10300 SW GREENBURG ROAD STE 450 I
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10300 SW G reen bu rg Rd #450
CITY OF T I`V A R D _CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: BUP2002-00488
13125 SW Hall Blvd., Tigard, 13 97223 (503)639-417,1 DATE ISSUED: 11/6/2002
PARCEL: 'IS135AB-01003
ZGNING: C-P
JURISDICTION: TIG
SITE ADDRESS: 10300 SW GREENBURG RD 450
SUBDIVISION: LINCOLN ONE/RED I.OBSTER/C.ASA L
BLOCK: LOT:
+CLASS OF WORK: ALT
TYPE OF USE: COM
TYPE OF CONSTR: 2FR
OCCUPANCY GRP: B
OCCUPANCY LOAD: 15
TENANT NAME: YUM! BRANDS INC
REMARKS: Create (3) private offices.
Owner:
EOP LINCOLN, LLC
10260 ';IN GREENBURG RD
SUITE 100
11 55jkeND29�6967F3
Contractor:
C SCHIEINE+ASSOCIATES
1024 NE DAMS
PORTLAND, OR 97232
Phone: 234-6617
Reg #: LIC 54105
This Certificate issued 12i9/2002 grants occupancy of the abnve referenced
building or portion thereof and confirms that the building has been inspected for
compliance with the State of Oregrin Specialty Codes for the group, occupancy,
and use tinder which the referenced permit w Issued.
—i�:...r:to -�--��.'.-_-'------------------ — � 4-1---._._._---------- --..-._ ..
BUILDING INSPE(.:TOR BUIL IN , IC AL
POST IN CONSPICUOUS PLAGL
CiT'Y OF 71GARD 24-Hour
BUILDING Inspection Line: (5031639-4175
MST
INSPECTION DIVISION Business Line: (503) 539-4171
t3UP —_�----_
Received Date Requested___-_� � �'?__ AM__. __. PM__ Bur) -.----- ----- -
L.ocation --_- -- f �(:2_;R___
; �'✓`��Suite �JMEG
Contact Per on
Ph( 1 ------- PLPLM
— _
Conhactor Ph SWR _------- -
BUILDING Tenant/OwnerS ELC
Footing T ELC
Foundation Access: `
Ftg Drain ---
Crawl Drain
Slab Inspection Noles: SIT
Post&Ream - -
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
Post 4 Beai.,
U;ider .'ab -
Roug,i-In
Water Service -- -
Sanitary Sewer
Rain Drains ----
Catch Basin/Manhole
Stoi m Drain —-
Shower Pan
Other: -----
Final
PASS PA R7 FAIL
wnECHANICAL -
Post&6eam
Viough-;n --- - -- -- --- - - -
Gas Line
Smoke Dampen: —
Fincl
PASS PART FAIL
ELECTRICAL
ServiceRough-In
UG/Slab - --- -- - — - _.�
UG/Slab
Low Voltage --
Fire Alarm
n Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ZrAjD PART _ FAIL
Please call for reinspection RE Unable to inspect-no access
Fire Supply Line
ADAy4+ 1 �� ��� Ext
DW �' -�-�---- Inspector-_ � -�j�-'�- -----
Other_
Final F)O NOT REMOVE this Inspection record from the Job sites.
PASS PART FAIL
CITY A F TIGAR® - -- ELECT PERMIT-�—
�`Ji RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2002-00264
13125 SW Hall Blvd..Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 11/26/02
SITE ADDRESS: 10300 SW GREENBURG RD 450 PARCEL: 1S'135AB-01003
SUBDIVISION: LINCO!_N ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Tei,ant Improvement Job No 5964
A. RESIDENTIAL_ _ B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: L.ANDSCAPEIIRP,IGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: ---------------`_��----- -- Contractor: -- ---------
E_OP LINCOLN, LI-C BACHOFNEP DATACOM INC
10260 SW GREENBURG IRD 55 SE MAIN ST
SUITE 100 PORTLAND, OR 97214-3346
PORTLAND,OR 97223
Phone: 233-7873 Phone: 233-7873
Reg #: I.1C 111978
1 1 1: 26-953CEP
St!P 2808S
_ FEES _ Required InsF,ictions _
Description _ Date __ Amount Ceiling Cover
(ELPRMT] E:LR Permit 11/26/02 $75.00 'Nall Cover
-- I I:lect'I Final
[TAX] 8%State Tax 1,1/26/02 $6.00
Total $81.00
L_
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty CodesV
and all other app!icablE laws All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 &,vs of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rule- adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 01i2-001-0100 You may obtain copies of thele rules or di onp to OUNC at (503)
246-6699 a
Issued by _ ��-r '��/ts�-_ Permittee Signature
OWNER INSTALLATION ONLY — _The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ _ DATE:
LICENSE NO: —
Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day
Electrical Permit Application
"DateeceivuJ: C Permit
ANk City of Tigard Project/appl.no.. Expire date:
CityojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
e
U I &2 family dwelling or accessory O CornmcrciaUindustrial U Multi-farnily O Tenart improvement
Q New construction O Add ition/altemtion/mplacemenI. U Other V O Partial
J6R SITIE INFORNIA]
Job address: 10300 SW GREENBVRG #450 Bldg.no.: as"Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: TAM BEU Description and localian of work on premises: TN.STAT.T, 't)r)TCR f/DATA CRT.Fq
Estimated date of completion/inspection:
1W i Z h 2i
Job no: 5964 Fee Maj`
--- - Descri livri Qty. (ea.j Iolrrl no.Insp
Business name: 13A('FTnF'NF:R DATACT)M, TNC'_ New residential-single ormuld-family per
Address: 55 SE MAIN dwellingunit.Includes attached garage.
City: PORTLAND Stott OR ZIP: -7.214 Service Included:
Phone: 503-233-Z(l Fax: ?33-29(3 G mail: loon sq.ft.or less _ 4 -_
Hach additional 500 sq,ft.or portion thereof
CCB no.: 978 _�E c.bus,lie.no: Limited energy,residential 2
City/me o II'. O.I Limited energy,non-residenlial 2
t LL�_12=5� Each manufactured home or modular dwelling
Ignature o sulrervising elect n(required) Date Service and/or feeder 2
Sup,elect nane(print) 79}ZI' }(• wtll3•NI4� Licensena 17695 Seerationorices—or elon-Installatlou,
alteration or relocation:
200 amps or less 2
blame(print): 201 amps to 400 amps 2
— 401 amps to 600 amps 2
Mailing address_ _- 601 amps to loon amps 2
City: Slate71: P: Over 1000 amps or volts 2
Phone: Fax: E mail: Reennnectont I
Owner installation:The installation is being made on property 1 own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to 200amps or psorleentlon,orrcloryllon:
2W aless____ _ � 2
ORS 447,455,479,670,701. 201 amps to 400 snips 2
Owner's si nature: Date: 401it)600amps 2
Branch circuits-new,*iteration,
or extension per panel:
Name: A. Fee for hrench circuits with purchase of
Address: u service or feeder fee,each branch circuit 2
City: Slate: 71 P: B Fee rot branch circuits without purchase
— --- -- -- of service or feeder fee,first branch circuit, 2
Phone: Fax: E.-mail' Foch additional branch circuit
Mlsc.(Service or feeder not Included):
U Service over 225 anips conuncicial U Hcalth carr facility Foch pump or irrigation c2
circle
U Service over 320 amps-rating of 1&2 J Hatatdo is location F.ach sirn or outline lightinl, _ 2
familydwellings U Building over 10,000 square feet four or Signal circuil(s)or a limited energy panel, I 75
U System over 6(x1 voils nominal more rest lential units in one structure alteration,or extension* 2
U Building over three stories U Feeders,400 amps or more •lkscri tion.
