-In
Water Service ------ - - _--- --
Sanitary Sewer _
Rain Drains
Catch Basin/Manhole
Storm Drain -- -- -�
Shower Pan - -- -- -
Other: -
Final
_PASS PART FAIL - - -
MECHANICAL --- - ---- - -- - ---------- - —
Post&Beam
Rough-in ------- - -- ---
Gas Line
Smoke Dampers - ---- -- - ---- - --- -
Final
PALso PART FAIL --- ------------ --- - ---
ELECTRICAL
Service
Rough-In ------- ---- -- --------- -
UG/Slab
Low Voltage --__-- --_---- ---------- -
Fire Alarm
If 4@111L. n Reinspection fee of$_-- _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinenection RE:--- -.- Unable to Inspect-no access
Fire Supply Line
ADA � '�" C) Incoector - Ext
Approach/Sidewalk Dat -1`------ F- -
Other:--_--_- -
Final UO NOT REMOVE this Inspection record from the job site.
PASS PARI FAIL
CITY OF TIGARD BUILDING PERMIT
�ES V,ERMIT #. . . . . . . : BLIV-98-000;
DEVELOPMENT SERV:
DATE ISSUED: 02/24/98
13125 SW Hall Blvd., Tigard,OR 97723 (.503)639.4171
PARCEL..: 1 S 135AB-01003
SITE ADDRESS. . . : 10300 SW GREE NBURG-1 RD #i30 ZONING:C-F'
'3UHDIVISION. . . . : ONE LINC::OLN• LOT. JURISDICTION:TIG
__
----------------------- --------------------------- --------------------------------
AREAS----------- --
REISSUE: Ex1*ER:IOR WALL CONSTRUCTION-
CLASS OF WORK. :ALT FIRST. . . . : 0 sf N: 5: E:
W.
TYPE OF USE. . . :COM SECOND. . . : 5 306 s f PROTECT OPEN I NGS'?--_.--W+__.__
TYPE OF CONST. :2FR 0 sf N: S
OCCUPANCY GRP. :B TOTAL. -- -- -- ; 5306 s f ROOF CONST: FIRE RET? :
OCCUPANCY LOAD: 69 BASEMENT. : 0 s AREA SFP. RATED:
STOR. : 0 HT: 0 ft GARAGE:. . . : 01 s f OCCU SEP. RATED: -F
BSMT?: MEZZ? SE"TBAL:K:i--_____.__ REQUIRED-- _--___..__:_..
F1..GOR LOAD. . . . : 0 ps f I..TEFT: 0 ft RGHT: 0 ft F I R SPKL._:Y SMOK DF_1 . . .
DWELLING U".� i_ ; 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:
PE:DRMS: 0 BATHS: 0 IMP SURF=WCE:: 0 r,RO CORR:Y PARKING: 0
VALUE. $ : 5.3060
Rpmarks : Tenant imvroverent-cosbin• two existing suites into one.
Owner,: _____.__..._...._.._..__..._..._.._______._____.___. _.._____ .__ .
MELVIN MARK type amount by date recpt
1.0220 SW GREENBURG RD PLCK $ 191. 75 13EO 12/c:9/97 97--30c063
T I GARD OR 97223 FIRE $ 118. 00 GEO 12/2'3/97 97-302083
PRMT $ 295. 00 GEO 'A2/2L%/98 98-:303,551.
Phone t4 -. 452-5900 5PCT $ 14. 75 GEO 02124198 98-303551
Contrar_.tor:
MAL_I PU PACIFIC
7:35 NE JACKSON SCHOOL ROAD
H I LL.SBORO OR 9-/1.,'-,4
Ph nn e #: 693--9797 $ 619. 50 TOTAL..
Rpq #. . : 059045 ---
--- -- REQUIRED 1 NSF'E:CT I ONS
This permit is issued subject to the regulations contained in the Framing Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Gyp hoard Insp _ ---
applicable laws, All work will be dane in accordance with Susp Ceiing Insp _--.-
approved plans. This pernt will expire if work is not started .
within 190 days of issuance, or if work is suspended for sore
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 952-181-1810 through OAR 952-0A181987. — - -
You many obtain a copy of these rules or direct questions to Ol1NC --
'v calling (513)246-1987.
-ptSianatI.ire:; J_ut�� / -
++•+4_+++++++++4+ +++G}�+"++++++ +-4+++++++++++.+++++++++++++.-++++++^F•+1•++++++++.+++++-1
Call 6.39-4175 by 7:00 p. m. for an inspection needed the next business day
4 ++++-+++++++++++++•Fir++++++++++++++++++++�+++++++++++++.4-+++++++++++++++++++++++
mw•
=
CITY OF TIGARU Commercial Building Permit Recd By Rb, 7
13'125 SW HALL BLVD. Tenant Improvement Date Recd
Daie to P E. `
TIGARD, OR 87223 Date to DST1
49 W
(503) 639-417 Permit# &,P9�O0Xa
Print or Type Related SWR
Incomplete or illegible applications will not be accepted Called p� .,�..
Name of DevelopmenUProiect - Existing Building X New guilding
Job L iwdA Civ'
Address Street Address — — Sul Building L i ytcnf H Cewtvv-
lowv SVJ Gre�- 1�dl
Data
Bldg* City/State zip Existing Use of Building or Property
----- one
Fort, Cfg7�2-3
Name
,,11� Proposed Use of Building or Property.
Property �rlit _r �r1UpPruef C.. V ���
Owner Mailing Address`s Sui e vT T7 C C
low so evr"Ar V', IV. ?C�� o. 4�1 ones
City/State —� Lip Phone �— 5
ort Sq. Ft. Of Project:
Occupant Name -�— - - :"2.4~ �,�w� $d, FT,
cornsys _—_ Occupancy Class(es)
Name (- t� _
Contractor �/;- Ty e(s)of Construction
Prior to permit Melling Address Sude
issurince,a copy Will this project have a ire Suppression System')
of all licenses Yes C] NO
are required if sty/State Zip Americans with Disabilities Act (ADA)
expired in C.O.T.
database Valuation X 25% _ $ .l p°Participation
�� A J �„
Oregon Const.Cont.Board Lic.>r Exp.Date Complete Accessibility orm �!3 �•
Project $ �p
--- Name Valuation .
Archlf-ct GPP )"i' ec-+S IKC , Plans Required: See Matrix for number of sets to subnu
Mailing Address Suite on back
92e rw 13 I'd 400 -
city/state Zip — Phone I hereby acknowledge that I have read this application,that the information
POr.1 �Q 97 ZX) 2Zd �(�.- given is correct,that I am the owner or authorized agent of the owner and
l t� I-._.. ( that plans submitted are in compliance with Oregon;;ate Laws
I Engineer Name —
Signature of Owner/Agent Date
Mailing Address —�— Suite
Con*t Person Name Phone
City/Slate Zip Phone a 'Z24 C��lvr - 9(119J6I
--- FOR OFFICE USE ONLY
Indicate type of work: New O Addition O Demolition O MapITLO7�_ Land Use: —
Accessory Slnmcture O Foundation Only O Alteration W 15135-/M'0/e,0-sI
Repair O Other O Notes,—
Description of work: �}
Tena•. 1►'' � "" TIF:
t•arks: Estimated 0 of Employees --—
Nnte: Site Work Permit Appilcatlon mu!it precede nr accompany Building
Permit Application
I\COMNEWDOC (DST) 1397 q
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
DISTRIBUTION TO PLAINS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL fOTA1, CPE PPE ERF: -� CPE PPE EPE
SITE 1 1 3 (j,o.u) -- --
B (New or Add) 1 1 - - 3 (j,o,w) -- -_
F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f)
M (New or Add. or Alt) 1 1 -- 20,o) -- --
B & M (New or Add) 1 1 - -- 3 (j,o,w) -- -
P (New, Add. or Alt) 2 -- ? -- -- 20,o) --
B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) --
E (New, Add, or Alt) 2 -- -- 2 -- -- 20,o)
B & M & P & E (New, Add) 3 I 3 (j,o,w) 20,o) 20,o)
B or B & M(Alt) l 1 -- -- 20,o) --
B& M& P(Alt) 3 1 2 -_ 20,o) 26,o) --
B & M & P&E (Alt) 3 1 1 1 2 (j,o) 2 (j,o) 2 (i,o)
NOTES:
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o = Office M = MEC
updates and adds actions. f= Fire P = PLNI
u = USA E = ELC
b. Shaded areas designate ALT'submittals only. w= Wash. County F= FPS
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved F-e sprinkler and fire alarm plans with
calculations.
