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11895 SW GREENBURG ROAD i a Ch W 07 U e I C � r f I i 1 C✓ CIV08 DWRN22ND MS 568TT CITY OF TIGARD ELECTRICAL PERMIT PERMIT#: E LC2003-00508 DEVELOPMENT SERVICES DATE ISSUED: 8/14/03 13125 S'VV Hall Blvd., -I iciard, OR 97223 (503) 639-4171 PARCEL: 2S102AA-01200 SITE ADDRESS: 1180)(1 SW GREENBURG RU ZONING: C-P SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: JOB NO. 3758 Day Center, alter branch circuit _ RESIDENTIAL UNIT TEMP SRVCIFEEDERS _ _ MISCELLANEOUS 1000 SF OR LESS: _ 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL./PANEL: MANF HMI SVC/FDR: 601+amps- 1000 volts: MINOR LABEL (10): SERVICEIFEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: LUKE-DORF INC WILLAMETTE ELECTRIC INC 11895 SW GREENBURG PO BOX 2-30547 PORTLAND,OR 97223 TIGARD,OR 97281 Phone: Phone: 503-624-3631 Reg it. LIC 75059 SUP 1965S _ FEES El I 34-2830 Description Date � Amount Required Inspections (EI.PRM"1'1 ELC1'rnnu 8/14/03 $46 85 --i--' (TAX18%Sinn l ue 8/14/03 $3 75 Ceiling Cover Wall Cover Total $50.60 Elect'I Final This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or 9 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Ore,on Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or.lirect questions to OUNC at(503)2466699 or 1-800-332-2344. t Issued By: --f=— Permit Signaturr?:� 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. EL.EC'W ___. _ DATE:_ LICENSE NO: Cali 639-4175 by 7:00pm for an inspection the next business day r Rut 11 03 f)3: 48p Luka Dorf Inc 503 598 8632 p, 2 FOR-OFFICE IJSE.QNI,V Electrical Permit A�ppileation � Received P.Icctr,cal --- 11 Z� Date/By: -1 Permit No.;8&d crb 3'X00 City of Tigard i'1U17 RU Planning Approval _1 tNo.: UattdB Permit mi 13125 SW Hall Blvd. GIjY QF I A Plan ReviewOther Tigard,Oregon 97223 �N [)1 ..— l ION D■Wl3y _ Fcn.,it NoA Phone S03-fi39 4171 Fax: 503-598-1 � Post-Review Land Uae Date/By. _ Caso No_ Internet: www.ci.tigard.ontis Contact Juris.. See Page 2 for 24-hour inspection Request: 503-639.4175 Name/Method: _ Sup tLlementd Information. Wd WKM New construction Demolition U Service over 7.29 amps- lir;th•care fa.lilt -- corrtmercial ❑Hazardous location Addition lterati0 a lacement Otltcr ❑Service over 320 amps rating cif ❑Building over 10,000 square feet, 1&2 family dwellings four or more residential units in 1 &:2-Family dwclhn Commercial/Industrial [3 System over 600 volts ourtuna, one structure �- - Q Building over three stones ©Feeders,400 amps or more Aceesso Buildin 1Vlulh_Fa!n�, I ❑Occupant load over 99 persons Q Manufactured structures Lir RV park Master Builder Other n da,- w � Cl Cgresslligh(ing pia, ❑Other__ Submit_scte of plans with any of the above. `,ly ii+�! 7lS5_� 1 he above are nota illcuble to tem orar construction service Job site address:_ I I kq-1' S10 Suite#: Bld ./A tp n: ___ Num cr of ins ections per ermit allowed Description — Qty Fee(a.) Total Project Name: �- New resldratial-single or multi-fatuity per Cross Strect/Directions tojob site: , dweaing unit,includes auarhed garter. U,t'_b'i- i'reciAvv, Ilk/. / rFb/� �i9 ytCi t.(./h1k OWL Service Included: 145.15 4 ���_ � 1000 .R,or less Each dditwnal 500.sq.ft . .or portion thereof 77.40 I L mitwf eons residential _ 75.00 _ 2 Subdivision: _ �1 Lot#: _ Limited inter Lion residential 75,00 Tax tna / t3rCe1#: f ach mtnurn'"it home or modular dwelling x• r r.. service an(Vor feeder 90.90 2 Services ur feeders-installation, `'2 T N1 C•[ /f u'/v alleratioa or relocation: 2110 amps or less _. 80,30 �_ 2 -•--- 201 ampi to 400 106.85 2 160.60 2 ti 601 ams to 10000 amps 24D.60 _ 2 l �^+i 1„ 2 17ver I WO amps Lir Volta _ NamC: t t 1(ts -cbo o--F (NC !t<,:o iimt only_ 66.85 2 Address: (O'�► ?7 r�1n-J ry 1-�_ Temporary services or feeders-Installation, alteration,or relocation: Cit /State/'Lip: f 1� A' �)O7r3 3 200 amps or less i 66.p5 l Phone:(.CUI 63t�-p�b Fax: 6-tn 6?,ej �i 4S zUl am sa,400srnps _ _ 10030 2 401 to 600 ams 133.75 2 � Bi circuits-new,alterNlnn,or Narne: extension per panel: —__-_ _ _ __� A.Yee for branch circuits with pwotase of Address: _ _ service or fader fee,each blanch circuit 6.65 2 — B Fee for branch circuits without purchase of City/StatC/ZI� -__ -- service or feeder fee,fret brat,:h circuit 46.85 2 Phone: - , FaX. Ili additional branch circuit 6.65 2 E-mail: e CIS or fader not included) jigo b tmi or un acorn circle___ _ 53.40 2 J t - Each stnor outline lighting 53.40 _ 2 rJob No: S / Signal cucuit(s)or a limited enemy penal, -- "- alteration,or extension P 2 Z �usiness Name: - Address: C 2.3o_t-�7 Each additional infection over the allowable In an of the above: C1t 7/state/Zip: r, .a G _ Per inspecuonpei how min 1 hour) 62.50 Phone: GAY 3(0'!