10300 SW GREENBURG ROAD STE 470-3 0
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10300 SW GRBBNBURG RD ST #470
CITYOF TIGAsRD CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVk3ES �FRMIT#: BUP2002-00181
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 D^.TE ISSUED: 5/9/2002
PARCEL: 1 S 135AB-01003
ZONING: C-P
JURISDICTION: TIG
SITE ADDRESS: 10300 SW GREENBURG RD 470
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: 32
TENANT NAME: 13USINESS TRANSITIONS
REMARKS: Tenant Improvement
Owner:
EOP LINCOLN, LLC
10260 SW GREENBURG RD
SUITE 100
PORTLAND, OR 9722.3
Phone:
Contractor:
C SCFIIE7WE +ASSOCIATES
1024 NE DAVIS
PORTLAND, OR 97232
Phone: 234-6617
Reg #: LIC 54105
This Certificate issued 5/311/2002 grants occupancy of the above referenced building a
portion thereof and corfirms that the building has been inspected for compliance with the
State of Oregon Specialty Codes for the group, occupancy, and use under which the
referenced perpif, was issued.
BU—UJING INSPECTOR uu6.IILDING FICIAL
POST IN CONSPICUOUS PLACE
CITY OF TICARD 24-Hour
BUILDING ; Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP
Received ___ _Date Requested T ' AM PM BLIP
Location G - �'C' Suite 2 0, MEC
Contact Person _ Y'LL.k_ Ph _) �-z S7 PLM
Contractor_ _ __ Ph SWR _
BUILDING Tenant/Owner _ ELC _
Footing ELC
Foundation Access:
Ftg Drain ELP
Crawl Drain
Slab Inspection Notes: �� SIT
Post&Beam ___.�_ - '�C� �L _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing I
Insulation
Drywall Nailing — - --
Firewall
Fire Sprinkler ---- --- - --- - ——.
Fire Alarm
Susp'd Ceiling
Root
Other: -- - - -
ZPARTFAIL
MBIWG-----
Post&Beam
Under Slab
—
Rough-In --
Water Service --- - - - --— ---- ---- --
Sanitary Sewer %
Rain Drainr, -- -- -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other. _ - -- - - - -
Final
PASS PART FAIL
MECHANICAL _
Post&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$--_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS PART FAIL
SITE Please call for reinspection RE: L] Unable to inspect-no access
Fire Supply Line / r r7
ADA
Approach/Sidewalk Data ' 5_G� Inspector -_- Ext
Other: __ _
Final DO 'NGT REMOVE this Inspection record Brom the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 ��� MST
I -31
SUP �.
Received Date Re nested � 1 3 i AM PM BLIP _
Location I uite__ d MEC
Contact Person c``J'1A�L Ph `LL' 7 116/0 P! P1 _—
Contractor__ __ _ Ph( ) --_ SWR
BUILDING Tenant/Owner _ _—__ _ _ _ ELC --
Footing ELC
Foundation Access:
Ftg Drain ELR �-
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors - - ---
Ext Sheath/Shear _
Int Sheath/Shear
Framing - -- -- --
Insulation `.
Drywall Nailing -- —
Firewall ,
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling -
Roof
Other: _ _ ---- ------ ------ --------
Final /
PASS PART FAIL — 7�j ' � 447l
PLUMBING - "
Post& Beam -- �- --- --- - -
UndPr Slab
Rough-In
Water Service - —
Sanitary Sewer
R
Rainin Drains - -
Catch Basin/Manhole
Storm Drain ------�`� -�- --- -
Shower Pan
Other: - - - --
Final _ ------ - Low — I k&w �
_PASS_ PART FAIL �- U -- --��--�
MECHANICAL
Post&Beam --^--
Rough-In �----{r ---
Gas Line
Smoke Dampers - -- - - - - —----- - ----- .
Final
PASS PART FAIL ----- ------- -------
ELECTRICAL
Service - �� - --- --_-- ---_---- - -
ough-In
UG lab
Low Voltage
FiSgAllarm
ina, Reinspection fee of$ required before PART next inspection. Pay at City Hell, 13125 SW Hall Blvd
Sp
[] Please call for reinspection RE: - [_] Unable to inspect-no access
Fire Supply Line
aaa -� �
Approach/Sidewalk Date _f�� Inspector____ '' � _ Ext - _-.--
Other: --
Final - DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line, (503)639-4171 MST
BUP
Received __ — Date Requested_� � AM __P SUP —
Location __,C_�� (, �r"c't<'n Swte_ hIEC _
Contact Person Ph( ) c7 3�--L7_,�3 PLM
Contractor11�i�t� { ���.Lr1� Ph( -) - SWR
BUILDING - Tenant/Owner - ELC �c
Footing
Foundation Access: -- ELC
Ftg Drain ELR _-
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors --- -
Ext Sheath/Shear
Int Sheath/Shear -- - -'
Framing
Insulation
Drywall Nailing _-
Firewall
Fire Sprinkler - -------- ----_ __
Fire Alarm fCfr�c��
Susp'd Ceiling -
Roof - 44 Z;.
Other:---- ----- -�-� --
Final
PASS PART FAIL _-------- --
PLUM_BING
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
PASS PART FAIL
ELECTRICAL
Service ------ - -----" --- - ---
Ruugh-In __-
UG/Slab /
Low Voltage '�t4d
Fire Alarm
GO PART FAIL L_.J Reinspectior,fee of$ requireo; fore next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE F_� Please call for reinspection RE:_ _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Onto� � Inspeetor_ 4 -1� _ -.-Ext
Other: _ _
Final - DO NOT REMOVE this Inspection record from the fob she.
PASS PART FAIL
n
CITY
I TY o f T I A A R D -- ELECTRICAL P -
1 \ (�.I_ (`� RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2002-00097
13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 DATE ISSUED: 5/24/02
PARCEL: 1 S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 470
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of Data/Telecommunication cabling.
A. RESIDENTIAL _ B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
FIVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRr ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EOP LINCOLN, LLC ALLNHIN COMMUNICATIONS INC
10260 SW GREENBURG RD 23220 SW BOSKY !SELL LANE
SUITE 100 WEST LINN, OR 97068
PORTLAND, OR 97223
Phone: Phone: 503-698-9000
Reg #: ELE 3-406CLE
1.R, 107548
FEESu� !' — Required Inspections
_Type By Date - Amount Receipt — Law Voltage Inspection
PRMT CTR 5/24/02 $75.00 2.720020000 Elect'I Final
5PCT CTR 5/24/02 $6.00 272002 'D
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. 'This permit will expiry'if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
regUires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-187.