U(kcupant load over 99 persons U Manufactured structures or RV park Eich additional Inspection over the allowable in any of the above:
U F4resti ightingplan U Other: Perins ection _
Submit__sets of plans vrllh any of the above. Investigation fee
The above are not applicable to temporary construellon service. Odirr -r_��
Not all Jurisdictions accept credit cards.please call jurisdiction f«romr intn;; ionPllaa. n rNotice:Tltis permit applicali:m Pnlrl fit- .(........ . $ _1 S.`-"'"
U Visa U MasterCard expires if a ncrmit is not oboined review(al __ °k.)Slate surcharge(896) ...$
Credit card number: _______�.— � within 180 lays after it has been
r spires accepted as complete. TOTAL
.......................
'Name of c o usi mown on�iCar
_ _ S
C r sitrunwe i Amount 4104611(6UW'OMI
CITY OF T'IGARD 24-Hour
BUILDING Inspection Line: (503) 639-4115 MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received . _ Date Hequasted--jo2 AM- -___-_ PM ._ _ BLIP
Location __/0_W- p—lad ) CiLr%h L2j z. • ___Suite" _ ____ !EIEC -- -.
Contact Person _-, _ —� _. Ph (--.—) _-_—_—-- PLM
SWR
- --
Contractor.-�7 1L�SrY �' -_ Ph(---- ) =-- �- -#
BUILDING Tenant/Owner _—_ ELC
------------
Footing ELC -_
Foundation
Access:
Fig Drain ELR
Crawl Drain __—_-
Slab Inspection Notes: SIT
Post&Beam —__--- -----
Shear Anchors - --_
Ext Sheath/Shear
In?Sheath/Shear
Framing - -- - - - --- - - -.
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ------ - --- -- _ ____
Fire Alai in -
Susp'd Ceiling ---
Roof
Other: -
Final
PASS PART FAIL — - --- -------�-- --- - ---
PLUMBIN_G__
Post&Beam _
Under Slab ---- ------ - -- -- - — ----- — --
Rough-In
Water Service _---
Sanitary Sewer
Rain Drains -- -- -- ---- - --
Catch Basin/Manhole
Storm Drain _.-
Shower Pan
Other. - -- - - -- --- -
Fin:il
PASS PANT FAIL
MECHANICAL
Post& Beam
Rough-In
Gas LOP
Smoke Dampers —
Final
PASS PART FAIL - ---_---
ELECTRICAL -
Service
Tough-In
UC/Slab CQIL -
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of$ - -_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S�
1 Please call for reinspe0on RE: -- ---__- _-_-_ ___ L_I Unable to inspect-no access
Fire Supply Line
ADA _
Approach/Sidewalk Date __ �? Inepe+ttaa _ _ "� _ __Ext
�Lr j✓
Other:_--
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART_ FAIL,
CI'T'Y OF TIGARD 24-Hour
BUILDING Inspection Line: (503)539-4175
INSPECTIOP! DIVISION Business Line: (503)539-4171 MST
RUP
Raceived RequesteLJ,2 "02- AM---.- PM -- BLIP --
Location ('—ween to RCLI Suite__— __ - __ __ MEC
Contact Perso _— P l( ) _—_ :__ PLM
Contractor— - Cs1��'1Ph( ) SWR -
BUILDING Tenant/OwrM ELC
Footing
Foundation Access: ELC ----- - ------_--_cc--
Ftg Drain ELR -_G27y�tr,
Crawl Drain _q
Slab Inspection Notes: SIT
Post&Beam -__-- -_.- -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation / -
Drywall Nelinrj ,Lf �--i�G'�✓ -� --
Firewall
Fire Sprinkles ---- - ---- -- __ -- - - - - -
Fire Alarm
Susp'd Ceiling ------
Roof ,r p
Other:
Final -
PASS PART FAIL - r-, -- - ---" — ------ ---
PLUMBING -
Post&Beam 1 /��
Under Slab
Rough-In
Water Service - --_-- -- - --- — -------
Sanitary Sewer
Rain Drains --- ---- - --
Catch Basin/Manhole
Storm Drain - --------
Shower Pan
Other: - --- - ---
Final - -----�-
PASS PART FAIL - -' --� --- ---
MECHANIC_A_L—
Post& Beam - ---_--------- ---Rough-In
Gas
Gas Line —
Smoke Dampers -
Final
PASS IRT FAIL - - -- -- -- ------ ------
ELECTRIGAL
Service - --
Rnugh-In
UG/Slab -- -------- ---
Low Voltage
Fire Alarm �� ____ - _----------�_-
PART FAIL 0 Reinspection fee of$_- required before next inspection. Pay a!City Hall, 13125 SW Hall Blvd.
SITE _-- 0 Please call for roinspection RE:_ _ - LJ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date- O_ Inap�ctor
Other:
Final DO NOT REMOVE this Inspection record from the fob site.
PASS PART FAIL
Y
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (5;J3) 639-4171 MST
BUP
Received _ Date Requested_ AM--. /PM BUP --
Location ��.0_30_0_ Suite__- Z s� MEC
Contact Person — Phy---) — PLM --_
Contractor — -- - - — _ - Ph( ) c0 a- Lf-34,O3 1 SWR _
BUILDING Tenant/Owner —_ — ELC
Footing
Foundation ELG ----
Access: _--
F iH Oraln ELF!
Crawl Drain _ _ --
Slab Inspection Notes: - - SIT z
Post&Beam
Shear Anchors -- - ---
Ext Sheath/Shear
Int Sheath/Shear
Framing -- - - - - - -- - -
Inaulation
Drywall Nailing - - --. - -- -- -- - -- ---
Firewall
Fire Sprinkler -- --- - - - - -- --_ -_
Fire Alarm
`3usp'd Ceiiing - - ----
Roof 0
0 c^
Other:
Final
PASS PAriT FAIL -- -- - - --- - -`-----.-- /
PLUMBING,
P39t&Bearn-_ -!