h Vnstnc Doc
;�� CITY OF TIGARD
FiEVE'LOPMEwr SERVICES
Tiqafc', OR 97223 (503)639-4171
Plan
CITY OF TIGARD Mechanical Permit Application RecdSec'd
"
P� Rec'd
13125 SW HALL BLVD. Commercial and Residential ,�]� Date (�
TIGARD, OR 97223 U� Date to P E._
(503) 639-4171, x3(14 I �� Date to DST
Print or Type 1e ( Permrt# 4"UE-z'S -voV
Incomplete or illegible applications will not be accepted Called
Nerr>9 nr Develop enuranle% I Description
Table to Mechanical Code Cry PRICE AMT
Job Street Address SuAerY A) Permit Fee
0- Q 10.00
Address r 25
eagrr lutea 'e zipor 1.) Furnace to 100,000 BTU 6.00
including ducts&vents
Name(or name or busing ) 2.) Fumace 100,000 BTU+
7.50
Owner including ducts 8 vents
Malffhg Address 3.) Flcor Furnace 6.00
inrwding vent
(Statep Phone 4,) Suspended heater,wall heater 8,00
_ _ or floor mounted heater
No e(or name of b slneaa) 5.) Vent not included in appliance permit 3,00
r
OCCupam Mailing Aaaren
8.) Boiler or comp,heat pump,air cored. 8,00
d1l �� to 3 HP;absorb unit to 100K BUT"
c /Slate zip ('Phone 7.) Boiler or comp,heat pump,air ccnd. 11.00
✓ jj 2,9a 3 � 3-15 HP;absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp,heat pump,air Gond. 15,00
15-30 HP;absorb unit.S-1 mil BTU"
Prior to permit Mailing Adaress 9.) Boiler or comp,heat pump,air Gond. 22.50
issuance,a copy ' 30-50 HP;absorb unit 1.1.75mil BTU"
of all licenses _ rfst to zip Phone 10.) Boiler or comp,heat pump,air cond. 37.50
are required it >50 HP;absorb unit 1.75 mil BTU"
-
expired in COT Oregon Conal.Com 1381rd ME# Exp.Date 11.) Air handling unit to 10,000 CFM 4.50
database 9
Architect Name 13.) Non-portable evaporate cooler 4.50
Of Mailing Ad se ��� � -
14.) Vent fan connected to a single dud 3.00
Engineer cityfstste 7.Ip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New O Addition O Alteration,! Repair O 16.) Hood served by mechanical exhaust 450
to be done Residential O Non-residential O
Additional Description of work: 17) Domestic incinerators 750
%l i _ 18.) Commerr 1 or industrial type 30.00
Incinerst.
Existing use c 19.) Repair units 4.50
building or property
10.) Wood stove 4.50
Proposed use of
building or property 21.) Clothes dryer,etc. 4 50
22.) Other units _ 4 50
Type of fuel-oil O natural gas O LPG O eledri 23.) Gas piping one to four outlets 200
1 hereby acknowledge that I have read this application,that the 24.) More than 4-per outlets(each) 50
information given is correct,that I am the owner or authorized agent of
the owner,that plans submitted are in compliance with Oregon State CITY.SUBTOTAL
laws.
Signature of Owner/Agent Date 'SUBTOTAL
` 5%SURCHARGE s
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
i
a�� TOTAL 1 /
I�niecm.
hpdoc (rev 9 J • Inlmum pem.;t fee is$25+5%surcharge
G-Residential A/C requires site plan showing placement of unit
VV 1
CITY OF TPLUMBING PERMIT
., DEVELOPMENT SERVICES PERMIT #. . . . . . . : PLM98-0014
13125 SW Hall Blvd., Tigard, OR 97223 (501)639.4171 DATE ISSUED: 01 /27/98
PARCEL: 1S135AB-01003
SITE ADDRESS. . . : 10300 SW GREENBURG RL) #230
SUBDIVISION. . . . : ZONING: C-P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : JURISDICTION: TIG
CLASSOFWORK. . :ALT GARBAGE. DISP0SAL_S. : v) MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFL0W PREVNTRS. . : 0
OCCUPANCY GRP. . :B FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : I CATCH BASINS. . . . . . . : 0
FIXTURt-_3------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . .. 1 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 1 RAIN GRAIN (ft) . . . : 0
Remarks : Comsys TI
Owner: --------•----------------------------------------------- FEES - --_- --- ------
NORRIS BEGGS d• SIMPSON type amoi.int by date recpt
121 SW MORRISON PRMT $ 27. 00 GED 01/27/98 98-302847
PORTLAND OR 97204 SPCT $ 1.. 35 GEO 01/27/98 98-302847
Phone #:
Contract
DETEMPLE CO INC
1951 NW OVERTON ST
PORTLAND OR 9720' _--
Phone #: 227-2641 $ 28. 35 TOTAL
Req #. . : 00002
--- --- REQUIRED INSPECTIONS - -
This permit is issded subject to the regulations contained in the Rough-in Insp r
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM/Underfloor
applicable laws. All work will be done in accordance with T o p--o l.tt I n s p
approved pbins. This permit will expire if work is not started Final Inspection _
within 180 days of issuance, or if work is suspended for more
than IN days. ATtrNTION; Dregdn law requires yo,i to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-MI-BNIO through DAR 952-SNNl-NNAN. You may _—
obtain copies of these rules or direct questions to (XJK by calling _
(503)246-1987.
l� —Permittee Si natlAre . e bus.
1.s s�_�e d B y: _—� 9 —.—
++++++++++++++++++++++ ++++++++++++•1++++++++++++++++++++++•++++++++++++++++41
Call. 639-4175 by 7:00 p. m. for an inspection needed the next business day
++++++++++++++++++++++++i +++++++++++++++++++++++++++++++++•I++++++++++++++++++ 1
o1.22•,98 THU 10:1:*, FAX 5032747686 DeTEMPLE COMPANY INC 004
N OF TIGARD Plumbing Application ROCA 01
I once Rech c.Lft
125 SW HA .L BLVD. Commercial and Residential Onto b p E
GARD, OR 97223
oats to WT
13) 639-4171 venrvt•
Print or Type wletlw SWR s c- ;
Incomplete or illegible applications will not be accep-W CaW4 "-
Cj6�.=r.
___ �r;,e of t�e�aloymenv�eopa - FIX RLEg.Qndhidwl) p
Jab LN U i TE 30 Lam" — -
Addf,9sa stfset Addrssa sone
Lzveesry 9.00
to 300 2 A) Gr n bi Tub or TublShaver Comb. 9.00
Bt1g a Utpstate Op shower onry -- 0.00
-r1 -. D q ?Z 3 Weer Qotet 9.00
raartw �iYleraahar
d1P�ri (3 i✓►� S 0 - -- - 000
Owner twang Adm.K 53.M C�afsa0e Ot.00t.l � 9.00
W Nl 4f r i SV yj Wtaf*V Mod** 9,00
I51atr DO pAnrn -� F:.•+w onr, r a o0
r I �
Nan"
C(DMS -S it.00
Occupant A1119NAedrtma sr, VvaorrQWW I 9.00
00 SwiC Lsur ry Racm rm 0.00
City hemp r 'ap PnoneK-11 _ 9.00
-
Olf-Ftaftrttne(soe'ay) 0.00
Yte
Contractor "algry "°"'"af swot 9.W
1951 NWOUE' ttY� —
•t for to dasnnra q4v rStaa /ty� p FIN" '_ 0.00
-uplic+nt mtot 12-r., Of- 11 .09 - �,a YI
aroMe all Oregon ConaL ConL Board Lic! Fxv Date- C� g U0
mrre'achrs Qa,5-1 — - / .U _-�__ 9.00
kerneF'UrttbWv Lfc.R Ego.oats �' S�__ S4WW-Y- tt 100`' 3o.tfo
trtnnr.attflrt -(� _ O Smror-each addlf zvW 107 --- 25 a
for Coo GOT Busumea Tax or Mow 8 Ev.Daae Q y,ty Sere--1n 100' _ 3000
da to has&1 -
_.___ Wa
�� ter:senna-each aadison.0i ear 23:00
A r c h itfa ct s rare,a Ralh van-ill 107 -^ _« 30.00
or Ma*v Ananw suim Slam►aHMn Dvn-.ecil aoeloenal 100• 25M -
Mcbit Meme Space 25.00
Engineer Gtyrstate _op - vnons - c'mmwrWr aear rice.t•+erentiQ,O�or Awa• 2s o0
_ ptkldtn Drv" _
cscnuw.ora Now O Aadfdon A Aletroeon O Repar O Resrfer"aidt5ra.Pm~rbon Dance' 15.00
be done- ResidentW O - Man retwentlalA Any Trap or Waste Not C,ssmedad to a Fitcave� 900
camon0! .mrnplian M wort— Cwun Breit 900
Irup of �netlrej pRenbbv a0.fm
Per
.ul�MO
sta�•-�h Aw�+t�Irtspectsona X0.0000
.&m"LLoA of !oa4 f/ h.cctn.. - ft
'WLqq or wry- Ran brani,s"le family comMig 30.00
rnpnvrd taw of yeast Traps 9.00
,A'ding or 9mpoM_- - - -- -
QUAAITTIY TOTAL •'-•••
rw you c9Dpttq. movlrtg or rt±plat]ng arty 16cttues7 YM O Np Im n e a"ser aararrm a ra"W M QuarWV Teat ai
H awe faeek Y 'SUBTOTAL
of form)
YR'Dy acknowledge that I have read U1ts appUotlon ft-it Me infonnarion c;�r
vara is mnvw3.d%it I am T*owner or autnartzed ageM of the owner and 3%SURCHARGE
1.35 7
'3t
at Owns submitted are in com0lisnce with Ortym State L ftm --- �—
ry�p��/jjv►*1oAf�UrrrrfAgent /, Datan -PLAN RMEW 25`8,OF SUBTOTAL.
L-
-v t��1/'I �__�►i��%I CN" �.-�- ! 1 Awruee a+►r f terve ar�trnl is>_4 e
t ; v TOTAL `�•. 1,,3�
,,nor:T Pamon Kama Phorw
Mlnlmum •, S%evdtargw,rescapt Resiuenml Badlow
�/aanYlorl VhUrrae- ?--7 Gr1 D=,AM".M. aS2bS3
L\ptmapp.doc 1196 (dst)
Accumulative Sewer Taily
Tenart dame: <; _ This SVVR# / (J
Address /6-5Ke 77 Z _S L' This PLM#:�
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 _
l -Jacuzzi/Whidpool 4
Car Wash- Each Stall 6
Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher-Commercial 4
_ -Domestic 2
Drinking Fountain
Eye Wash
Floor Drain/sink- 2 inch 2
3 inch 5
_ -4 inch _ 6 _
Car Wash Drn 6
Garbage Disposal 16
Domestic(to 3/4 HP)
Commercial(to 5 HP) _ _32
- Industrial(over.5 HP) 16
Ice Machine/Refrigerator Drains 1
Oil Sep(Gas Station) 6
Rec.Vehicle Dump Station 16
Shower-Gang(Per Nead)` 1 _-
- Stall2 _
_Sink- Bar/Lavatory _Y 2
Brad!ey — 5 —- - - -
�_Commercial 3
_ Service 3
Swimming Pool Filter _ 1
Washer-Clothes _ 6
Water Extractor _ 6
Water Closet Toilet_ 6
Urinal 6
i --7
TOTALS I
Total fixture values:_, '/ _divided by 16 �4DU
HISTORY _
PLM# -0 r 3 E'7U# -'N SWR# T e-c ? PLM# 1 -0t'4 C'_ EDU# /7, SWR# 7.5 O-VT 1
PL M# � oW/ -,
L. V SWR_ PL_M i�� EDU# S1NR#c?
PLM# EDU# SWR# PLM# EDU# SWR#
PL_M# -O'YW EDU# e -� SWR# r7-o-T, PLM# EDU# SWR#
i ldats\swrtaly.doc
CITY OF TIGARD ELECTRICAL. PERMIT
PERMIT #: ELC98-0036
DEVELOPMENT SERVICES DATE ISSUED: 01/22/98
13125 SW Hall Blvd., Tigard,OR 917 223 (50.3)639-4171
PARCEL : f.513SA8-0100
SITE ADDRESS. . . : 10300 SW GREENBURG RD tj�.,-0
SUBDIVISION. . . . : ZONING:C-P
BL..00K.. . . . . . . . . . 1. C1T. . . . . . . . . . . . . . JURISDICTION: TIG
Project Description : Add twenty-eight (28) branch circuits to an existing tenant
within a couercial bldg.
- -RESIDENTIAL. UNIT-- -- ---TEMP_SRVC/FE'EDERS---- -----MISCELI-.ANEOUS-------
1000 SF OR LESS. . . . : 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
FACH ADD' L 50&7F. . . - 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . 17,
LIMITED ENERGY. . . . . : 0 401 — 604' amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . 0
MANF. HM/ EVC/FDR. .- 0 E-.O1+amps-1000 volts. : 0 MINOR LABEL. ( 10) . . . : 171
-.-----SERV---SERV ICE/FEEDER------ — -- BRANCH CIRCUITS----- --- ----ADD' L INSPECTIONS—-
0
NSPF_CTIONS—-
0 _ ;-,00 amp. . . . . . : 0 W/SEP,VICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 400 amp. . . . . . : 0 1 st W/0 SRVC OR FDR. : 1 PIER HOUR. . . . . . . . . . . : 0
401 _ 600 amp. . . . . . : V1 EA ADD' L.. BRNGH CIRC: c17 IN PLANT. . . . . . . . . . . : 0
601 — 1000 amp. . . . . : 0 ------.----- -------PLAN REVIEW SECT I ON---__---_---_—__---_
1000+ amp/, :• t. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL_. . :
Reconnect only. . . . . : 0 SVC/FDR )= 225 AMPS. - : CLASS AREA/SPEC OCC. :
Owner: --------------------------------------------------------- FEES
MEL.VIN MARKtype amount r date r•ecp+
102r'-_,O SW GRE.ENBURG RD F'RMT $ 170. 00 GEO 11 /22,/98 98 302681
TIGARD OR 97223 SPCT $ 8. !0 GEO 01 /22/98 9F-3026,81
Phone #:
GOTItr^actor: __.__.___._____—____--_.-----.___...._.___._..---- -------------------------------____
CHRISTENSON ELECTRIC INC $ 178. 50 TOTAL_
111 SW COLUMBIA
STE 480 ----_~---- RECJUIRFD INSPECTIONS -__.....__
PORTLAND OR 97201 Ceiling Coven Undergroi.tnd Cove
phone #: 241--48liWall Cover Elect' ] Service
Reg #. . : 000004
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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: Oreqrn law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in CZAR 952-001-0010 threugh CZAR. 952-001-1987. You say obtain a copy
of these rules or direct questions to (tlldl: by calling (503)?46-1981.
P e r m i.t t e e yzf-L,x4`i'� I s s i.t e d
OWNER INSTALLATION F)NL.Y-- ---------------_-.____--_--_--__
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 SUFIR. ELEC' N: ___ _ BATE:
LICENSE NO:
+++++++++++++++++++++++ +++++++..++++++++++++f++++++++++++++++++++++++++++++a+4.4
Call 639-4175 by 7:00 p. m. for an inspection needed the next bi.isines 7 day J
CITY CF TIGARD P'ectrical Permit Application Plan Check#_
13125 SW HALL EILVD. Recd By
TIGARD OR 97223 bate Rec'd
Date to P.E.
Phone (503)633-4171, x304
Print or Type date to DST�r
Inspection (503)639-4175 Incomplete or illegible wiil not beaccepted Permit#�GC `1' i ' r3_
Fax(503)684-7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development LINCOLN CENTRE LINCOLN I Number of Inspections per permit allowed
Name(or name of business) COMSYS SUITE 225,230 Service included: Items Cost Sum
,address 10300 SW GREENBURG RD � 4a. Residential-per unit
PORTLAND OR 1000 sq.ft.or less $110.00
City/State/Zip Each additional 500 sq.ft.or
❑ portion thereof $25.00
Commercial Residential
Limited Energy $25.00
ROSS CROSBY MALIBU PACIFIC Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00
2.a. Contractor installation only. �-
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Contractor CHRISTENSON ELECTRIC, INC Installation,alteration,or relocation
AddfeSS.
111 SW (JOLUMBIA SU1E200 amps or les4 $60.00
201 amps to 400 amps $80.00 2
City PORTLAND State OR _ Zip 97201-_5886 401 amps to 600 amps $120.00 7
Phone No._ 241-4812 601 amps to 1000 amps $11,10.00 2
Job No. 222-0:56 Over 1000 amps or volts $340.00 2
Elec.Cont. Lice. No. 26-341,. Exp.Date Reconnect only $50.00` -
OR State CCB Reg. No. 4.51 _Exp.Date 4c.Temporary Servicer.or Feeders
COT Business Tax or Metro Nn.-__ Exp.Date Installation,alteration.or relocation
200 amps or less $50.00
Signature of Su r. ` `n L - ~� 201 amps to 400 amps $75.00
g p ----i-�t-=� 401 amps to 600 amps $100.00
8 7 3 S Over 600 amps to 1000 volts.
License Nr' Exp.Date see"b"above.
Phone N
-- 1/14T-9-9-' 4d.Branch Circuits
Now,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
-- --- - �- Each branch circuit _ $5.00
Address b)The fee for branch circuits
-- ---- -
City State..___._. Zip __. without put chase of
Phone No._ service or feeder fee. 35.
First branch circuit 1 $35.00 ,.
The Installation is being made on property I own which is not Each additional branch circuit.= $5.00 _ 135
intended for sale,lease or rent. 4e.Miscellaneous
Owner's SI nature. (Service or leader not included)
9 - Each pump or irrigation circle $40 00 _
Each sign or outline lighting $4000
3. Plan Review section (if required):" Signal circult(s)or a limited energy
panel,alteration or extension $40.00 -_
Minnr Labels(10) _ $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f.Each additional Inspection over
Service 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 sets of plans with application where any of the above apply. 5. Fees: 170.
Not required tot,temporary construction services. 5a.Enter total of above fees $
Surcharge(.05 X total fees) $ --��
NOTICE Subtotal $
5b.Enter 25%of line 5s for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review It required(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
TIME AFTER WORK IS COMMENCED. ❑ Trust Account#_
S
total balance Due
178. -)0
11USTSTi CNG AN' nov 4'96 --�
� CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT --
13125 SW Ha!I Blvd„ Tigard,OR 97223 (503)639-4171 RESTRICTED ENERGY
PFRMTT #: EL.R98-0022
DATE ISSUED: 02/03/98
PARCEL: 1S135AB-01003
SITE ADDRESS. . . : 10300 SW GREENBURG RD #230
SUBDIVISION. . . . : Z ON 1 NG:C--P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTN: TIG
Project Description : Comsys Z-
A. RESIDENTIAL---------
B. COMMERCIAL------------------------------------------
OMME_RCIAL—•_--•-----------------------•-------------_AUDIO & STE,'�EO. . . ! AUDIO ' STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . . LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . . MEDICAL. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : X NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE. ALARM. . . . . . : OUTDOOR LANDSC LITE:
JTHER: : : HVAC. . . . . . . . . . .. . : PROTECTIVE SIGNAL_. . :
INSTRUMENTATION. : OTHER. . :
TOTAL # OF SYSTEMS: 1
Owner: FEES -- --__------_..___
NORRIS BEGGS^& SIMPSON- _ --'-- type amoi_rnt by date recpt
10220 SW GREENBURG RD PRMT $ 40. 00 .TSD 02/03/98 98-302972
TIGARD OR 97223 SPCT $ c".'. 00 JSD 02/03/98 98-302972
I
Phone #: 452-5900
Contrarctora ----•___. .___._..___..___._ _.._._.__.___._.___.____.___
GREENLINE INC S 42. 00 TOTAL
F'0 BOX 230755
--•--•-••— REQUIRED INSPECTIONS
--------- -
TIGARD OR 97223 Ceiling Cover Low Voltage Insp
Phone #: 968—ISIS Wall Cover Elect' l Final
Reg #. . : 001030
Tnis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will by done in accordance with approved plan- This permit will expire if work is not started within 160
days of issuance, or if work is suspended for more than 190 days. A TFNTION: Oreqnn law requires you to follow rule adopted by the
Oregon Utility Notification Cente, . Ttn�p rules are set forth in OfiR 95F 001-0010 through OAR 952-001-0060. You say obtain copies of
these rules or direct questions ` a _t6-1981.
Permittee Si
T s s�r.r e d by "--" �_.r__
----..--OWNER INSTALLATION ONLY-----------------------------
[tie installation is being made on property own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
----CONTRACTOR INSTALLATION ONLY- --------- ---'--'—
S IRNA"f 1_IRE OF SUL'R. EL.EC' N: — _ DATE:
LICENSE NO
+++++-1-+•f•+•• +++++++++++++++++++-f+4•++++++++++++++++++++++++++++++++++++++++++++++. �
Call 639-4175 by 7:00 P. M. for an inspection needed the next business day
++++++++++•F++++•h++++++++++F++++++4-i•+++++++++++++++++•4F++++++++++++++++++++++++++ r
CITY OFTIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Recd By
Date Recd r:71_G 3_ 11
TIGARD OR 9'7223
Date to P.E.
Phone(503)639.4171, x304 Date to DST _
Print or Type .'.�
Inspection (503)639-4175
Fax(503)684-7297 Incomplete or illegible will not be accepted Permit a C-;
Called ae_Q73 � 3u
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development LI N C b LN l/E N I E Number of Inspections per permit allowed
Name I/ ( r yrta of business) C O MSy `� Service Included: Items Cost Sum
Addl't3s� 1D �' ShJ L KE EN l3(1 L- RI) 31 4a. Residential.per unit
City/State/ F0P T 1-H►J D �ok 17223 Each
adsq.Il.or less $110.00
Each additional 500 sq.ft.or
/ portion thereof $25.00
Commercial Residential ❑ Limited Energy Y $25.00
Each Menul'd Home or Modular
Dwelling Service or Feeder $68.00 _
2a. Contractor installation only:
(Attr. .t ipy of all current lice 9b) 4b.Services or Feeders
Llectrical Contractor C P,t f-ry L I NE N_(_ Installation,alteration,or relocation
Address F0 f3U 7-3075 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City ' K-_. State U ZIP 401 amps to 600 amps $120.00 2
Phone No. - 1`17 F 601 amps to 1000 amps $180.00 2
Job No. tijo _ Over 1000 amps or volts $340.00 2
Elec.Cunt. Lice. Nc 3E: 76 LExp.Date Reconnect only $50.00 2
`bR State CCB Reg. Nn.. ._.Exp.Date ________ 4c.Temporary Services or Feeders
COT Business Tax or Metro No.-.-E xp.Date-- Installation,olteratlon,or relocation
200 amps or less $50.00 2
Signature of Su r. Ele''n _ 201 amps to 400 amps _„ $75.00 2
g P - 401 amps to 600 amps $100.00
r JL-C-
L Over 600 amps to 1000 vo Is,
License No. 14- __- _-Exp.Datesee"b"above.
Phone No. to�"I r'1-7_�s4d.Brenzh Circuits
New,alteration oI extenalon per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name _ feeder fef
Address Each branch circuit $5.00
h)The lee 1^r branch circOts
City State u _ without purchase of
Phone No. _ _ _,___ service or feeder fee.
First branch circuit $35.00 - 2
The Installation is being made on property I own which is not Each additional branch circuit_ $5.00 2
intended for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not Included)
Owner's Signatur@ __ Each pump or irrigation circle $40.00 _ 2
Each sign or outline lighting $40.00 2
3. Plan Review secticn if required):' Signal circuits)or a limited energy pp
panel,alteration or extension ( $40.00 2
Minor Labels(10) $1��
Please check appropriate Item and enter fee in section 5B.
_4 or more residential units In one structure 4f.Each additional Inspection over /i
Service 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 oc..upmnr.y Per hour $55.00 _
as described In N.E.C.Chapter 5 In Plant _ $55.00 _
"Submit 2 note of plans with application where any of the above nppl1 5. Fees:
Not required for tempnrary construction services. 5a.Enter total of above fees $
5%Surcharge(.05 X total fees) $ c O c
N TICS. Subtotal $
5b.Enter 250%of line be for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If reguired(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
TIME AFTER WORK IS COMMENCED. ❑ Trust Account a $ Z
VTotal balance Due
10STMELCM APP Rav W9C
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
CF..RTIFICATL OF
OCCUrANCY
PE RMIT #. . . . . . . 131t{�'c�f i1�0R�,
DATI". U3SUE~Ds 04/034919
P(+F��`E.I..a 1�larA17•-0t��c'�::;
ADDRLS9. . . ; 11331710 SW F;REP-NBLJRr3 RL) It 121;'0
.Wt 1U3DIVISION. . . . sRCD LOS9)TER / CAS -1 L.UPITA ZONINOsC-k
131-OCK. . . . . . . . . . e LUT. . . . . . . . . . . . . a JURISDICTIONS '1113
CI-ASS OF WORK. sALI'
TYPE: OF USE'. . . s COM
f'YVIE OF CONSTRs2F'R
0'-' UPANC:Y GRP. -8
UCCUPANCY LOAD: f,��
NAN7 NAME. . . c U' ti v ;
omartcss Tenant impr•ovenjent -c,omt.-inp two F!•, istin,t suites into one.
4nerr __. .._...__ ._._-._ .. .... - _.. ._.._.. . - -.. ...__
+ICVLRSOCKER PROP, INC XXIV
r HORR I S BE[.)GS & 5I MPGUN
1 o obo SW GRCENbURG FAD #200
I J';{ARD OR 97.::23
onR #c
lt_1nU Pp.rIFIC
;5 NE JACKSON SCHOnL ROAD
,I t I.Sr3OR0 OF? 17124
14.)rrH Ne 693-9797
I�P'14 #. . : 2593145
Thais Ce'rtificaie grunts ccc-1.1paenc:y of the. +brave r,pfer^ended hcii '1d+ng ur pur-tau
t-t)er•Ncjf asci r:,anfir•ms that the building hai3 been inspected far r.-umpliance with
pie St ate at Oryon t3pec:ialt Cade• foi the yrcr y cac.cupanr.y, and c.tie 1.,ndrl
vefc•!r enc,ed Kee► w s i ys�as!d.
'r i i I IC.; l ld!aPEl TOR E!U I 1_�LNd 0F'F'i C I r
F'09-1 IN CONE P I CLIOL►S PLACE
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Lina 63,94175 Business Phone: 6394171
r
Date Requested: — " 3 _ _ AM — M. MST:
Location: imp.
Tenant:_ C. Suite: .?. 0 Bldg:
Contractor: (_- Phone j C' ( -C// PLM:
Owner: Phone: / ELC:
_Y�'Z( ELR: —
_ kt�rn1 _�"Q t C /J SIT:
BUILDING BLDG(con't) PLUMBINGECHANICAC ELECTRICAL SITE
Site Post/Beam PostAicam J Cover/Service Se%-cr/Storm
Footing Roof Undl l/Slab Rough-In Ceiling Water Lune
Slab Fratning Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer flood/Duct Reconnect Vault
Bsmt Damp Drywall Stonn Furnace 'Temp Service MISC.
Masonry Coiling Rain Dram A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I ICat Pump Low Volt
�1C)!pr07Approved A rrovcd_ Approved Approved
Appr/Sdwlk "1Qf1 Hued Not Approved Not Affroved Not Approved Not Approved
FINAL - FINAL—i FINAL FINAL
>��-
--= Stir
Cl('at for L--.s Reinspection fee of S y ed before next inspection O Unable to inspect
Ins{xxtor - -�—-- -- "at,.- > -- Pagc_-_--or---
_ _BUILDING PERMIT
CITYOF TIGARD - PERMIT#: SUP2002-00.133
DEVELOPMENT SERVICES DATE ISSUED: 4/16/02
13125 SW Hall Blvd.,-f;aard, OR 97223 (503) 639-4171 PARCEL: 1 S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 230 ZONING: C-P
SUBDIVISION: LINCOLN ONF/RED LOBSTER/CASA L JURISDICTION: TIG
BLOCK: LOT: _
FLUOR AREAS EXTERIOR WALLCO__ NSTRUCTION_
REISSUE: — S: E:W:
CLASS OF WORK: ALT FIkST-7 3,704 sf N. PROJECT OPENINGS?
TYPE OF USE: COM SECOND: sf -•sf g; E:
W:-
TYPE OF CONST: 5N
N,
OCCUPANCY GRP: B TOTAL AREA: 3,704.00 sf ROOF CONST: FIRE RET?
BASEMENT: sf AREA SEP. RATED:
OCCUPANCY LOAD: 37 GARAGE: sf OCCU SEP. RATED:
STOR: HT: ft REQUIRED
BSMT?: MEZZ?: REQD SETBACKS_ �_
FLOOR LOAD: psf LEFT: ft RGHT-ft REAR: ft FIR ALRM : Y HNDICP ACC:Y
DWELLING UNITS: FRNT:
BEDRMS: BATHS:
IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 7,500.00
Remarks: Tenant improvement, construct 25 feet of wall and relocate exit door.
Contractor:
Owner:
EO? LINCOLN, LLC C SCHIEWE & ASSOCIATES INC
1024 NE DAVIS ST
10260 SW GREENBURG RD PORTLAND, OR 97232
SUITE 100
P�pTL AND, OR 97223 Phone: 503-234-6617
one. Reg #: LIC 54105
REQUIRED INSPECTIONS -,
FEES -
- �—
Type By Date Amount Receipt Framing Ins I
Gyp Board Insp
PRMT CTP, 4/16/02 $120.10 27200200000 Final Inspection
5PCT CTR 4116/02 $9.61 27200200000
PLCK CTR 4/16/02 $78.07 27200200GOO
FIRE CTR 4/16/02 $48.04 27200200000
Total $255.82
This permit r issued subject to the regulations ll be done inained in the Tigard Municipal Code,ac accordance with approved plans. This permit ild expire if work is
and all other applicable law. All work
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon R
requires you to follow the rules adopted( �b87 the Oregon Utility
ain a Notification
oCenthese er. Th se rules reons torOUth rNCO by
952-001-0010 through OAR 952-001-1987.
calling (503)246-6699 or 1-800-332-2344.
Pennittee - __—
Signature:
Issued By: — -
Call 639.4175 by 7 p.m. for an inspection the next business day
Building Permit Application
Uatereceived: Permit n(, /33
City of Tigard Projecl/appl.no.: ire date:
Cirygffigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: no.:
B Receipt
Fax: (503) 598-1960 case file no.: Payment type:
Land use approval- - 1&2 family:Simple Complex:
30 11
U I &2 family dwelling or accessory U Commercial/industml J Mult-lastly J New construction U Demolition
U Additiott/alteration/replacemenl 41'enant improvenn•nt U fire sprinkler/alarm U Other:.109 SITE
INVORMATION
Gr
ewLjr, ( d, Su( � Z 3U - - - Bldg.no.:uNc N Suite no.: VSd
Job address: O 0 SW
Lot: Block: Subdivision:
IJ'ax map/tax lot/accountno,:
Project n a m�e E mm eft r arc
Description and location of work on premises/special conditions: TeNa��rt M ►tr/eMeH
Name: C-6"? OFF(cF tvfwr,Iir4TuF tsolar,
Mailing address: 102& SW C-+ree" v� A . Su; e b� I .Y 2 family duelling:
t'ily: Pb►f ar,>{ State:a/-- ZIP:97221 Valuation of work......................................
Phone5o3 892-1 SC- Fax:
E mail: No.of hedrooms/baths.................................
Owner's representative: V GL`s Ar'A t�c� Total number of floors.................................
Phone 2�4-9asc. I rix li nf:til: New dwelling area(sq.ft.) ..........................
APPLICANT Garage/carport area(sq.ft.).........................
Covered porch area(sq.ft.) .........................
Name: G15P f'r ek�t•ec'�
_ -�_ Deck area(sq.ft.)
'� sw 3rd aVeMu� 5,�; •tom 4'Oo� ........................................ ---
Mailing address: 92e
_ Stale:CF- ZIP: 9'720_ k liner(y'mmtntcwre arca(sq. ft.)......................... .
City: or't B-
: mail. ereit+lllndustriallmulti-femlly: v
lhone51
o3-z�Q 96e6 I t $ �SOO°
Valuation of work........................................
Existing bldg.area(sq.ft.) ....... ..................
Business name: C� se e• Cohn. -- New bldg.area(sq. ft.)................................ �O s F
Address: (p'Z�_ NF Dater r `1'E •
Number of stories ........................................
City: PVA State:0
type of construction....................................
Phone5o3 234-6617 Fax:_ E-mail Occupancy group(s): Existing:
CCB no.: Sg 105 New: 6
City/metro lic. no. Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 find may be required to he licensed in the
jurisdiction where work is being:performed. If the applicant is
Address: exempt from licensing,the following reason applies:
- - --
City: - _ Stt ale: 711' _
Contact person: Plan no.: -- - _—
Plwnc f;tr
MM. ilia
Name: ( )utact person: Fees duc upon application
Address: -_ Date received: _
City; EState: 7.I P: Amount received ......................................... $ _-.--
Phone: Fax: E-mail: Please refer to fee schedule.
hereby certify I have read and examined this application and the Not all jurisdictions accept credit crud+.pleax call jurisdiction for more Writ-matron
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 number _—_ - — — rxpir-
Authorized signature: _ �-�'�^__ Date: G.OZ _ Name or cer older u shown on credit card S
Print name:_ _ Cardholder signature Amount
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.
41t14f+11 f.spK'OMI
Commercial flan Submittal
Requirement Matrix
0A,of r,gal-d
TYPE OF SUBMITTAL. # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3**
1
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
I
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over-the-counter commercial tenant improvements, submit 2 sets of plans.
**"New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
I•\dats\forrns\COM-matrlx.doc 9/24/01
CITY 4F TIGARD 24-Hour --
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MS'r
C_r a BUP
Received __ _ Date Requested _� AM_ pM BUP _
Location — -l Vit. L G' lac 'A--t, 'l Suited MEC _
Contact Person �►��� Ph( ) 6?<- 7 00 10 PLM
Contractor
-- Ph( ) . -- SWR
BUILDING Tenant/Owner _- _
------ -- - _—._ ELC
Fooling ---
Foundation ELC
Ftg Drain Q 5e4�i� Z '�
Crawl Drain ELF! _
Slab Inspection Notes: SIT
Post&Beam ---- -_
Shear Anchors —-
Ext Sheath/Shear — - -
Int Sheath/Shear
Framing
Insulation - - — - -----
Drywall Nailing
Firewall -- -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof - ----
Other: _
Final ---
PASS PART FAIL
_PLUBIN
_MG - -
Post&Beam
Under Slab
Rough-In -
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
ASS PART FAIL_
ICA
os
Fos A Beam--
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL. —-- - -
ELECTRICAL -
Service _-
Rough-In
UG/Slab --- __
Low Voltage
Fire Alarm ---
Final
PASS PART FAIL LJ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE C� Please call for reinspection RE:
Fire Supply Line - -- - Unable to inspect-no access
ADA
Approach/Sidewalk Date ._�^'-0 -LI=
laa ecto�
Other: - ` �C cZ c.A.
Final DO NOT REMOVE this InRpection record from the job site.
PASS PART FAIL
CITY OF TIGARD ---- -
� PLUMBING PERMIT
DEVELOPMENT SERVICE'S PERMIT #: PLM2002-00129
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/19i02
SITE ADDRESS: 10300 SW GREENBURG RD 230 PARCEL: 1 S135AB-01003
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOV1i PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF PAIN DRAINS:
�^ SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: TI Add (1) sink, cap 1 sink, water heater with hub drain.
--- — FEES -- —
Owner: � -- —
Type By Date Amount Receipt
FOP LINCOLN, LLC PRMT C1 R 4/19/02 $72.50 27200200000
10260 SW GREENBURG RD 5PCT CTR 4/19/02 $5.80 27200200000
SUITE 100
PORTLAND, OR 97223 Total $78.30
Phone 1:
Contractor:
KSM PLUMBING INC
DBA SUNSET PLUMBING
PO BOX 23263 REQUIRED INSPECTIONS
TIGARD, OR 97281 --_---_- — —_— _---
Phone 1: 503-657-0010 Rough-in Insp
Reg #: LIC 141154 Final Inspection
PLM 34-366PB
phis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not Started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. �)
Issued B Permittee Signature. /kz///z/Y�'
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Plumbing Pennit Application
— Date received: I Q ) Permit no.:
City of Tigard Sewer permit no.: fluilding permit no.:
Address: 13125 SW liall Illvd,'figard,OR 97223 ecUa Ino.: Expire date:
Ciryoffigard phone: (503) 639-4171 I'ra J PP P
Fax: (503) 598-1960 Date issued: _ By: it Receipt no.:
Land use approval: —
u��C a "OG 13� Case file no.: Payment type:
—_
U:NmAruction
amily dvciting or accessory U Commercial/industrial 0 Multi-family U Tenant improvement
U U Addition/alteration/repi.rccment U Food service
INFORMATIONJOB SVFE
Description Qty. Vee(ea.) Total
Joh address: (0'300 3 W /^ U izC� New 1-and 2-family dwellings only:
Bldg.no.:—OIZ 1414Co/P7 I Suite no,: L 30 (includes too it.fureachutility connec(ion)
Tax map/tax lot/account no.: SFR(1)ball) _, _
Lot: _ Block: Subdivision: SFR(2)bath
Project name: SFR(3)bath _.
City/county: ZIP: Each additional bath kitchen
Description and location ofwork on premises: !7el J 15f-41k Site utilities:
Catch basin area drain _ --
Drywells/leach line/trench drain
Estdate of completion/inspection: Footing drain(no,lin.ft.)
WManufactured home utilities _
Business name: A( �-� .-f Hs. art r Manholes
Address:�,v, rev ? 31 v 3 Rain drain connector
City: �/ t' State:o ZIP: ?Z p2 / Sanitary sewer(no.lin. ft,)
E-mail-: Storm sewer(no.lin.ft.)
Plu►nb,hos.r no: Water service(no.lin. ft.)
CCB no.: S g y" j r3 Fixture or Item:
City/metro lie.no.: 3e,c( Absorption valve
_Contractor's represent^.five signatur::: Back flow prcventcr
Print name: cv
_
l /'/I/ 1 ?,ilr: -/ Backwater valve
>
Imins/lavatory
Clothes washer
Name: Dishwasher
Address: Drinking fountain(s)
City: _ Ejpectors/sum
Phone: —,Tax: I: ntuil. Expansion tank
Fixture/sewer cap
Floor drains/ or sinks/huh _
Name(print): _--------- —. Garbage disposal
Mailing address: Bose.hibbCity: Stalia!
ice makerPhone: Fax: Interceptorl reale trap _
Owner instal lation/residential maintenance only: The actual installation Primer(s)will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's A nature: Date: Sum
- Tubs/shower/shower pan
Urinal
Name: Water closet
Address: — Water heater
City: State: ZIP: Other. JI-11.1 c; t �l�
Phone: Fax:
E-mail: Total I
Minimum fee................$
Not VI)urlrfictlona ttcap credo card+,pteaee cell jurisdiction iedlc(Inn rnr m� hdcxmtlan. Notice:This permit app ieation Plan review(at _ 76) $ _-
O Visa ❑MtutlerCard expires if a permit is not obtained
(reds cud numtm: / / within 180 days after it has been State surcharge(896) ,...$ --
Ea irc� ;
_ � accepted as complete. TOTAL .......................$
Name or cerdlwlder asshown on credit tau s
----('udhdder�Iltnaturc A40-1616((�l(vCOM)
Amount
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only
FIXTLh
URES In, ,.L ual QTY eN AMOUNT (includes all plumbing fixtures In PRICE TOTA'.
--- + 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Sink for each utilit connection _
1660 Oneg1L bath _ $249.20
Tub or Tub/Shower Comb 1660 Two(2 b) ath 5350.00
Shower Only --- - --- 16 60 Three 3 bath --- $399.00
Water Closet 1660 --- — SUBTOTAL -
Urinal 16.60 - 8%STATE SURCHARGE
Dishwasher 16.60 _PLAN REVIEW 250/6 OF SUBTOTAL
Garbage Disposal
16.60 _-- _-___TOTAL _-- ---_
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink -z'- -� ,6.60 PLEASE COMPLETE:
3 - 16.60
q 16 60
Water Heater O conversion 0 like kind 1660 I(r to U _ Quantic b Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
Ca ed
-Permit----- ._
MFG Home New Water Service 46.40 Sink
MFG Homo New San!Storm Sewer 46.40 Lavatory__ —
_ 1 ub or Tub/Shower
Hose Bibs 1660 Combination _ --
Roof Drains 16.60 Shower Only _-
Drinking Fountain 16.60 Water Closet
16 60 .� Urinal ---
Other Fixtures(Specify) Dishwasher__ -..
Garbage Disposal
Laundry Room Tray
WashingMachine _
Floor Drain/Sink: 2"
Sower-1st 100' 55.00
Sewer•each additionol 100' 46.40 4"
Water Service- 1st 100' 55,00 Water Heater
Other Fixtures
Water Service-each additional 200' 4640
Storm&Rain Drain-1st 100' 55.00
Storm&Raln Drain-each additional 100' 46.40 -
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 2755 - -_
Catch Basin 16.60
Inspection of Tx1sting Plumbing or Specially 62.50
Requested Inspections erAU COMMENTS REGARDING ABOVE:
Rnin Drain,single family dwelling 6525
Grease Traps 16.60 ---- ---
QUANTITY TOTAL -
Isonmtrlc or riser diagram Is required if
t]uanllty Total Is >A _ ! __
-- "SUBTOTAL - -
8%STATE SURCHARGE - --
"PLAN REVIEW 25%OF SUBTOTAL
Re aired onl II firlure t total Is r fI
—_9
_U_
TOTAL
TOTAI_ $:
.Minlmum permit fee it E72 50-8%state surcharge,except Residential Backflow
Prevrntion Device,which Is$36 zb+8%state surcharge
**All New Commercial Buildings require 2 sets of plans with Isometric or riser
1 diagram for plan review.
Of-100orms\plm-fees.doc 12/26/01
ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT#: ELC2002-00177
DEVELOPMENT SERVICES DATE ISSUED: 4/19/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 230
SUBDIVISION: LINCOLN UNE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT : JURISDICTION: TIG
Prosect Description: Tenant Improvement
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS _ 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 HM/SVC/ FDR: 601+amps - 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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+ amn/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS: _ CLASS AREA/SPEC OCC:
Owner: Contractor:
EOP LINCOLN, LLC WILLAMETTE ELECTRIC INC
10260 SW GREENBURG RD PO BOX 230547
SUITE 100 TIGARD, OR 97281
PORTLAND, OR 97223
Phone: Phone: 624-3631
[leg #: LIC: 75059
SUP 1965S
ELF 34-283C
FEES Required Inspections
Type By Date Arneunt Receipt rElect'l
lect's Service
PRMT CTR 4/19i92 $60.15 2720020000( Final
5PCI- CTR 4/19/02 $4.82 27200201100(
Total $64.97
This Permit is issued subject to the regulation,,,contained in the Tigard Municipal Code,State of OR. Specially 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 o`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 952-001-0010 through OAR o 2-001-0080. You may obtain copies of these nudes or direct questions to
1
Permit Signature: Issued By:
OWNER INSTALLATION ONLY
1 he installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _. _ DATE.
CONTRACTOR INSTALLATION ONLY
SIGNA1 URE OF SUPR ELEC'N: �.� _ DATE-----------
LICENSE
ATE -_-_ __--
LICENSE NO --__---
Call 639-4175 by 7:00pm for an Inspection the next business day
Electrical Pcr[nitApplication
Daterecelved: q-1 ?-,OZ- Pcrtnit tlgl� _ 7
City of Tigard Project/appl.no.: — Expire date:
coyo,Tigard Address: 13125 SIN IfallBlvd,Tigard.OR 91223 Dale issued: Ity: Receiptno.:
Phone: (503) 639-4171 --
Fax: (503) 598-1960 Gsefileno.: 1'aymcnitypc:
Lilltd USC Atli iOVAl:
T-
®I OF
U I c'.t.'l family dwelling ur accessory U Commercial/industrial U Will-family U Tenant improvement
U Ncw construction U Addition/alicialioit/rcplaccntcnt U Other: _ U partial
!ob address: /r 900 sw /C, ' 2I Bldg.no.: I ISui(e no.: 27C ITax map/lax lot/account no.: —
LUI: f31a:k: Sul vision:
Project nante: �'m r4Px I Description and location of work on premises: j� T I,. ,Q r.'n/
Estimated date of coinpletionhosliectinn:
Job nos Z Z t< t vee nLx
mc: Description �jt . (ea halal no.ln+
Business na
W, p ) �`s' - Nen reshknlial-single 0r muld family per
Address: 4) A 2 T O 4 7- _ dnellinp unlC h little,;attached garage.
City: 11CArlto State:9-r& I Zip: 9;r ta- I — %erviceIncluded:
Phone: p L m.t_3 - , 11-ax: 6? •2 ;?� E-mail: 1000 aq ft.or less -- 4 --
CCB no.: 7 fo �f� Elec.bus.tic.no; 3 [inch additional W)s .n.or portion thereof
7- ` Limited ener ,residential _ 2
Cilytippim Ilc.no.: /5-y L Unilledenergy,non-residential _ 2
di Z_ Each manufactured home or modular dwelling,
Signature of su rvis eleculclen(required) Date L4UI
and/or feeder 2
Sup.elect.name(print): C),N ,. f;, License no /qG t- or feeders-Installation,
n or relocallon:
f t a or leas 2 _
Name(print): s to 400 amps _ 2
s to 600 amps 2Mailing address: amps to 1000 amps _ __ 2
City: _ Stale: ZIP: Over 1000 snips at volts __ 2
mlone: ---Tr-ax, E-mail: Recnnneclon.1y �Y- _ I
Owner installation:'11se installation is being made on property I own Temporary aervire+or feedris-
which is not intended for sale,lease,rent,or exchange according to hndall20on,alteration,orrelocation:
200 amps or less 2
ORS 447,455,479,670,701 _ —
201 amps l0 400 amps 2
Owner's si nature: Dale: 401 to 600 ams 2
Branch circuits-nen,alteration,
Naltte: or extension per panel:
A. Fee for branch circuits Willi purchase of
Address: service or feeder fee,each branch circuit 2
City: - Stale: ?,Ip: B. ree for branch circuits without purchase
Fax: 1;-mail of L:�
ph
-- -- of service or feeder fee,first branch circuit: �_ 1� 2 one:
"ch additional branchhiircuiC
ITT Misc.(Serslce or feeder not Included):
O Servloe over225 amps-commercial U Health-care facility Each pump or irrigation circle 2
•Service over 310 amps talingof 1&2 LI livAttdouslwation Eschsign oroutline liglding
fandlydwellings U Iluilding over I0AX)square feet four or Signal circull(s)or a limited energy panel,
O System over 600 votes nominal more residential units in one etruclure alleralion,or extension• 2
O Building over IN cc stories U Feeders,400 amps or more •DescriDon:
O Occupant 10241 over 99 persons U Manufactured structures or RV park fish additional Inspection over life alloy►able In any of the show
U Egress/hghlingplao U Otter' erinspection
Submit_-_.Bels of pians with any of(he above. Investigation fee
'life al►ove are not applicable to temporary construction service. Other
- -- — permit fee.....................
Not all judedictims acrert rm!il roils,pleau call iuriuhction fa rrxxe Information Notice:11ris permit npplication
❑Vin U Mastercard expires if a permit is nol obtnined flan review(al %) 5
credit cod namhn: . _.. _ -L_. .__ widiin 180 days after it has Been Stale surcharge(8%) ....$ -
tfrpbe' accepted as complete. TOTAI, .......................S
Nims a7cu�rilder u nvn one it e
l:rdhdJer sl`nature Amount 4Ir!JbIS(6I0f!IfOM)
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: R — — --_
lteslrlcted Energy Fee...................................................... X75.00
Number of inspections par Cermlt allowed (FOR ALL SYSTEMS)
Service Included: Items Cost Total + Check Type of Work Involved.
Residential•per unit
1000 sq.0 or less _--- $145.15 4 [__j Audio and Stereo Systems
Each additional 500 sq.It or
portion Iheroof - $33.40 1 ❑ Burglar Alarm
I Imiled Energy $75.00
Each Manurd Ilume or 11IWular Garage Door Opener'
Dwelling Service or reader _ _ $9090 , 2
Services or Feeders n Healing,Ventilation and Air Conditioning Syt III'
Installation.allerallon,or relocation
200 amps or less _ 500.30 _ Vacuum Systems'
201 amps to 400 amps _ $10685_ 2
401 amps 10 600 all 9s $160.60 — 2 Other
C�
60 amps l0 1000 am,u 1240.60� 2
over 1000 amps or volts $45465 2 ------ - - - ------ --- -Reconnect only $66.05 -- 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,allera!k)n,or relocation
200 amps or less $66.05 2 Fee for each III.................................................... .... $15.00
701 amps to 400 amps $100.30 - 2 (SEE OAR 910-260-260)
4011 amps to 600 amps _-_ $13375_ l
oChock Type of Work involved:
over 600 amps to 1000 volts,
see"b"above.
nranch Circuits
L� Audio adxl Stereo Systems
IJew,alleralkm or exlonsioo per panel n Boller Controls
n)l ler lee for branch circuils
with purchase of service or
feeder fee. Clock Systems
tach branch circuit $6.66 2
Ill 1 he lee for brarxar circuils ---T yJ- - Dala Teleconununir:alion htslalla.:orl
wffhouf purchase of service
orfeeder fee. Fire Alnnn Installation
I Irtrt branch circull - $4605
Caclr addllional branch circuil - $6,65 1IVAC
Miscellaneous
(Service or feeder not Included) Instrumentation
Cecil pump or Irrigation circle $5340
Each sign or otilllne light1ty _ $5.340 — Ej Interconn and Paging Systems
Signal eireull(s)or a HiOnd enor:v
panel,alleratlun or extension __ $76.00—
Minor Labels(10) _ $125.00 Landscape hrigallon Conliol'
Each additional Inspection over L� Medical
the allowable In any of the above
Pur Inspection _ $62.50 -- Nurse Calls
Per hrx•r _ $62.50
In Plaol `—_ $13.75
Outdoor Landscape Lighting'
Fees:
Protective Signaling
Enter total of above fees $
0%Slate Surcharge $
n Other---- ------ -- - ---
_ Number of Systems
25%Plan Review Fee
See'Plan Review"sectirnl of $ No Incenses are required. Licenses are required for all other InsLdlallons
had d appli anon
Total Balprice Due $ _ Fees: J —
r Enter total of above fees -
L� Trust Account q__- -_-- '---- '- I -
J 9%State Surcharge
Tofal Balance Due
i:Mspilfunnskic-fees.duc IOfi9'00
CITY OF TIGARD ELECTRICAL PERMIT
T PERMIT#: ELC2002-00192
DEVELOPMENT SERVICES DATE ISSUED: 5/1/02
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 230
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Install 6 branch circuits and low voltage for Data Telecommunication.
_ RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS _ MISCELLANEOUS_
1000 SF OR LESS: _ 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 491 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 5 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 AMERICAN ELECTRICAL SERVICE
10260 SW GREENBURG RD PO BOX 1057
SUITE 100 SHERWOOD, OR 97140
PORTLAND, OR 97223
Phone: Phone: 204-9864 PAGE
Reg #: LIC 00101587
SUP 4106S
ELE 36-59C
w FEES v� Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 5/1/02 $155.10 2720020000( Wall Cover
Rough-in
5PCT CTP, 5/1/02 $12.41 2720020000( Rough-in
Total $167.51 Elect'I 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 pe,mit will expire If work is not started within 180 days of issuance, or if
work Is suspended for mons 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 552-U01-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to
Pormit Signature: Issued By:
_.,
OWNER INSTALLATION ONLY
The installation is being made on property I own whirl is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: ___ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNA rURE OF SUPR. ELEC'N: _ _�_— DATE:
LICENSE NO: r' C- — _ —
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
— —
"Dateeceived: 6"2- Permit no.:7. .�G
cit. of Tigard Project/appl.no.: Expire dale:
011 u/7igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Byv Receipt no.:
Phone: (503) 639-4171
7 Fax: (503) 598-1960 Case file no.: Payment type:
Jt ' Land use approval: _--
'FYPF OF PERMIT
U I &2 family dwelling or accessory U Commercial/industrial J Multi-family Tenant improvement
L!New construction U Addition/alterafton/rcpt arcnlcrll U Other: _ U Partial
J01041-F.
��h address: /02000J Bldg.no.: Suite no.:dTax map/tax lot/accaunt no.:
Lot: B1ocl: Subdivision:
Project name: #?19/IJ6 f1 Description and location of work on premises:
istitinmled dale of ronlplction/imprrtion:
Pec %tax
Job no: _ Description 0". (ea.) I(11al no.Imp
BUSlne89 nAli1C: Ness rrsish•ntlal sinRkormulri-family Irr•r
Address: 45; R d"elling unit.lot iu&%atiacheil Laragr.
City: h y
State:�r ZIP: Servicelnciuded:
Phone: Fax:53d- E-mail:
I INTO sy.ft.or Icss _ 4
Each additional-SIN1 sy.ft.or portion thereof
CCB no.: u!5Elec.bus.lic.no: jG- Limited energy,residential 2
Limitedener y,00n-residential _ 2
City/metro tic.no.: —
,ry �• Each manufactured home or modular dwelling
[)file service andtor feeder 2
Si nature n skirvi.' e1 tricion(re wired) Service sorfeedets–Installdlon,
Sul, Ayer narnctpriit) C-7 Pi.'l ' License no: IIt-rationorrelocatlon:
200 amps or less 2
201 amps to 4110 amps _ 2
Name(print): 401 amps to 6(10 amps 2
Mailing address: 601 amps to Iow amps 2
City: _ Stale: l.il': over 1000 amps or volts 2
Phone: Fax: E-mail:
Reconnect onl I
Temporary services or feeder
owner installation:The installation is being made on property I own Installation.alleraIon,orreiocation:
which is not intended for sale,lease,rent,or exchange according to 20(1 Imps or less J _ 2
URS 447,455,479,670,701. 201 amps 0,100 amps -- _ 2
Owner's si nature: nate: 401 l•.,6110nm s 2
Branch clrcults-new,alteration,
or extension per panel:
Name: _ A. I'ce for hrnnch circuits with purchase of
Address:
service or feeder fee,each branch circuit 2
City: State: ZIP: B Fee for branch circuits without purchase �
of service or feeder fee,first branch circuit: 2
Phone: Far- F.-nt:nil: Eachadditionnlbranch circuit
. 1
Misc.(Service or feeder not Included):
Fach pum or iT alion circle 2
U Service over 225 amps couunctr;; U Health-care facility F.ach signor outline lighting ::J=2 UService over 320amps-rating of 1&2 Ullazardoushxation Signalcircuit(s►orallmitedenergypancl.
familydwellings U Building over 100111 square feet four or acircur(%)orextensi limited
U system over 600 volts nominal more residential units in one structure
O Building over three stories U Feeders,AM amps or more s 1 k scr t,tion:
C1 occupant load over 99 persons U Manufactured structures or Rv park Each additional inspectloe over the allowable in any of the above
U F.gress/lightingPlan U Other. _ Perinspection F _
submit sets of plane with any of the above. investigation fee _
The above are not applicable to temporary condruction service. Other
F'etYtrit fee.....................$ S S. zy
Not all)wtsdicuons weep,cfedit cards,please call Jurisdiction for more Information. Notice:This permit application Plan review(at _ %) $
U Visa U MasterCard expires il'a permit is not obtained
_ __ within IRO days eller it has been Slate surcharge(89h) ... $ .
Credit card aumher ---- Expires
accepted as complete. 'TOTAL .......................$
Name of ca oder es shown on credit erd –—
c'uslholder signature6�r10I
mmOunl 440-461S( COM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT Fl=- E-.;:
-- TYPE OF WORK INVOLVED - RESIDENTIAL ONLY _
--- ..... $75.00
Complete Fee Schedule Below: Restricted Energy Fee.................................................
Number of Inspections or ermit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Tota; I Check Type of Work Involved:
Residential-per unit $145 15 4 Audio and Stereo Systems'
1000 sq.ft.or less -- -
Fach additional 500 sq ft or 1 O
portion thereof __� $33.40 __ 13urgiar Alarm
Limited Energy _-__ $75.00
Each Manufd Home or Modular Garage Door Opener"
Dwelling Service or Feeder _ $901 1 _ _ 2
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation $80.30
200 amps or less Vacuum Systems'
201 amps to 400 amps $106.85
401 amps U 600 amps $16060 2
Got amps to 1000 amps $240.60 2 Other
f
Over 1000 amps or volts $454.65 _.
Reconnect only $66.85 2
--' TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Temporary Services or Feeders Fee for each system.......................... .................... .......... !75.00
Installation,alteration,or relocation $66.85 2 (SEE OAR 916-260 260)
200 amps or less 1000
201 amps to 400 amps $ 00.3 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Ove,600 amps to 1000 volts, Audio and Stereo Systems
see"b"above.
Branch Circuit,; Boiler Controls
New,alteration or extension per panel
a),The fee for branch circuits Clock Systems
with purchase of service or
feeder fee.
Each branch circuit $G 65 Data Telecommunication Installation
Lly
b)1 he fee for branch circuits
without purchase of service Fire Alarm Installation
or feeder lee. / G �
First branch circuit $46.85 �fC' 0 5 HVAC
Each additional branch circuit $6.65
Miscellaneous Instrumentation
(Service or feeder not included) $53,40
Each pump or Irrigation circle $53.40 Intercom and Paging Systems
Each sign or outline lighting _ —
Signal circull(s)or a limited energy Landscape Irrigation Co itrol'
panel,alteration or extension $75.00 _ -
Minor Labels(10) _ $125.00
Medical
Each additional inspection over
the allowable In any of the above $6250 Nurse Calls
Per inspection — -
Per hour $02.50
$73.75 Outdoor Landscape Lighting'
In Plant
Fees: Protective Signaling
Enter total of above fees $ % ,,�JJC)�� Other
n%State Surcharge $_(/�L Number of Systems
25%Plan Review ree $ ' No licenses are required Licenses are required for all other installations
See"Plan Review"section on
front of application - - Fees:
Total Balance Due $ - ,I Enter total of above fees
Trust Account p _ _ 8°,'.State Surcharge --
---- -_— — — Total Balance Due
All New Commercial Buildings require 2 sets of plans. �
i:\dsts\forms\e1c-fees.doc 08/30/01
CITYOF TIOARD CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: BUP2002-00133
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 416/201;2PARCEL: 1S135AB-01003
ZONING: C-P
JURISDICTION: TIG
SITE ADDRESS: 10300 SW GRF_ENBURG RD 230
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L
BLOCK: LOT:
CLASS OF WORK: ALT
TYPE OF USE: COM
TYPE OF CONSTR: 5N
OCCUPANCY GRP: B
OCCUPANCY LOAD: 37
TENANT NAME: EMMETT TRAVEL
REMARKS: Tenant improvement, construct 25 feet of wall and relocate exit door
Owner:
EOP LINCOLN, LLC
10260 SW GR EENBURG RD
SUITE 100
PORTLAND, OR 972.23
Phone:
Contractor:
_ C SCHIEWE & ASSOCIATES INC
1024 NE DAVIS ST
PORTLAND, OR 97232
Phone: 503-2346617
Reg #: LIC 54105
This Certificate issued 51101211112 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 Specialty Codes for the group, occupancy, and use under whirh the
referenged,petmit was issue. .�7
BUILDI I ECTOR BUIL IN O IC A
POs'r IN CONSPICUOUS PLACE
CITY OF TIG. RD 24-Hour
BUILDING inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST ��
2 BUPA 43
Received __- _Da/te\Reques ed ✓�%' AM PM SUP
1-ocation --- �w P Suit— e �C� MEC --�.---
Contact Persor Ph `
---- � � .— PLM
Cont Ph( ) SWRgo----
TenanVOwner -- _- ELC
Foundation ELC - --
Ftg Drain Access:
ELR
Crawl Drain _
Slab I Inspec!ion Notes; ,� 1` sJ SIT
Post&Beam _
Shear Anchors -
Ext Sheath/Shear lit-�D I-J
Int Sheath/Shear -
Framing
Insulation
Drywall Nailing - --------- _
Firewall g �—
Fire SprinklAr
Fire Alarm
Susp'd Ceiling - -- - ----- -�� --- —
Roof
PART FAIL
-
PINAD
Post&Beam -
Under Slab
Rough-In C—
Water Service - -- ---
Sanitary Sewer
Rain Drains - ----
Catch Basin/Manhole
Storm Drain -- — —
Shower Pan
Other: ----- — —
Final
PASS PART FAIL - —- -
MECHANICAL
Post 8 Beam -��-
Rough-In -- --- —
Gas Line
Smoke Dampers
Final
PASS 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 Inspect-no access
Fire Supply Line
ADA r
Approach/Sidewalk Data I_ !.��- Inspector -Ext
Other:
Final DO NOT REMOVE this Inspoction record from the Job site.
PASS PART FAIL