Issued by t_ q Le L, / Permittee Signature
OWNER INSTALLATION ONLY
The Installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ DATE:
LICENSE NO: ---
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Perri tApplication Pe=t no - -cr
pDaterew"Gived. L-V-
clty Of xl�,aCtfl Rojecusppi.no.: f'xpirodate __
CtryofTigard Address. 13115 SW Mall Blvd,Tigard,OR `11223 pale issued: Hy 1',,/ llcccipteo__�
Phone: (503) 639-41'1 Cue file no,. Payment type:
Fax: (503)598-1960
Land use approval:
MIME
Multi-famil enant improvement
C'
MM dwelling or aec:ssory U CornmcrtraVmdustnal y
O New c.nsw, ❑Addiuor✓alteration/replacement O Othct O Facial
A 1 1 1
Job address: U"3 DO 1. t +' Bldg.no.: Suite no.'t 7L, T x map/tau lot/account no
Lot: Block: Subdivision:
Project `�,t 1 -_-�OCscripGon and location of work on premises: VO l I! 4A l�L� Uf1
Eatimated date of compleuortl 11511 :tion: (, u
1 1
Foe f•S.0
JOtr 001 ��_� polripciom (try. (ce) 'foul no.uisp
BuaiBesattiame: ,, o _ �`'n ,^ - 'cwr,�rnal amekormdu•�a`ut>-P�
hddress' c OS � (�- L�/Ui% d«cillorunN.lnNudeerrtt>•crwd►,ures.' ,w
Ci L AW State:D ZIP G - servicrincluded: 4
E-mail: 1000 sq.n.or lees
Phone: - U0 U Fax: Epyh addiuond 500 14 tt or poltion thereof
CCB no..d U r'2/` Elec.bus.lie.no: ) t" (Jrry�Ellefjy,nr�e�ra.l
City/metro llc no..
lima onergy,non.resioesuai 2
; Z p- ErAct,manufactured home or modular dwelling 2
- - - Due Service and/or reNJn
Si nature a siipervulne eiectrlciYi p aired) Serviceeorf n-iasis alion,
Supclot.twoc(pant) �t' Litt
no;3') Z+TLC alteralion or relocation:
1 ' 200 amps or lass
201 sm ►to 400 amps 2
Name(pant): -- 401 amps to 600 amps 2
601 to 1000 amps 2
Marling
address: _ - 2
City;
..ate: I ZIP; — Over 1000 un s or vote 1
Fax: E-mail: ftcoonnnclunl
Phone; Temporary services or teeUM-
Owner installation•The installation is being made on property I own trlabii„tlon,duration,orreloeetion:
which is not iateaded for sale,lease,ron6 or exchange according to 200 Ynpa or)eat z
OILS 447,455,479,670,701. 201 amps w 400 amps iT
Ownu's Si namm: Date: 401 w trio Amps
z
llranch circular-eon,1110111111 Ntent on,
or eatmloa per pruteb
Name A Fee for brunch cin.uirs with purchase of 2
---- Service or feeder fee,each branch circuit
Addrrsa B. fW or nu+r b ch dreuiu widaut purchase
S
Cittate 21J', of service or feeder fes,first branch circuit: 2
City:
PhOnc. TE-mall! Pachadditlon brarlchcircuit.
lse,(Servlteor cW*rnot Ine u e4): 2
U Heahhtare[Acdny Fsrhpumporirtigationcircle _� Z
C)Service over 123 amps eomniucid Earh sign or nuilint lighting __
Pservice over 120unoS-nungoflkl OHsaArdowlocadon ( ri0
farruly dwelling► C7 Building over 10,000 aquae feel four or Signal circuits)or a limited energy panel. �"� 2
O system over 600 vola nominal
more realdenuAl units m one rwaure
Lit erauon,or extension•
O Builders over ttutee trona ❑Fcederu.400 Yaps or more •po4�7==
mon --
*(kcuparil load ovet 99 persons O Manufactured structures or RV pods FApt<yioo ave.she Alio�aLle rh any off the Alrovt� -
p isgrp✓hghunapiN O other �_ _-_ pero,, —
Suberlt.___arts of plain ovtrh any of the above. Inv _-----�-
m above tyre aor applicable to tem nary coo_stsuctioo service, Ower _ _.----_..—
Po �-
- application Permit fee..,.... S
Na YI wnld,�7am eueF sed,i card+,pita call iuritdwyon res rrwn,rifarSnsees
Noll This permit app plan review(at _ ' 1 S --
Q V N U MuterCud expires if a permit Is not obtained State surcharge(1190 •.•$ �-
within ISO days after 1t has been TOTAL $
`�
Ueda cud numbs ......
.- /lrcs accepted at complete.
-rudlw r as s Wn on a r e s
MpA1 S(6100rCON
Car Was IrPliv� Amount
400 aMY911 JO (.11) 09e1994C05 %Vd 44 91 zootn,411
CITY OF T I GQ R D ELECTRICAL PERMIT
PERMIT#: EI_C2002-00214
DEVELOPMENT SERVICES DATE ISSUED: 5/13/02
'13125 S'n Hall Blvd.. Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AE3-01000,
SITE ADDRESS: '.0300 SW GREENBURG RD 470
SUBDIVISION: LINCOLN 01�'E/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Tenant Imr.,ovement
RESIDENTIAL UNIT TEMP S_RVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: �— PUMPIIRRIGATION:
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 I-ABEL (10):
_ SERVICE/FEEDER BRANCH CIRCUITS — ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 400 arnp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amu: _ PLAN REVIEW SECTION _
1000+ amplvolt: >=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 GREF..NBURG RD PO BOX 230547
SUI"EE 100 TIGARD, OR 97281
PORTLAND,OR 97223
Phone: Phone: 624-3631
Reg #: LIC 75059
SUP 1965S
ELE 34-2830
FEES — Required Inspections
Type By Date_ �! Amount ReceiptWall Cover
PRMT CTR 5/13/02 $66.80 2720020000( Elect'I Final
5PCT CTR 5/13/02 $5.35 2720020000(
Total $72.15
This Permit is issued subject to the regulations contained In the Tigard Municipal Code,State -i OR. Specialty Codes and all other applicable
laws. All work will be dons in accordance with approved plans. This permit will expire N 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 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to
Permit Signature: - Issued By:
OWNER INSTALLATION ONLY
The installation is being made on properly I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE' _._ _ DATE:�r
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE N O — _ ----- ----- --------- -------
Call 639-4175 by 7:OOpm for an inspection the next business day
Electrical Permit Application
IDatercceived: permit ,Z�,,Z
City of Tigard Project/appl.no.: Expire date:
Citt ofligurd Address: 13125 SW hall Blvd,Tigard,OR 97223 Date issued: — By: Receiitnu.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
7U I &.2 family dwelling or accessory .Commercial/industrial U Multi-family LI Tenant improvement
U New construction U Addition/alteratiun/replacement i_)t Ilher _ U Partial
1
Job address: 10 3 U t) SLI 6 Od LOA-
Bldg. no.: tiuitc nu J Tax map/tax lot/account no.: �I
Lot: I Block: Subdivision: J
Project name: I Liv SC '-1 O Description and location of%vork on premises: jI i+s [ritrMc
Estimated date of coniplrti,nt/inspection:
1
Fee Max
Job no: Z Z 7
Description "y. (ea.) 'Total no.tnsp
Business name: t. rM c H C ^- r Ne"residential-single or nudd family per
Address: 106 t1, 1 ;4 dweWrtgunir.IncludesattachedgarRW.
