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12100 SW GARDEN PLACE BLDG 4 .1, N C'? O �C C D v m -v r H OD �G r v .p a I, 12100 SW GARDEN FL BLD 4 CITY OF TI GARD CERTIFICATE OF 00'UPANCY DEVELOPMENT SERVICES PERMITM BUP20C3-00479 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/19/20(3 PARCEL: 2S1011313-01400 ZONING: C-G JURISDICTION: TIG 517E ADDRESS: 12100 SW GARDEN PL BLD4 SUBDIVISION: PARK 217 BLOCK: LOT:002 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 3N OCCUPANCY GRP: B OCCUPANCY LOAD: 339 TENANT NAME: IKON REMARKS: Tenant improvement, demo and remodel entire floor. Owner: SPIEKER PROPERTIES LP 4380 SW MACADAM AVE STE 100 PORTLAND, OR 972.01 Phone: 503-234 6617 Contra:tor: C SCHIEWE& ASSOCIATES INC 1024 NE DAVIS ST PORTLAND, OR 97232 Phone: 503-234-6617 Reg* LIC 54105 This Certificate issued 1/13/12004 grants occupancy of the above reference: building or portion thereof and confirms that the building has been inspected for coml- `-ince with the State of Oregon Specialty Codes for the group, occupancy, ar`d use under �Ihich the referenced permit was sued. r � , B !L INGI � ! A WY � I — -------- ----- 1•Li1 I S ECT R BUIL IN ICIAL POST IN CONSPICUOUS PLACE G:TY CIF TIGARD 24-Hour BUILDING Inspection Line: (51713) 639-4175 MIST - Business Line: 503) 639-4171 til(1 gU j_? ._ �4��9 `NS4�EGTIUN DIVISION ( ; i AM PM BLIP Received DME! Re Z -7 nested MEG _ - ---- �---- qI d . Location L- PLM Contact Person Ph(�� ) Cont �/( G 2�2ti G Ph SWR Tenant, Wri /Oor _ _ ELG (�MhG_ _ ELC Foo Foundation Access. ELR Ftg Drain Crawl Drain SIT _ Slab Inspection Nates: �►�' � Post&Beam Shear -- - - -- _ - - -- Shear Anchors _ Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Flailing Firewall Fire Sprinkler Fire Alarm -- -- Susp'd Ceiling RoofFin - - —. - PART FAIL �PL USING - - 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. _ -- Pnst&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 Hull, 13125 SW Hall Blvu. PASS PART FAIL. Please cell for reinspection RE: Unable to inopect-no access SITS U - ___ -- - -- - ❑ Fire Supply Line ADA Date Other: Inspector - _-- Ext Approach/Sidewalk other:_- Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD -� BUILDING PERMIT PERMIT#: BUP2003-00479 DEVELOPMENT SERVICES DATE ISSUED: 8/19/03 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-417 PARCEL: 2S10186-01400 SITE ADDRESS: 12100 SW GARDEN PL BLD4 SUBDIVISION: PARK 217 ZONING: C-G BLOCK: LOT: 002 JURISDICTION: TIG REISSUE: FLOC'2 AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf ____P_ROJIE_CT OPENINGS_?_ TYPE OF CONST: 3N sf N: S: E: W:� OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 339 BASEMENT: St AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BS"T?: MEZZ?: REQD SETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: �ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 240,000.00 Remarks: Tenant improvement, demo and remodel entire floor. Owner: Contractor: SPIEKER PROPERTIES LP U SGI IIEWE & ASSOCIATES INC 4380 SW MACADAM AVE STE 100 1024 NE DAV iS ST PORTLAND, OR 97201 PORTLAND, OR 9732 Phone: Phone: 503-234-6617 Reg #: LIC 54105 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require IlitiPPLNj Pin Rv 8/5/03 $838.70 Electrical Permit Required I I IFLS Pin Rv 8/5/03 $516.12 Plumbing Permit Required Framing Insp 1III1ILUI Permit Pee 8/19/03 $1,290.30 Gyp Board Insp IAN IS",,State fax 8/19/03 $103.22 Susp Ceiing Insp Total $2,748.34 Final Inspection 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, or if work is suspended for tc,ore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifir'ation 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 calling (503)246-6699 or 1-800-332-2344. Issued By: C�0 t,V 4 Permittee Signature: /) Call 639-4175 by 7 p.m. for an inspection the next business day 12-100 -514J 614RDCN P44(-,&, pp>z-o v E� 8-l�t•D3/13 S ftilding Permit Applicadon PFF!C. F. USE ONLY r City O! I'ig;�rd Date received' -c Permit no.:^ C�(7'�-c7� ('ilv ri/l'i);urd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl. no.: Expire witc: Phone: (503) 6.39-4171 Date issued: 13)0 Receipt no.: Fax: (503)598-1960 Case file no.: Payment type: Land use approval: W' family: Simple-176) Complex: r ' J I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition J Addition/alteration/replacement 110,enant improvement U Fire sprinKler/alarm U Other:.1011 SITE 1 ' Jobaddress: MICID SW P1c� _ Bldg. no.: Suitcno.: Lot: Block: Subdivision_ -Tax map/tax lot/account no,: Project name: 114pN Description and location of work on premises/special conditions: _1LA+,eyi o1• K h Aod(.e j_ Name: [L� Mailing address: 12.0 tw tum i +0H Sir• I & 2 famill duelling: City: �kj _ Slalc 7.IP: S valuation of work w $ -71 Phnm':'La1S SyyS Fax:�S•(ILS E-mail: No.ol'bedrooms/baths............................... OwnL'r's representative: FT(eea Total number of floors ................................. Phone: Fax: I: mail: New dwelling area(sq.ft.)............................ Garage/carport area(sq,ft.) .......................... - — Name: Nle(dhun Re.Aga Csyotwr PG Covered porch area(sq. ft.) .......................... Mailing uddress: ,0 5( ) �j, ( �( (� Deck area(sq, ft.)....... ................... City as-A Statea'�(Z ZIP: 47Z7.j Other structure area(sq.ft.).......................... Phone: • V51- 7171:-mail:�� M, Commercial/industrial/multi-family: Valuation of work ......................................... $ '140,DOO Business name: 0 t (rExisting bldg,area(sq.ft.)............................ Z?,Zoo l _t Address:y State: jLIP New bldg.arca(sq, ft.).....,..Tor................ Itoco -- Cil Number of stories........... � : Type of construction ..................................... MZN Phone: Pax: Email CCB no.: Occupancy group(s): Existing: New: !3 City/metro tic.no.: Notice:All contractors Pnd subcontractors are required to be t licensed with the Oregon Construction Contractors Board under Name: (• provisions of ORS 701 and may he required to be licensed in the jurisdiction where work is being performed,If the Address: .I b{x' applicant is City: State: ZIP: exempt from licensing,the following reason applies: Contact person: Ilan no.: Phone: Fax: I?-m:lil Name:7i11 p4j)fi, Sftu e. Cor.tu,i person: V-,,t(pt, Fees duo•upon application.............................$ — Address: o Sw (xttl Sk - Date received: City:V4 apik Statc:til ZIP: -717.2,1 Amount received...........................................$ Phone:4111k.'j4G.o Fax:4+1#47oo E-mail: _ Please rel'er to fee schedule. hereby certify I have read and txamined this application and the P ,all Jurisdictions accept credit cards,please call Jurtsdicdon for more infomration 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 mrmhec f / ff �� "" n Authorized signature: ar(/ls Date: is•C3. _ le of cardholder as shown on credit card lit ircs Print name: _ C ��. r �g��.,.1 --- ------- a cardholder slgnnure Amount No•�.ce This rmit application crpii;s if a permit is not obtained ss ithin 180 days utter it has been accepted as complete 4.10 4h1s 1MXYCOs1) �� MECHANICAL PERMIT CITY n TIGARD _ DEVELOPMENT SERVICES PERMIT#: MEC1003-00575 DATE ISSUED: 10/17/03 13125 SW Hail Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S101BB-01400 SITE ADDRESS: 12100 SW GARDEN PL BLD4 SUBD!VISION: PARK 217 ZONING: C--G BLOCK: LOT: 002 JURISDICTION: rIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT S(STEMS: STORIES: B_OILERS/COMPRESSORS HOODS: _ FUEL TYPES 0 - 3 HP: -I DOMES. INCIN: 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 < -1001K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Tl : Relocate grilics anal add AC in scncr room, Al' Icy" than 5000 Value: $22,000. 