/ Fax: oda( InYaautaienie - -,----- --.- CLB Lic. #: 7SU Lic,#: S Utb`t Supervising electrician �'� _ Subtotal Ski si attire re wired: R�. Plan Review(25%of Perm►t Fee) S Print Name: dam" F t Lic,#: �•YS�__C State surnha c. 9%of Pemut Fee) S 1 _ _ TU'fAl.PERMIT FB)i S _J50 Authorized , / Notice: Thls permit application expires I(*permit ft not obtained within Signature- _. Date /IP 180 days alter It has been actepted as complete. ` •Fee methodology sot by Tri-County fluildlag Industry Service Board. Q Tse pont name) L D - I\n.gts\Perrrit Fomis\17UPermstApp.due 01103 i .t: � s ' �� l CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP `__.---__------------- Received -- Date Requested - '� ' �` AM PM -_ BUP 4' r Location MEC Contact Person ------ --- -- - ----- - `_ PFi(_—T} _ _� PLM Contractor -- -- - -- - --- ._�_. _ Ph(----) L q SWR _7 _ BUILDING Tenant/Owner _-_- � �.�- _ ELC Footing E LG Foundation Access: Ftq 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 PL_U_MBIN(i - — Rost&Beam Under Slab - - - Rough-In Water Service - - Sanitary Sewer Rain Drains - - Catch Basin/Manhole Storm DrainShowerPan _C6 4?� 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 - --- - ----------------_�._.__ lal� n Reinspection fee of$._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. j; A�RT FAIL _ Please call for reinspection RE Unable to inspect-no a cess Fire Supply Line ADA �- Approach/Sidewalk Ante flS �. Inspector _1 � Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL ,�MECHANICALPFRMIT CITY OF TIGARD DEVELOPMENT SERVICES PERMIT#: /3/03 3 00082 3 13125 SW Hall Blvd., Tip?r:1, OR 97223 (503) 639-4171 DATE ISSUED: 3/3/03 PARCEL: 2S 102AA-01200 SITE ADDRESS: 11895 SW GREENBURG RD SUBDIVISION: ZONING: C-P BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: CCA UNIT HEATERS: VENT FANS: 1 OCCUPANCY GRP: R.; VENTS W/O APPL: VENT SYSTEMS: 2 STORIES: BOILERSICOMPRESSORS HOODS: 1 _ FUEL TYPES _ 0 3 HP: DOMES. INCIN: 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 10 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HN: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN —100K BTU: <= 10000 ctm: GAS OUTLETS: > 10000 cfm: Remarks: Relocate(1)range Venting.(2) hrtl111v(lurt mid t 1 )hill III o til r\IImIst. Project \,11m \250,00 Owner: FEES LLIKE-DORF INC Description Date Amount 11895 SW GRE=ENBURG PORTIAND, OR 97223 �MLCHJ i'crmit I rr 3/3103 $7250 1TAXI 8" 3i3/03 $5.80 Total $78.30 Phone: Contractor: MARLAND H HENDERSON 12950 SW PACIFIC FIWY STE 5 TIGARD, OR 97223-5061 REQUIRED INSPECTIONS Mechanical Insp Phone: 503-039-5537 Duct Inspection Reg#• Final Inspection 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 acoordance 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. AT-f ENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 Issued r / � � Permittee Sioaturil: Call (503) 639-4175 by 7:00 P M. for inspections ne6ded the next business day Mechanical Permit Application ' ReeelVed � Mehnical ca Date/B : �u Permit N_o_.:l !t!'pr<YJJ 8� City of Tigard Planning Approval Building 1 Date/ft: Permit No.: 13125 SW Hall Blvd. Plan Review other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Internet: www.ci.tigard.or.us Date/By; Case No.: Contact Juris,: see Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Methodi I —__ I-Supplemental Information. TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST New construction Oenlohtion Mechanical permit fees'are based on the total value of the work Addition/alteration/re lacement I El Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,q ui2ment,labor,overhead and profit. F-1-1 &2-Family dwellingCommercial/Industrial value: $ See Page 2 for Fee