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12168 SW GARDEN PLACE i i N a 00 0 A O m z v r n m y i 12168 SAN GARDEN PLACE CITY OF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT 13125 SRI Hail Blvd., Tigard,OR 97223(503)639-4171 PERMIT #. . . . . . . : E3UP98-033C DATE ISSUED: 08/c26/96 PARCEL.: c5101BB-01400 SITE.. GaDI)RE SCi. . . : t '245-Fr `::>W (34)RDEN F11_ ii f{I_1). . .1) ,r-UTADIV15T(IN. . . . : CROW PARK. 217 7ONINCS:C---G BLOC'K. . . . . . . . . . .. l_OT. . . . . . . . . . . . . ..002 .IUR.I Sl)I CT I ON.T I G REISSUE_: FLOOR AREA,._..._.__.—.__---._ EXTERIOR WALL. CONSTRUCTION CLASS OF WORE;. :AI-T F1 RC)T. . . . : 3000 s f N: c-i: E: W: TYPE OF USE:. . . :COM SECOND. . . : 0 s f PROTECT OVEN I N(3S?-- __-_—___.. TYF'E OF CONST. :3N . . . . 0 5f N- 9: E» W. OCCUPANCY GRP,. :H TOTALL...- — - --» 3000 s f ROOF CONST: FIRE RET? OCCUPANCY LOAD; E,6 BASEMENT'. : 0 s f AREA SEF'. RATED: ST0R. : 0 EST; fe) f1-. GARAGE. . . : 0 sf OCC;L) SEP. RATED: BSIhT? : ME:7'7_? : REOD SETBACKS----------,-- REQUI RED---------------.---. FLOOR L.DAD. . . . : (11 ps f L-EFT: 0 ft RGHT: 0 i't F IR SP,Kt_ : SMOK DET. . : DWE l-L. INC, t I N TS; 0 FRNT : 0 ft REAR: 0 ft FIR ALRM: HNI)If'.F1 Ar,C: BEDRMS: 0 BATHS: 0 IME, SURFACE: 0 PRO CORR: PARKING: 0 VALL.)E. $ ; 22430 Remarks : Adding 3,000 sq. ft, to existing tenant space 12168 Sw Garden Place. A mechanical, sprinkles, electrical, and plumbing permit is required. Owner: __._--.__._.__.___...___.__._._._..._..___-----.....___._._-------____.__._.__.____ FEES SF'TEKER PROPERTIES type amol_Int by date recpt 4380 SW MACADAM PRMT $ 15A. 50 H 06/126/9b STE 1.00 5PCT $ 7. 93 H 08/26/98 98--328628 PORTLAND OR PL..CK 0 10.-x. 03 H 2E?/2.6/98 96-30861_18 Phone #: 221-5702 FIRE $ 63. 40 B 08/26/98 '38-30BEE:8 C 3CH I EWE R ASSOCIATES 1024 NE I)AV I S PORT'L_.AND OR 97232 Phone #: 1D.34 -6617 $ 332:. 86 TOTAL Reg #. . : 000541 --RFC�I l I Ri:D ACTIONS or INSPECTIONS—— This permit is issued subject to the regulations contained in the Framing Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other C3yp Hoard Insp applicable laws. All work will be done in accordance with Sr_(sp Cei ing Insp approved plans. This permit will expire if work is not started Misr. 'nspection within 140 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Netification Center. 'hose rules are set forth in DAR 952-001-0010 through OAR You many obtain a copy of these rules or direct questions to MJNC by calling 1503)246-1987. F,er-mittee SignatLIre : �� IssiIed By : +++++++++++++++++++ + +++++++++++++++++++++++++ +++.+++++++++++++++++++++++++++ Call 6.x,9--4175 by 7;00 p. m. fore an insper2tion needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++•1-+-++++++++ Recd Ry CITY 4F TIGARD Commercial Building Permit Application 13125 SN HALL BLVD. Tenant Improvement Date Redd qf- TIGARD, OR 97223 Date to P E. (503) 639-4171 Date to DST. 9 J H Permit* . Print or Type Related SWR t Incomplete or illegible applications will not be accepted Called__ Name of DevelopmenUProJed Existing Building New Building p Job Address Street Address Suite Building l 2i*G8 Gw iso loc^r-c Data Bldg aK City/state Zip Existinp Use of Building or Property: T'l�neo, oil. Name Property �'�j p�p �7c , Proposed Use of Building or Property: Owner Mailing Addre s Suite No. Of Stories: Clty/State Zip Phone _ _ I�ot2��.rp itL2 2 f --S 76sFt. Of Project Occupant Nam,, Q Ob AL(-_ A"u7 "IXe6lJEc_.- Occupancy Class(es) � Name Contractor C SCtfj1- F- vt ej tom- Type(s)of Cortstructian �� Prior to permit Mailing Address Suite — N Issuance.a copy Will this project have a Fire Suppression System? of all licenses 1024- NE OAj(S Yes No are required If Clty/State Zip Phone � expired In C.O.T. ,rb `�f� Americans with Disabilities Act(ADA) database [t , 0 P, 2?�' -ia(6 i Valuation X 25% = $ ` c' Participation Oregon Const.Cont.Board Lic.