City: State:pti ZIP: 2tr / Service included:
c Fax: t E-mat: 100(1 aq.u.or less _—
Phone: t S� I ��' Y_;� _ Each additional 500 sq.ft.or portion thereof
CCB no.: Elec.bus.tic. It's �--• Limited energy,residential 2
City/iNetro lic,no.: Limited energy,non-residential -'_
U Z Each manufactured home or modular dwelling
,141m of supe sine electrician(re wired)
Date Scrvicennd/frfueder 2
License n r /9G j 7- Services m,seders-Installation,
Sup.elect name(print): �, l �r ahentlonorrclocailon:
2W amps or less 2
201 amps to 400 amps 2
Name(print): —�_ 401 amps to 600 amps — — 2
Mailing address: __ _ 601 amps to IWOstrips 2
City: State: ZIP: Over IOW amps or volts 2
—� — I
Phone: Fax: mail: Reconnect of
Owner installation:The installatiop is bein- made on property I own Temporary services or feeder-,
installation,alteration,or rel(cnl Ion:
which is not intended for sale,lens -,it,or exchange according to 200 11111p of less _ 2
ORS 447,455,479,670,701. 201 amp-.to 400 amps iJ—— _ 2
Owner's si nature: Date: _ 401 to 6 X)ams 2
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. - -- State: ZIP: i B. Fee for branch circuits without purchase S b t
of service or(ceder fee,tint branch circuit: / Y6 - Y� 2
Phone: I a is-Mail Each additional branrh circuit
Mist.(Service or feeder not Included):
Foch pump or irrigation circle 2
d Service u�'et 225 rings anunurciul J Ilealth-corefacilily 2
•Scrvltxover�2Oamps•retingofl�2 UHnzardauslocation Each sign uroullinclighting _ —_
family dwellings U nuilding over 10,000 square feel four or Signal circuit(s)or a limited rnrrpy panel,
U System over 600 volts nominal more residential units in one structure alteration,or extension* 2.
U Building over three stones U Feeder-,4(10 amps or more +I)escn --
O Occupant load over 99 persons U Manufactured structures or RV park Fwch additional Inspection over the allowable In any of the above:
U 1'ftreWlightingplan U Other __ - perins tion
Submit_sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
• Permit fee.....................$
Nni all jurisdictions accept credit cents,pleasecall iariuilaion for more inffiMnurunn Notice:This permit application Plan reVICW(AC �) $
L)Visa U Mastercard expires if a permit is not obtained --
;•rr•dit card number: / 1 within 180 days eller it has been State surcharge(8%) ....$
accepted as complete. TOTAL .......................$
Name c of res s own on cnah aM
-- Cardholder si`rreture -Amoum 440-4615(~'OM)
I
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
1
Complete Fee Schedule 3eiuw: 1 TYPE OF WORK INVnLVED -QESIDENTIAL ONLY
p I Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOL{ALL SYSTEMS)
Service included: Items Cost Total
Check Type of Work Involved:
Residential-per unit (�
1000 sq ft.or loss — $145 15 4 LJ Audio and Stereo Systems'
Fach additional 500 sq It or
porlion thereof $33.40 1 I I Burglar Alarm
Limited Energy
Fach Manurd Home or Modular
Dwelling Service or Feeder $90.90 2 Garage Door Opener`
Services or Feeders Healing,Ventilation and Air Conditioning System'
Installation,alteraticn,or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 Vacuum Systems`
401 amps to 600 amps $160.80 2
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts $454.65_ 2
Reconnect only $66.85 2
Temporary Services or Feeders T:`PE OF WORK INVOLVED -COMMERCIAL. ONLY
Installation,alteration,or relocation FPP for each system.......................................................... $75.00
200 amps or less $66.65 2 (SEE OAR 918-260-260)
201 amen to 400 amps $100.3n 2
401 ampE to 600 amps $133.. . Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. Audio wid St3rso Systems
Branch Circuits ❑
New,allocation or extension per panel Boiler Controls
a)The fee for branch circuits
with purchase of service or Clock Systems
feeder fee.
Each branch circuit $6.65 2 Data Telecommunication Installation
h))he fee for branch circuits
without purchase of service ❑
or feeder fee. Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 E] HVAC
Miscellaneous F-1 instrun,nntation
(Service or feeder not Included)
Each pump or Irrigation circle _ $53.40_ a
Each sign or outline lighting _ $5340 Intercom and Paging Systems
Signal circult(s)or a limited energy
panel,alteration or extension $75.00 I_an:,�,=+pe Irrigation Control'
Minor Labels(10) $125.00
Each additional Inspection over Medical
the allowable In any of the above f—I
Per inspection _ $6250 _ _ _ LJ Nurse Calls
Per hour _ $62 50
In Plant _ $73 75 Outdoor Landscape Lighting'
Fees: F_� Prntertive Signaling
Enter total„f at-rive fees $ n Other.