Schedule �1 Accessory Building Multi-Family RESIDENTIAL E t IPMENT/SYSTEMS FEE*SCHEDULE MMaster Builder Other: Description ty Fee ea. Total Heatin Conlin JUB SITE,INFORMATION and LOCATION Furnace-add-on air conditioning•• 14.00 _ Job site address: IIB 7,3 -'Ji j rJ u4.0 Gas heat pump Suite #: Bid ./A tI: Duct work _ / 14.00 Project Name: H dronic hot waters stem 14.00 Cross street/Directions to job site: Residential:goiter for radiator or h dronic s stens 14.00 Unit heaters("fuel,not electric) in wall,in-duct suspended,etc.) 14.00 Flue/vent(for any of above) 10.00 Subdivision: Lot#: Re air units _ 12.15 Tax map/parcel#: Water heater Other Fuel Air liances 10.00 DESCRIPTION OF WORK Gas fireplace 10.00 Flue vent(water heater/ as fireplace) 10.00 Log lighter(gasl 10.00 ��-- -- Wood/Pellet stove _ 10.00 Wood fire lace/insert _ 10.00 Chittwey/liner/flue/vent 10.00 PROPERTY OWNER___ _FCTTENANT_ Other: 10.00_F_ I Name: ki( _ /p1 Environmental Exhaust 6r Ventilation Range hood/other kitchen equipment / 10.00 Address: 1 895 FAtv /Lttt/J ��_ Clothes dryer exhaust 10.00 City/ tate/Zi : lL r 02 `17P-;-'_5 Single duct exhaust Phone. Fax: (bathrooms,toilet compartments, APPLICANT CONTACT PERSON utilityrooms 6.80 Name: _ Attic/crawl space fans 10.00 i Address: __.� Other: Io.00 �— — Fuel Piping City/State/Zip: ••($5.40 for Ora(4,$1.00 each addi(ionaf) _ Phone: Furnace,etc. —^ •+ _Fax: .— Gas heat Pump E-mail: Wall/suspended/unit heater •• CONTRACTOR Water heater _ •� BtlSln-$S Name:HA L.}� Nt Fireplace +• Address: Ran a •• _ Cit /State/Zi _ -BBQ +� — — ---� _ Clothes dryer as 44 Phone: Fax: Other: _ 0 CCD Lic. #: 70' ^ notal: Authorized _ M_echa.nteal Permit Fees• 1 Signa re: �'� -- Date" 3 �� — Subtotal: ��! — Minimum Pennit Fee$72.50_ 5 Plan Review Fee 25%of Permit Fee $ Ere (Please s - (Please print name) _ State Surcharge(8%of Permit Fee) $ TOr_AI.PFRMIT FEE 5 Notice: This permit application expires If a permit is not obtained Nitldn *Fee methodology set M Tri-Cbanty Bullding Industry Service Board. IAO days after It has been accepted as compiete. "Site plan required for exterior A/C units. i\DstsTermit Fonns\MecPermitApp.doc 01103 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to$S 000.00 Minimum fee$72.50 $5,001.00 to$10,000,00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof to ant'including$10 0(x1.00. $10,001.00 to$25,000.00 5148.50 for the first$10,000 00 and $1.54 for each additional$100.00 or fraction thereof,to and including $25,000.00. $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional$100.00 or fraction thereof,to and including $50,000,00. $50,001.00 and up $742.00 for the first$50,000.00 and_ $1.20 for each additional$100.00 or fraction thereof. Assumed Valuations Per Appliance: --�— Value Total Description: Qty (Ea) Amount Furnace to 100,000 BTU,including 955 ducts&vents Furnace>100,(00 BTU including ducts 1,170 &vents _ Floor furnace includin vent 955 Suspended heater,wall heater or floor 955 mounted healer Vent not included in appliance permit 445 Repair units 805 <3 hp;absorb.unit, 955 to 100k BTU 3-15 hp;absorb.unit, 1.700 1 101k to 500k BTU 15-30 hp;absorb.unit,501k to I mil. 2,3)0 BTU 30-50 hp;absorb.unit, 3,400 1-1.75 mil.BTU >50 hp;absorb.unit, 5,72:, >1,75 mil.BTU Air handling unit to 10,000 cfm 656 Air handling unit>10,000 cfm 1,170 Non-portables 656 Vent fan connected to a single duct 446 Vent system not included in appliance 656 permit _ Hood served by mechanical exhaust 656 Domestic incinerator 1,170 Commercial or industrial incinerator _4,590 Other unit,including wood stoves, 656 inserts,etc. _ Gas piping I-4 outlets 360 _ Each additional outlet 63 TOTAL COMMERCIAL $ VALUATION: i\Dsts\Petmit Forms\MecPcmmitAppPg2.doc 01103 CITY OF T I GA R D __ BUILDING PERMIT PERMIT#: BUP2003-00033 DEVELOPMENT SERVICES DATE ISSUED: 1/21/03 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S102AA-01200 SITE ADDRESS: 11895 SW GREENBURG RD SUBDIVISION: ZONING: C-P BLOCK: LO'r: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: R_EQD SETBACKS _ _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: _ V SMOK DET ^� DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: 'PARKING: VALUE: $ 20,000.00 