10/28/03,adding rooftop unit with add l project value ot'$3,600. Owner: FEES i-- - SPIEKER PROPERTIES LP Description Date Amount 4380 SW MACADAM AVE STE 100 [TAX]8%StateTax 9/25/03 $31.48 PORTLAND, OR 97201 [MECH] Permit Fee 9/25/03 $393.50 [MECPLN I Ilan Rev 10/29/03 $12.15 Phone: [MECFII PCP11111 Fcr 10/29/03 $48.60 [TAX JW',,Slatc Surch ri 10/29/03 $3.89 Contractors =_ Total $489.62 NORTHWEST MECHANICAL SPECIALITIES 2130 NE GRIFFIN OAKS ST.#200 HILLSBORO, OR 97124 REQUIRED INSPECTIONS_ _ Cooling Unt Insp Phone: 503-944-4798 Misc. Inspection Rey #: LIC 156706 Final Inspection This permit i5 issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if worts is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules ate set forth in OAR 952-001-00 Iss d By: ��" _ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day �' i mechanical Permit Application / rDitceceivedp.+ j Permit no. - 'J j City of Tigard Project/appl.no.: Expire date: C'ifynfTlgnrd Address: 13125 SW Ilall Blvd,Tigard,Olt 97223 Phone: (503) 639-4171 Date issued: By: pt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval; -- - -- - _ -- �_--- Building permit no.: U I d'd 2 family dwelling or accessory Commercial/industrial U Multi-family U Tenant improvement U New construction -4TAdcition/alteration/replacement U Other: 1 1 1 1 Job address: 12.1 tO0 4 indicate equipment quantities in boxes below. Indicate the dollar Bldg. ao.: Suite no,: T value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ d d . Lot: Block: Subdivision:_!--� - 'tide checklist for important application information and Project name: T 1910 14 j ,diction's fee schedule for residential permit fcc City/county: ?;at ZIP: SCHEDULE Rcscri tion an ncifilog of work on premises: C s + 1 � G. ,date of completion/inspection: 46--�Iu.,Gti Descrl ion Qt . Nes.only Nes.only -Tenant improvement or change of use: -nvxrt Is existing space heated or conditioned?U Yes ❑No Air handling unit CFM y po Air conditioning(site plan rcyuuc� Is existing space insulated?U Yes U No ; t7lTeraton o exist ng system Nil ( IIANICAR, 1 1 –Boiler/compressors Rosiness name: t � �� State boiler permit no.: ` Wig•--�fe, lip—Tons- BTU/If Address~ O/lt;.r tsap Firc/smo a dampers/duct smoke detectors City: j , /h (yip I State: LIP: q ,Z ca-Tl-t ump(site plan re aired) Phorc: *yy-y aff I Fax#W-WWyj E-mail: nstu rcp acc fumac CCB no.: L 5 Including duetwork/vcni lincr U Yes U No _ nsta ,rcp acc rc ocatc heaters suspended, CiWinetro lic.no.: wall,or floor mourned _ Mum,(please tint): �� -- Vent for appliance oiliccr than furless 1Refrigeration: Absorption units. BTU/11 Name: �/ �_ ^�.. Chillers . IIP ----------- Compressors III' Address: ;nv ronment,rl exhaust and ventilation: City: - - — State: /.IP: Appliance vent Phone: FXK F-mail: D cr ex gust f ends,Typc h Wires.knchcn hazmat u- --- hood ftrc suppression system Exhaust fan with%ingle duct(bath funs) Mailing address: ,n S LJ C,),4 4,4,7 Lyty &0 Exhaust system a art from hcatin or AC' Fuelp p ng andistribution(up to outlets) City: 1, 06e-4 State' /II': Type: HIG NO Oil Phone: Fa\ .-mail FUCI nt m�sac i to tuonal over out ets ra:ess p p ng(schematic required) _ Name: -"MNumber of outlets lrrrlisted app enceoregn pmenlf Address: Uecorstivc fireplace City: _ _ State: ZIP: _ nserl type__ Phone: Fax: Ci-mail: 0o stove/pc ct stove Other: Applicant's signature: .�, 1)1! :�i 61 p� Other., Name(print): J �,✓. -- Not all jurisdictions accept credit earls,please call jurisdiction for more information Permit fee S ,�T�3 .30 U Viso U MasterCard Notice: This perpermmit i application ofbin Minimum fee................ S Credit card number expires tf a permit is not obtained Plan review(at _ %) S _ fsp;,es within IRO days after it has been __ State surcharge(R°io).... S Name oP cardholder as shown on credit card accepted as complete. 3 59 .9'?9 . 5 TOTAL........................ $ :J l'udholdcr signature Amount AC CITYOF `*32 ® RD TEMPORARY CERTIFICATE OF OCCUPANCY DEVELOPMENT SEKVICES --- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PERMIT#: BUP2003-00479 PERMIT ISSUrD: 8/19/03 PARCEL: 2S101BB-01400 ZONING: C-G JURISDICTION: TIG SITE ADDRESS: 12100 SW GARDEN PL BLD4 SUBDIVISION: PARK 217 BLOCK: LOT: 002 CLASS OF WORK: ALT TYPE OF USE: COM OCCUPANCY GRP: B OCCUPANCY LOAD: 339 Ol�JlfC COPY PY TENANT NAME: OMCE G REMARKS: TEMPORARY OCCUPANCY FOR �3O DAYS FROM Tenant improvement, demo and remodel entire floor. Owner: SPIEKER PROPERTIES LP 4380 SW MACADAM AVE STE 100 PORTLAND, OR 97201 Phone: Conti actor: C SCHIEWE&ASSOCIATES INC 1024 NE DAVIS ST PORTLAND, OR 97232 Phone: 503-234-6617 Reg#: LIC 54105 It is understood by the ownedtenant that the issuance of this Temporary Occupancy Permit by the Ci'y of Tigard for the use and/or occupancy of the structure located at the site address listed above(hereinafter"structure"), does not grant or convey to the owner or tenant any property right or other protectible property interest in the use and/or occupancy of the structure for any purpose. It is further understood that this Temporary Occupancy Permit shall only be valid for the number of days from date of issuance listed above and that the owner/tenant will no longer be authorized to occupy the structu-3 after the period specified, unless and until all the ;onditions of approval Imposed under the City's or County's Notice of Decision for the project's land use case(s)issued by the City's Development Services Department or the County's Department of Land Use and Transportation a /or the Clean Water Services and all buil ing and related code requirements and any other applicable requirements hav een comp ely fulfilled an omplied with to the Cit s or Co s satisfaction, {� ILDING INSPECTOR BUILDING OFFICIALIV POST IN CONSPICUOUS PLACE CITY OF TIGARD 24-Hour BUILDING inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST Received Date Requested._ /-Z—AM � ___ PM__� BLIP -_ Location _,� ! D .a�1' PL_ �Re 4* ____ MEC Contact Person _ ,LsvL4111"2- Ph(--) 'Y3 G _ PLM Contractor __-_ - _— Ph( _) _—__ _—_ SWR BUILDING Tenant/Owner KBD rJ _- __-___ ELC Footing Foundation FLC Access: Ftg Drain ELF _ Crawl Drain Slab I,ispection Noto s: SIT _ Post&Beam Shear Anchors - ----- Ext Sheath/Shear Int SheathdShear Frarning - Insulation Drywall Nailing Firewall Fire Sprinkler - - Fire Alarm Susp'd Ceiling Rn(-,f _ Other -- --- - --- Final PASS _PART FAIL �- PLUMBING Post&Beam Under Slab - - --- Rough-In Water Service -- -- Sanitary Sewer Rain Drains ---- Catch Basin/Manhole Storm Drain - Shower Pan Other. AS PART FAIL HANICAL 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$-__ required before next inspection. Pay at City Hall, 131255W Mali 111M PASS PART FAIL SITE Please call for reinspection RE: _ _ [� Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date / ., Inspector '� _ Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP - -- - Received --- Date Requested_1 _ D3___ AM------- PM - BLIP Location _; 0 0 C ARh1 - Suite MEC Contact Person ��'�a�� -- - - Ph(_� ) _� �:- 5 PLM - -- _ Contractor ______. Ph( ) -__ SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT _-- -- Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing Insulation �„ \ - C Drywall Nailing -� � � o�1 Firewall v Fire Sprinkler - - - - Fire Alarm Susp'd Ceiling ----____ Roof Other: Final PASS PART FAIL - PLUMBING Post&Beam Under Slab ---- _ Rough-In Water Service Sanitary Sewer Rain Drains - - Catch Basin/Manholee,A) ,- hG ' ;corm Drain Shower Pan Other. Final PASS PART FAIL -- - - - - MECHANICAL Post& Beam Rough-In Gas Line Smoke Dampers -- Final RT FAIL - _ RICA _ Service Rough-In UG/Slab ow olte Fire Alarm na [] Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. P RT FAIL SIT Please call for reinspection RE:—. _. �[� Unable to inspect-no access Fire Supply Line ADA Date, 5� fnspec�LC/�''? Ext Approach/Sidewalk -Z=--�` Othe►: -- Final DSO NOT REMOVE this Inspection record from the jam site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPEC7►7N DIVISION Business Line: (503)639-4171 MST - _ BIJP Received �2�Date Requested__ Z _ M P BLIP Location T2 1�� V-Vt- _Suite MEC , jr Contact Parson VA-A 1�11,K Ph( L% U — ,,�11 PLM Contractor �f-"Ti-R i'1 (��- c _ Ph(—) SWR BUILDING Tenant/Owner Footing Foundation Access: ELC Ftg Drain ELR Crawl Drair. ��----� - Stab inspection Notes: SIT Post&Beam _ Shear Anchors V� -- Ext Sheath/Shear Int Sheath/Shear Framing _— Insulation — Drywall Nailing - Firewall Fire Sprinkler -- ----- Fire Alarm Susp'd Ceiling — --- - ---- Roof Other: -- -- --- - - -- - - Final PASS PART M1 PLUMBING Post& Beam ---- Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain - - -- Shower Pan Other: --- Final PASS PART FAIL MECHANICAL Post 8 Beam - ----- - Rough-In _ Gas Line Smoke Dampers Final PASS PART FAIL ---- - ---- ELECTRICAL - Service -- Rough-In UG/Slab Low Voltage F' ASS RT FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SI7_ Please call for reinspection RE: Unable to inspect-no access Fire Supply Line .� ADA A � C,�' Approach/Sidewalk DateInspector �'`'►� __- Other: Final _ DO NOT REMOVE this Inspection record from the jo site. PASS PART FAIL ELECTRICAL PERMIT - CITY OF T I SGA R D RESTRICTED ENERGY _ DEVELOPMENT SERVICES PERMIT#: ELR2003-00295 13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 DATE ISSUED: 9/29/2003 SITE ADDRESS: 12100 SW GARDEN PI- Bl_D4 PARCEL: 2S101136-01400 SUBDIVISION: PARK 217 ZONING: C-G BLOCK: LOT: 002 JURISDICTION: TIG Proiect Description: Low voltage: Protective sig,,aling. A. RESIDENTIAL _ _ B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: SPIEKER PROPERTIES LP SONITROL PACIFIC 4380 SW MACADAM AVE STE 100 8220 N. INTERSTATE AVE. PORTLAND, OR 97201 PORTLAND, OR 97217 Phone: Phone: 223-5822 Reg#: LIC 53535 ELE 26-370CLF _ FEES Required Inspections Description _ Date _ Amount_ I.ow Voltage Inspection LLPRM 11 ELR Permit 9/29/2003 $75 00 Elect'I Final I"I A X 1 8%State Tax 9/29/2003 $6 00 Total $81.00 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 morn than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utilit;Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these pules or direct questions to OUNC at (503)246-6699. Issued by li!2.L1 Permittee Signature 1 l(_.y 4- l < OWNER INSTALLATIO� NF)NLY The installation is being made on property I own which is riot intended fur sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day h"lectrical Permit Applic�><tion FOR ' ONLY — -- --i'i-=--------- ReceivedElectrical Date/By:: r Permit No.;— (. ► It Olt TiLill d Planning Appr al Sign y Date/By: 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 - Date/B : Case No.: Internet: www,ci.tigard.or.us Contact Juris.: Z See Page 2 for - 24-hour Inspection Request: 503-639-4175 Name/Method: Fri Supplernenta!information. TYPE OF WORK _ PLAN REVIEW Please check all that apply) ❑ New constraction I El Demolition Service over 225 amps- Ll Health-care facility LJ Addition/alteration/re lacement Other: commercial El I lazardous location ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, _ CATEGORY OF CONSTRUCTION 56 1 � I&2 family dwellings four or more residential units in 2-Family dwelling— - Commereial/Industrial Ll System over(Yx)von:nominal one structure El Building c,,er Wee stories E]Feed(rs,400 amps or more Accessory Building _ Multi-Famil 0 Occupant�oad over 99 persons ❑Manufactured structures or RV park Master Builder _ Other: ❑egrets lighting plan I ❑Other: .JOB SITE INFO"CATION and LOCATION Submit__sets of plans with any of the above. Th-above are not applicable to temporary construction service. Job site address: t ► t)_� ,{�„ �b l G�(_� FEE-SCHEDU: E Suite#: Bld ./A t.#: _ Number of it icclions per permit allowed Project Name: S kcNY1 Description I Qty Fee(ea.) Total New residential-single lir multi-famlly per Cross street/Directions to job site: dwelling unit.Includes attac;,ed garage. Service Included: 1000 sq.11.or less ___ 145.15 4 Each additional 500 sq.it.or rbon thereof 33.40 I Limited energy,residential _ 75,00 2 Subdivision: �— Lot#: _ Limited energy,non residential 75.00 -- Tax map/parcel #: Eath manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 2 Services or feeders-installation, alteration or relocation: 200 mps or less _ 80.30 2 - -- -- 201 amps to 400 at- s 106.85 -- 2 401 amps to 600 amps 160.60 2 PROPERTY OWNER TENANT 601 ams to 1000 ams 240.60 2 Over 1000 amps or volts 454.65 t Nanle: Reconnect only 66.85 2 Address: Temporary services or feeder-installation, City/State/zip:/State/Zip: alteration,or relocation: 200 amps or less 66,85 1 Phone: Fax: AI amps to 400 amp i 100.30 2 APPLICANT I LJ CONTACT PERSON 401 to 600 ams 133.75 2 Branch circuits-new,alteration,or Name: extension per panel: Address: - A Fee for branch circuits with purchase of service or feeder fee,each branch circuit 6.65 2 City/State/Zip: B.Fee for branch circuits without purchase of service or feeder fee,first branch circuit 46.95 .' Phone: Fax: Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included): CONTRACTOR Each pump or irrigation circle 53,40 2 — Each sign or outline lighting 53.40 2 Job NO: ( 'ia-,)Cr Signal circuit(s)or a limited energy panel, Business Name j lt�1 1 C�� t alteration or extension Pa e2 — 2 Description: Attdress: `b 3 �- 1-' Lk�► Cit /State/Zi �L�t kt t t nl' Each additional inspection Durr the allowable in any of the above: Per ins ction r hour(min. i hour) 62.50 — Phone:r �� Fax: 5Ci3 3' `1 1 Investigation fee: CCB Lic. #: Lic. #: ) _ 3.-1 6 �► � other Electrical Permit Fees* Supervising electricianA Subtotal S v2 7 signature re uired: /' zatl�--j Plan Review(25%of Permit Fee) 5 Print Name: 5c 0 6-Li2 Lic. - State Surcharge 8%of Permit Fee S TOTAL PERMIT FEE 5 , Authorized Notice: This permit application expires if a permit is not obtained within — Signature: _ Date: 180 dais after it has been accepted as complete. 'Fee methodoloa set by Tri-County Building industry Service Board. (Please print name) is\Dsts\Petmit Forms\E1cPermitApp.doc 01103 Electrical Permit Application - City of Tigard Page 2 -Supplemental Inturmation LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY. Feefor all systems............................................................ $75.00 Check Type of Work Involved: ElAudio and Stereo Systems* 71 Burglar Alarm ElGarage Door Opener* I Icating,Ventilation and Air Conditioning System* Vacuum Systems* Other -- -- COMMERCIAL WORK ONLY: Feefor ench system..................................... .................... S75.00 (SEE OAR 918-260-260) Check Type of Work Involved: Audio and Stereo Systems Boiler Controls Clock Systems Data Telecommunication Installation Q fire Alarm Installation HVAC Instrumentation Intercom and Paging Systems Laodscapc Irrigation Control* Medical Nurse Calls C� Outdoor landscape Lighting* E Protective Signaling Other -- Number of Systems * No licenses are required. Licenses are required for all other installations i.