8%State Surcharge $
– - Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ No licenses are required Cleanses are required for all other installations
front of application ---
-- -- Fees:
Total Balance Due $
- Enter total of above fees $_ _
ElTrust Account#
3"/.State Surcharge $• ��
Total Balance Due $
i�dsts\formable-fees.doc (X/07101
i
CITY ®F T I G A R® --- BUILDING PERMIT
PERMIT#: BUP2002-00181
DEVELOPMENT SERVICES DATE ISSUED: 5/9/02
� 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171
PARCEL: 1S135AP, 01003
SITE ADDRESS: 10300 SW GREENBURG RD 470
SUBDIVISION: LINCOLN ONE=/REQ LOBSTER/CASA L. ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS _ _ EXTERIOR WALL CONSTRUCTION _
CLASS OF WORK: ALT FIRST: 1,792 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FR sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 1,792.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 32 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: M-ZZ?: READ SETBACKS_ ____ REQUIRED _
FLOOR . .)AD: psf LE _FT: ft RGHT: ft FIR SPKL_Y SMOK DET:Y
DWELLING UNITS: FRNT: It REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 12,000.00
Remarks: TI
Owner: Contractor:
EOP LINCOLN, LLC C SCHIEWE A- ASSOCIATES
10260 SW GREENBURG RD 1024 NE DAVIS
SUITE 100 PORTLAND, OR 97232
PgpjkAND,OR 97223 Phone: 234-6617
o e:
Reg #: Luc 54105
FEES REQUIRED INSPECTIONS _
Type By Date Amount Receipt Framing Insp
PRMT CTR 5/9/02 — $158.50 27200200000 Gyp Board Insp
Susp Ceiing Insp
5PCT CTR 5/9/02 $12.68 27200200000 Final Inspection
PLCK CTR 5/9/02 $103.03 27200200000
FIRE CTR 5/9/02 $63.40 27200200000
Total $337.61
This permit's issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 day-, of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246-6699 or 1-800-332-2344.
Pe tmittee
r �
Issued B
Call 639-4175 by 7 p.m. for an inspection the next business day
CITY OF TIGAR.D --- BUILDING PERMIT
PERMIT#: BUP2002-00181
DEVELOPMENT SERVICES DATE ISSUED: 5/9/02
13125 SW Hail Blvd..Ticiard. OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 470
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
YREISSUE: —� FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 1,792 sf N: S: E: W:
TYPE OF USL: COM SECOND: sf PROJECT OPENINGS?
TYPE Or CONST: 2FR sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 1,792.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 32 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft
GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED _
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BF..DRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 12,000.00
Remarks: TI
Owner: Contractor:
EOP LINCOLN, LLC C SCHIEWE + ASSOCIATES
10260 SW GREENBURG RD 1024 NE DAVIS
SUITE 100 PORTLAND, OR 97232
P9POTL.AND, OR 97223 Phone: 234-6617
one:
Reg #: LIC 54905
FEES_ REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
Gyp Beard Insp
PRMT CTR 5/9/02 $158.50 27200200000 Susp Ceiing Insp
5PCT CTR 5/9/02 $12.68 27200200000 Final Inspection
PECK CTR 5/9/02 $103.03 27200200000
FIRE CTR 5/9/02 $63.40 27200200000
Total $337.61
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, of if work is suspended for more than 180 days ATTENTION Oregon law
requires you to follow the rules adopted by the Oregon Utiiity Notification Center. Those rules are set forth in OAR
952001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246-6699 or 1-800-332-2.344.
Permittee I1")
Signature: -----
7
Issued By: __------
Call 639.4175 by 7 p.m. for an Inspection the next business day
Building Permit Application _
Date received: ��:! Permit no. U-��" -u,"i'61
City of Tigard
Address: 13125 SW Hall Blvd,Tigard.OR 97223 Project/appl.no.: Expiredate:
City u(Tigrud Phone: (503) 639-4171 Date issued: _ By:�10 I Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: i xk2 family:Simple Complex:
t
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction 0 Demolition
U Adclition/alteration/replacement U Tenant improvement U Dire sprinkler/,Hann U Other:
�111 110 11 M 113 two HMO
1
Jobaddress: 102;M SW Grtevlbvr, U Bldg. no..
Suite no.:
Lot: I Block: Subdivision: Tax map/tax lot/account no.: -
Project name: Int,S ihe.--5 Trans icel c DLC,_ __
Description and location of work on premises/special conditions:_ Tehavi \ J "pp!_'vewle,!Ai
OWNER FOR S111"CIAL t
Name: C-611JtT•Y OFF(CE l°f-�6179TM ./ (I loodplain,s6pilleca.pacity,solar,etc.)
Mailing address: (C 2 C-o SW Gr e-e.-L y, cc 1 &2 family dweiling:
City: f Cr t Q", State: ZIP: 1722, Valuation of work........................................ --
Phone501 $92-2.;00 l-ax: E mail: No.of bedrooms/baths................................. _
Owner's representative: Fay (L. G(ur GAD Arcg;tt-�'tr ,r Total number of floors.................................
a
2.2 -y05ta� Fax: I nutil New dwelling area(sq. ft.) ..........................
Garage/carport area(sq.ft.)......................... _
WWII
Name: GSD ;Ark te Al, lrl c Covered porch area(sq. ft.) ......................... _
Mailing address: 92o sw 3r avenue S�/to 4bOU Deck arca(sq.ft.) ........... . .......................... _
City: C,rt a State:C) 'LIP: Other structure area(sq. ft.).........................
Phone50Z 1 2. u - mmercinUindustrial/multi-family:
�E 5(� Fax: E-mail:[:-mail: 2 000 "
Valuation of work........................................ $ _-
Existing bldg.area(sq.ft.) ..........................
Business name: �, ��ch i�w e CC.-s*,
Address: t72 N` Pavis S't New bldg.area(sq. ft.) .............:..............
State:0 ZIP: 9 Z 32 Number of stories................... ...
City: Port(at Type of construction ... L- F L
Phcne5o3 Z3 -60k1 fax: F.-mail:
Occupancy group(s). Existing:
CCB no.: 5410 _ New, U
City/metro lic.no.: Notice:All ce.,,ractors and subcontractors are required to be
licemed with lite Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to he licensed in the
Address: jurisdic!ion where work is being performed.If the applicant is
Cif : -- State: ZIP:
exempt from licensing,the following reason applies:
Contact person; Plan no.: -----
Phone: Fax: E-mail
Name: Contact person: Fees due upon application ........................... $
Address: _ s Date received:
City: tate: Zlp: Amount received ......................................... $
Phone: Fnx: E-mail Please refer to fee schedule.