* t-xp.Date Complete_ Accessibility Form a Oqj Project $ ---- - Name Valuation 1 2 2—, Architect M Icox&-j Plans Required: See Matrix for number of sets to submit Melling Address Suite on back ( ►v 3e ski KEre32 s — --- City/State Zip PhoneI hereby acknowledge that l have read this application,that the Information V I Crjy�y � ZAY4 0S>S, given is correct,that I am the owner or authorized agent of the nwner,and Name that plans submitted are in compliance with Oregon State Laws. Engineer N// t -_- t rgn ure of Ow nt Date Mailing Address Suite_ r-- 8/2C9 e C ntact Person Name Phone City/State zip Phone FOR OFFICE USE ONLY Indicate type of work. New O Addition O Demolition O Map/TL# Land Use Accessory Structure O Foundation Only O Alleration I fir. I Repair O Other O Notes: — - Description of work: TIF. TE M��" MOO F?C^7t� Note: Site Work Perrnit Application must precede or accompany Building Permit Application ':=MNEWTI.DOC (DST) 5/98 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan Rewew is dependent capon submittal of BOTH plans AND a COMPLETED application. For an electrical submittal, the application must contain the signature of the supervising electrician before plan review will ')e conducted. After plan review approval, Plans Examiner will contact the applicant to request additional plan sets for distribution purposes. (Copy for Contractor, City, Washington County, Tualatin Valley Fire & Rescue) Total # of TYPE OF SUBMITTAL Plans KEY_ : _ Submitted S (Private) 1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B-K—M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add)- 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) _ Building *B or B & M (Alt) *B & M & P (Alt) 3 E(Alt)W -B & M & P & E & F(Ait) � �3 NOTES: *Shaded areas designate ALT submittals only. I ldsts\maxtrixtdoc 07/08/98 SUBJECT: ACCESSIBILITY BARRIER REMOVAL IMPROVEMENT PLAN REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation,alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom,telephones and drinking fountains are readily ac sible to individuals with disabilities,un!ess such alterations are disproportioiate to the overall alterations in terms of cost and scope. (2)Alterations made to the pat.,of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five percent VALUATION of all renovation, alteration or modification being done excluding painting, wallpapering. $ M4 t'tply:. 25% Barrier removal requirement. ,25 BUDGET FOR BARRIER REMOVAL (21 $ In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $J (b) An accessible entrance: (c) An accessible route to the altered area: _ (d) At least one accessible restroom for each sex or a single unisex restroom: $ �J J D . "_ (e) Accessible telephones: _ (f) Accessible drinking fountains: and _ (g) When possible, additional accessible elements such as storage and alarms: TOTAL: Shall equal line '? of value coi,iputation _ 1 f Z 7S e4 d 3 Q of — CITY OF TIGAa,RD BUILDING INSPECTION DIVISION MST I 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BOP Date Requested � � - _AM PM _ BLD Location 1 5 )L�- Suite MEC Contact Person Ph PLM Contractor �% GuF �. Ph �5�' 9 �i1 SWR y /1/ BUILDING Tenant/Owner ELC -4 -L)c�0- Retaining Wall /�,/ )u 7 n /SLR C zS fr Footing Access: ' Foundation FPR _ Ftg Drain SIGN Drain Inspection Notes: --- --- Slab ___- ---- --- ._...-- - -- . SIT Post& Beam - Ext Sheath/Shear Int Sheath/Shear Framing Insulation -�— Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: _ Final PASS PART FAIL ----- -- - PLUMBING ` Post&Beam - -- Under Slab Top Out — -— Water Service _ Sanitary Sewer — Rain Drains Final PASS PART FAIL MECHANICAL Post&Beam - Rough In Gas Line ---- - Smoke Dampers Final PASS PART FAIL --fLECIRICAL`' Servic Rough In UG/Slab Low Voltage Alarm Fi PART FAIL Backfill/Grading '—------ - --- Sanitary Sewer Storm Drain ( J Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ j Please call for reinspection RE: [ J Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Date --- Inspector - �,— Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 M5 f Date Requestedld U AM ^_ BLD Location �� Suite _ MEC — Contact Person A Ph �SS``gy PLM Contractor Ph SWR BUILDING Tenant/Owner Retaining Wall ELR Footing Access: Foundation /PO TP I{,IT ic I O S(W Ftg Drain l J 1 f� FPS Crawl Drain Inspection Notes: SGN Slab Post&Beam — --y- 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 PLUMBING Post& Beam --------_ ..� --- -- ___. Under Slab Top Out - - - ---------- Wates Service Sanitary Sewer - _ ------- Rain ---- -Rain Drains ---- ------------ Final - - --- PASS PART FAIL IMECHANICAL ---------------------------- Post& Beam -- - _. --__ --- ------------.-_ .. .... Rough In Gas Line - -- -- - Smoke Dampers Final --- -- - -- - -- ---- PASS PART FAIL ELECTRICA --- -- ------------------------ Service Rough In - - -- - - ----- - UG/Slab Low Voltage Ek&Alarm --- 1-Fina ----'�-- PART FAIL Backfill/Grading — _— Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ )Please call for reinspection RE: _ [ Unable to inspect-no access ADA Approach/Sidewalk Other Date Inspector _ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the jcsite. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Flour Inspection Line: 639-4175 Business Line: 639.4171 --- --- ,��/ ! � BLIP �d Date Requested - , '-VAM PM BLD �_ Location ` � -�- ��-- -C-'Suite Gno"3 MEC Contact Person C kU-yJ(.te ph - PLM Contractor C CUC Ph SWR - BUILDI Tenant/Owner _ (J �Q (LTi �(/ �- ELC Retaining Wall ELR Footing Access Foundation FPS Fig Drain Crawl Drain Inspection Notes. SGN — Slab Post&Beam — "_-- SIT _ Ext Sheath/Shear Int Sheath/Shear --- —_--- Framing Insulation - - - Drywall Nailing Firewall -- Fire Sprinkler Fire Alarm Susp'd Ceiling -- Roof PASS PART FAIL - — - ---- --- ------ — _�_ _ PLUMEIING Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final - -- -,----- -- ---- PA,$S------RA T FAIL MECHANICAL i,o-sTWTMWrfi` Rough In Gas Line - - --- - - - _ Smoke Dampers PASS PART FAIL ELPECTRICAL - ---- - Service Rough In _ --------- ------ UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer IStorm Drain [ j Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hell Blvd Catch Basin Fire Supply Line [ j Please call for reinspection RE; [ j Unable to inspect-no access ADA Approach/Sidewalk Other Date/ Q ector ?' Ext Final PASS PART FAIL DO 1107 REMOVE this inspection record from the job site. CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard, OR 97223(503)639.4171 CERTIFICATE i:rF" OCC;UPANC�Y #1. . . . . . . . DLFP 96- 0-"�, DATE ISSUED: 1 cd 1"r`-:3;9!i POR(I'l.- a1t�111PF3- 1lr�rQ+ S i TE ADDPESS. . . ; 1 '1 F~f3 '.:;W GARDEN PL #C+L..D3 SUBDIVISION. . . . x C ROW PARK 217 r ON I N0 s C---G BLOC K. . . . . . . . . . .. L.OT. . . . . . . . . . . . . :002 JURISDICTIONx TIG CLASS OF WOPK. :AL.T TYPE OF USE. . . :C;ClhI TYPE. OF GONSTR A: lJ OCCUPANCY UK". :13 OCC UPP4IVC,Y LOAD: a' TF1\44NT NNI+IE.. . . -k,_L ASOUT "FRAVUlL Rem+arkm : Ar�tiin� ;s, +7�NO +:r7. ft, tc, etnrstln� trrr.ani, eCr r.e Owner.e _ .. . . ..._ SPIERE:R F'RO017PTIE .4360 SW MACADAM tiT'E 100 P OPI L-AND OR Phone 0: Contractor l _...._._....•_._....._.._._.__..__.,.._. __.......___._ C:' 31:HIF:WIR & ASSOCIATES 1024 N(✓' DAVIS PORTLAND OR 97i:32 Phonw #: 234 -6617 Req #. . t 000541 Thi 5 Cert i.f i cat ea grArrt s. ac:c:c.rpancy of the above rpf'e+r Pric ed building or portion thereof and confit-m% thAt the b1 t1ding has b@;?n i.n!sper,ted for compliance with the State of Ot-gon u-:pec-ia.lty C:or_le+s for- thp Rrol.tp or..c .rpaznr.y, and use +..1nrJer which the r•eferranr.ed permit was insar.ed. A� SUTi_UING TN CIErT1^Fe nuit..r) Nd WrICTAL' POST IN C'ONSPIC:LjoliF, F,t...ACC CITY OF TIGARD PLUMPING r'FRM1J DEVELOPMENT SERVICES F)ERMIT #. . . . . . . . P,L.11980320 13125 SW Hail Blvd,, Tigard, OR 97223(503)639-4171 DATE ISSUED: 09/11/9S PARCEL_.: 2SI0IBB-01400 SITE ADDRESS. . . : 12168 SW GnRDEN PIL. SUBDIVISION. . . . : CROW PIARK '217 ZONING: C---G KOCK. . . . . . . . . . : L.OT. . 002 JURISDICTION: TIG CI-ASS) OF WORK. . :nI.-T GARDnGE D T SP,OSAL..S. : 0 MOBILE HOME SP,ACES. : 0 TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 SACKFLOW P'REVNTRS_ : 0 OCCUPANCY GRP,. . :B 0-OOR DRAINS. . . . . . : I TRAP,S. . . . . . . . . . . .. . . : 0 STORIES. . . . . . . . : 0 WATER HIEOTERS. . . . . . I CATCH PASJNS. . . . . . . : 0 L-AUNDRY TRAYS. . . . . : 121 93F RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . : I URINAL-S. . .. . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 L.HVATORIES. . . . : 4 O-rHEIR FIXTURES. . . . : iT TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . : WATER Cl.-OSETS. : 2 WATER 1-INE (ft ) . . . : DTSHWASHFRS. . . . 0 RAIN DRAIN (ft ) . . . : 0 Remar-ks : Tenant improvement of pittmhing fixi.i_tveF,. Owner-: FEES (11-1- ABOUT TRAVEL. t y J:)e amoi.int by date r-erpt 12168 SW GARDEN F,LACE F,R mT s 62400 JSD 09/11/98 98-30906_2 Dl_DG #31 5r,CT $ 3.. 15 JSD 09/11/98 9/3-309062 TIGARD OR 9722'3 Phone #: ROWI-AND P'l-UlIBING 452'.4 N L.nMI3nRD r-,ORT1_.nND OR 97203--4799 Phone #.