Remarks: New accessible ramp, entre door and restroom. Electrical permit is required. Owner: Contractor: LUKE-DORF INC MARLAND HENDERSON CONSTRUCTION 11895 SW GREENDURG 12950 SW PACIFIC HWY PORTLAND, OR 97223 ftB-2 TIGARD, OR 97223 Phone: Phone: 503-639-5337 Reg#: LIC 70266 FEES REQUIRED INSPECTIONS Description Datp Amount Framing Insp J RUI I DI I'ri mit Fee 1/21/03 $23 .30 Gyp Board Insp TAXI 8" titan'Faa 1/21/03 $1812 Final Inspection X111'1'1'1 I'll) 14 1/21/03 $15:.95 Total $406.37 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 wil be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if wo,* is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by (-,ailing (503)246-6699 or 1-800-332-2344. Issued By: c / Permittee -'� Signature: / " Call 639-4175 by 7 p.m. for an inspection the next business day Butiiding Permit Application City of Tigard Date received: / / o '� Permit no. f' 3 Cn ity f7'igard Address: 13125 SW Hall Blvd,'pigard,OR 97223 ProjecUappl.no.: Expire date: Phone: (503) 639-41'71 Date issued: By:4p9l Receipt no.: Fax: (503)598-1960 Case file no.: Payment type: Land use approval: 1&2 family:simple Complex: U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction O Demolition 141 Addition/alteration/replacement U Tenant imprtrvcmew U Fire sprinkler/alarm U Other: JOB SITE INFORMOXION Job address: el ILL .t •�f j ,- Bldg,no.: Suite no.: Lot: Block: "- Subdivision: :ice Tax map/tax lot/accoura no.: Project name: u 1[ 1(_ tLZ e Description and location of work on premiscs/special conditions: FOR SP% Name: tl r tJu t , Mailing address: e j, j , 1 &2 family dwelling: City: t& U f a,.{ Statc:pQ ZIP: c_j��rValwuion of work........................................ -,_- Phone: Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: 'total number of floors....I...I........................ _ Phone: Fax: E-mail: New dwelling area(sq ft.) .......................... Garage/carport area(sq.ft.)..... ................... Name: _ t; t Covered porch area(sq.ft.) ......................... _ -- Mailing address: - t Deck area(sq.ft.) ........................................ City: Q Stare 'ZIP: Other stnuture area(s(l Il.)_....................... - -- ommercial/industrialhnul+i-famil Phtmc��• _ I�:tx. _' I: m;til: f/��- i( Y: Valuation of'work.................. . ............ .. .. $ COO_! Existing bldg.area(sq,ft.) .......................... Business name: ` ,tt o s,f New bldg.area(sq. ft.)..............I........... ...... Address: Number of stories. City: � State• 7.IP• <'. ;� ....................................... 72 ki Phone: Fax j R E-mail: �,ki , Type of construction............................... V _ -'Occupancy group(s): Existing: _ i - New: City/rncuo lie.uo.: �;•1�iG n�, �����r F edit Notice:All contractors and subcontractors are require to be 11111111 IN IN 11 V-1 W licensed with the Oregon Construction Contractors Board under Name: provisions of URS 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:_ ^- _ Plan no.: -- Phone: 1 t F nt,til -- Name: _ t,untact person: Fees due upon application ........................... $ Address: Date received: City: State: ZIP: Amount received .................................. ..... $ Phone: I E-mail: Please refer to fee schedule. hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit cards,please call jurisdiction for more information attached checklist. All provisions pf laws apd ordinances governing this U Visa U MasterCard work will be complied wi rti herein or not. crcau e.re number _._f`-�_ _ _ Expires Authorised�ign g'+C— Date: -1-5-y 2 Nurse of cardholrlrr as shown on credit cud Print name: q, r4r, Ik7c4�_ Ctudh-lder signature Amount Notice:This permit applieatior expires if a permit is not obtained within 180 days alter it has been accepted as complete. mo-m13(&W/Com) Commercial flan Submittal * Requirement Matrix City of Tigard 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 Utili"-s 2 Building �* 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 fterplan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plans bear the original seal (_4 an Oregon licensed fire suppression engineer, or NICET level "3" technicians. iAdstsUoims�COM-matrix doc 9124101 i i I II City of f igord INSPECTION REQUEST for I � " INSPECTION PERMIT NO.: i DAT E:o;?Ji2.11Z DATE ISSUED: OWNERS NAME: ` . ADDRESS: -e - I CONTRACTOR :---, 'r TEST:Air O, water p�,�liorol D , Loftorator1 D RESULT: Approved Cf Disapproved O D I SKETW: 1 I I INSPECTOR DATE CUM: AtteeA 9600Io~t6! 