Under Sleb -_--- --. - =
Rough-in
Water Service - - -- _-_-
So itary Sewer
Pain Drains --- -
rJatch Basin/Manhole
Storm Drain - - -�-- - -
Shower Pan
Other: _ --- _-
Final -__
PASS PART FAIL -" -' ---- - --
-MECHANICAL
Post&Beam -
Rough-In -. - _- ------ -.
Gas Line
Smoke Dampers - ----_-.-_ - - ---�_-_--
f final
PASS PARI FAIL ---- ---- -- - -- - -
ELECTRICAL
Service
Hough-In
LIG/Slab ----
Low Voltage
Fir larm - -
AS PART Reinspection fee of$- required before next inspection. Pay at illy Hall, 13125 SW Hall Blvd.
_ [ Please call for reinspection RE: inabie to Inspect-no access
Fire Supply Line x �1
ADA
Approach/Sidewalk D#ft ��- -Q�� Inspector Ext-
Other: ---------______- ---
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL jl
CITY OF TIGARE1 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INS^ECTION DIVISION Business Line: (503)639-4171
J q S U P
Rerowid _-_— Late Requested-! _ /-AM PM______ BUP —
Location -- -�� �C� _..�.- � SuiteMEC ------- --- -- - --
Contact Person Pft(- _) ve-d5.--3 PLM
Contractor--____ ----- - -_-- Ph(---) --- ----- SWR
BUILDING _ Tenant/Owner ___- __--_.___ __ ____
ELC
Footing�-��- ELC
Foundation Access: ------ - ---- -
Ftg Drain ELR
C rawl Drain _
Slab Inspection Nut_,3: SIT
Post& Beam �l�r
Shear Anchors ----- ---- -
Ext Sheath/Shear
Int Sheath/Shear C
Framing - -- --— - -�— �5- --
Insulation
Drywall Nailing --
Firewali
Fire Sprinkler - -- - —- - ---
Fire Alarm
Susp'd Ceiling -
Root -`---� --
Other: - - --- -
------------------
'rfAqp PART FAIL -- --- - - - — _
PLUMBING----, _--_---_-�-- —
I Past&Bea -- -- - -- - -
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains — -- -
6etch Basin!Manhole
Sturm Drain — -
Shower Pan
Other _ _ -- -- —
Final
PASS PART FAIL �`� 'L
_ _ _
MECHANICAL
Post& Beam
Rough-In —
Gas Line
Smoke Dampers - -- -F-al
P"CC PART FAIL - ----- - -- —� - --
_ELECTRICAL
Service
Rough-In
UG/Slab _
Low Voltage
Fiie Alarm
Final ❑ Reinspection fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd,
PASS PART FAIL
$ITE Please call for reinspection RE: _._. ..___--._ _--____. Unable to inspect no access
Fire Supply Line O
ADA �2
Approach/Sidewalk Dirb _ "�� Irva�pectar i �'� Ext
Other:
Final DO NOT REMOVE this Inspection record from the job Sita.
PASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phon,s: 639-417
Footing Rain Drain Cover/Servide
FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mach.
Plbg.Und/Fir/Slab Plbg.Top Out Insulation
-Elect,
Post/Beam Struct. Mach. Rough-In Gyp;. 3d. 0 on
San. Sewer Gas Line Appr/Sdwik Reins.
Other:
Date:
P.M —_ Entry:
Address- _�bj(dC�
Tenant:
Ste: ( jMST:
Con/Own: r _ ��C�'_-_- MEC:
I PLM:
THE OF LLOWING C ECTIONS ARE REOUIRED: ELR:
Inspectgr Date:
_APPROVED DISAPPROVED/CALL FOR REINSP.
CF CO
i
i
I
I
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
Sari. Sewer Gas Line eApprr/Sdwlk ems
Other:
Date: / ��2 3 A.M. Entry:
Address:
Tenant: --__ __ Ste.4"51?) MST. _ y
BUP: — _—
Con/Own: _ - _- MEG:
PI.M: _
ELC: .
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: Cr
I
r
0C
f
I
Inspector: -__ Datgr —
XAPPROVED —DISAPPROVED/CALL FOR REINSP. CF` CO ,"
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
I
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling um
Post/Ream Mach. Shear;Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
i'ost/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _
Date: A.M. _P.M. -- Entry -
Address: .. yi1�
Tenant:
�-7�
— -- ----- Ste: S—Z MST: _--._--_
_—
Con/Own: BLIP:--_-- ___-- -_-- _ MEC:
PLM:
ELC: —
THE FOLLOWING CORRECTIONS ARE REQUIRED: Et ry
Inspector:
Date-
PROVED
_DISAPPROVE D/CALL FOR REINSP. CF COI
f
CITY OF T1 GARD __---ELECTRICAL PERMIT
PERMIT#: ELC2002-00595
DEVELOPMENT SERVICES DATE ISSUED: 11/8/02
13,25 SW Hall Blvd , Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 450
ZONING: C-P
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install 1 branch circuit for, tlel and 3 switches.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
F-1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
FACI-I Ann'I 500SF• 201 - 400 amp: SIGN/OUTLINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL. (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD L INSPECTIONS
0 - 200 arnp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOAR:
401 - 600 amp: EA ADD'I_BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: _ +>=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: _ SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: _
Owner: Contractor:
EOP LINCOLN,LLC WILLAMETTE ELECTRIC INC
10260 SW GREENBURG RD PO BOX 230517
SUITE 100 TIGARD.OR 97281
PORTLAND,OR 97223
Phone: Phone: 624-2938 FAX
Reg#: 185e4-3631 14-283C
FEES i
Description Date Amount
Required Inspections
)ELPRMT]FL.C'Pernnr I I A"rr' $46.85 —^—��
jTAXI S Stare Taa 1 18�r_' $,1,7;=, Rough-in
Elect'I Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty%odes 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 0 work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notitication Center. Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rule5,ordirect questions to OUNC at(503)
246.6699 or 1-8013-?32-2.344
Issued By: rA , 6 �a Lac_. ��/L.c �u t'S _ Permit Signature. " s;
OWNER INSTALLATION ONLY _
The installation is heing made on property I own which is not intended for sale, lease, or rent. I
OWNER'S SIGNATURE: DATE:-----
CONTRACTOR
ATE:____CONTRACTOR. WST ,ELATION ONLY
SIGNA"rURE OF SUPR. ELEC'N: _-_ _ DATE:-------.---,--
LICENSE
ATE:______-.__-.-LICENSE NO: ___ /"' �� _`.-------- - ----_— ------- _ ----
Cali 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Do&received• - Permit no.:
City of Tigard Project/appl.no.: Expire date:
ligurd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Fay: Receiptno.:
Phone: (503) 639-4171 — —
Fax: (503) 598-1960 Case file no.: Payment type:
Lancs use approval:
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family 4,renant improvement
U New construction U A(I(lition4tlterilion/replaccnicnl U Other: _ U Partial
JOB SITE IN FORMATION
Job address: j 0-su o i-i 1 Bldg. no.: / Suite no.: ti_tl 'fax reap/tax lot/account no.:
Lot: _ Block: Subdivisiun: _
Project name: E-6 __I M-scriplion and loca,;on of work on premises: AJA 0J c,I I(, ( Sa( ,7 c 6..a_,.;
Estimated dale of com; i tion/inspection
SCHEDUE
Job no: 7, z S- r`Y u"
t)Lwcriptiort ___ Vtv. (ca.) liNal n,,.iugr
Business name: Lc;l 9t; (rL Ne»rrsidential-s,,,gleortnulti familvwr
Address: PO �a 2 4 T dwelling Unit.lnclurtesnitnch,41garage.