I hereby certify I have read and examined this applicution and the Not all judslicdana accept credit anti,please call jurisdiction for mote inforrtutuon.
Poached checklist.All provisions of laws and ordinances governing thi,. Uvi"a U Mastercard
work will be complied with,whether specified herein or not. Credit card number:
Authorized signature: 7_ �`"` Date: 9 G`L i Name of cardholder u shown on credit call
- S
Print name:- a �I", _ - Cardholder d6nature Amnutr
Notice:This permit application expires if a permit is not obtained within 180 days atter it has been accepted as complete. ")-*II tMM'oMI
Commercial Plan Submittal
Requirement Matrix
City.of Tigard '1
I -
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 §►
I
Building 1*
Fire Protection System 3**
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
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 conimercial 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.
r\dsts\forms\COM-matrix.doc 9/24101
(business Lr�.hs�'t.iC�t•, c Ll-C
- D CZ
Accessibility:
Barrier Removal Improvement Plan
City of Tigard
REQUIREMENT; OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to-.ffected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
ALUATION: of all renovation, alteration or modification being done
excluding painting, wallpapering. [11 $ Coo,o0
multiply: 25% Barrier removal requirement. 25
BUDGET FOR BARRIER REMOVAL (�1 $ 3 GCC• 00
In choosing which accessible elements to provide under this section, priority shall be given to t! use
elements that will provide the greatest access. Elements shall be provided in the following order:
dU
(a) Parking lot Jtrip'4 1) new C�•rb cert r, -1((Qt-Alkr $ -''C)
S\c1��c�gt t (rJvil0.�� Ctnt�Aiit['Jt a'C dolt FYI` �J
-All f
(b) An accessible entrance: $— —
(c) An accessible route to the altered area: $.
(d) At least one accessible restroom for $
each sex sex or a single unisex restroom:
(e) Accessible telephones: $
(f) Accessible drinking fountains: and $ —_ ----
(g) When possible, additional accessible
elements such as storage and alarms: $ _
TOTAL: Stia,l equal lino 2 of Value Computation_ $ 00 7 00
i\fists\rom,s\Accrasibility.doc 09/24/01
CITY OF T I G A R D BUILDING PERMIT
PERMIT#: BUP2001-00113
DEVELOPMENT SERVICES DATE ISSUED: 4/17/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 470
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: _ _FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT -- FIRST si N: S: E: W: —
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? _
TYPE OF CONST: 2FR sf N: S —E: W:
OCCUPANCY GRP: B TOTAL AREA: 000 sf ROOF CONST: FIF RET?
OCCUPANCY LOAD: 15 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft -GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: _ READ SETBACKS _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 10,000.00
Remarks: Tenant Improvement
Owner: Contractor:
KNICKERBOCKER PROP, INC XXIV C SCHIEWE + ASSOCIATES
BY NORRIS. BEGGS + SIMPSON 1024 NE DAVIS
10p300 SW GREENBURG RD STE 200 PORTLAND, OR 97232
P PPone ND, OR 972.23 Phone: 234-6617
Reg #: LIC 54105
FEES T — REQUIRED INSPECTIONS W
Type By Date Amount Receipt Mechanical Permit Require
PLCK CTR 3I29I01 — $90.55 27200100000 Electrical Permit Required
Sprinkler Permit Required
FIRE CTR 3/29/01 $55.72 27200100000 Framing Insp
PRMT CTR 4117/01 $139.30 27200100000 Gyp Board Insp
5PCT CTR 4/17/01 $11.14 27200100000 Susp Ceiing Insp
Final Inspection
Total $296.71
This permit is issued subject to the regulations contained in the Tigard Municipal Code, S'�,te of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans Thi; permit will expire if work is
riot 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 adapted by the Oregon Utility Notification Center. Those ru es 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) 246-6699 or 1-800-332-2344.
7 ,
Permittee 11
Signature: ��• ��� —
i
Issued By: —
Call 639-4175 by 7 p.m. for an Inspection the next business day
Building Permit Application
Datereceived: Permit no. ' ;
City of Tigard Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Ball Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: 1&2 family:Simple Complex: _
t
1
U I roc 2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Addition/alteratiort/rcplacemcnt )UTenant improvement U Fir!sprinkler/alarm U Other: _
11 SITE INFORMATION
Job address: 10300 SW Grea'6jr drt a 9 2"L3 Bldg.no.:L10 Suite no.: 4']G
Lot: Block: Subdivision: Tax map/tax lot/account no.:
Project name: One i vireo - su O -_-------._.--
Description and location of work on premises/special conditions: TeNaitt- t '�`�►"`e"� �'°��`- _��_
OWNER 1 INFORMATION
Name: SPIE:�Q PI-CFFP-11 -f (FIdbilplain,septic capacity,solar,eic.)
Mailing address: 02(vC -SW (•�reev+bur PA. SL+i 100 I &2 family drieWng:
_City: C— State. QZIP: 97223 Valuation of work................................. ...... $
Fhone503 892.2500 I Fax: E-mail: No.of bedrooms/baths................................. w
Owner's representative: G u►^ GDO {arch.;tee tJ) 'Cotal number of floors................................. _—
Pltone5o15 22 -9(,5(- Fax. E-mail: New dwelling area(sq. ft.) .......................... _
Garage/carport area(sq,ft.)......................... _
Name: GPE) The . Covered porch area(sq.ft.) ......................... _--
Mailing address:`)20 SW 3'-d a\1emee, S i to +000 Deck area(sq. ft.)........................................ _
city: FC)rtl a
State: ZIP: `372o Other structure.area(sq.ft.).........................
-- Contmercialr'indttstrial/multi-family:
Phone: Fax: email: ............. O(>00 00
1 1 Valuation of work........ ............................... 1c),
,—__--
A31 AIN
ll
Existing bldg.area(sq.ft.) . _
Business name: G, Scl1 lew e. t,e ns`� New bldg.area(sq.ft.)................................ S•P ..
Address: 02 aV is S Number of stories........................................ (5) FIV'
City• r,y 3a-d State:tv L ZIP: "�"]�32 -
Type of construction.................................... 1L Ff-- -- -
I'hone5o3 23 frbl Fax: I?-mail: — Occupancy group(s): Exist __..
CCB no.: 5 C'S _ hcvv: _ IS
City/metro Ii• to.: Notice:All contractots and subcontractors are required to be
i "U41(It 1001 V1 11 M Lela licensed with the Oregon Construction Contractors Board under
Name: -8"E- fl-` AP P L I ct4t-►7 provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed.If the applicant is
Cit
State: ZIP: exempt from licensing,the following reason applies:
Contact person:
Phone: Fax:
RL-12 Ila I
Name: Contact person: _ Fees due upon application ...........................$
Address: Date received: -
-- — —
City: Siste: ZIP: Amount received ..............................I.......... S_
Phone: Fax: �G mail: 1'leasc refer to fee schedule.
I hereby certify 1 have read and examined this application and the Na m junsdidioru KvW c"t cards,Wsm cdt jurit&90n for more+nfornm6on
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 numbn
Capin r
Autl+or'ved signature: Datc: '29 '0 - N.mc or c.rdtiowcr u arro«n oo erg+cbd
$
Print name: d _ �,t Glur Cardbotdersig"We Aa1Oa01
Noticr 11+is permit application expires if a permit is not obtained within 180 days after it has been accepted as complete 1� _I 440 4613(&WICOM)
L0
Date Recd:
CITY OF TIGARD Recd By:
COMMERCIAL TENANT IMPROVEMENT t
APPLICATION/PLANS SUBMITTAL REQUIREMENTS
Applicants: Please complete APPLICANT
1. APPLICANT NAME:_ PHONE #:__
2. SITE ADDRESS: -- FAX #
1. SITE PLAN (Fully dimensional, drawn to scale, showing existing parking, accessible route
to building) labeled with:
❑ map & tax lot #, ❑ project name, ❑ site address, ❑ site number,
❑ zoning, ❑ applicant name, ❑ phone number.
A. North Arrow
B. Scale (any standard, architectural or engineering only)
C. Street Names
2. See the "Commerical Plan Submittal Requirement Matrix" for number of plans required
based on submittal type (no redlines or tapeons accepted).
SIZE REQUIREMENTS: 24" X 36" (ROLLED)
ALL DETAILS LISTED BELOW SHALL BE INCORPORATED INTO THE PLANS
A. Floor plan(s)
B. Wall details
C. Reflective ceiling plan
D. Seismic bracing detail for suspended ceiling
E. Specifications & calculations
F. ADA barrier removal worksheet
G. Deposit - based on valuation of project
I:klstsVormsk;omdapp.doc 101000
One L kx,.Ol , - zt„+,_c 47o
_21� -C) I
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
sach alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed a.sproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION of all renovation, alteration or modification being done
excluding painting, wallpapering. (�] $ E%
-- ELECTRICAL PERMIT-
CITY OF TIGAR.D —
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2001-00134
13125 SW Hall Blvd.,Tipard, OR 97223 (503) 639-4171 DATE ISSUED: 5/7/01
SITE ADDRESS: 10300 SW GREENBURG RD 470 PARCEL: 1S135AB-01003
SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of low voltage for HVAC control.
A.RESIDENTIAL B.COMMERCIAL_
AUDIO & STEREO: AUDIO& STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOI!_ER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
INSTRUME-NTAT ION: OTHER:
TOTAL#OF SYSTEMS: 1_
Owner Contractor:
KNICKERBOCKER PROP, INC XXIV AMERICAN HEATING
BY NORRIS, BEGGS SIMPSON 1339 SW GIDEON ST
10300 SW GREENBURG RD STE 200 PORTLAND, OR 97202
PORTLAND, OR 97223
Phone: Phone: 239-4600
Reg #: LIC 00033135
ELE 26-683CLE
FEES _ Y Required Inspections _�—
Type By Date Amount Receipt Low Voltage Inspection
5PCT CTR 5/7/01 $6.00 2720010000 Elecl'I Final
PRMT CTR 5/7/01 $75.00 2720010000
Total $81.00
_ _J
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 acco•dance with appy oved 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.ybu to follow rules adopted by the Oregon Utility Notification Center. Those rules ar set forth in OAR
952-0 1 0010 through OAR 952,AO1 You may obtain copies of these rules or dir t uestionOUNC at (503)
?_46- 987. .- r
Issue by / / Permittee Signature �G
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: _ - DATE:---
CONTRACTOR
ATE:_ ,CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:----
LICENSE
ATE: --LICENSE NO: ------------- ------- ----- ---
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
41
Electrical Permit Application
Date received::h Permitno.y�/�• ov/-
City of Tigard Projcct/appl.no': _ Expire date:
t ut
of 11Kurd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639-4171 ---
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: ►'g ?e,
U I &2 family dwelling or accessory Commercial/indust i al U Multi-family �r`renant improvement
U New constriction U Addition/alterationheplacrnu ml U Other: U Partial
.1011 SITE 1
Job address: /0300 SW Ordend _ Bldg. Tax maphax Iollaccount no.: _
1-ol: HI(xk: Subdivision Linau^
Project name: Description and location of work on premises: NVAC
Estimated date of con Ietion/ins ction:
Job no: Pee Max
Ikscription Ot (ell.) no. nsp
BUsines5name: Klr.,r^, rL_cL tjea) r--T- New rrsitierdial"single ormulH-iamikper
Address: dwellingunk.Inrhmtesattached garage.
city: - , 41ckia State: 1e I ZIP: zU z 5ervirincluded:
Phone: Fax: E-mail: HxN)sq.It or less 4
Each additional 500 sq,ft.or portion thereof
CCH no.: ) Elec.bus.11C.no: C C Limited energy,residential 2
City/metro lie.no.: t b «r Limitedenergy,non-residential __ 2
��— _;J_O� Each manufactured home or modular dwelling
,< Service nmUmr feeder 2
Si nature o supervising electrician(required)/ ate
Su .elect.name(print): License noVj V-0•-/X rvicesorfeeders-Installation,
alteration or relocation:
20f)amps or less 2
Name(print): Q,�,r-1-.1 16201 amps to 4(x1 amps 2
•� ��'� �`r - 401 amps to 600 amps 2
Mailing address: StatC: 601 amps to I( xxlamps _ 2
('Ili: — ZIP: Over I(Xxl amps or volts — _ 2
Phone: FifX: E-mail: Reconneclonl�_
owner installation:The installation is being made on property I own 'Temporary Services or feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:
S
200 amps or less
447,455,479,670,701.
201 amps to 400 amq's
Owner's signature: Date: 401 w 100:111111%EW
Branch circuits-new,alteration,
or extorsion per panel:
Name: 7 f-I&L, C A. Fee for branch circuits with purchase of
Address: C service or feeder fee,each hranch circuit - ?
City , State�ltF' ZIP: B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit:
Phone: Fax:, �( E-mail:
Each additional branch circuit: _
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U Health care facility Each pump or irrigation circle -'
U Service over 320 amps-rating of I&2 U llnrardous locatioo Each sign or outline lighting 2
family dwellings U Building over 10,000 squaro Seel four or Signal circuh(s)or a limited energy panel. 1
USystem river 600volts nomimal more residential tools in onestructurr alteration,or extension* 2
U Building over three stories U Feeders.4W amps or more *Oescnpuon _
U Occupant load over 99 persons U Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above:
U E:gress/hghtingplan U Other .. -- Perms ecuon
Submit__setr of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. other
--—
Permit fee.....................$ 1 S-.O U
Not all poiulicllonr accept credit cards,please call lurtulicom Hn ounr infxmMmOor. Notice:'this permit application
U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ _
Credit card nunther _ —_ _ -_1_L within 180 days alter it has been Stale surcharge(8%) ....$
Expires accepted as complete TCTA1, $
- - Nui of cii borer as shown on credit card --
S
- Cardholder sitinsture Amount 4404615(WM*0101)
Electrical Permit Fees: Limited Energy Fees:
--- —� TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Postricted Energy Fee........................:............................. $15.00
Number of Inspections per permit allowed) (FOR ALL SYSTEMS)
Service included: Items Cost Tctal I Check Type of Work Involved:
Residential-per unit ❑
1000 sq ft or less $145 15 Audio and Stereo Systems
Fach additional 500 sq,ft,or
portion thereof $39,40 1 Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular F] Garage Door Opener"
Dwelling Service or Feeder $9090 2
Services or Feeders E] Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less _ $80.30 2 Vacuum Systems'
201 amps to 400 amps _ $1.16 85 _ 2
El
401 amps to 600 amps $16060 _ 2
----- — _
601 amps to t 000 amps $24060 _ 2 Other -- -
Over 1000 amps or volts $454.65 _ _ 2
Reconnect only $6685 _ 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Fee for each system.......................................................... $75.00
Installation,alteration,or relocation
200 amps or less $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps _ $10030 2
401 amps to 600 amps $133,75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see"b"above. Audio and Stereo Systems
Branch Circuits Boiler Controls
New,alteration or extension pet panel
a)The fee for branch circuits ❑
with purchase of service or Clock Systems
feeder fee.
Fach branch circuit $6 65 _ ' Data TeleCOmmlmicat on Installation
b)The fee for branch circuits
without purchase of service Fire Alarm Installation
or feeder lee.
First branch circuit _ $46.85 HVAC
Each additional branch circuit $665
Miscellaneous l J instrumentation
IS or leader not included)
Each pump or irrigation circle _ $53 40 Intercom and Paging Systems
Each sign or outline lighting $5340
Signal circuil(s)or a limited energy Landscape Irrigation Control'
panel,alteration or extension $75A0 _ _
Minor Labels(10) $12500 i
❑ Medical
Each additional Inspection over
the allowable in any of the above Nurse Calls
Per inspection $62.50
Per hour _ $62pe Lighting'
.50 _
In Plant $73.75 _ Outdoor Landsca
Fees: Prolective Signaling
Enter total of above fees $ n Other
8%State Surcharge $ -____Number of Systems
25%Plan Review Fee I No licenses are required Licenses are required for aft other installations
Seo"Plan Review'section on $
front of application
Fees:
Total Balance Due $
---- - Enter total of above tees
❑ Trust Account#_ 8%State Surcharge
Total Balance Due
i\dsls\forms\elc-fees duc l0/09100
CITYOF T I G A R D MECHANICAL PERMIT
PERMIT#: 5/7/01 1-00149
DEVELOPMENT SERVICES
DATE ISSUED: 5/7/01
LIM 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 1639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 470
SUBDIVISION: LINCOL N ONE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS _ HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
( 'AS � 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: 1 <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of HVAC.
Owner: � FEE__S�_'
KNICKERBOCKER PROP, INC XXIV Type By Date ! Amount Receipt
BY NORRIS, BEGGS + SIMPSON 5PCT CTR 5/7/0'1 $5.80 272001000C
10300 SW GRE ENBURG RD STE 200 PRMT CTR 5/7/01 $72.50 272001000C
PORTLAND, OR 97223 -- - — ---
Total $78.30
Phone: �_-___�� _ -----
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202 Mechanical Insp
Phone:239-4600 Fi,ial Inspection
Reg #:LIC 33135
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 rough OAR 952--001-0080.
You may obtain copies of tese rules or direct questions to OUNC by g (503)Z46-9189,
Issue By: L Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections neede the next bus ness day
a
Mechanical Permit Application
FDatereceived: I Permitn,.,/ I
City of Tigard Project/appl.no.: Expiredol.: -
City ojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 bate issued: By: Receipt no.:
Phare: (503) 639-4171 _._
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval _ Building permit no.: �,_ 2oO1- 00 11`
TYPE OF PERMIT
0 I &2 family dwelling or accessory Atommercial/industrial Q Multi-family XTenant imprnvement
U New construction ❑Additron/alteradon/replacement U Othcr:
1 : SITE INFORMATION1 1SCHEDULE
Job address: /pgpp 4.W.Crreenlau Indicate equipment quantities in boxes below. Indicate the dollar
Bldg,no.. ! heal 1 uite no.: .070 value,of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$ Ie2 4 09.OV _
Lot: Block: Subdivision: - $See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: 71! ao, ZIP: 47 22 3 IN Description and location of work on premises: µVAC 1
_ Fee(e%) Total
Est.date of completion/inspection: Description Qty. Res.ouly Res.only
Tenant improvement or change of use: !AAirhindlingunit CFM_
Is existing space heated or conditioned?OW Yes Q No
Air conditioning(site plan require ) _
1s existing space insulated?¢i Yes O No r Alteration of existing HVAC system T�
MECHANICAL CON1111WFOR Boiler/compressors
Business name: q r,, , /fGQ.�� Siac State boiler permit no.:
HP Tons BTU/H _
Address: / JF , o S Fire./smoke dampers/duct smo tectors _
City: St '',tat pump(site plan required) W
Phone: _ Fax _ Email L•a urep acefurnac umer T M
-'--- Inclw.. q ductwork/vent liner O Yes Q No
CCB no.:
�/� r nstal repacOrelocatcheaters-suspen ed,
City/metrolic.no.: /0;7,7 _ wall,or floor mounted
Name(plr m! print): f„�- r m r; p -� Vent I-or appliance other than furnace
CONTACT PERSON Refrigeration:
1 Absorption units BTU/11
Name: r»In PT7 Chillers HP
-
Compressors HP
Address:
Environmental exhaust and ventilation:
City: �- , State _ ZIP: v1 Appliance vent _
Phone: 234 EMFax:X,9,,V3E-mail: Dryerexhaust
floods,Type res.kitchenlh:umat
J hood ire suppression system _—
Name: ,•,� ,ter � � _ �-yir� Exhaust fan with single duct(bath fans)
Mailing addre s: -5haust system apart from heating or AC
Cit State: ZIP: Fuel piping and utribution(up to 4 outlets)
Y -_ Type: ---�Ll(, NO Oil e _
Phone: 1 ax: E-mail: Fuel piping each additional over4out ets
rocesspiping(schematicrequired) _
Name. /r/ ` Number of outlets -
1Y�6'TUt er lisled app-tance or equipment:
Address: /,3,3 .S r/ iJ�P n _ Decorative fireplace _
City: ,-Y'/nom c( LS tat e:0,Fe ZIP: 7,70.E insert-type -----�
Phone - V,500 J Fax; E
-70 mail: Woodswvc/pclletslosc .4
Uther
Applicant's signature' Date:S-/-O/ Other. _
Name (print): r` --
Va alt junsdicuonf accept credit cartl7,pleasr call jurirallu�r
ct for more Inf�muuon. Permit fee.....................S �2 !9
.4 Visa 13 AtasletCud Notice:This permit ap^.tcatron Minimum fee................S
Credit cud number _ / expires if a permit is not obtained plan review(at _ %) S
EXP,re, %�ithin ISO days after it has been State surcharge(8%) ,...S ,
Name or cardholder at,haws on credit cud accepted as complete.
S, TOTAL. .......................S
Card older nputute Amount 4404617(&WICOM)
...........
.... .......... ....... .. ....... ...... ....... ..........
... ... ..... ......
.... .......
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6
........ ...
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....... . .... ......1 i...... ........ .... ...... ...... ....
7--
I I^
.......... 0
Crry
.... ......
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..
............ . .......• ................. ....... .............................. j..;. . . .............. .. .......1.......t.......,.......,.......,.......:.......,... .
NEW
2 REFLECTED CEILING PLAN FOR SUITE 470
DRAWING TITLE:AMERICAN
PVAC LA-Y-.OUT-
JOB TITLE
8� 4vo
H EATING, INC. u-r-rEi, f
1339 S E. GIDEON STREET CJ497- 1.'INCOL1�
PORTLAND, OREGON 972022418
TELEPHONE (503) 239-4600 FAX (503) 239-7038
CITY OF TIGARD BUILDING INSPECTION DIVISION C / MST
�4-Hour Inspection Line: 639-4175 Business Line: 635-4171 ----
BUP
Date Requested— S– l _ AM PM �_� BLD
Location �(�.3 UU S w t?r./ �u,.TT^ Suite — MEC ------ —
Contact Person Phi��G_� PLM —_--
Contractor — — Ph SWR —
113UILDING Tenant/OwnerELC
Retaining Wall —^ ELP
Footing Access:
Foundation FPS
Ftr3 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: --- G� yZL l �? {� Yl 4 �.�_=E�_L_ -------
Final - --------
PASS PART FAIL - -- -------- - -- --- -
PLUMBING
Post& Beam _--
Under Slab
Top CIA
Water Service
Sanitary Sewer --- — -- -- .�.`-- --.
Rain Drains
Final ------ --_—_-__
PASS PART FAIL
1 MECHANICAL --
Post& Beam -----._.--_._-- —__ —.— -- — _------
Rough In
Gas Line --- ---- — — — ----___—_
Smoke Dampers
Final -- ---- --- - -- ---
PASS PART FAIL
Service AOP
Rough In
UG/Slab
c ow Vol
-Tire ------- ---- -------- --- -...
' am
PASS PART FAIL
'rE
Backfill/Grading _-- -�— ----- — — ---
Sanitary Sewer
Storm Drain [ )Reinspection fee of$_—_ -equired before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( J Please call for reinspection RE:^- _ _ )Unable to inspect- no access
Approach/Sidewalk _
Other Date InspADA ector _ _Ext
Final
PASS PART FAIL. DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639.4175 Business Line: 639-4171
BUP
Date Requested S_ 2-3 -- _AIA PM BLD
Location / �'U S w67y-�.4,-67c. ✓ -e Suite MEC Zirlv/--
4 G� G 3
Contact Person _� � Ph PLM_.� _Contractor Ph—_ — Ph -- SWR
BUILDING —� Tenant/Owner _ —_ _ — _ _ ELC
Retaining Wall ELR
Footing Access: t FPS
Foundation 'VO
F"t5 Drain SGN
Crawl Drain Inspection Notes: ---- -
Slab - ----- _ _— -- ---- -- _--- -- - SIT
Post& Beam
F xl Sheath/Shear
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing
Firewal!
Fire Sprinkler _----.---_ - —_ _ _--- --- - -_-.—.---- --- -
Fire Alarm
Susp'd CeilingRoof
Misr;Misr, _ -- - .�_------- ------- ---� �_ _ - --- ---- —
Final -
PASS PART FAIL -- -- --- - - - ---- ..-Y-__- -- --
PLUMBING
[lost& Beam
Under Slab
lop Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
Pos :Team --- - - .. - --------.._- - -- - -
Rough In
Gas Line 1 a -- -- ""
Smoke Dampers
Final'"""" ._ _-- -- - --- -
PASS PART FAIL_
ELE RICAL -
Service
Rough In
UG/Stab ---- -- - - - --- -
Low Voltage
Fire Alarm
Final
PASS PART FAIL _^---�-- - --- - -- -- .__.._.�---- ---- - -SITE -
Backfill/Grading -•---
Sanitary Sewer
Storm Drain [ I Reinspection fee of$-. required before next inspection Pay at City Hall, 13123 SW Hall Blvd
Catch Benin
Fire Supply Line ( )Please call for reinspection RE. ( ]Unable to irspecc- no access
i
ADA j
Approach/Sidewalk Date 2 Inspector. Ext
Other - - -------._ --
Final
PASS PART FAIL ; D9 NOT RE ROVE this inspection record from the jots site.