1116t dot* 110r*10� f I P.imit We 1 L Name of Oaovpant (� -Y], Pomit chum_------ — Paid by ---- _ _ �`�._ _ ---. ------ Dab oomn`c•�W_ ` 1 ..��_ Topa of Buildiaq_l1� � hwpectim Ma__ _ ----..-- S*fvkv Raw P-tid by � —Paw--. i c mod CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00436 13125 SW Hall Blvd., igard, OR 97223 (503) 63F-4171 DATE ISSUED: 11/14/02 SITE ADDRESS: 11895 SW GREENBURG RD PARCEL: 2S102AA-01200 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DF.AINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY T RAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER r IXTURFS: TUC /SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Install fixtures. 1 lav, 1 dishwasher, 1 Fink, 1 water heater. _ FEES "v Owner: — — – _-- Description Date Amount LUKE-DORF INC — ---- 11895 SW GREENBURG II'LUNIIII Pcrnut Fee 11/14/02 $72.50 PORTLAND, OR 97223 11'111MB Permit Fee 11/14/02 $0.00 1 IA X 1 8," State Tax 11114102 $5.80 1 I AXI 8 State Tax 11/14/02 $0.00 Phone 1: -- Total $78.30 Contractor: WESTERN PLUMBING 9460 SW TIGARD STREET TIGARD, OR 97223 REQUIRED INSPECTION Phone 1: 503-639-5296 Top-out Insp ^ Final Inspection Reg #: \11-T 0001'1703 LIC 24?9 PLM 34-29PB This permit is issued subject to the regulations contained in the Tigard Municipal Code. Slate of OR. Specialty Codes and all other applicable laws. All work will be don ' in accordance with approved plans. This perr,lit will expire if work is not started within 180 days of issuar._-_ or if work is suspended for mcre than 18J days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You ►nay obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: 4 Permittee Signature: _--:.__ Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day i 1'111-In ing Permit Application City of Tigard Dalereceived: 41 _ -4' - Permit no. _0 Address: 13125 SW }tall Ellvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: � Phone: (503) 639-4171 P r Lt- I'roject/appl.no.: Expire date: Fax: (503) 598-1960 NN�� 11;! Date issued: By: Receipt no.: t'1 Land use approval: Case Iib'no.: Payment type: U I &2 family dwelling or accessory >fC'onunercial/industrial J Multi-tanuly U Tenant improvement J New construction )LO ddition/al it-rat ion/rep)ace men I U Food service U Ocher: Job address: yq ' Descr•i tion �`o/�J� � � New I-and -tam well n s only: �t Fee(ca.) l utul Bldg,no. Suite no.: (includes IOOH.fore chutiiitycconne Ilon) Tax map/tax lot/account no.: SFIt(1)both _ Lot; Block: Subdivision: — SFR(2)bath Project name: &,C- SFR(3)bath -� - City/county: ,O ZIP: Each additional bath/kitchen Ucsc prion and location of work on premises: _ SiteuNlities: fdtra/,,(. ,�.at' itra" _ Catch basin area drain Est.date of completion/inspection: d wells/leach lineArench drain Amu Pouting drain(no. lin. ft.) Manufactured home utilities ` Business name: j L ' ✓6 _ Manholes Address: Svifr 41 v/ Rain drain connector City: State ZIP: 7,?'?!7 Sanitary sewe•(no.lin.ft.) Phone:617-,� Av I Fax e/d� E-mail: Storni sewer(no, lin. ft.) CCB no.: r `• Plumb, bus, reg, no: f Wa'er service(no.lin.ft.) City/metro lic.no.: / (,TJ Fixture or Item: Absorption valve Contractor's representative signature: . �— Back flow reventer _ Print name: �% sent �.' Date: �� o Backwater valve -kWll'PERSON e Basin, avator _ - 0 Name: Clothes was ler _ Address: -- Dishwasher — _ _ _-- _-- —---.--- Drinking fountains) - - C'ity: Si:u; LIN: E ectors/sunmp Phone: I as - 1 1. tttalll. - Expansion tank Fixture/sewer cap _ Name(print): floor drains/floor sinks/hub _ - Mailing address: - Garbage disposal -- _.--_---_-_ .