- 285-2586 $ 66. t5 TOTAL. Rey if. . : 5628 REQUIRED TNSPIECTIONS This permit is issued subject to the regulations contained in the Roi.igh—in Insp Tigard Municipal Code, State of Ore. 5ppcialty Codes and all other Under-f I oav-/UndPv applicable laws. All work will be done in accordance with Tap—o,.tt Insp approved plans. This permit will expire if work is not started Final Tvispertion within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires ycki to follow rules adopted by the Oregan Utility Notification Center. Those rules are set forth in DAR 952-080I-0010 through OAR 992-08@I-0080 You may obtain copies of these rules or direct questions to OLK by calling TSsi.ipd By : rle"-Mittee Signatl.lv-p : ++-+.+A 4-4-++++++++++4....................+++++++++-++++-+•++++++++++++++4.++++++++-H Call 639-4175 by 7:00 p. m. for an insper-t i on needed the next; business day +++++-+++++++++++++++++++++++++-+, ++++++++++++++++++++++++++++++++++++++•+-++++++ UTY OF TIGARD Piumbing Permit Application Plan Check#o/`'- C 13125 SW HALL BLVD. Commercial and Residential Recd By ' TIGARD, OR 97223 DateRec'd (503) 639-4171 6� Date to P.E. Print or Type / Date to DST Incompiete or illegible applications will not be accepted Permit#pl-"- Related SWR / 'p'r�o(�y Calledl,�E-'Ty 11/Al /L -1Z Na t Development/Project FIXTURES (Individual) _ G2YY PRICE •AMT Job wo < — Sink 9.00 1 Address Street Address / Suite Lavatory _ --�— z7--s �� I�I�fr3 ` 1Lb or Tub/Shower Como �� 900 Bldg# C /Stgte �D Shower Only 9.00 _-- Water Closet 9.0C Name Q_ � Ik eo Dishwasher --__ --------- 900 Owner Melling Address Suite Garbage Disposal 9.00 Washing Machine a 9.00 City/State Lip Phone - - Floor Drain/Floor Sink 2" �! 9.00 /� �— 9.00 NageL 41 /r 3" 9.00 Occupant Mailing rens Suite Water Heat14 LAA,, er—0conversionF kind ' 9.00 C Gas piping requires a separate ical permit. City/State Zip Phone Laundry Room Tray 900 - - — Urinal 9.00 Name'—� `��tw�A Other Fixtures(Specify) 9.00 Contra Mailing Address '-� Suite 9.00 9.00 Prior to permit /State Zi hone Sewer-1 st 100' 30.00 issuance,a copy Ujp QT 2�1�- -�- Sewer-each additional 100' 25.00 of all licensee are Oregon Const.Cont.Board Lic.# Exp. Date 4 required If �j 2- o/�- ��( Water Service-1 st 100' 30.00 expired In COT PlumGbin�Llc.# Exp.Date Water Service-each additional 200' 25 CFO— database - Zoe) P2 .e;- R Rain Drain-1st 100' 30.00 Neme Sturm&Rain Drain-each additional loo' 25.00 Architect Mobile Home Space 2s.00 or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 _ Pollution Device Engineer City/State Zip Phone Residential Backflow Prevention Device' 1500 (Irrigation timing devices require a separate Describe work to be done- -- restricted energy ermit. New O Repair O Replace with like kind: Yes O No O Any Trap or Waste Not Connected to a Fixture 9.00 Residential O Commercial Catch Basin 9.00 Additional description of work --- _ Insp.of Existing Plumbing 40 00 nA, VO Of KC-F Specially Requested Inspections 4000� ( _per.00 er/hr Are you capping,mo Ing or replacing any fixtures? Rain Drain,single family dwe'ling 30.00 Yes7.. No O Grease Traps 9.00 If yes,see back of form to indicate work performed by —` gUt,NTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required dQuantity Total ts -9 WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL I hereby acknowledge that I have read this application,that the information given is correct,that I am the owner or authorized agent of the owner,and 5% SURCHARGE that Ian submitted a om liance with Oregon Slate Laws. +.15 SI net- of nor/ ent,_ Date ""PLAN REVIEW 26%OF SUBTOTAL Required on y fl rixlure qty totalis •g ( NOTAL Contact Person Name Phone 64,/$ �c i T l_IT �- I / ?� Wlnlmum permit fee is$25+5%b surcharge,except Residential Backflow /V Prevention Device,which is$15+5%surcharge -All New Commercial Buildings require plans with isometric or riser diagram and plan review I viststplurnapp dtx 7r190 I PLEASE COMPLETE: T- Fixture Type Quantity by y Work Performed New Moved _ Replaced Removed/Capped Sink Lavatory Tub or Tub/Shower Combination _ _ 2 Shower Only Water Closet — _Dishwasher_ _ Garbage Disposal Washing Macl,'!ne Floor Drain/Floor Sink 2" _ 3" --- 4" Water — -- -- --- -- Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) �— v COMMENTS REGARDING ABOVE: I I%dslslplumapp dor 7f7f?9 Accumulative Sewer Tally Want Name: /nrLL DO GIT �(/EL This SWR#____�_ _ dress. 1',2/6je Su) e-Aj -C_6LoG >#3 This PLM# -tune Value Previous Previous Credits Capped Fixtures Fixtures New lotal New # Value Capped off value added# added #s total _ Count oft#s count value values ptistry/Font ----- _ 4 i -�- ---- -- - th-Tub/Shower 4 _-Jacuzzi/Whirlpool 4 rr Wash-Each Stat 6 -Drive Through _ 16 ispidor/Water Aspirator 1 ` shwasher-Commercial 4 -Domestic 2 inking Fountain 1 re Wash 1 oor Drain/sink -2 inch 2 _ v/-- 3 inch 5 4 inch 6 Car Wash Drn 6 arbage Disposal 16 Domestic(to 3/4 HP) _Commercial(to 5 HP) 32 Industdal (over 5 HP) 48 _ .e_Machine/Refrigerator Drains 1 'il Sep(Gas Station) 6 ec. Vehicle Dump Station 16 _ hower-Gang(Per Head) 1 _ - Stall 2 ink- Bar/Lavatory _ 2 _ Bradley _ 5 _Commercial _ 3 Service 3 swimming Pool Filter Vasher-Clothes 6 Vater Extractor 6 _ Vater Closet-Toilet 6 lrinal �6 -OTALS Fotal fixture values'_. _ _ divided by 16 = _ EDU �!' �'f1f��1GtF 7-V It s via q iISTORY �r;C s PLM# _ EDU# S_WR# _ PLM# EDU# SWR# _ PLM# _ EDU# _SWR# PLM# _ EDU# SWR# PLM# _ EDU# - SWR# PLM# _ EDU# SWR# PLM# FDU# SW_P# PLM# EDU# SWR# kistsV%wrfaly.doc CITY CF TIGARD 5 ELE'CTRTrAL.. PERMIT PERMIT fk: EI_.C913-0,r4:_ DEVELOPMENT SERVICES DATE" I5E'iL FD;, 09/1 1 /9e 13125 SW Hall Blvd., Tigard OR 97223(503)639.4171 (�.\ 6p PARCEL: c 51 0:1 IaR 0 14kti0 ,.LII L: AUE''RE.SIG. . . : .l-r�t':Tf3' SW L3)ARDL,.N P'.. 4' L.L.D. SUPDIv?STON. . . . :CROW PARFC 217 Z.ONINO:C- G BLOCK. . . . . . . . . . : L.0T. . . . . . ,. ., . . :lb0i2 JURISDICTION: T I C Pr^o jest Descript i on: Installation of 1 200 amp or less service or feeder and 37 branch circuits. RF_SIllrhITlAI._ L11hITT-- - TEMP 0RVC_;/rI7EDERS---.~ -___..__..._-MI 9rITL.L,1NE0U43--._._. . 1000 SF OR LESS. . . . : 0 i7c -- 2'00 ramp. . . . . . . : 0 P(.1MP/IIRRIGATION. . . . : 0 FACH ADD' L 500SF. ,. . : 0 2'01 400 amp. . . . . . . : 0 G T GN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 1401 - 600 Rn1p. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps--1000 volts. : 0 MINOR I AI:AEt_ ! 10) . . . : 0 --- ---SERVICE/FFf"DFR------ ---- BRANCH CTRCLJITS--- ----- ----ADD' L INSPECTIPr43 • Qi 7"00 amp„ . . . . . : 1 W/SERVICE. OR FEEDER: 57 PIER INGPECTION. . . . . . 0 -'01. 400 amp. . . . . „ : 12c 1 st W/0 SRvc OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0 401 G 0 0 amp. . . . . . : it EA ADD" L PRPICH CTRC: 0 TN PLANT. . . . . . . . . . . : 0 F,01 1000 amp. . . . . : 0 --- --______..___.-__.---PLAN REVIEW SECT I 1000+• amp./volt. . . . . : 0 > =4 RES) UNITS. . . . . . . . : > 600 VOLT NOMINAL. . : Rpc.orill rIl-t orr1y. . . . . : 0 SVC/FDR > 225 AMPS. . : CLASS AREA/SP'E'C OCC. . Owner: _...._.... . __ _ _._.._..,_.________...__._.._____.___......___....._._..-.. . FEE GENE" MiLDR1711 type amor.cnt by data recpt 11830 SW KE:RR P'RMT 2 45. 00 DEP Q19/11 /913 98..30906'' STE' 325 SPCT $ 12. 25 DEP 09/11 /9A 96-309069 I-ARE 0SWE"GO OR 97035 Phone #: Contractor: CAt' ELECTP,T.C CO I IVC $ 257. P5 TnTAL 1.2810 NE AIRPORT WAY UNIT 1 - ----- REDO T RED INSPECTIONS --- -- PORTLAND OR 972,:30 Ceiling Cover Fler_t, l Service Phone #: Wall Cover EWlert' I Firral Reg #. . : 0004137 This persit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 180 days of issuance, or if work is suspended for tore thar 180 days. ATTENTION: Orega you to follow the rules adopted by the Oregon Util'ty Notificaticn Center. Those rules are set ` OAR 952-001 0!@ through OAR _^-001-1987. You eay obtain a cop: of these rules or direct questions t by ca ing f2 P'ermi.ttee Signatr_rre: Iasr_r01 err __._.____.__________---•--__._._._._____OWNFR TNSTAI_LATTnN Thr, installation is being made on property T own wlri.ch is not intended for- .;ale, lease, or rent. 9WNFR' S t;TBNATURF: DATE: I-ATION ONLY- 1 NLY I f.,NA71JRF. OF- IPP.SI� . F'! E C' N: �D � �� DATE.- Ajo'�___—._ +_.T CENSE" NO: _ /j� 5 ++++++++++++++++4+f+++4 +++4 +++++++++44......4 ++4-++++++++-+++++•++++++++++++++++4.4++ Call 639--4175 by 7:00 p. m. for- an inspection needed the next br.cainess day t--; .1-+4,+4......4-1-4++•+•+-4.4 +-f-+++-+-++4-+++++++++++++++++++++++-++-I-++++-F f•++-+++++++++++++-r CITY OF TIGARD Electrical Permit Application gg Plan Che 13125 SW HALL BLVD. n �•3/�' Recd B TIGARD Ori 97223 I Date Recd q-!r-�i_ri { I Date to P.E. �- Phone (503)639-4171, x'304 ! Date to DST �- Print or Type Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit# � Fax (503)684-7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of DevelopmentAA�� L Number of inspections per permit allowed Name(or name of business)iltl_L_ 17/)oL !P/4 V r, Service included: Items Cost Sum Address t C 4a. Residential-per unit City/State/Zip P - _ Each additional 500 sq.It.or $110 no 4 Commercial,� Rar idential ❑ portion thereof $25.00 p 1 Limited Energy $2.5.00 Each Manuf'd Home or Modular Owolling Service or Feder $68.00 _ 2a. Contractor installation only: (Attach copy of a({curront (cense ) I .� 4b.Services or Feeders Electrical Contractor_C.,/+111 0 I �*�l L C, RC. Installation,alteration,or relocation 0 C� Address )'r 200 amps or less $60.00 _ 2 201 amps to 400 amps $80.00 2 City`? r State�;�_ Zip_ 7 .�3L 401 amps to 600 amps $12000 2 Phone No. S0 - `'S 9 _ 601 amps to 1000 amps $180.00 _ 2 ,lob N0. Over 1000 amps or volts $340.00 2 Elec.Cont. Lice. L Exp.Date � y ) Reconnect only $50.00 2 OR State CCB Reg. No.� _Exp.Date,,; _ `e33 - 4c.Temporary Services or Feeders 6AT-E�usin�e-Te�t or Metro No Exp.Date I, ' Installation,alteration,or relocation 200 amps or less $50.00 201 amps to 400 mps $75.00 Signature of Supr. Elec'n �/ ,ti,�V 401 amps to 600 amps $10000 _ Over 600 amps to 1000 volts, License No.31.12 _ S Exp.Date IL' I`�2 ' see•'b"above. Phone No.- S -`�y- -^�'�-- 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a) rhe fee for branch circuits with purchase of service or Print Owner's Name_ _ feeder fee. Address Each branch circuit $5.00 8-� b� b)The lee for brench circuits City, $tat@ Zip without purchase of Phone NO, service or feeder fee. First branch circuit $35.00 The installation is being made on property I own which is not Each additional branch circuit_ $5.00 2 intended for sale,lease or rent. 4e.Miscellaneous (Service or leader not included) Owner's Signature __ Each pump or irrigation circfe $40.00 Each sign or outline fighting $40,00 _ 2 3. Plan Review section (if required): Signal circuit(s)or a timitod energy panel,alteration or extension _ $40.00 2 Please check appropriate item and enter fee in section 5B. Minor Labels(10) $100.00 4 or more residential units in one structure 4f.Each additional Inspection over Service and feeder 225 amps or more the allowable In any of the above System over 600 volts nominal Per inspection _ $35 00 Classified area or structure containing special occupancy Per hour $55 00 as described in N.E.C.Chapter 5 In Plant Y_ $51100 Submit 2 sets of plans with application where any of the above apply. Jam. Fees: Not required for temporary construction services. 5a.Enter total of above fees $ .Z J '` 5%Surcharge(.05 X total fees) $ '� 17 NOTICE Subtotal $ 5b.Enter 25%of line Sa for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if teguir (Sec.3) $ > L_5 NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. n Trust Account Tofal ba'nnre Due VW TSIELCM APP Rev 9'96 CITY OF TIGARD MECHAN11",01., PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : MEC98-037'B2 13125 SW Hall Blvd., P ard,OR 97223(503)639-4171 DATE ISSUED: 09/04/98 PARCEL: E'510tBB-01400 131TE ADDRESS. . . . 8 SW GARDEN F-11- fl P L 1). SURD I V I S I(IN. . . . : CROW PARK 217 ZONING: C--G 13LOCV. . . . . . . . . . . L01.. . . . . . . . . . . . . :00JURISDICTION: TIG ,,LASS OF WOR(;. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :COM UNIT HEnTERR. . : 0 VENT FANS. . . - 0 OCCUPANCY ORP. . :B VENTS W/O APDL: 0 VENT SYSTEMS: 0 !STORIES. . . . . . . . :, 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL 'TYPES----------__—.__ 0-3 HP. . . . : 0 DOMES. INCIN: 0 C-1 5 H;::,. . . . . V, COMML.. INC:IISI: 0 MAX INPUT: 0 BTU 15-30 HP. . . . . 0 REPAIR UNITS: 0 FIRE DAMPERS?. . . 30-50 VA WOODSTOVES. . .- 0 GAS PRESSURE. . . : 50+ HP. . . . - 0 CLO DRYERS. . : 0 NO. OF UNITS----------- AIR HANDL.ING HN I T5 OTHER UNITS. : I F.URN ( 100K BTU: 0 10000 cfm - 0 GAS OUTLETS. : 0 TURN ) =100K BTU: @ > 10000 cfm : 0 Remarks : Modify ducts and replace grilles, no additional or replacement of existing units. DW n v r-: ----------------------------------------------------- FEES ()OHMAN MECHANICAL INC type amol-tilt by date recpt '0980 5 GOULD PRMT $ 25. 00 DES 09/04/98 98--308870 OREGON CITY OR 97045 5PCT $ 1. 25 DEB 09/04/98 98-308870 Phone #: Contractor: GOHMAN MECHANICAL INC 20980 5 GOULD CT 26. 25 TOTAL OREGON CITY OR 97045 Phone #: 650-1588 Req #. . : 119952 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Mechanical Irsp Tigard Municipal Code, State of Ore, Specialty Codes and all other Dj.ict Inspection Pppliz'ablp laws, All work will be done in accordance witli Misc. Inspect ion ,ipproved plans. This permit will expire if work is not started Final Inspection 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 DAR 952-001-0010 through CAR 952-001-0080. YOU may obtain copies of these rules or direct questions to OUNC by calling S75 s Permittee 9 i gnat i-irp I LR�_ +++++++•+++++++++4-++++4.......................................................... Call. 639-4175 by 7:00 p. m. for inspections needed the next bL(Siness day ............... ....................... ................................... Plan Che 8 CITY 0--F TIGARD Mechanical Permit Application Recd By - 1•3125 SW HALL BLVD. Commercial and Residential Date Recd TIGARD, OR 97223 , "'. j Date to P.E. _ (503) 639-4171, x304 60 t ( J Date to DST -- Print or Type Permit# 1"'l-�(' Called _ Incomplete or illegible applications will not be accepted Name of DevelopmenUProjecl Description Table 1A Mechanical Code _ _ at Price Aint e_ A) Permit Fee 10.00 Street Address SUReA Job _ ) 1) Furnace to 100,000 BTU Address I cJ( I J ��N rt�G► t V517 (f including ducts&vents 6.00 BldgM eRy/State Zip 2) Furnace 100,000 BTU+ Zincludin ducts&vents 750 Name name of business) ---- �� 3) Floor Furnace _— L includin vent __ _ 6.00 Owner (. I i t 4) Suspended heater,wall heater Mailing Address or floor mounted heater _ _ 6.00 _ 5) Vent not included in appliance permit CRylStete — Zip Ph-)no 5) _ CHECK ALL 'Boiler Heat Air Nemo for name o1 buslnese) THAT APPLY: or Pump Cond Qty Price Amt / comp 'N(_.0 fV L.t _ —'� '✓ L 6)<31113;absorb unit to g Occupant Mallin Address 100K BTU 6.00 7)3-15 HP;absorb unit CilyiState Zip Phone 100k to 500k BTU — 11 00 8) 15-30 HP;absorb _ _— unit.5-1 mil BTU — 15.00 Contractor Name l 9)30-50 HP;absorb 1 , I I lo' " YI le 1 Jr unit 1-1.75 mil BTU _ —_ 22.50 Prior to permit Mailing Address 10)>50HP,absorb unit issuance,a copy 'L) � ��CJ� C >1 75 mil BTU 37.50 of ail licenses CRY/State zipPhone /S 11)Air handling unit to 10,000 CFM 4.50 are required if f P(�r�lU C I j 7o` r expired in COT Oregon const Cont.Board L .S Exp Date 12)Air handling unit 10,000 CFM+ l7 750 database1 / Architect Name q. 13)Non-portable evaporate cooler 4,50 Mailing Address - 14)Vent fan connected to a single duct or Mail300 15)Ventilation system not included in Engineer GryrState Zip Phone appliance permit :50 16)Hood served by mechanical exhaust Describe work to be done, 17)Domestic incinerators 7 50 New O Repair O (Replace with like kind: Y09 dNo O 18)Commer;:ial or iu fustrial type incinerator Residential Commercial1�- 30.00 Additional information or description of work: ^ 19)Repair units — (�' (�'.JI��C C'. 4.50 I tGY I r <�t_il t �J Ck.I 1 20)Wood stave _ 450 l-l.t•t.t.J�iJ 21)Clothes dryer,etc. � ` _ 4 50 Type of fu6l oil O natural gas LPG O eledrl O 22)Other units J 450 _ I hereby acknowledge that I have read this application,that the information 23)vas piping one to four outlets 2.00 given Is r(e4 that I am the owner or authorj,;ed agent of -- thet5 t lens mitten are Irmo nce with Oregon Slate lays, 24)More than 4-per outlet(each) 50 Slgnaturc of OwnerlAgent Date Minimum Permit Fee$25.00 SUBTOTAL i ))L), ( -_C_-'i I I �I-C,�I ) 5%SURCHARGE ontact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL Required for ALL commercial permits onl TOTAL 'State Contractor Boiler Certification required "Residential A/C requires site plan showing placement of unit I\mechperm doc rev 07/20198 CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd.,Tigard,OR 97223(503)639.4171 ELECTRICAL. PERMIT - RESTRICTED ENERGY PERMIT #: F'LR98-41 56 DATE ISSUED: 09/1.5/38 PARCEL_.: 2,S 1 O 1 Bt4--01400 `TC ADDRESS. . . : 1-Pfes SW GORDEN 1='I._ #P.I._D„ 13DIVISION. . ,. . :CROW PARK '''17 ZONING:C...G LICK. . . . . . . . . . . LOT. . . . . . . . . . . . . :OO2 JUR I SD I CTN: T I O faject Desrr'i.ption : Electrical TI RESIDENTIAL.-- _.._._.____ P. AUDIO & STE RE'n. . . : AUDIO & STEREO. . : I NTFRCnM & PAG I NO. . BURGLAR ALARM. . .. : BOILER. . . . . . . . . . : LANDSCAPE/T.RP I GAT. . ; GARAGE nPENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL.. . . . . . . . . . HVAC. . . . . . . . . . .. . . . DATA/TE'I...E COMM. : X NL.IRSE CALLS. . . . . . . . VACUUM SYSTEM. . ,, . : FIRE AL.ARM. . . . . . : OUTDOOR L.ANDSC LITE: art 1E P: . . MVAC. . . . .. . . . . . . . F`m"FECT I VE S T GNAL. . . INSTRLIMF'NTATION. : OTHER. . : : TOTAL_ # OF" SYSTF_.MG: I FEES Sf'IEKER PROPERTIES type am0IATIt by date recpt "i0P1 OW MACADAM F'RMT 9•, 4 L 00 13 09/15/98 98 3091GO ,_E 100 `,PCT 00 'a 09/15/98 98-309168 `RTL.AND OR 97=01 ione #: 2'''1--574~0 'VANCED COMMUN I CAT T ON Trrl!_ $ 4F,. 