City: T( A it 0 Stale:0/, ZIP: �% .5 / Servlrclncluded:
Phone: bs y-R"St Fax: _ tcj E-mail: 1000 sq ft.of less 4
Each additional 5W sq.to n porticm lherc d _
CCB no.: 7 S U S Elec.bus.IIs,no: j 4 t ;c. Limited energy,residential 2
City/m tro lic.no.: /5-e/� Limited energy,non-residential _ 2
Each manufactured home or modulardwelIing
Sign dture of su i n electrician(ret Bred) Date Service and/or feeder 2
License no: (9b 5 Services or feeder-Installation,
Sup.elact.name(print): <' alteration or relocation:
i 11'A01 1' 200 amps or less 2
Natne(print): 201 amps to 4W amps _ _ 2
------- - — 401 amps to 6W amps _ 2
Mailing address: - 601 amps to 1000 amps 2
City: _ State: ZI:': Over 1000 amps or volts _ 2
Phone: I ix: I E-mail: Reconnect only
Owner installation:The installation is being made on property I own Tempomry services orfeeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:
200 amps tai less 2
ORS 447,455,479,670,701. _
201 amps 1(r 400 amps 2
Owt`ces signature: date: _ 401 to 6W am ps ---- 2
WIN INN 01 Branch circuits-new,alteration,
or extension per panel:
Name: ^ A Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: Slate: ZIP: B. Fee for branch circuits without purchase
— of service or feeder fee,first branch circuit: ti
Phonc: I:tx ti-ovist: Each additional branchchcuit:
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U I Icalth-care facility Fach pump or irrigation circle 2 _
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting
familydwellings U Building over 10,0(N)square feet four or Signal circuits)or a limited ererg)panel,
U System over(M volts nominal more residential units in one structure alteration,or extension*
U Building over three stories U Feeders.400 amps or more "Description._
U Ckcupant load over 99 Persons U Manufactured structures or RV park Fitch additional Inspection over the allowable In any of the above:
U EgressAighting plan U Other: ---- Per inspection j_--
Submit sr(%v plane with any of the above. Invewigatignfee
Be above ere not applicable to temporary construction service. Other
U
--- Permit fee.....................$ N t•
Na all po iActlona rccept credit cards.plead call iuriwiction for more information. Notice:This permil application —
U Visa U MasterCard expires if a permit is not obtained Plan review(at __ %) $ _
Credit said number: within 180 days after it has been State surcharge(896)....$ v� _
xpirea accepted as complete. TOTAL .......................
Named:ardhol er a a n un Moth Laid
S _
- -�
Cardholder signature Amount 44)4615(&MrOM)
ELECTRICAL PERMIT PEES: LIMITED ENERGY PERMIT FEES:
— - ^- -- --- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee.......................................I............. $75.00
Number of Inspections per nermit allowed (FOR ALL SYSTEMS)
Service included. Items Cost Total Check Type of Work Involved:
Residential-per unit r - — 4 ❑
1 $144 5 15 Audio and Stereo Systems'
000 sq.fl.or less
Each additional 500 sq.ft or 1
portion thereof $33.40 ❑ Burglar Alarr t
Limited Energy $75.00 _
Each Manufd Home or Modular L� Garage Door Opener"
Dwelling Service or Feeder _ $90.90
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps'x less 29n e0 _--- 2 Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 ^ 2 Other --
601 amps to 1000 amps -— — $240.60 2
Over t000 amps or volts $454.65 _ 2
Reconnect only _ $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY 11
Fee for each system.......................................................... $7!"".00
Installation,alteration,or relocation
"nl temps or less $66.85 2 (SEE OAR 918-260-260)
201 .mps to 400 amps — $100.30 -- ? Check Type of Work Involved:
401 amps to 600 amps 8133.75
Over 600 amps to 1000 volts, ❑ Audio and Stereo Systems
see"b"above.
Branch Circui,s ❑ 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 $( 65 Data Telecommunication Installation
b)The fee for branch circuits
without purchase or service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 ---__-- HVAC
Each additional branch circuit _ $6.65
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle — $53.40 _- ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s)or a limited energy Landscape Irrigation Control'
panel,alteration or extension _ $7500
Minor Labels(10) — $12500 — ❑
Medical
Each additional inspection over
the allowable in any of the above ❑ Nurse Calls
Per inspection $62.50 _- r
v; hour _ $62.50 ^�---
In Plant --_ $7375 _ Outdoor Landscape Lighting'
Fie Ps- Cl Protective Signaling
Enter total of above fees $ ❑ Other
8%State Surcharge $ _Number of Systems
25"/Plan Review Fee $ No licenses are required Licenses are required for all other installations
See"Plan Review"section on
front of application _—.____- -
FPes:
(Total Balance Due $ ----- Enter total of above fees
LJ i r ast Account#______T__.. 8%State Surcharge s
-- -- — Total Balance Due =
All New Commercial Buildings require 2 sets of plans.
i�dsts\fomuklc-fee s.doc 09/30/01
CITY
TY O F T f G A R D ._.T__ BUILDING PERMIT
C
/ PERMIT#: BUP2002-00488
DEVELOPMENT SERVICES DATE ISSUED: 11/6/02
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 450
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
REISSUE FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION _
CLASS GF':rCRK: AL'T FIRST: st N: S: E: Vl.
TY0E OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FR sf N: S E: — W:
OCCUPANCY GRP: B TOTAL AREA: r) un sf ROOF CONST. FIRE RET?
OCCUPANCY LOAD: 15 BASEMENT: st AREA SEP. RATED:
STOR: HT: ft
GARAGE: sf OCCU SEP. RATED:
BSM'T?: MEZZ?: 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 CORR PARKING:
VALUE: $ 10,000.00
Remarks: Create (3)private offices.
Owner: Contractor:
FOP LINCOLN, LLC C SCHIEWE + ASSOCIATES
10260 SW GREENBURG RD 1024 NE DAVIS
SUITE 100 PORTLAND, OR 97232
PORTLAND, OR 97223
Phone: 2.34-6617
Phone: 234-6617
Reg#: LIC 54105
_ Y FEES _ REQUIRED INSPECTIONS —
Description Date Amount Eiec rical Permit Required
BUILDJ Pennit Fee 11/6/02 $139.30 Gyp B g Insp
fAX 8'%State'Fax 11/6/02 $1 1.14 Gyp Beard Insp
I ] Final Inspection
113UPPLN] Pin Rv -11/6/02 $90.55
Fl.;J FLS Pin Rv 11/6/02 $55.72
Total $296.71 ---�--
This permit is issued sut,ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable ti 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. chose rifles are set forth in OAR
952-001-0010 through OAR 962-,101-0100 You may obtain a copy of these rules or direst questions to OUNC by
calling (503)246-6699 or 1-800-332-2344.
Issued By: tc�C%�.1_( C i Z -IL — ------
Pe rm ittee 7
Signature: f' X- f j� 11�zx -- ----- -
17Call 639-4175 by 7 p.m. for an inspection the next business day
Building Permit Application
City of Tigard Datereceived:, Permit no.: FVF.V0
City of Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date:
Phone: (503) 6394171 Date issued: By Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval — I&2 family:Simple Compiex:
t
0 I & 2 family dwelling or accessory O Commercial/industrial U Multi-family O New construction U Demolition
U Addition/alteration/replacement Tenant improvement U Fire sprinkler/alarm ❑Other:_
.1011 SITE IN�ORMATION
Job address: QS00 SW Greeh6jrq NoM Bldg.no.LN opt Suite no.:
Lot: Block: Subdiviaio:l: Tax map/tax lot/account no.:
Project name: UY1'1. d .YZG --- ---- --- - ------— ---- ---------
Description and location of work on premises/special conditions: Tevtaft* lhi !32ye►'heiett
Name: C-Q�I7Y oFF1eE PRc�PEf�-7tEs '
Mailing address: 102.Go tW SUITE 100 1 &2 family dwelling:
City: Pop-TLP00 State:OP. ZIP: 97223 Valuation of work........................................
Phonetio'S 892-15oo Fax: E-mail: No.of bedrooms/baths.................................
Ownrr's representative: ('-AY fL. GLufl- Goo Ar4itec*r,Inc Total number of floors ................................
Phonc5�' 22 -965(0 Fax: [?-nuu1: New dwelling arca(sq. t.
APPLICANT r5 Can, area(sq.ft,).........................
Name. &RC' Arch;tei -r Jnc_. Covered porch area(sq.ft.) .........................
Mailing address: W- o SW 3-ld aven" 4000 Deck area(sq.ft.) ........................................ _
City: POYt _ _ State:p� ZIP: 972 Other sinicture area(%q. ft.).........................
Phone'So� 22 -9� Fax: -T rn;tiJ Commercial/industrialhnuiti-family: CFO
Valuation of work........................................13MOR M__
Business name: i✓ $o C f ,N S Existing bldg.area(sq.ft.) .......................... 9'Z Al
Address: 4 2 E a�J S $ New bldg.arca(sq. ft.).................................
City: _ 0F6Va'�y Statc:G Z1P: 972�j' Number of stories........................................ c
3 23 � Fax: Email:
Type of construction....................................
Phone - - —
- — - — Occupancy group(s): Existing:
CCB no.: Cj41a5
New: d
City/metro lic.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: '~SHME A,_T APPL•I Cr`T provisions of ORS 701 and may he required to be licensed in the
Address: -- —! jurisdiction where work is being performed.If the applicant is
Cit : State: I ZIP; exempt from licensing,the following reason applies:
----------
Contact person: I Plan no.: — --
Phone: - Fax- F mail -- -- --
Name: c onlat t pclson: _ Fees due upon application ........... ..
Address: — _ Date received:
City: Statc: ZIP. Amount received ........................................ $
Phone: Fax: G mail: Please refer to fee schedule. --J
I hereby certify I have read and examined this application and the Not all Jurisdictions rxep credit cards,please call Jurisdiction for m xe inforn edon.
attached checklist.All provisions of laws and ordinances governing this U visa U Mastercard
work will be complied with,whether specified herein or not. c mdit care name-r
f spirct
Authorized signature: 12 Date: I I •G �Z - Name of cardholder as shown on credH card
Print name: L. G —-- -s --
Cardbotder HjNture Amount
Notice:This permit application expires ifs permit is not obtained within 190 days after it has been accepted w complete. aaa-u,l i(~OW
`�,m f arands Inc .
i
Accessibility:
Barrier Removal Improvement flan
Ci1r of Tigan!
REQUIREMENT: OREGON REVISED STATUTE (ORG) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and rel2'9d
facilities shall be made to insure that the path of travel to the altered Brea and the restroom,
telephones and drinking fountains are readily accessible to individuals with d sabilities unless
such alterations are disproportionate to the overall alterations in terms of co!.t and scope.
(2) Alterations made to the path of travel to an altered area may be dPamed di,proportionate to
the overall alteration when the cost exceeds twenty-five per-cont(25%).
VALUATION: of all renovation, alteration or modification being done �1) $ d OOO,00
excluding painting, wallpapering.
ul25.--
mtiply: 25% Barrier removal requirement.
BUDGET FOR BARRIER REMOVAL 121 $ rip oo -
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:
9 t��i v; t work rel.46- -t. $___ dU vo
(al Parking dot ►ed J
(b) An accessible entrance. $— —
(c) An accessible route to the altered area: $ —
(d) At least one accessible restroom for $ --- —each sex or a single unisex restroom:
(e) Accessible telephones: $
(f) Accessible drinking fountains: and $ — --------- -
(g) When possible, additional accessible $
elements such as storage and alarms:
2 500.°`
TQTAL: $hall egu Ila n-g 2 o�Value Computation $
i wsu\fortro�Accessibthty doc 09/24/01
; �, �
-��
i
��
i
CITY OF TIGARD ELECTRICAL PERMIT
RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #z ELR96-0266
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-41711 DATE ISSUED: 06/2-3/96
1-4ARCEL: IS135f-'IB-010033
(TE ADURESG. . . .- lill .00 S14 GREENSURG RD #450
JBDIVISION. . . . i ZONING:C-P
-OCV%. . . . . . . . . . . i-OT. . . . . . . . . . . . . :
-oJect Description : RE: REPUBLIC INDEMNITY TENANT
RESIDENTIAL-- B.
AUDIO & STEREO. . . : AUDIO A STIEEREO. . : INTERCOM A PAGIN6.
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT.