- ---�__-- Hose bibb State: - Lip: _ Ice maker I'hunc: Fax: E-mail: Interceptor/grease trap _ 0%user instal lation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(t-ommercial) employee on the property I own as per ORS Chapter 447. Sinkls ,hasin(s),lays(s) (A�ner's signature: Date: Sul-lip - Tubs/shower/shower pan Nome: Urinal Water closet Address: _- --—` - - tef heater _ -City: _ _ State: ZlP: - _ Other; Pl,.,ne: Fax: E-mail: Total Not all)IlrisdicUona accept credit cards,please call)urisdiction for more iofnnnmionh'l imnium fee $ J�� J visa U Mastercard Notice:This permit application plan review(at _ %) $ _ expires if a permit is not obtained s � - Credit cud number 1�_ within 180 days after it has been State surcharge(8%) ....$ ,__ Expires TOTAL . $ M -V Name of cudhol r as shown on credit card accepted as complete. ^^ S Cardholder signature Amount JJU-rb l h t W1lYl;U11 i; CITY OF TIGARD ELECTRICAL PERMIT PERMIT#: ELC2003-00077 DEVELOPMENT SERVICES DATE ISSUED: 2/19/03 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 2S102AA-01200 SITE ADDRESS: 11895 SW GREENBURG RD ZONING: C-P SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: I RESIDENTIAL UNIT _ _TEMP SRVCIFEEDERS _ MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE 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 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCFI CIRC: 4 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVCIFDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: I_UKE-DORF INC WILLAMETTE ELECTRIC INC 11895 SW GREENBURG, PO BOX 230547 PORTLAND,OR 97223 TIGARD,OR 97281 Phone: Phone: 624-2938 F-AX Reg#: 6IZ4-3631 75059 SUP IWS FEES FLE 14-283t' Description Date Amount Required Inspections (I:LPRM I( ELC Permit 2 19 03 $73.45 (I AX]8%State Tax 2 11103 $,88 Rough-in Elect'I Final Total $79.33 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more 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 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at(503) 246-6699 or 1-800- 2.23�,, r Issued By: l��.S[�d1 Z Permit Signature:—� E3 vL� _ OWNER INSTALLATION ONL; __ ^ 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 NO Call 639 4175 by 7:00pm for an inspection the next business day Electrical Pernut lIcation Valereceived2_/rf- Permit no..� 2003.t-V C'% J City of Tigard F'roject/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall B10,Tigira;�0AM,223 pate issued: 8y:~ Receipt no.: Phone: (503) 639-4:71 Fax: (503) 598-1960 ,JTYC)F I i6ARU Case file no.: Payment type: Land use approval: t)ILDI' a U 1 &2 family dwelling or accessory tdl Commercial/industrial U Multi-family U'I'enanl intpnnentcnl U New construction U Addition/alteration/replacement U Ulher: U Partial JOB SITE INFORMATION Job address: SS` ev Bld F, nu.: Suite nu.: I ax Inap/tax louaccount net.: Lot: bltxk: Subdivision: -- — --� Project name: L.V- 0,:f- I Description and location of work on premises: —I'- Estimated date of completion/inspection: Job no: 2" Pee Max Description Qty. (ea.) 'Total no.lnsp Business name: P e r New reshletdial-xingk or multi-family per Address: O A,- Z -y doellingunit.Includmattachedgarafe. City: Tr Slate: C' 7.1P; q �2S / Seryice included: Phone: Fax: -Z E-mail: lam sq.ft.or less __ _ a CCB no.: Vault additional 5(K)sq it.or pot tion thereof ��r Elec.bus. lie.no: 34 -2� i C Limited energy,residential City/me ,clic.no.: ,eZ, Lind(cdenergy,non-residential -C1,5 Each manufactured home or modular dwelling Signature of supervisinj Fheffician(required) Date Service and/or feeder 2 Slip,elect.namelprintl' r Yi License no f�/6 j Services orFeeders—Installation, lteration or relocation: 2(m amps or less 2 Name(pent): 201 amps to 4(m amps — 2 --- 01 amps to 600 mops 2 Mailing address: 601 amps to tam amps 2 City: Slate: ZIP: 77:,1' over 1000 amps or volts 2 Phone: Fax: E-mail: econneetonly 1 — Owner installation:The installation is being made on property 1 own 7empo"ry services or feeders- which is not intended for sale,lease,rent,or exchange according to install■tlon,alleration,orreloc■llao: URS 447,455,479,670,701. 2(m amps or less 2 201 amps to 400 amps 2 owner's si naturc: _ Date, _ 401 to 600 amps — 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: H. Fee for branch circuits without purchase , — of service or feeder fee,first branch circuit yds �s3 2 Phone: Fax: E-mail: trach additionnl branch circuit J- Misr.