\Dsts\Permit Forms\ElcPermitApppg2.doc 01!03 � T 4z- fir. c7 LL v ~9 IIIs ov u 1 � v s LJ o ''.mo� �.t` B a C of R LL tL s l .) •� h ti S •) �i •�� R� 1 1 1 � 1 1 . • 1 1 1 . . � : . / 1 1 1 • a � s 3 � 4 r , r, O L i ur J v � 3 3 �G. •M v fids. 3 hvi a • 1C. S 1-� • • •1• 1t r {• ` �J • 1 ►i • r 1 1 ° 1 , , 1 r r / ► 1 t s i J Q C3 O cc r, c� M Z'S .e 3 7 . �C • • 1 1 •1 1 1 1 1 1 Icy • • • • • • ^ i '�I�� • 1 • 1 1 1 1 ��.,� • 1 1 1 1 1 ` t 1 � 1 • 1 1 ! C'1 1• • 1 1 1 1 ( 1 • f ! I � 1 ea � 6 •} L J 'M 3 ..a T �fy 1 1 1 1 11 •• • • • • • •• • • • • CITY ^C T I^ /rl R D _ _ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT#: ELC2003-00543 DA i'E ISSUED: 8/29/03 13125 SW Hall Blvd., Tiaard, OR 97223 (503) 639-4171 "ARCEL: 2S101BB-01400 SITE ADDRESS: 12100 SW PL BLD4 SUBDIVISION: PARK 217 ZONING: C-G BLOCK: LOT : 002 JURISDICTION: TIG Project Description: J0131\1061744,' Provide power/lighting RESIDENTIAL UNIT TEMP SRVC;FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: i PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10): _ SERVICE/FEEDER BRANCH CIRCUITS ADD'L.INSPECTIONS 0 200 amp: 1 W/SERVICE OR FEEDER: 34 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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 NZ MINAL: Reconnect only. SVC/FDR — 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: SPIEKER PROPERTIES LP FRAHLER ELECTRIC CO 1380 SW MACADAM AVE STE lot) 11860 SW GREENBURG RD FORTLAND,OR 97201 TIGARD,OR 97223 Phone Phone: FX 639-4673 Reg #: 16R9-4627 37410 -- - SUP 18165 FEES _ ELE 34-13C Description Date Amount Required Inspections [I?LPRMTJ I:LI' I'rimii "i ii1^-- $306.40 [ELPLUK] FL(' 111n Ilc% n; $2451 Wall Cover —_ Eleet'I Service Total $330.91 Elect'I Final This Permit is Issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialtv 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 riles are set forth in OAR 952-001-0010 through OAR 952-001-0100. You mny obtain copies of these rules or direct questions to OUNC at(503)246-6699 or 1-800-332-2344. Issued By: J L Permit Signature:.) (� j _OWNER INSTALLATION ONLY _ 1 Iie installation is being made on property I owr i which is riot intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CCPNTRAC-rOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: �— -� DATE: LICENSE NO: -- — _---- - ----- - - --- --- --- Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received: Permh no-: r. 1 LU 3 City of Tigard -ITE�! I VE[) 1'rojeca'eppl,no.: Expire date: �P c'uv rlT1,¢ard Address- 13125 SW Heil Blvd, OR 97223 Date issued: By: Receipt no.: - phone: (503) 639-4171 Fax: (503) 598-1960 1 Case file no.: ` PRymeM type: Land use approval: C17-Y OF NGARD 7Job -g' 2 family dwelling or accessory UCommercial/industrial U Mulli-family 15;)Tenant improvement w construction U Addition/,tilers ion/repincernent U Other: _—U Partial dress: 12100 SW GARDEN PLACE Hldg.no.:_1 Suite no.: Tan map/rex lotfaecotmt no.: Lot: JBlock: Subdivision: Project name: IKON Ubiscripti m and location of work on premises: PROVIDE POWER/TAT -Estimated date of completion/inspection: moikumpalffmirmi ob sot 61749 pKIK.x Business name: FRAHLER ELECTRIC COMPANY Description Qty (ew.) Total n . air Address: 11860 SW GREENBURG ROAD "'""''roes'(°I anRl.nrrradn-nrmR,per dnentrrR orrk.Ir,rrodeq dtschrd RrrraRr. City: TIGARD State: OR ZIP: 97223 9errkrincladedt Phone: -4627 �Fex: 639-467 I mail: 1000 sq.R.or less _ 4 Club no.; 37410 Elec.bus.tic,no: 3_4-13C Each ndditiooai 500 sq.R.or portion thereef —W Limited energy, residential 2 City/metm lie.n 7 Limited energy, non-residential -f 2 ��J� _ i 08122/03 F.nch mnnufnchtred home or modrder dweUh* Signature— ignature of supervising electrMen (required) - Dote - service andror feeder 2 Sup.elect.name(rrinl): R. W. FRAITLER 1 - Rerrlregnrreedwtrq-In.hlbtlon, 1.��i�J atfeMNenert.IgeaHen. NNt nmps or less 1 80...3 --7 - Name(print). tot amps io 400 am�r— __ _ - - --_ Z Mailing address. -` 401 amps to 600 emus --^�- 2 City: 60'-mpg to 1000 nes 2 ------ - - - - �Slete; ZIPc i I her I WO amps or volts _ 2 Phone: l-- lax E-mall: _ t scounect on a y 1 owner installativtt -1 he installdinn is being made on pmpr•tty 1 awn 0ratpornngrr.lrr.wrnrdrn- which is not intended for sale,lease,rent,or exchange nsenrditiR to 1"0011allon,wtteewrinn,ar rvloraatnn• ORS 447,455,479,670,701. 21x1 amps or leas __ 2 T- 201 amps to 400 nmps _ 2 Owner's si nature: Date: 401 to 600 amps 2 Ilne"irb chviritq-new,alirr mon, 7iq: or entrtrglon per panel, -- -_ A. Fee for branch -irvoiiq with pomhn- ,f service or feeder fee,each branch circuit 34 26. 0 2 -St 8-1 /.IP: H. Fes Rtr branch chcults withutA purchase ,_ _ of service or feeder fee,first(ranch circuit, 2 Fan p mail: Lech additional branch circuit: '� Mlgc.(14rnler oc(eedrr not Included): U Service ova 221 nmps-rnmrtteminl U neafth care f)tc0ity Lach pump(r irrigation circle 2 U,4en•ice over 120 ampq-tstinp of 1 a2 U Ilarnntorrq hKathm Ench sign-.r-.Td-&-e lighting v 2 family dwellings U nuihfing river 10,M)ggoare feet four or Signal circolt(q)or it limited energy pone!. - - -- - U System over 600 volts nominal more regfdential rmitq fn one gmrchire alteration• or extension• I 2 U Building over three anrleq U Feeders.40[)ampq or more U occupant Mad over 99 prrgnnq U MantAchned gtnrctureq nr Rv path —' e: Each MiMfonam l 1pertlon mer the allonaAlr 1-ianyattire shorTe: U rVegdlighkinp plan U tither Per inspection l _ 1._-- 9ubmN gehnf plain with rent-of the about. Inve Mion fee Ilse above —_� erre not applicable to temporary cnm ---- trntiion service. other - - Not ail Modictiono accept credit cards,cards,ptaae roll prisdictlon air mm.innrmoi o-n Notice: "lit permit application Permit fee......................S Y06•_4F U Visa U MoOrWard expires if a pemrit is not obtained Plan review(at-___ %) S _ Crodit card num1w: -L�. within 190 dRys ager it has been State sumfuirge(8%).....S 24._51 exp ras Naini o� accepted sq complete. TOTAI..........................S 0.91 . - cs o ar as a rm oh ria�t eats .-` _ S �r�lto-1 Tjnatunmit 440-4e1 T ta/(OrrnM) (i ELECTRICAL PERMIT FEE; : LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below- TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Restrlded Energy Fee...................................................... 475.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Residential-per unit Check Type of Work Involved: 10o0 sq." or leas _- $143.15 4 C, Audio and Stereo Systems' Each additional 500 sq it Or portion thereof _ _ $33.40 1 1 mused Energy $75.00 ❑ Burglar Alarm Earth Manut'd Home or Modular Dwelling Service or Feeder $90.90 , r ❑ Garage Door Opener' Services or Feeders Heating,Ventilation and Air Conditioning Installation,alleruUon,or relocation ❑ g� g System' 200 snips or loss $80.30_ 201 amps to 40U amps 5106.85 2 ❑ Vacuum Systerns' 401 imps to 600 amps $160.60 2 601 amps to 1000 amrps $240.60 - --- - 2 l 1 Other -— — -— --Over 10001 amps Or VOlib $454.65 _ 2 Reconnect only $68.85 _ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED-COMMERCIAL ONLY histaVatlon,alteration,or relocation Fee for each system.......................................................... 075.00 200 amps or less $66.852 (SEE CZAR 918 260 260) - 201 songs l0 400 songs $100.30 --- _ _ _ 2 401 amps to 1300 amps $133 75 2 Check hype of Work Involved: Over 600 amps to 1000 volts, see"b"above. L7 Audio antl Slereu Systems Branch Circuits New alterallun or Hxtarsioii per pirnal Boller Conhols a)The fee for branch owulib wldr purchase of servka cr LJ raur.l SyslHnn feeder too. Each branch circuit $h 65 I rdl I lPrunnn+ni.aiiun Inslallaliur+ U)The fes for branch circuits El without purchase of servic. or feeder he. Fire Alarm Instsuadon First h,anoh LilCUll $46-85 k:6101 sudrtionel U11111101 an.wi _------------ ba 65 ❑ HVAC Miscellaneous (Sol vice or feeder not included) E] Instrumentation Each pump or irrigallon circle $53.40 Each sign or outline lighting $53,40 ❑ Intercom and Paginy Syetyinb Signal clrcult(s)or a lirnited energy ^� panel,alterallun or extension _ $75.00 El I andscapH Inlyatlun C:unhul' INlnoi labels(10) $125.00 Each additional Inspectlun over C___1 Medical the allowable In any of the above Per inspection _ $62.50 Nurse Calls Per hour _ __ _ $62.50 In Plant $7375 Outdoor Landscape Lighting' Fees: n Protective Signaling Enter total of above fees $ Other __ --- —------ -- 8%Stale Surcharge $ ------------ _. of Systems 25%Plan Review Fee See"Plan Review"section on $ No Ilcenses are required I-icenses we required for all Other InGtHllallons front of application, _ - - - Fees: Total Balance Due $ Enter total of above fees $, L1 Trust Account M 8%Stats Surcharge All New Commercial Bur„'rugs require 2 sets of plans. Total Balance Due i:Wrts\lbmn\elc-tles.doc 02/05/02 CITYOF �''I�ARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003 00351 13125 SW Halt Blvd., Tigard, OR 37223 (503) 639-4171 DATE ISSUED: 9/30/03 SITE ADDRESS; 12100 SW GARDEN PL BLD4 PARCEL: 2S1011313-01400 SUBDIVISION: I'AkK 217 ZONING: ('-(I' BLOCK: LOT: 002 JURISDICTION: TI(; TENANT NAME: IKON USA NO: FIXTURE UNITS: 5 CLASS OF WORK: All DWELLING UNITS: TYPE OF USE: '.;OM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .3 EDU increase. Previous EDU=2 for a total of 32 fixture values. Addition of 5 fixture values for a new total of 37 fixture values = 2.3 current EDU's. Owner: — - - SPIEKER PROPERTIES LFEESSP 4380 SW MACADAM AVE STE 100 Description Date Amount PORTLAND, OR 97201 �SW1j.SAI S\\r( unncc. 9/30/03 $720.00 (SWUSAj SWrConnecl 9/30/03 $0.00 Phone: -- Total $720.00 Contractor: Phone: Rey#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Perm Issued by: "Zt Zee c.` ?�)c< Permittee Signature Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD ELECTRICAL ENER - RESTRICTED ENERGY' DEVELOPMENT SERVICES PERMIT#: ELR2003-00301 13125 SW Hall Blvd.,Tiqard, OR 97223 1503) 639-4171 DATE ISSUED: 9/30/03 SITE ADDRESS: 12100 SW GARDE! PL L3LD4 PARCEL: 2S 101 BB-01400 SUBDIVISION: PARK 217 ZONING: C-G BLOCK: LOT: 002 JURISDICTION: TIG Proiect Description: Install voice and data cabling. A._RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: �^ BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS. VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE OTHER: HVAC: PROTECTIVE SIGNAL. INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS: 1 _ Owner: Cor.tractor: SPIEKER PROPERTIES LP NETVERSANT CASCADES INC 4380 SW MACADAM AVE STE 100 9020 SW GEMINI DRIVE PORTLAND, OR 97201 BEAVERTON, OR 97008 Phone: Phone: 503-646-0533 Reg #: ELE 34-258C.:LE LEC 150328 SI!P 29031.1-'A FEES Required Inspections _ Description Date Amount Low Voltage Inspection 111IRNI '] ELR 11cnnii 9/30/03 $75.00 Elect'I Final IAN 18"/o State Tax 9/30/03 $6.00 Total` $81.00 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 pians 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 alas 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. Issued by ._.(.L; �C_� '/� ��i /� � Permittee Signature ��!� 1 _ 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 SIGNATUP.E OF SUPR. ELEC'N _ DATE:_ 4 LICENSE NO Call 639-4175 by 7:00 P.M. for an inspection needed the next business day t '14 ' 00:1 i C 0 f 1':1.0 5:3 (i4 1 1;61 3 tint Vot,sant Cas(—.rides, I ric z oo l Electrical Pernut Application Date received City of Tigard Project/appl.no.; _ Expiredate: �'uy uj'a'igrrrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 nate issuctt_�— By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Calc file no.: Payment type: Land use approval Ll 1 &2 family dwelling or accessory ommercial/industrial U Multi-family Li Tenant intpit�vement U New construction Addition/alteration/replaccment U Other:. U Partial Jab address: 1VO S V! P-11 ITax ma /tax lot/account no.: Lor.; Block: Subdivision: Pro3cct nalne:j. 4y) 77 S(/j U OG I Description and location of work on premises: Estimated date of cornpletiordias I ection: Job no: U`), (U3 i" q 6P(lrY n nee Mi Busineasname: NeiVersu_y11--l (.(SL'G�P � '� - Uescriptlon Ot ea 1'ofal no.insp y N•«resldenflal-sinRk or multi-family per Address: of q y o SW /V I vM ys 114/elit vz dwelling unit.Includes attached garage. City: Sept yaZ-fgo I State:0 4-1 ZIP: 17900 if Service Included: Y(0 US r 3 (�, I ODU sq.h or less 4 Phone: Fax: oY-(ply/ E-mail:il2a 0r �/3�"'r*� Each additional 300 sti.ft.or portion thereof - — CCC:' no. 5p3� Elec,bus.lic,no: 7,t{- 5R ["OP Limitedenergy,residential 2 City/metro Uc.no.: (!-ZX- Limited energy,non-residential -- _ 2 -Q 3 Each manufactured home or modular dwelling silifiaturt of supervising electricinn(required)) Date Service and/or feeder 2 5up.elect.narne(print): f� - r[A-WesA License no:IIJ371 Serv(eesorfeeders--instal Wion, alteration or relocation: t OWNER 200 amps or less 2 Name(print): 201 amps to 400 amps _ 2 - ---- - 401 amps to 600 amps 2 Mailing address: 601 amps to I000 annps 2 City: _ State: ZIP: Over 1000 amps or volts 2 Phone: Fax: E-mail: ry Reconnectonl I 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,orrelocation: ORS 447,455,479,670,701. 200 amps or leas 2 201 amps to 400 amps 2 Owner's si ture: Date: 401 to WO ams v 2 Branch circuits-naw,allcratlon, or extension per p.mel: Name: T _..__. A. Gre fat bra- h circuits with purchase of Address: service edet fee,each branch circuit 2 City: _— - State: ZIP: T B. Fee t ranch circuits without purchase - - - ------ — —---- Photic: Fax E-mail: of service or feeder fee,first branch circuit: 2 - - -- ---- Eacb additional branch circuit: Misc.(Service or feeder not Included): U Service over 225 amps-mince od l]I lealth-care facility Hach pump or irrigation circle J- 2 U Service over 320 amps-rating of I&2 U Hmardous location Each sign or outline lighting, 2 familydwellings U Building over iO,q)O square feet four or Signal circuil(s)ora Limited ener y pruiel, USystem over 600vnitsnominal morr residential units in one structure alteration,or extension• ' f/� is 2 U Building over three stories U Feeders,4(10 amps or moor •Vescri tion: U Occupuu lone over 99 persons U Manufactured slnachucs or RV park Each addlironal Inspecflon over the allowable In any of the above: U Egressilighungplun U Other _--.------ - _-----._,_--- Penins ectinn Subunit_sets of phos with any of the above. Investigation fee 'Ilse above are not app8cable to tempots"construction service. other Not all)urisdlctiona rxepl credit cards please call Jurirfdktlon for more htkrrrneiMn. Notit:C:TniS permit application Pcrmit fee... ................5 •7 S•_SL-- U Visa U MasterCard expires if a permit is not obutined Plan review(at _- %) r',redll cud number: hr / >' _ within 1 SO days after it has been Stale sort har>'e(84f) ....$ _U -U0 `h nee accepted as complete. TOTAL ... .. . ..._....... S a i .o0 Name of cudso16,,ns shown on etedb cud s ♦ro�ens taAOK csMr _ � Arn,wnl CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00479 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6.39-4171 DATE ISSUED: 9/30/03 SITE ADDRESS: 12100 SW GARDEN PL BLD4 PARCEL: 2$101136-:71400 SUBDIVISION: PARK 217 ZONING: C-G BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 2 TRAPS: STORIES: WATER HEATERS: 2 CATCH BASINS: FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAW.: SINKS: 4 URINALS: 2 GREASE TRAPS: LAVATORIES: 4 OTHER FIXTURES: 3 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 7 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: TI building plumbing. 4 sinks, 4 lays, 7 WC, 2 fl. drains, 2 water heaters, 1 lau. tray 2 u-inals, other fix. 3 caps. FEES Owner: — Description Date Amount SPIEKER PROPERTIES LP 43F30 SW MACADAM AVE STE 100 INi 'Ntli1 I'rrniit 1-cc 9/11/03 $415.00 PORTLAND, OR 97201 I I'I.�11'I.N I I'L•m Itr%ir�� 9/11/03 $103.75 i 1 1NJ � tit;ur I;,\ 9/11/03 $33.20 Phone : Total_y $551.95 Contractor: PURE PLUMBING 1350 LEWIS ST. SE SALEM, OR 97302 REQUIRED INSPECTIONS Phone : Top-out Insp Final Inspection Reg#: L.K• 00071677 I'LM 24-214 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 Issued By: �u.� ,�, � Permittee Signature Call (503)639-4175 by 7:00 P.M. for an inspection needed the next business day Bullaung r ixtures 1zs -oo%— Plumbing Permit ApplicationReceived -J l'inn,E -, Date/By:r li' 1�j 1'crmit NO.:, CityCit Or Tigard and Piannin-A prov Sewer Date/By: Permit No. 13125 SW Hall Blvd. Q Plsn Review Other Tigard,Oregon 97223 0 E E' Datdt3 : Pernut No.: Phone: 503-639-4171 Fax: 503-5� -1960 i'ost-Review land Use — t Date/t3y: ('ase No.: Internet: www,ci.tigard.or.us ,� contact Juris.: S.ei'ade 2 for 7.4-flour inspection Request: 503-6394175 Namc/Mcthod / Su +lemcnial Information. CITY OF TIGARD TYPE OF WORK _ FEE*SCIIL:DULE for snecial Irformation use New construction I Demolition Description Fce(ea.t frrtat Addition/xlteration/replacement I _Other: New 1-&2-family dwellings CATEGORY OF CONSTRUCTION _ includes 100 ft.for eech v Ility connection 1 _ 1 &2-Family dwellingSFR(1)bath 249.29Commercial/Industrial SFR(2)bath _ 310.00 Accessory Building_ E_ Multi-Family SFR 3 bath — 39900 —„ Master Builder _ Other: Each additional bath/kitchen 45 00 _ JO13 SITE INFORMATION and LOCATION Fire sprinkler-sq.. ft.: Job site address:� /04 .cro-.dg f e Site Utilities _ — y— Catch basin/arca _ 10Suite#: Q .4-y Bld ./A t.# Dr el)/lcach line/trench dram I6,60 Project Name:` -E k ) N rooting drain no.linear ft. Page 2 Cross street/Directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector _ 1 G 6 Sanitary sewer no.linear ft. Pe c 2 Subdivision: _ Lot#: Storm sewer no. linear ft. Page 2 _ Water service no.linear ft. Pae 2 ax ma i arcei#: kixture or item DESCRIPTION OF WORK _ - AbsorFtion'sive _ _ I6.60 t yy, 4 1,' backflow preventer i T Page 2 y, y_ Backwater valve 16.60 Clothes washer 16.60 -- — Dishwasher 16.60 _ PROPERTY OWNER TENANTDrinking fountain 16.60 — Ejectors/sump 16.60 Name: _� -- -.- Expansion tank — 16.60 T-- Address: Fixture/sewer cap 16.60 Cit /State/Zip Floor drainifloor sink/hub 2. 0.60 -_ -_- _— _— Garbage disposal 16.60 Phone: Fax: _ _ Hosc bib _ 16.60 El APPLICANT C9 CgIVTACT PERSON Ice maker 16.60 Name: `� r>; y rr Interceptor/grease trap 16.60 Address: �X Z/, �u / e/y��- r dkr Medical as-value: $ Pae 2 (J" C_it /State/Zi ]16 -J ntPrimer IG.GO (� _— Roof drain(commercial) I G.6J t Phone: Fax:S'�J- yG3-4Jg9 Sink/basin/lavatory 16.60 M E-mail: ( r� '' Tub/shower/shower pan 16.60 S`t CONTRACTOR Urinal 2- 16.60 ", J V} Business Name: Water closet 16.60 ', - `/'r s '`'" r Water heater 16.60 Add' ss: _ Other: TT` Cif i State/Zip: Other: e- Plumbing Permit Fees* Phone: Fax:� U 3- C 3- �4' - CCB Lic. #: /(,. 7 Plumb. Lic.#:2 -�l P subtotal $ Minimum Permit Fee$72.50 $ Authorized %IS, l I �® �0 j Residential Backflow Minimum Fee$36.25 2 Signature: c=' Date: Plan Revicw(25%of Pcrrnit Lee) $ ( State Surcharge 8%of Permit Fee $ (Please print name) _ TOTAL PERMIT FEE $ r Notice 7 hFs permit application expires If a permit Is not obtained within All ness commercial nutldingi require 2 sets of plans with Isometr c nr 180 da.s after it hAs been accepted as complete. ricer diagram for plan resicss. 'Pee mcU+odology set by'1'rI-(Dunn Itnitdinl,,IndnorN Seriice Board. 01)wTermit Forms0mPermitApp.doc OUO3 PlumbingPeri,'it Annlican•_- '�ity of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su ression Systems: Site Utilities Qty. Fee(ca) Total Square Footage: Permit Fee: Footing drain- I° 100' SS 00 00 to 2:000 1 $11500 Footing drain-each additional 100' qG ,p 2 001 to 3600 1 $160.00 3,601 to 7,200 1 $220.00 —i— sewer- Ist 100' 55.00 7,201 and greater 1 $309.00 a Sewer-each additional 100' 46.40 -- Water Service- Ist 100' 55.00 Medical Gas Systems' Water Service-each additional 100' 4040 Valuation: Permit Fee: Storm&Rain Diain-Ist 100' 95 uu _ $1.00 to$5,000.00 Minimum fee$72 50 Storm&Rain Drain-each additional 100' dt,an $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each Fixture or Item Qty. Fee(ca) Total additional SIOUX)or fraction thereof,to and including$10,060.00. Commercial(lack Eli w I'rcvention Device 4nA1' _ $10,001.00 to$25,000.00 $148.50 for tie first$10,000.00 end$L54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee$30.25 27.55 and including$25,000.00. Rain Drain,single family dwelling 0.25 $25.001 00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for Inspection of existing plumbing or each additional$100.00 or fraction thereof,to specially requested inspections•per hour 1 72.50 end includin $50_000.00. Subtotal: -- $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. Fixture Work: Are you capping, nro%ing or replacing existing fixtures' It "Yes",please indicate work perforated by fixture. Failure to accuratel},re op rt fixtures could result in increased sewer fees*. uanth •b Flxtttrc Work I'crforntcrl Comments rC� rdinv fixture tsork: 1 ��, Fiahtre Type: Replace f . r� 1 Ntw Moved Exlttfn Ca d --�{- —�--- Ba lisle"i.nit _SEI i t P .lilt Bath -Tub/Shower -Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru "us ndor/Water Aspirator .I'4 "�-+ �'Z t r •'L�+—r_� �ti"� Dis`twashcr -Commercial _ -Domestic Drinking Fountain rt1"-f`•C Eye Wash �! rj►tr. S Floor Drain/sink 2" -- 3,. — 4„ — Car Wash Drain _ Garbage -Domestic — — "Note: If the fixture work under this rcrmit results in an Disposal -commercial i — — increase of sewer EDUs,a sewer permit will be issued and -Industrial — fees assessed for the sewer Increase must be paid before the Icc Mach/Refri .Drains _ plumbing permit can be issued. Oil Separator Gas Station Rec.Vehicle Dump Station Shower Jiang -Stall Sink -Bar/Lavatory i -Bradley -Commercial Service Swimming Pool Filter -- T Washer-C'lothe's ... Water Extractor Water Closet-Toilet f I.Innal + Other Fixtures: i\Dsts\Permit F1rms\PlmPcnmitAppPg2.doc 01103 CITY OF TIGARD 24-Hour BUILDING Inspection Line: 1503)E.,9-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST __ BUP _ Received y 1-3 Date Requested Z Z 0 AM PM BUP Location _-_--� Z 45UL Suite _��_--- MEC ---- Contact Person ( in �QL� Ph Contractor _ 4f 6,tr' PLM Qom_ Pit( ) _ __.______.__...__. SWR BUILDING Tenant/Owner ELC _ Footing Lu Foundation ELC _ Ftg Drain Access: J 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 --- ------ -- PLUMBING Post&Beam Under Slab _-- Hough-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 - -- - - ---- PA_SS PART FAIL - --_ -- ELEC'TRICAL - Servire Rough-In Ulf/Slab ow Voltage ---- arm -- ------- - - -- mal__� PART Reinspection fee of$ _-_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS FAIL SITE Please call rot reinspection RE _- - _- _-_-_ _ �� Unable to inspect no access Fire Supply Line ADA _ Approach/Sidewalk Date '� Inspector 1 l l' ~- - _ r' # Other: - Final DO NOT REMOVE this Inspectla,6 record ffom the job alto. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 �_-- BUP Aeceived ._ --___ Date Requested _- -_�n�"-�_ AM PM BUP Location ___ _- ` a - � �+^-- C1 --____-_,.Suite� _ _ MEC —_ Contact Porson - -_�G --_- -_-- - --- -- _- Ph (---) PLM Contractor ----- - - ---- - - - Ph !_ _ ----- ---.� SWR ---- — BUILDING_ Tenant/Owner ��_U�f___.�u ��_�_.._. ELC Footing ELC Foundation Access. f� Ftg Dram LR - Crawl Drag Slab Inspection Notes: SIT Post& Beam Shear Anchors - -- -�-__--- - r.._�----- - -- --- Ext Sheatf/Shear Int Sheath/Shear Framing -- - - - -- --�. Insulation Drywall Nailing - -- - -------- -- -- ------- Firewall Fire Sprinkler ---- --- -- _ Fire Alarm N G- r QN i` d Susp'd Ceiling - Roof Other: --�- - Final _PASS_PART FAIL_ PLUMBINQ _ Post a Beam Under Slab Rough-In Water Service ---- Sanitary Sewer Rain D ains - -- Catch Basin/Manhole Storm Drain -- -- - Shower Pan Other: — Final PASS PART FAIL -- MECHANICAL Post&Beam Rough-In Gas Line Smoke Darr,,iers ----- Final PASS PART FAIL fELECTRICAr 1 Rough-In - UG Slab 1, o7 Volta e� -ire—ATa—rm— (n7naD Reinspection fee of$ required before next ins PASS PART _FAIL - p q inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE �� Please call for reinspection RE_____ n Unable to Inspect no access Fire Supply LineADA Approach/Sidewal►r Date M �_.G -� lnspr►ctor �-'^_ _ Ext _ Other: Final DO NOT REMOVE this Inspection rec d from the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- -- - C' r- BUP _ - Date Requested ,t W' (- )' _AM _PM BLD I-ovation_ l_� (` >�l rt/`C�,(,� ' �',�� . Suite MEC _ Contact Person _ �] / Ph PLM /,ontractor _ (� � ��1 tl-i) Ph SWR _ BUILDING enartj/Owner ` 1. �0/'::7; 6 C- a / E L C _^ Retaining Wall ELR Footing --- -- Foundation ACC(?SS: FPS _ Ftg Drain — 5GN Crawl Drain Inspection Notes- - --- Slab _ Post 6 Bearn --�- ------- SIT - Ext Sheath/Shear Int Sheath/Shear Framing Insulation ------ - --_.____-_--_-- Drywall Nailing _----------_- -- _- Firewall -- ----------..___._- Fire Sprinkler ----- _-----------_- ---�- _ Fire Alarm Susp'd Ceiling ,_-- Roof Misc: ------- _- ------- Final - -•- ------- PASS PART FAIL --- -- --- _.-.. -- Post&Beam ---- - --- -- ------ ---- Under Slab Top Out Water Service Sanitary Sewer -Rain-Drains PART FAIL Post& Beam - ---- - Rough In Gas Line - - - ------- Smoke Dampers Final -- - ---- --r -- PASS PART FAIL ` ELECTRICAL __ --- -- --- Service Rough In UG/Slab _ 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, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ j Please call for reinspection RE: ^_ [ ]Unable to inspect- no acr.ess ADA F / Approach/Sidewalk G'r- other -- Dates - Inspector l/� --- ----- Ext-.— Final r PASS PART FAIL _J 00 NOT REMOVE this inspection record from the job site. CITY a F TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM1999-00124 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/23/99 SITE ADDRESS: 12100 SW GARDEN PL PARCEL: 2S101BB-01400 SUBDIVISION: ZONING: C-G BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replace an existing water heater Owner: — FEES _ IKON OFFICE_ SOLUTIONS Type By Date Amount Receipt _ 12100 SW GARDEN PARK PL PRMT GEO 4/2.3/99 $25.00 99-314818 1IGARD, OR 97223 MISC GEO 4/23/99 $1.25 99-314818 i Total _526.25 Phone 1: Contractor: GEORGE MORLAN PLUMBING 9806 SW TIGARD ST TIGARD, OR 97223 REQL IRED INSPECTIONS Phone 1: 624-6895 Final Inspection Reg #: LIC 000027 PLM 26-60BP 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 accordan -�-- with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is :,uspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Gregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. i issued By Permittee Signature:_ Cal1 (503)439-4175 by 7:0-o P.M. for an inspection needed the next bi:siness day �� RPR-21-1999 11:02 �I l Recd 0r -Y OF TIGARO RECEIV Plumbing Application Date Recd 125 SW HALL BLVD. Commercial and Residential o.,,e to P E _ ao/ ;ARD, OR 97223 APR c rs Date to 40k y 13) 639-1171 �' egg' v?rm,l>�N1�irt9- COMMUNITY t)EVEIppM�,�, print or Type Related SWR a Incomplete or illegible applications will not be accepted Called FIXTURES (Individual) QTy PRICE AMT ^ Name dr QrPveldOmenuProlea 9.00 ��)he Sink 9 00 .lob 11 L'TT l�'Q. �-�"'` rN Lavatory $;rent Andress �rk PL 900 Address W fU0 or Tubr5hawer Comb of C� r W Shower Ontr 9.00 J St-ig s wfvrSldro �i0 7 � ____ Water Glosel _ 900 _ wamtl Disnwasner 9 00 6� Garbage Deposal 9 DO Halling Aodres.n Sura 9 0o Owner Washing Mach,ne _ CrryrSt>u Zip Phone Floor Drain 2' ^r 9 00 �- 9.00 Name • — 900 water Master 9.00 occupant Mailing Suite 9.00 p Laundry Room Tray _ CrlyrSlate Z,D� Phone Unnal 9 CO Otner Fixtures;Soeulyl 9.00 NJAMS 9.00 9.00 Contractor a'I'"g A so—ri SWe 9.00 1 onor to issuance I IStals 2 Phone — 9 00 luplrcar,l must CIL q.L C, 4— 9U orovrde all Orego Const. Cont.Board Lic a Exp gate, 9.00 ;�nUaCars [ -- license Plumbing Lr 0 F�rp. its Sewer••tsl 100' ]0.00 ,nformari0n �— Sewer•each add,banal t DO' +J 25.00 for COT COT Business Tax or Matra a EA a � Water Service-nit 100' JO-00 _.,Oalab73e1. 1-//n / {/ 15.00 _ raj--+--- Plater SBMG eac71 add'lranar 200 , Name 70.00 Storm b Ram Drain• 1s1 100' Architect — J 25.00 hWknq Address SuNe 51orm b Rain Onun-eactn Additional 100'_ — — or Mobile Home Space 25.00 Engineer I C't'/S'ate Zip PhdnO Commernat Bac Flow Prevention Devic or,anu- Pollution Devrca =es:r•.be work New ,� AOCrtion � .iltenhon O Repair O -s,oenual 93cktlow'rcvenaon Ctwu' 15.00 o :e bone Res,denpal O Non-residential 11,11 Any Trap or Was:"Nct Connects to a Fixture I 9 00 cdc:onal desaiouon or wore; Calm Basin V 900 I t�r2te.r l2 s?A r t--e—Pl0- emert_-L nap of Existing�-umb,nq 40.0f) } peuhr Specialty Redueaied rncpaarons fl' =us,nq use 7l _ I we,rnr ,ilc nq or prooeny__ _ Ram Dramng. single dwelling ]n.i) , osea use or Grease Trarl I I 9 u0 rd,nq or"roceny -- QUANTITY TOTAL e au capemq moving or replacing any fistures" res C NO] lWmvT-c x ntM a sgnrn f rlicu,rod 1 qu.ngy*ow f ►1 SUBTOTAL if ,es see back of fbnnt _ ' ie1e3y adindwledge M71t I nava rase this app-c3Uon. that the,nfom'auon 5% SURCHARGE -,en s coriecl that I am'he owner or authorizR'agent of:ne owner and ..it dtans suorrtrttad are :amaliance wire 0-mon Slate Laws. PLAN REVIEW IS".OF SU9TOTAL ignalu of Owner/Agent Date a.cuna tine fcr! :ma,,s•9 tOTAL unett D&non Nr.rn• Phon• �• � q•. m p. Arr V66 s'urcna9e erpResiasnunl Hautnew Prevertson pace w",U1 s S 15 wrcnarye6a30 '4313'.01maD0 dcc&M RPR-21-1999 11:02 Plumbing Application Reca By _ f OF TIGARD RECEIVI Oat•Recd 125 SW HALL BLVD, Commercial and Residential D„tl to r F ;ARD, OR 97223 APR c� 1n/� Date to OST H!'� �) IJ;1� Pvrmit�/�lf -� 13) 639--1171 Rotated swR a COMMUNITY OEVROPMy4; print or Type — Incomplete or t.,!'nible applications will not be accepted Called l�/ /D C1?( ( , — PRICE AMT FIXTURES (IndIViduall --dT Mame at CevtapmenuProtecs \ 9.00 Sink Job h�On ICQ L- `_ �V Lavatory 900 Address S,reet Aadres9 D� iub or TucrShowlr Como 900 a �� Ga-rt�( t21'f� 19.00 Oi.1g r �.dlrP,tate ,.gyp !7� Shower t7nlr _ — Wa1ar Claret 900 Nam• Disnwasner 9 00 Garbage Onposai 9 00 Owner Marling Aadreu Suite 900 washing Mactrme C tyrSlat• Zia Phone Floor Drain 2' _ 900 �• 9.00 Marne J 4- 9.00 Occupant Marling Address r Suite water Haaur goo J Laundry Room Tray 9,00 CrtyrState Zip Phone Unnal goo Other Fixtures 1Soeutyl 9.00 N�r e 420 . Mo r i Q — 9.009.00 Contractor at��as�� suite t 4.00 Pear to issuance C+ rstale Z Ppo'na9.00 1pphcant must lSt ” ` '�. —� 9 UU provide all oreqollillCoiist, cont. Boars LUC.a Fcp aro 9.00 c7nrraCors Q -- -- rcense Pfumbling Lt 0 Exp. ate Sewer-1st 100• _ 30.00 mronna(fon � Sewer-each 366,60M.11 100' _ 25.00 'or COT CO' Bu—siness or Metra a Exp a water Sarnce-1st 100' 30.00 aataoasel — / qI ----� V`Nter Servtr:e •ars atladronat 200 25.00 Name Storm 6 Ram Oram- 'St 100' 30.00 Architect Mining Address Su,l• storm 6 Ram Oram-each addtaonu 100 25.00 Of Mobile Hame Spade 25.00 Engineer C tylsiate _ Zip Phone Commercial Baca Flow Prevention Coyle or Anu- 2500 Pollution Device y aenllm 9acxmaw �revenlron Ce'Ace• 1500 es.-.be wark New � Addrhon C lternuon Repair Q o .e bon• Residential 0 Non-recdenuat Any Trap or was;!NC:Connec'."to a F xwre 900 ,cor::onal aaesurouon of worn L / camp,sawn 900 I ()Qti2 r' lZ�. L F / ��nQ.� mtlp. or:craun9 umbmq ---— 140.00 JI oeunr i _ Specially RK estea intpecf ani 40.00 I ='is'nq use�f oenhr jilt ng or property Ra,n Orarn, Srngie'amiiv awturng 30)0 .rosrro use of Grease TtaCs - I —9 Co ntl ng Of property. — -- ouiNT1TY TOTAL I eou Uoa ng moving or reputing any fi:tures� yes C No ] lso^'ee•c r ns°r:"gfsim s recurred f eur,n4y Imm a ►1 i I .if ,as se•back of forint •SUB'OTAL "le•eay acknowr•ope mar i have read tnrs appticatlon that the nlorrnauan 5:4 SURCHARGE : .en's carred that I am•he owner or authonzad agent of:the owner and at Mans suomrtteo are ameuance with Oregon Slate Laws. — dignat ;M of OwnerlAgent Date PLAN REVIEW 25"4 OF SUBTOTAL Iscusea ornty t 5vrwv cr, :Orsi,s�9 1-0 — TO`rAL I � $ At-3ct Dan reName Phone I---- I -Mln.mum petrnrt r44 f Sc5 --Y�SWG-argeYerpt Re lurerttFO!HaGAOW Prevention Device w-icn ra SIS- 5%wrcnarq• r'U1a.plmaDp Oct 5/96 CITY OF T DEVELOPMENT SERVICES ELECTRICAL.. P'F..RMIT - 13125 SW Nall Blvd., Tigard,OR 97223 (503)639.4171 RESTRICTED ENERGY PERMIT #: ELR98-0055 DATE ISSUED: 02/201/98 PARCEL..: uS 101 RB-•01400 TE ADDRESS. . . : 1;=.,100 SW GARDF 11) P1 . !BDIVISION. . . . :CROW PARK 217 ZONING:C-G t?CI:. . . . . . . . . . . LOT. . . . . . . . . . . . . .002 JUR I SD'I CT•N: I IG o J ert De sirr i pt i on: Installatior of data telecoaaunication systes. ---------------------------------------------------------------------------------- RE:S I DENT I B. COMMERCIAL.------------.____________________________._. AUD I Cn R STEREO. . . : AUD T 0 & STEREO. . : INTERCOM R• PAGING. .. BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . : GARAGE OPE'NER. . . . . CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . • . . . HVAC. . . . . . . . . . . . . DATA/TELE COMM. . :Y NURSE CALLS. . . . . . . . . VACUUM SYSTEM. . . : FIRE ALARM. . _.. -. OUTDOOR LANDSC I.-ITE: OTHER: : : HVAC.. . . . . . . . . . . . . PROTECTIVE SIGNAL... . : I NSTRUMENTA'T I ON. : OTHER. . : . . TOTAL_ # OF SYSTEMS: 1 Owner: ___._.___...._....__________.___w_..____._.__-..___._..._........_.._..-.._ ._._..__..__._.._.__. FEES nr'T INCMUNICATIONS type amount by date recpt '010 SW GARDEN PLACE PR14 1 $ 441. 00 B 02'/20/98 9830348 * IIGARD OR 97223 SPCT $ 2. 00 P O2/20/98 963,,034P; I"'hone #: 670--7777 Contractor. ADVANCED COMMUNICATION TECH. 42. 00 TOTAL_ 9500 SW TUAI_.ATIN-SHERWOOD RD K'0 BOX t665 ------ ?ECRU I RED INSPECTIONS --- TI.IAL.ATIN OR 97062-1665 Ceiling Cover Low Voltage InsC Phone #: 692-4040 Wall Cover Elent' ] Final Reg #. . : 000716 This persit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All Mork will be dyne in accordance with approved plans. This perait will expire if work is not started within tee days of issuance, or if work is suspended for sort than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-eel-8010 through OAR 452-801-08 You say obtain copies of these rules or dir ct questions to OUdC at t5e3►246-1987, I s e r e ri b y _.._._.._.__. �`'�_._._. Permittee S i o n a t i_i r e _..__._.__....__.. ...._..___..___._..._....__._____. ..__-OWNER INSTALLATION rhe installation is being made on I)roperty I own which is not intended fns lease. or rent,. nWNE R, S S T C3NATURF r. DATE: _^ INSTALLATION ONLY------__-___-_-___.-_----__ 13IGNATURE OF SUPR. EL_EC' N. N A DATE: L..I CENSE NO- .............4......4..............4............. O:+++++++++++++•+•++++++•++++++++++++•4•++++++++++++}-+++++++++f•++++4-++++++++++++++++ 1 + Call 639-417' by 7:00 P. M. fnr an inspection needed the next hi.i,iness clay -F++++++++++•+•++++++++4•+++++++++++•t+.!•+++++++•M+++4,+++++++-t+++++•4- +++++++ t-++4-+++ 4 i i ' A.C.T. , INC. Fax:5036707788 Feb 19 '98 17:47 P.02i02 Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 1-412 5 SW Hall Blvd. Tibird, OR 97,223 °ERMIT#_ _-1_~ ( c� ' (.'�• �� -). __ _ Prune (503) 639-4171 FAX(5031' 684-7297 DATE ISSUED TDD No. (50:4) 68.3-2772 —`-- --^— — CITY OF TIOARD Inspection (503) 639-4175 155VED BY PLEASE COMPLETE Al l SKTIONS 1. LOCATIOCN OF INSTALLATION 4. I PF OF WORK _&idr ss r RESIDENTIAL ---Restricted Enerp Fre . . . . . . . . . S io.ao R, t _1109, _ _ � (FUR ALL SYSTEMc� City State zip C.htsck Type of Work involved PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK IS NOT STARTED WITHIN 1 Bu DAYS(jF ISSUANCE OR IF WORK 15 SUSPENDED FOR ❑ Audio and Stereo Systems' 150 DAYS ❑ Burg(ar Alarm 2. CONTRACTOR APPLICATION El Garage Door Opener' � f'-r� I ➢ r 1 1 i n L� Heating, v'cntilation and Air Conditioning Sytitem• Contractor-I lam rid ��• TYPe nod ��t�LLuo�� U Vacuum Systems* Address { (�/� U /��"� ❑ Jthe _ —� -- ----- Date Gf�"� COMMERCIAL—Fee for each system . I . . . . I . . s4o.00 !SEE OAR 918.260-260) Y Pro enr Owner P ._-___-.._— --- _-- ChfssTYne of work Irnolved• Contractor'sBoard Re (�. ;.q. No. C t uL LJ ,audio and Stcreo Systems' T'1 r'� ,�� 7 ❑ BoilerConllols Phnne# .1,f �J J _ _ ❑ Cluck Systems 3. OWNER APPHCATION `Ix– Data Telernmmunication Installations ❑ Fire Alarm I mlallation ❑ HVAC Print Owner's Name Phone No ❑ Instrumentation Address ❑ Intermm and Paging`systems ❑ landscape Irngatien Control' I City State Zip 11 Medical -� v L _ This permit Is is ued under OAR 918.320.370.This applicant agrees to make only Nurse Calls b 1" 10110-ing energy installations(100 volt amps or less)under this hermit and to do the ' Iolle..ring; ❑ Outdoor Landscape Lighting 1. Only use electrical licensed persnris to do installations where required.(Certain ❑ Protective Signaling moidenbal and other transactions are exempt from licensing.These have ❑ Other asterisksl`).All others nted licensin f). 2. Call for an inspection when all of the instillations under this permit arc ready for inspection at 503-A39-4175. ❑ Number of Systems 3 Purchase srparttR permiLl for all instittations that are not ready for inspraion when the inspector is out to inspect under this permit. IN.,licenses are required Licenses are required for all other Installations. 4. Assume responsibility for assuring that afl corrections required by the inspector _ are done.and S. Assume responsibility for calling for a final inspection when all of the corrections S. FEES are comparted. I The person sig ni \r this permit must be the applicant or a person a. Enter Fees $ auth ' ed tact a applicanL I 1 �1 -3— il�r � b. 3% Surcharge(.05 x total above) g J TOTAL $ Authority it other than applicant