GARAGE OPENER. . . . CLOCK. . . . . . . . . . . . MEDICAL.. . . . . . . . . . . . :
HVAC. . . . . . . . . . . . . DATA/TELE (_`OMM. . - 'X NURSE GALLS. . . . . . . . :
VACUUM 'SYSTEM. FIRE ALARM. . . . . . : OUTDOOR LANDSC LI I'E-
OTHER: HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL— :
T 1\19`TRUhE1%1'TATI(IN. OTHER. . :
TOTAL., # OF SYSTEMS: I
Uwnet,: FEES
NORRIS SEGOS & SIMPSON type amaLtnt by date reept
10220 SW GREENBURG RD #235 PRt1T $ 40. 00 JGD 08/23/96, 96883i239
5PCT $ 2. 00 .TSD 08/23/96 96-283239
TICARD OR 97223
Phone #: 452-5901A
f*ontractor:
PROGRESSIVE COMMUNIG'AT IONS Of: $ 4,--:,. 00 TO1441-
UREGON INC
ci252 SE 186114 AVF REQUIRLD INSPECTIONS
PIORILAND OR 97233 ceiling Covet-, r* lert' l Final
665-691. 1 Weill Cover
Rey #. . : 111241
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, Stitt of Ore. Specialty Codes and all other Pev-mitee5 Z:i1,g* na e
applicable iaws. All work will be done in accordance with
approved plans. This permit will expire if work is riot started
within 160 days of issuance, or if work is suspended for more
than 180 days. I(SSLled By
-OWNER 1i";TAL.LA'TI0N ONLY-------- -
fhe installation is being made on pt-oHct,ty I own which is not intended for
sale, lease, at- I-ent.
OWNER' S SIGN(IJURL: DATL:
----CONTPAC TOP rALLATI014
S-1GNAT URE. OF: cjUPR. FLEC7N- OATE-
I.- ILkLINISE NO:
Call for inspection - 6.39--4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard,OR 97223 I'I I.r.1i i or /
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUED_
TDD No. (503)684-2772
CITY OF TIOARD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF VVORK
Address RESIDENTIAL—Restricted Energy Fee . $4SL!?S2
(FOR ALL SYSTEMS)
City State Zip ch c Tye of Work Involved:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS ❑ Burglar Alarm
❑ Garage Door Opener'
2. CONTRACTOR APPLICATION r,a ❑ Heating,Ventilation and Air Conditioning System"
Contractor Type_ ❑ Vacuum Systems"
^� ❑ Other
Address—.2-Z52.. J� / . /��:f�1�^ 6n `t V l , --—
Date Q-, l 6 _ COMMERCIAL—Fee for each system . . . . . . . . . 4Q,SJ4
(SEE OAR 918-260.260)
Property Owner-,-___ Check Tyne of Work Involved:
Contractor's Board Reg. No. // /.Z y_� - ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone# 6 41 `(1?�� _ _ ❑ Clock Systems
(data Telecommunication Installations
3. OWNER APPLICATION ❑ Fire Alarm Installatiott
1,`Y,�,c�,.„�v n .7 2 3 -S 13.1 ❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
/u j C 4 tea+-► 6,��.��r�.�ti _ a-� -Alt y T Q ❑ Intercom and Paging Systems
Address -r
��.9K _ ❑ Landscape Irrigation Control'
City State Zip ❑ Medical
This permit Is issued under OAR 918.320.370.Thr,applicant agrees to make only El Nurse Calls
restricted energy Installations(100 volt amps nr less)unclmr this permit and to do the ❑ Outdoor Landscape Lighting'
following: ❑ Protective Signaling
1. Only use electrical licensed persons to do installations where required.(Certain ❑ Other
residential and other transactions are exempt from licensing.These have
asterisks(*).All ethers need licensing).
2. Call for an inspection when all of the installations under this permit are ready 'I
(or inspection at 503.539.4175. ❑ / Number of Systems
3. Purchar-�separate permits for all installations that are not ready for inspection
when the inspector is nut to inspect under this permit. •No licenses are required. Licenies are required for all other Installations.
4. Assume responsibility for assuring that all corrections required by the inspector -are done,and
5. Assume responsibility for calling for a Final inspection when all of the 5. FEES
corrections are completed.
The person signing for this permit must he the applicant or a person a. Enter Fees $_
authorized to bind the applicant.
b. 5%Surcharge(.05 x total above) $
Signature TOTAL $
Authority if other than applicant
ENERGAP.CHP
DERNIT
L
Cirf OF TlCjp^RD DATETISSUED:
07/2'03/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Orogon 07223.8190 (503)639-4171 [-,ARCEL: 1913)AH 0100.11"
L. A DD R I::;3 S. 116 ,)Vlo t„w
SUBD 1 V 16I ON. . . . .. ZONING:C-P
GSI_OCK. . . . . . . . . . . 1_.01'. . . . . . . . . . .
pvoject 'oescriptior: Installing six bvlanch c:ircLtits-
UNIT—— SRVG/F'EEDERS---
1000 SF OR LES(' 0 0 200 amp. . . . . . . k7 PUMP/IRRIGATION. . . . : 0
';:ACH ADD' L 500SF. 0 01 ".00 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
L.I il I TED ENERGY. . . 0 14-01 600 amp. . . . . .. . 0 SIGNAL/PANEEL_. . . . . . . : 0
MANE. -'M/ SVC/FDR. . 0 601+amps-1000 Volts. : 0 MINOR LABEL . 0
CIRCUITS--------- ---ADD' L IN5Pr_(.T IONS
0 2.00 Amp. . . . . . :, 0 W/SERVICE. OR FEEDER: 121 PER INSPECTION. . . . . : 0
C201 400 amp. . . . . . .* 0 3.5zll W/o 5RVC UP FDR. : I PER HOUR. . . . . . . . . . . : 0
600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 5 IN PLANT. . . . . . . . . . . : .t
C, 1000 amp. . . . . : 0 RE',V I EW
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . : 0 SVL/FDR a25 AMPS. . CLASS AREA/SPEC OCC.
Owner: FEES
PEPUSLIC INDEMNITY type AM OUn t by d0.e t,ecpt
1.0300 SW GREENVURG RD PRMT 8 60. 00 ('"is
`'iUJTE 450 3. 00 rj,,�3 96--2(31 788
1ICARD OR 97L'=`;-.*3
1-'hone #:
I2I9TENSON E-LECTRIC IN(: f?,3. 00 TOTAL
1._150 SW GREENTYAUFtG ROAD
REQUIRED INSPECTIONS
BARD OR 9712i*.3 Final
,�,ne #c 503—;::141-4812 Elect' t Sprvir_-e
qg #. . - 00543
,s ptreit is issued subject to the requlations contained in the
gard Municipal Code, State of Ore, Specialty Codes and all other Permittee Signati-ole
applicable laws. All work will be done in accordance with
approved plans. This pervit will expire if work is not started
,ithin 180 days of issuance, or if work is suspended for sore ChCZ r 4f-S
an 180 days. Isskkeo by
INSIALLATION 0NL.Y---
tie installation is being made on property I own i,lhich is not intended fo
,'t e, leace, ni- rent.
4N4 R` SIGNATURE: DAA E-
INSTALLATION 0NL`r-
-AiNATURE OV S3UPR. ELEC" N: Plotted i L .
("ENSE NO
I for inspection 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd
Tigard, OR 9722: Permit # /
Cate Issued
Phone (503) 639-4171
FAX (503) 684-7297
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complell Fee Schedule Below:
Name of Development LINCOLN CENTER _ Nurnbrr of Inspections per permit allowed
Address 10300 Si�GREENBURG RD SUITE 450 Service Included Items Cosuea)
City/State/Zip. PORTLAND, OR 97223 4a. Residential -per unit
1000 sq. ft or less $110.00 _-- ---_
Name (or name of business) REPUBLIC INDEMNITY Each additional 500 sq it or
12500
MALIBU IFIC CONTRAC�'OR piled Energy
$2500 ---
r esldential ❑ Each Energy
emmerclal Each Manurd Home or Modular
Dwelling service or Feeder $6800
2a. Contractor installation only:
ROSS CROSBY 4b. Services or Feeder.
CHRISTENSON ELECTRIC, INC installation,oiieration or relocation
Electrical Contractor __ 200 amr j or less s60 no _
Address 111 SW COLUMBIA,SUTTR 480 201 art)a to 400 amps $0000
Cit PORTLI State_g_ Zip 472n t–5g8 401 or cps to 800 amps $
ten 00 —
y 901 a nps to 1000 amps —
Phone No. 503 241-4RI9 over 1000 amps or eons $34000 _ 2
Job NO. 967 Rea to—t only -- $5000
contractor's license NO.. 26-34C _ 4c. Temporary Services or Feeders
Contractor's Board Re _ nstanaunn alteration or relocation
Signature of Supr. Ele ' i° t 5l 200 amps or less
License No. 8735 Phone No.241-4812 201 amps to 0 amps $5500
401 amps to 6 6000 amps $7500
Over 600 amps to 1000 volts $10000 -- --
2b. For owner installations: see W above
4d. Branch Circuits
Print Owner's Name _ New alteration or extenslon per pane
Address - a)The tee for branch circuits with
City State___ Zip
purchase of service or feeder fee.
-- Each branch circuli $500 _
Phone No. b)The fee for branch circuits without
The Installation is being made on property I own which is purchase of service or feeder fee. 1
First branch circuit $3500 35.
not intended for sale, lease or rent, rarh addnional branch circuit $500 – T
Owner's Signet ire ___ 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): each pump or IMgMlcircle $$4000 _
F.ach sign or outline ligig $
circle
__^ $40 DO _
Signal circuttlel or a limited energy
Please check appropriate Item and enter fee in section 5B panel,alteration or extension $40 DO
4 or more residential units in one structure Minor Label$(10) $10000
Service and feeder 225 amps or more
_ 4f. Each add!tionai Inspection over
System over 600 volts nominal
Classified area or structure containing special ocr.upancy the allowable In any of the above
$3s on
as described in N E C Chapter 5 Per inspection _T
Per hour _ $5500
In Plant i $5500
Submit 2 sets of plans with application where any of the above _
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees y 60.
51A Surcharge (05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotalgh. Enter 25°/s of line A for
AUTHORIZED IS NOT COMMENCED WITHI 1 180 DAYS,OR IF Plan Review li required (Sec 3) $
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTEIR WORK IS
COMMENCED rR•T.omvnN• ❑ Trust Account #
pm pp
Balance Due 63.
BUILD114G PERMIT
#. . . . .
CITY OF T I GARD DATE PERMIT ISSUED: •
08/07/9,9604Z..',6
.101MMUNI'rY DEVELOPMENT DEPARTMENT ADUI IDARCEL: 1SI35AD-01002
_
13125 SW Hall Blvd,Tigard, 9722308199 03)639.4171
S W G R 17 1'�: IRG RD #450
=0,9 ff
.3UBTJ I V I S I UN. . . . Z ON I NO: R---I L
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :8
REISSUE':: FLOOR AREAS- EXTERIOR WALL. CONSTRUCTION
(',L(4SS OF WORK. :ALT FIRST. . . . -, IZA s f N: S: E- W.
TYPE OF USE. . . :COM SECOND. . . , 0 Sf PROTECT" OPENINGS?-
TYPj. OF CONST. .2N FOURTH. . . 1400 sf N: S: E: W.
OCCUPANCY GRF-,. :B TOTAL--------: 1.400 s-f ROOF CONST: FIRE PET? -.
OCCUPANCY LOAD: 13 BASEMENT. : 0 s AREP SEP. RATED:
STOR. : 0 HT: 111 1-t G:,ARAGE. . . : 0 s OCCU SEP. RATED-
BSMT? -. MEZZ?: REDD SETBACKS---------- REQUI
FLOOR LOAD. . . . : 0 p,5 f LEFT: 0 ft RGHT: 0 fi, FIR SP11,L:Y SMJK DET. . tY
DWELLING UNITS' 0 FRNI : 0 ft REAR: 0 f t FIR ALRM:Y HNDIEP, ACC."Y
13EDRMG: 0 BATHS. 0 IMV, SURFACE: 0 PRO CORR-N PARI-(ING: 0
VOLLIE. $ : 21450
Remarks : Telicklit improvemetit.
FEES
NORRIS BEGGS & SIMPSON tyre a m 0 l.kr., hay dat e reept
102!O SW GREENBURG RD #235 PLCK $ 99. 1.3 JDA 07/09/96 96-2'61425
FIRE $ 61. 00 JDA 07/09/96 96-281425
fIGARD OR 97223 PRMT $ 152. 50 LA 08/07/96 96-282633
Piorie #: 452-5900 5p(-T $ 7. 63 B 013/07/96 96-2t326;3.3
Conti-actor—
MALIBU PACIFIC
735 NE JACKSON SCHOOL ROAD
HILLSBORO OR 97124
PlnciTie if: 693-9797 f 3 '0. .26 TOTAL
Reg #. . : 059045
REUUIRED INOPECTIONS
This perwit is issued suh)ect to the regulations contained in the FramiTlq ITILip
Tigard Municipal Code, State of Ore. Specialty Codes and all other InSUISticin Iiisp
applicable laws. All work will be done in accordance with Gyp Board Insp
approved plans. This perv:t will expire if work is not started SLisp Ceilnq Irisp
within 188 days of issuarce, or if work is suspended for tore Final Inspecticir,
than 180 day.�.
f-ir,in 3. t-t P e S i t i..tr e -6A
1V L�Z=
A
S m La Ly ,
J
Call for itispertion 639-4175
Commercial 30dinc, Permit Application
C, of Tigard \�b
13125 SW Haff Blvd.
Tigard, OR 97223 ` \N,
(503) 639-4171
ONE UN('ptN 'ENTER r;../1- �rr..i�t � 9, f
03�0
Jobsite Address: LkEEPJ
Tenant: Office Use Only
Valuation: 4 J O Planck/Rec #
Permit#
Owner: Lk)lzu1 .S JLE4,�S Map & TL #�
Address: 10 2 ZU Z, . ('�KEEL G O R.� .
Approvals Required
Ju lTE Z 3 J 907 Planning
Phone. 45 L — S 7 0 O
Engineering
Other—_��—
Contractor NI AU V hhCl
Add _735 (q .E, aiclrJ c.Noo� K�
22- 2712-4 Type of const:
N���seaKv
p -, n
Occupancy class:
Phone: � 1.i '1 — --
�1 Sprinklered? No
Contractor's License �/
q (attach copy of current Oregon license) Sq. ft. of project: i (0c)
ConI�tra ,
acyname & phone: C lel(, JANLN(,E S!ory (1st, 2nd, etc.)
j II-- Proposed use: [�-�j �lArDUh
ArchitecUEngineer: �OVI L QL)1�111I I _s ' /�'
Previous use: U w
Address
Note. Plumbing & mechanical plans
must be submitted at time of
building permit application.
��hore
JOB OESCRIPTION: TE IV N Pi T .Zftil Prov E.NALPIT
r 93 �`�797
Applicant 64hature & Phone n tuber
Received by: �Ak✓ � Date Received:
Permit # Account Cescriptlon Amount Amt. Pd. Bal. Du*
Lr2.Cyl i Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) _
Mech. Pe;-nit (MECH)
State Tax (TAX) Z,63
_
Bldg: ^
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dere Charge (PKSDC)
Residential TIF (TIF P1
Mass Transit TIF (TIF-MT)
Commercia; TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office Ti (TIF-0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
'=ire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMlT) _
Erosion Planck/USA (ERPLAN)
Eros,on Planck/COT (EROSN)
�1 � ► r
TOTALS:
PLUMBING V`ERMIT
CITY OF TIGARL PERMIT :4. . . . . . . : PLMI)b
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/29/96
13125 SW Hall Blvd.Tigard,Oregu, 97223*8199 (503)639-4171
/C300 PARCEL: 1S135AR---0100i
7,
'31TE ADDRESS. . . : +tt�— SW GREENBURG RD #450 J -
':3UBD I V I S I ON. . . . : ZONING. R--12
. . . . . . . . LOT. . . . . . . . . . . . .
PLASS OF WORK. ALT GARBAGE DISPOSALS. 121 MOS ILF HOME SPACES. 0
IYPS OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . 0
OCCUPANCY GRP. . :B FLOUR DRAINS. . . . . . : 0 TRAPC. . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . — 0 CATCH BASINS. . . . . . . : 0
F I X'I-URC--*G------ LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : Ill
SINKS. . . . . . . . . . . I URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . :
LAVATORIES. . . . . : 0 OTHER FIXTURES. . . . : 0
1-UH/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . 0
WAI'ER C'LOSETS. . : 0 WATER LINE (I"u ) . . . 0
DISHWASHER g. . . . : 12.1 RAIN DRAIN' (ft ) . . . 1D
fkemar-k.s : Moving onE, sink.
uwnet-: FEES
REPUBLIC INDLMNITY type Amol..tnt by date t-ecpt
10300 SW GREENVURG RD #451b VIRMT $ 25. 00 CJS 07/29/96 96-282259
PCT $ 1. 291 CJS 07/1219/96 96- fV.-71 1z 1-1
G A Vi D 0R 97 1-23
1-horle #-
Cunt
PETEMPLE CO INC
195J. NW OVERTON ST
r--,0RTLAND OR 97209 ------------------------
"P
'hone #: 227-2641 26. 25 TOTAL
Reg #. 002110
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water- Line Insp
Tigard Municipal Code, State of Ore, Specialty Ccdes and all other Misc. Inspection
applicable laws. All work will be done in accordance with Final Inspection
a'pproved 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.
e t^ro i t t e e S i g at u e
Issued 13 y CtI,1V
Call for inspection 639--4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # q0- ";t
13125 SVV Hall Blvd. , ' Permit # F1 M Z�n X�
Tigard, OR 97223 ,01 qr_nit;-'P
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
New Single Family Residences Only
O 1 BATH HOUSE$140.00 11 2 BATH HOUSE$195.00
JO►a ) (i&(?e ❑ 3 BAIT] HOUSE$225.00
Addlfess . ar Fee includes all plumbing fixtures in the dwelling and the first 100 feet
(')rA TZ/9 (� O or water service, sanitary sewer and storm sewer See fees below.
IbiMtwnNn.Nau.Mwr FIXTURES QTY PRICE AMT
Sink 900
w a A"." Lavatory — - �- 9.00
Owner Tub or Tub/Shower Comb 9.00
"^"""'• t► Shower Only 9.00
Water Closet 9.o0
"'^��"^'""N'"""'•'� Dishwasher 9.00
L Garbage Disposal - 9.00
OccupantM,,,,,o,,tr� re... Washing Machine — - 900
Floor Drain ^-- -_-- - -9.00 -V-
"'"`•'•
all Water Heater 900-
Laundry Room Tray 900 --
'- N-W Urinal - 00
Other Fixtures (Specify) - 9 Qo -
Conlractor9 00
�' '��
goo
•� 9 ar - -• 9 00 V
0 id" 9 71?C' Sewer 1st 100' 3000
°1 1•�"•O*~0"me, O's...To "'• Sewer-ea. Addit. 100' 25.00
! -
X �/C, C
t' 7 � , Water Service 1st 100' - 30.00 - "-
I hereby acknowledge that I have read this application, that the Water Service ea. Addlt. 200' - 2500
Information glven Is correct, that I am the owner or authorized agent of ---"• ---
the owner, that plans submitted are It, compliance with Slate laws, that Storm 8 Rain Drain 1st 100' 30.004
1 am registered with the Construction Contractor's Board, that the Storm a Rain [gain Addit. 100' 25.00
number given Is correct (If exempt from State registration, please
give reason tx'ow.) Mobile Home Space 25.00
Back Flow Preventlon
Device or Anll-Pollution 0evice 900
"O•""•"""""Owl DW Any Trap or Waste Not -
Connected to a Fixture 9.00
Describe work new 0 afWkbn O afterntlon repair Catch Basin 9.00
to he done residential O non-residential (0-- Insp. of Exist. Plumbing 40,00/hr
Specially Requested Inspections - 40 00/hr
Existing use o1 J / —
building or property -�7 � G Q• . Rein Drain, single family dwelling 3000
Residential backflow prevention
devices 1500
Proposed use of
building or property _
'(f_arcepf rosldanNel backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
• L-
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED 18 NOT COMMENCED WITHIN 180 DAYS, OR IF 5%SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED --- --- -- (FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL
Special Conditions
_ Date Issued,_/a6ib?S' by