(Service or feeder not Included): U Service over 225 amps-commercial U Hcalth-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous location Ench sign or outline lighting 2 family dwellings U Building over 100x)square feet four or Signal citcuil(s)or a limited energy panel, U System over 6W volts nominal more residential units to one structure alteration,orextension• 2 U Building over three stories U Feeders,4W amps or inom 'tkscrition. — U Occupant load over 99 persons U Manufactured structures or RV park Fich additional Inspection over the allowable in any of the alcove: U Egress/lightingplmt U other —_ Per inspection Submit___—sets of plans with any of the above. Investigation fee _ 71te above are not applicable to temporary construction service. other — - ------ --- -- Net all jurisdictions accept redir canh,please call junsdtction for more infcxtnatinn Notice: Nis permit application Permit fee..... $ 4 U Visa U MasterCard expires il'a permil is not obtained Plan review(at _____ e7r) $ Credit card number _ ___ I I within 180 days alter it has been State surcharge(9e() ....$ -- Expires accepted as complete. TOTAL. ... .............. ... $ 7!j. 3Z Name c nus on it c S ---- Cardholder slpWure Amount Jat4615(6RXYMNtt ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed) (FOR ALL SYSTEMS) Se�vlce included: Items Cost Total L Check Type of Work Involved: Residential-per unit 1000 sq It or loss $145 15 _ _ 4 ❑ Audio and Stereo Systems' Each additional 500 sq fl or portion thereof $3340 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Dwelling Service or Feeder $90,90 2 Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 ( Vacuum S Stems' 201 amps to 400 amps $106.85 2 LJ Y" 401 amps to 600 amps $160.60 2 601 amps to 1000 amps _ $24060 2 ❑ Other G.(er 1000 amps or volts $45465 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $6685 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100.30 _ 2 401 amps to 600 amps $13375 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems ©ranch New,alteration or extension per parr, Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock systems feeder fee. Each branch circuit _ $8 65 2 ❑ b)The fee for branch circuits Data Telecommunication Installation without purchase of service or feeder fee. ❑ Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous (Service or feeder not included) ❑ Instrumentation Each pump or irrigation cirrle $53.40 _ Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s)or a limited energy panel,alteration or extension _ $75,00_ ❑ Landscape,rrigation Control' Minor Labels(10) $12500 _ Each additional Inspection over ❑ Medical the allowable In any of the above Per inspection _ $6250 _ ❑ Nurse Calls Per hour $6250 In Plant �_ $73 75 A ❑ Outdoor Landscape Lighting' Fees: [] Protective Signaling Enter total of above lees $ rr Other 8%State Surcharge $ 4_ Number of Systems 25%Plan Review Fee See"Plan Review"section on $ No licenses are required Licenses are required lot all other installations front of application Fees: Total Balance Due $ Enter total of above fees $ ❑ Trust Accourt as`--^ --- 8•/.State Surcharge s All New Commercial Buildings require 2 sets of plans. Total Balance Due S __ i.4lsts\fumis\eIc-fees.doc 08/30/01 CITYOF T I GA R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2003-00033 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 1/21/03 PARCEL: 2S102AA-01200 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 11895 SW GREENBURG RD SUBDIVISION: BLOCK: LOT: CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: TENANT NAME: LUKE-DORF REMARKS: New accessible ramp, entry door and restroom. Electrical permit is required Owner: LUKE-DORF INC 11895 SW GREENBURG PORTLAND, OR 97223 Phone: F-639-5537 Contractor: 639-5537 MARLAND HENDERSON CONSTRUCTION 12950 SW PACI':IC HWY #B 2 S01-619-5117 Reg#: I.I(' 70200 Th9V4_ ficate issued 4/1/03 grants occupancy of the above referenced bur portion the Of and confirms that the building has been inspected for co �e with then ar Oregon Specialty Codes for the group, occupancy, an nder w lch h referenced permit we. i sued BU G INSPECTO BUILDING OFFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST 13uP 3 Received __ _. __._._ Date Requested - _ AM_ PM _ BUP - L.ocation ____ 1� S _-_ Suite— _ MEC Contact Person ____ _ - fin.LA-14 Ph Pt.M Co ------— Ph( _ ) 3 �-�j - 0/S� SWR BUILDING Tenant/Owner -__ _�. ELC Foundation ACC@SS: /� ELC Ftg Drain ELR Crawl Drain s I L�tit TT1 L. z j'-•G1�-� Slab Inspection Notes: SIT Post& Beam __,— „�--_-- — -------__. - 'Jhear Anchors ----— -- ------ Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing -- -- _----- _ Firewall Fire Sprinkler - — --- ------------ Fire Alarm usp'd Ceiling ----- -_-- - ------ — Roof Oth SS ART FAIL Past 8 Beam Under Slab - Rouch-In Water Service Sanitary Sewer Rain Drains ---_----- ___ - Catch Basin/Manhole Storm Drain - ----- —----- -- Shower Pan Other. --- -- ---� --- Final PASS PART FAIL CH - — --- ��— —� MEAN_ICAL Post RoughIn Gas Line Smoke Dampers - -- -- -------- __ _-- -- ----- ------- - -- - Final PASS PART FAIL ELECTRICAL - Service -- _-----_ Rough-In UG/Slab Low Voltage -- --- — - ----... —-,—. -- ---- Fire Alarm Final L__J Reinspection fee of$___ _ required before next inspection- Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL SITE Please cull for reinspection RE:_ _ _- -_- _— Unable to inspect--no access Fire Supply Line ADA Approach/Sidewalk Date Inspector !" '� - _ Ext -_----- Other Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST _-_— BUP Received _ Date Requeste ,2 _ _ AM PM BUIP Location ��..___ _ee Suite—.�-. GG____ MEC Contact Person -__ ��>d �i/�s. ___—_ Ph ____) /,2., PLM a Contractor __..--_ ---.--------._ --- Ph(----) SWR BUILDING Tenant/Owner _ _ ^___ �_�__ ELC _ F_0o1i4-- ELC Foundation Access: - Ftg Drain j 1 f ELR Crawl Drain ✓-- Slab Inspection Notes: SIT — Post& Beam ------- --. --- ------ - -- -- — Shear Anchors ----`--J -'— - Ext Sheath/Shear Int Sheath/Shear i Framing -- --- - - ------._--- - - --- Insulation Drywall Nailing _-_-----..__----_-- Firswall Fire Sprinkler — --- - - - -- Fire Alarm Susp'd Ceiling Roof �✓ Other-. '' ------- --- -Final PASS PART_ FAIL PLUMBING Post& Bearn ----- Under Slab -- ---. . - - --- Hough-In Water Service -------- - ------ Sanitary Sewer Rain Drains ------- Catch Basin/Manhole Storm Drain -- Shower Pan Other: --- --- -- - -i P _ PART FAIL CNANICAL _ Post&Beam Rough-In Gas Line Smoke Dampers ----.___—_-_ - -- - - - Final PASS PART FAIL ---- ELECTRICAL Service Rough-In UG/Slab Low Voltage Fira Alarm Final Reinspection fee of$ -- - __required before next inspection. Pay at City Hall, 13125 SW Hall Blvd, PASS PART FAIL SITE [] Please ca for reinspection RE-_ _ _ n Unable to inspect-no access Fire Supply Line ADA l / " Approach/Sidewalk Date ` _�x-' - 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 MST —� INSPECT!.ON DIVISION Business line: (503)639-4171 2 BUP Received Date Requested__._?__— AM_.._______ PM ___.. _ BUP Location <7 ___.- Suite MEC 3 ' 9 o o $a Contact Person .___—. 7jlq - Aza - Phq-) ��—o rs� PLM — ---- - Contractor - ^----------- ---_ - Ph(--) G 7 SWR - --— BUILDING Tenant/Owner ELC Footing --- ELC Foundation Access: Ftg Drain /�' �- t5' � /�//��� G 'r ELR - Crawl Dain Slab Inspection Notes: SIT Post& Bearn Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing --- -- -- --- ---- -- --- ------ -- --------_-___�_�__..----- Insulation Drywall Nailirg -- -- - - --- - -- - _- ------ -._. ---- ------ - Firewall Fire Sprinkler --- Fire Alarm Susp'd Ceiling _-----... - --_- -- --- ---------._-__-------__ --- ----------._-.------- Roof Other:_ --- Final _ PASS PART FAIL ---- ---------- PLUM_BING__ Post 8 Bearn Under Slab -- -- ---- - - -- - - - -- -- -------- -- ---- - Rough-In Water Service - -- — - -- _.-- - ---_- -- - --...--.._...--- -- - Sanitary Sewer i Rain Drains - -- - -- - -- -- - - =- ------- - �..--- -------- Catch Basin/Manhole y Storm Drain Shower Pan lJ r Other: ----- ---- _ -- - - ----� \' - ------�--_ __------ --- -- Final -- CHANICAL _ ------ 249ALearn Gas Line Smoke Dampers -_- --- --- ------- - ----- - - -------- a SS, PART FAIL _ RICAL Service --_ ----- ------- ------ -- — Rough-In UG/Slab Low Voltage Fire Alarm Final �] Reinspection fee of$_- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection HE:___ -_ -__ _-__-___ _.._- Unable to inspect-no access Fire Supply Line ADA ' Approach/Sidewalk Date _3 Z�C 3 Inspector -_- ___ - Etat - Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL