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10300 SW GREENBURG ROAD STE 271-1 1 i 8 �Ty1 n v N rr 1 T, i' r i` 10300 SW GREENBURG 111) 271 CITYOF TIGARD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERM!T#: BUP2.001-00069 13125 SVti{call Blvd., Tigard, OR 97223 (503)639ADATE ISSUED: 02/23/2001 PARCEL: 1 S135AB-01003 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 10300 SW GRE.ENBURG RD 271 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: 25 TENANT NAME: REMARKS: Commercial TI Owner: KNICKERBOCKER PROP, INC XXIV BY NORRIS, BEGGS + SIMPSON 10300 SW GREENBURG RD STE 200 PORTLAND, OR 97223 Phone: Contractor: C SCHIEWE & ASSOCIATES INC 1024 NE DAMS ST PORTLAND, CR 97232 Phone: 503-234-6617 Reg #: LIC 54105 This Certificate issued 04/111/2001 grants occupancy of the above referenced :.'-Ading or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occt,,?ncy, and use under which the referenced permit was issued. BUILDING INSPECTOR _ BUILDINP OFFICIAL T +✓ POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639.4175 Business Line: 639-4171 MST _ Date --- Requested---_ AM-- PM a -- BLD Location lG' � U -_1� Suite MEC Contact Person - ( Ph PLNI Contractor Ph _ SWR 1 IG Tenant/Owner 7 ] �`f'� _ EL'S Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain - --�` -- Crawl Drain inspection Notes: SGN Slab -._ __.._ SIT Post&Beam -------- -- - _ Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -----------__-_-------_--...-_ _-..__-_� ------.._.----_-___ - Roof - ----- --- Mrs -------------- S3 PART FAIL -------- - - - - - --- __-- PLU1MBIING - - Post& Beam --_- - —-- - --- - - - -- Under Slab TopOut --_ --�------ ----- __ _ ....---------____.--------- Water Service Sanitary Sewer Rain Drains Final ----- --- ------- PASS PART FAIL MECHANICAL Post& Beam ----------- --.___.. -_ _ Rough In Gas Line ----- -------- — -- -- --- - Smoke Dampers Final PASS PAR1 FAIL ELECTRICAL - ------..__.------__.---._. ._ __-- Service Rough In - UG/Slab Low Voltage -- Fire Alarm _-....- - -- -- ---- - Final PASS PART FAILSITE Backfill/Grading --- -- —' -- Sanitary Sewer Storm Drain i ]Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin i ]Please call for reinspection RE: .__ ( ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Date �.- inspector_ l" _ _ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 21-Dour Inspection Line: 639-4175 Business Line: 639-4171 - SUP —___—Date Requested Z Z _AM_— _PM --_ BLD Location Suite --?- 71 MEC -- Contact Person _.— _ _ Ph Z - G PI-M — Contractor -1 1 �.---�..---- --- Ph ----- _ SWR IBUILDING _ 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 FAIL. --------- PLUMBING Post&Beam Under Slab Top Out Water Service s Sanitary Sewer Rain Drains Sty- 4Z de2 Final PASS PAR) FAIL _ MECHANICAL Post& Beam Rough In Gas Line - Smoke Dampers Final - PASS PART FAIL yr NIDE' Rough In `- C�✓H _.__. UG/Slab Low Voltage Fire Alarm H PAS PART FAIL Backfill/Grading ---- - -- - -- Sanitary Sewer Storm Drain f I Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I ] Please cell fnr reinspection RE _-_ I Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk DateG Inspector Ext Other17-_ZZ -- Final PASS PART FAIL. oo Mo,r REMOVE this inspection record from the job site. CITY OF TIGARD -- _ BUILDING PERMIT , PERMIT#: 1301'2001-2001- 00069 DEVELOPMENT SERVICES DATE ISSUED: 2/23/01 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003 SITE ADDRESS: 10300 SW GREENBURG RD 271 SUBDIVISION: LIN COLN ONE/RED LOBSTER,/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 Or ENINGS? TYPE OF CONST: 2FR sf N: S:J E: W:� OCCUPANCY GRP: B TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 25 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCC(I SEP. RATED: BSMT?: MEZZ?: _ READ SETBACKS _ REQUIRED_ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING: VALUE: $ 15,000.00 Remarks: Commercial TI Owner: Contractor: KNICKERBOCKER PROP, INC XXIV C SCHIEWE & ASSOCIATES INC BY NORRIS, BEGGS + SIMPSON 1024 NE DAVIS ST 10300 SW GREENBURG RD STE 200 PORTLAND, OR 97232 Pq�one:TLAND, OR 97223 Phone: 503-234-6617 Reg #: LIC 54105 _FEES _ REQUIRED INSPECTIONS__.____________.__ Type By Date Amount Receipt Mechanical Permit Require Pl_CK CTR 2/20/01 $121.75 27200100000 Electrical Permit Required Sprinkler Permit Required FIRE CTR 2/20/01 $74.92 27200100000 Framing Insp PRMT CTR 2/23/01 $187.30 27200100000 Gyp Board Insp 5PCT CTR 2/23/01 $14.98 27200100000 Susp Ceiing Insp Final Inspection Total $398.95 This permit is issued subject to the regulations contained in the Tigard Municipal Cade, 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 suSoenc+ed 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 rm itee Signature: Issued By: —_,_—_�_--- Call 639-4175 by 7 p.m. for an inspection the next business day Building Permit Applicatie:: Date received: Permit no.:,66/�elc�d�/'uO��p 9 City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of Tigard Project/nppl.no.: Expire date: Phone: (503) 639-4171 Date issued: By: eceipl no.. Fax: (503)598-1960 Case file no.: Payment type: 1 Land use approval: I&2 family:Simple Complex: ? TYPE OF PiRMIT Al U 1 &2 fam'.ly dwelling or accessory U Commercial/industnal U Multi-family `New construction I]Demolition U All(lition/alteration/replacement �I<Tcnant improvement U Fire sflrinkler/alarm U Other: 1, li SITE INFORMATION Jobaddress: 10WO SW C3reievt u�v��, POr awf, OF,. 97223 [ildE.no.:4Ne , Suite no.: 271 _Lot: Block: SubdivisltSn — Tax map/tax lot/account no.: Projectname: (Le ocattol„ o Q�ewr itrilr wad a* _gt,; e 'Z71 '56D Ho MAMIo_TT" SING itU- RELOCATION REth►•EEN -Cvl Description and location of work on prcmises/spccial� onditions:_� _ * 7f 2_70 AND 2'1 1 AT CNE LIN roc" - L/NCoL/u CC-A3-r=J FOR SPECIAL INFORAIATION; . 1 Name: S 1e Ar' t tom' 1111 Mailing a dress: 1024P6 SW Cbrerem rj Jv;+9 100 1 &:2 family dnclling: City: Ov State: ZIP: d)7T'L% Valuation of work........................................ `h Phonc:5151, ft?--WFax: &92.2510 E-mail: No.of bedrooms/baths................................. Owner's representative: R , t3 uv' GAP AWI1TflrrI' Total number of flours................................. I'hllnc: 2'Z r}.'7G5�, I,tx: 1; nihil New dwelling area(sq. ft.) .......................... _. Garage/carport area(sq.ft.) _ Name: C" Arc.t�-(eci-j INc Covered porch area(sq.ft.) ......................... . Mailing address: 920 S 3' rwt�v i Deck area(sq.ft.)........................................ -- --- City: Portia" State:OF- ZIP:aj7�O Other structure arca(s t.)......................... _ — ' omnterc Cial/industrial/multi-famlly. Phonc:50?, 2?• -`�Fa I ax: 299•fo277 l:-mail: eo 1 1 Valuation of work........................................ $15 000 Existing bldg.area(sq.ft.) ......................... Business name: c. -c_1t t ewe Co",.rt • 27D0 Address: 1074 Ot Davi—f St - New bldg. rea(sq.ft.)................................ ---- Cil of a� State:0 of ZIP: 232 Number of stories........................................ 5� ' eve y' Type of construction Phone:901 L •b61 Fax: E-mail: CCB no.: 5 ------ Occupancy group(s): Existing: 5 10 New: City/metro lic.no.: Notice:All contractors and subcont,actors are required to be A1RCIIITEt`T1DEsWNl171R licensed with the Oregon Construction Contractors Board under Name:^XAME A f APP LI `AOI provisions of ORS 701 and may be required to be licensed in the Address: i 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: I E-mail: - — x Name.: - Cotact pe nrson: Fees due ulymn application ........................... 4 Address: _- Date received: _ City: _ State ZIP: Amount received ............. ........................... $�— Phone: —i Fax: E-mail: Please refer to fee schedule. — I hereby certify I have read and examined this application and the Not all Jurisdictions.Keil credit cards,ptew caul jttdediction for more inrom aeon attached checklist. All provisions of laws and ordinances governing this U visa U MasterCard work will he complied with,whether specified herein or not. Credit card number: _ Ea i _ _ 2.20.o( ___ r Authorized signature: f''�•� Date: Name of cardholder a Shawn an credit c Print name: �'a F• �►"' cardhrdder n6rtature — $ Atnouat Notice:This permit applicntion expires if a permit is not obtained within 190 days after it has been accepted as complete. 4104617(tslaoaconmt ?y ��` n CITY OF T I ''A R® ELECTRICAL. ,'E RMIT \ PERMIT#: EL.C2001-00122 DEVELOPMENT SERVICES DATE ISSUED: 3/2/01 13125 SW Hall Blvd., Tiqard, OP 97223 (503) 639-4171 PARCEL.: 1S135AB-01003 SITE ADDRESS: 10300 SW GREENBURG RD 271 SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P BLOCK: LOT : JURISDICTION: TIG Proiect 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+amp:. 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ------ _�._. Af)D'L INSPECtIONS _ 0 2.00 amp: W/SERVICE OR FEFDER: _PER INSPECTION: 201 - 400 amp: 1 st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'1_ BRNCH CIRC: 2 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: Contractir: KNICKERBOCKER PROP, INC XXIV WILLAMETTE ELECTRIC INC BY NORRIS, BEGGS + SIMPSON PO BOX 230547 10300 SW GREENBURG RD STE 200 TIGARD, OR 97281 PORTLAND, OR 972.23 Phone: Phone: 624-3631 Reg #. LIC 75059 SUP 1965S ELE 34-283C FEES_ _ Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT CTR 3/2/01 $60.15 2720010000( Wall Cover 5PCT CTR 3/2./01 $4.81 272.0010000( Elect'I Final -------- Total -__--$64.96 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 work is suspended for more than 180 days ATTENTION Oregon law requires you,o 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) 246-1987 PERMITTEE'S SiGNH eJRE ISSUED BY: — _ OWNER INSTALLATION ONLY The installation is being made on pro?erty I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: — __ __ DATE:___ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _._ —_ DATE:— _ LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day Electrical Perinit Application Date received: Permitno.:96,2uy_c o Z City of Tigard Pro.;ect/appl.no.: Expire date: CityoJ'liKard Address: 13125 SW Hall Blvd,Tigard,Olt 97223 Date issued: By: I Receipt no,: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: — -_ 1 ' U I do 2 family dwelling or accessory O Commercial/industrial U Multi-family Tenant improvement U New construction U Addi(ion/altetation/replacement U Other: U Partial 11 PITE INFORMATION Job address: Ta • /I• 111dg.nu,: tiuitc nt;.:� / x map/tax lot/account no.: Lot: I Block: Subdivisio : Project came: S Description and location of work on premises: P, ,— t � Estimated date of completion/inspcc(ion: CONTRAC11 1 t-lY 11fr.x Job no: s Uescriptlon Qt). (ra.) 'rola! no.lns Business name: NewresldenlGl s!ngkor multi family per Address: dwelling unit.Inclndesatta(lredgarAge. City: T' jStatejCrj ZIP: ld/ Servicehicluderl: Fax: t Email: 1000 sq ft.or less _ _ ---- --_-- 4 - PIIonC: t N `3(, t 93,4' Each additional 5(N)sq.ft.or portion(hereof CCD no.: 3,)% S-y Elec,bus.lie.no: 3 -2t? s- Umited energy,residential _ 2 City/metro lic,no.: y-c1 Limited energy,non-residential _ 2 -- 2 _Z(' Each manufactured home or modular dwelling - Si n lure of au rvls n e ectricien(re tired) Dole Service and/or feeder - /y[ C- S Servlcesarteeden-InatallaUon, Sup.elect.name(print) �1,, .,, f -!' I.Ir ensr nn allentlon or relocation: 1 1 2W amps or less 2 201 amps to 400 amps 2 Name(print): _ ----- 401 amps to 600 amps - — 2 Mailing address: 601 amps to loon amps — - 2 City: Stale: ZIP: Over 1000 amps or volts 2 Phone: Fax: E-mail: Reconnect onlyI Temporary services Owner installation:11he installation is being made on property 1 own or locales- Installallan,alleratinlion,or rcloca(lon: which is not intended for sale,lease,rent,or exchange according to 2W snips or less ORS 447,455,479,670,701. 201 amps to 400 amps _ ! Owner's si,nature: _ Date: 401 to 600 ams 2 Branch circuit-new,alteration. or extension per panels Name: _. A. Pee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 Stele: ZIP: B cc Cor branch circuits without purchase City: -- of service or feeder fee,first branch circuit: 7V 2 Phone: l'nx: I' 11�url Each additional branch circuit: Misc.(Service or feeder not Included): 13 Service over 225amps-ronmrercinl Ullcalthcarefac+lt) Each pump orirrigation circle _ U Service over 320 amps-sling of 1&2 U Hazardous location Each sign or outline lighting — 2 family dwellings U Iluil ling over 10,000 square feet four or Signal circu)l;s)or a limited energy panel, U System over 600 volts nominal more-esidential units in one structure alteration,or extension* 2 U Building over three stories U Yeeden.t(10 amps or more 'Description: _._ --. — U occupsm load over 99 persons U Manufactured structures or RV pnrk Fach additional inspection over the allowable in any of lite above: U E:gressnightingp,en U Other: -__ - Perins ction Submit____sets of plans with any of the alcove- Investigation fee — lite above are not applicable to temporary construction service, Other — _ Permit fee..... ...............$ FO.edio jurisdictions reap crrdir cod,.tdeafe can)wtsdtcuoa for more inrormuion. Notice:This permit application plan review(at 96) $ Visa U MuterC'ard expires if a panni(is not obtained I within I BG days alter it has been State surcharge(89'0) .... _`-j crdnumler TOTAI. .... !a t=xp rci accepted as complete. ............ .... --Name of-`cer3hol�er u shown on etatil e�-- � s -�- Crrdhdder tianuure Amount 4404615(NO 70M) Electrical Pet mit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY P Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service Included: Items Cost Total Check Type of Work Inv 'ved: Residential-per unit 1000 sq.ft.or less $145 15 4 ❑ Audio and Stereo Systems Each additional 500 sq fl.or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 _ Each Manufd Home or Modular F-1Dwelling Service or Feeder $90.90 _ 2 Garage Door Opener' Services or Feeders ❑ Healing,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $8030 2 ❑ 201 amps to 400 amps _ $106.85 W 2 Vacuum Systems' 401 amps to 600 amps $160.60 2 ❑ 601 amps to 1000 amps _ $2.40.60 2 Other Over 1000 amps or volts ___ $454.65 _ 2 -----------_— _ Reconnect only _ $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation 200 amps or less $66.85 2 Fee for each system.......................................................... $75.00 201 amps to 400 amps $100.30 2 (SEE OAR 918-260-260) 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: see"b"above. ❑ Audio and Stereo Systems Branch Circuits New,allerallon or extension per panel ❑ a)The fee for branch circuits Boiler Controls with purchase of service or feeder fee. ❑ Clock Systems Each branch circuit _ $6.65 2 b)The le,for branch chcuils ❑ Data Telecommunication Installation without purchase of service or feeder fee. E j Fire.Alarm Installation First branch circuit _ $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous (Service or feeder not Included) ❑ Instrumentation Each pump or Irrigation cirrae $53.40 Each si0n or outline lighting $5340 Signal circuit(s)or a limited c imt» ❑ Intercom and Paging Systems panel,alteration or extensi m $75.00 Minor Labels(10) $125.00 ❑ Landscape Irrigation Control' Each additional Inupectlon over ❑ Medical the allowable In any of the above Per Inspection $62.50 Per hour _ $62.50 ❑ Nurse Calls In Plant $73.75 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Euler total of above fees $ 8%Stale Surcharge $ ❑ Other 25%Plan Review Fee —_ Number of Systems See'Plan Review'section on $ front of apphz alion, _ ' No licenses are required License,are required for all other h s,allallons Total Balance Due $ Fees: ❑ Tr usl Account q _ Enter total of above fees CIA Slate Surcharge Total Balance Due $_ i'fists\formskic-fecs.doc 10/09/00