4117.1 TOTAL__ 1.2010 SW GARDEN PLACE RFQLl I RED INSPECTIONS TIGARD OR 972i::'3 Ceiling rover• I..cow Voltage Insp Phone #; G7O--7777 Wall Covr-t- Elect' I Final Rr 9 #. . : 410071 C, This peroit is issred subject to the regulations contained in the Tigard Municipal Code, State oi Ore. Specialty Codes and all other applicable lawi. 1111 work will be done in accordance with approved plans. This per-lit will expire if work is not started within 184 .s of issuance, or if work is suspended for wore than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the gor Utility Notification Center. Those rules are set forth in DAR 952-MI-NIP through OAR 952-PPI-PP90. rise rules or dir t questions to RK at (503)246-1981, .- ,aed L _ �__, ."_Ad�_w.... �__ Pet-mittee Si �.tr-e 9nat INSTAL.L_ATION ONLY-----__._____.___.._...__..._..-------- ' ,e install.ati.on is being made on property I own whish is riot intended for- le, orlei lease, or, r- ent. IDLER' S SIGNATURE`: DATE'; __ ....._.__..___.._...._ CIINTRArT•OR TNSTAL.L.ATION ONLY..... rh1f3TURE OF 9UPR. EL.EC' N: DATE: CENSE NO: •++•1-+•+++F-t+++ F+++++F+++++++++i ++F++++-I-++ F++ F++++•h++++++F+•+•++++++i•+-+++..4-++++ Call G30--4175 by 7:00 P. M. fnr- an insper_tion needed the next bl.tsiness day +.} + 4 .+ + +A +.+ F I +++i ++++++++ t+++++ t'4 F+.•+•+ +4-4-4-4-4-+4 t 4+ 1-+-+++++++++++++•F+++-1-++++++•++ i CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd byU 13125 SW HALL BLVD Date Rec TIGARD OR 97223 PRINT OR TYPE V - 503-639-4171 X304 Permit#: �q� -6a7 F - 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK It OLVED-RESIDENTIAL i 1 'j' Restricted Energy Fe......................................... $40.00 f 1 l( o[A `W4 (FOR ALL.SYSTEMS) JOB Stre (�ddres+s/�r (fir' (I�1 I Ste# ADDRESS 17,M 4Jf'r �Il�l�l I I PL Check Type of Work Involved. /S t 'M 4 e � ❑ Audio and Stereo Systems �� Na �/�' ❑ Burglar Alarm C�I"/' �" �� ❑ Garage Door Opener' OWNER i , Ad-dre,�sm„ „n ,� I/y� t ! i tte= l f Zi Phoi a#W �_l ❑ Heating,Ventilation and Air Conditioning System' '-- Named cc ❑ Vacuum Systems' kj 1 , Inc. ❑ Other --- CONTRACTOR Mailing Address A' ,n /� V VV + I l TYPE OF WORK INVOLVED -COMMERCIAL (Prior to issuance a t lsI�t .t.o� P Re#)_ Fee for each system.............................................. $40.00 copy of all licenses Y l.. Q L�� l�" 1 (SEE OAR 918-260-260) are rep.iired if Oregon ontr Bird Lic # Exp Date Check Type of Work Involved: expired in C O T data base) Electrical Contr. Lic # Exp Date OF ❑ Audio and Stereo Systems C O T (r Metro Lic # Exp Date ❑ Boiler Controls Owner's Name _ ❑ Clock Systems OWNER - Mailing Address APPLICANT ld Data Telecommunication Installation LW City/State Zip Phone# ❑ Fire Alarm Installation This permit is Issu 3d under OAE 918-320-370 This applicant agrees to �1 HVAC make only restricV:d energy ins.allalions(100 volt amps or less)under this L_ permit and to do the following ❑ Instrumentation 1 Only use electrical licensed persons to do installations where required Certain residential and other transactions are exempt from licensing Intercom and Paging Systems These have csteri.sks(') All others need licensing, Landscape Irrigation Control' 2 Call for inspections when installation under this permit are ready for inspection at 503.839-4175; ❑ Medical 3 Purchase separate permits for all installations that are not ready for an Nurse Calls inspection when the inspector is out to inspect under this permit, 4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting' inspector are done, and, ❑ Protective Signaling 5 Assume responsibility for calling for a final inspection when all of the ❑ corrections are completed Other Permits are non-transferable and non-refundable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days _ Number of Systems The person signing for this permit must be the applicant or a person No licenses ere required Licenses air equired for all other installations authorized to bind th applicant — /� J FEES: yY C 00 ENTER FEES s_ I tUfe en SURCHARGE(.05 X TOTAL APLIVE) $ a.cv Authority if other than Applicant J TOTAL f i lresele doc 12196 n CITY OF TIGARD ELECTRICAL F-ER(v1IT '4 DEVELOPMENT SERVICES PERMIT #: ELC:98-0630 � 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISSUED: 10/15/98 ()_141 Q PARCEL : 251011313-01400 '�I TE ADDRESS. . . :1 c l:rfl SW GARDEN FIL #BLIT. SIJBDIVISION. . . . :CROW PARK 21 '7 ZONING:C- G BLOCK. . . . . . . . . . 1_0-C. . „ . . . . . . . . . . :oo2 JURISDICTION: TIG Project De scr•i pt i.on: All About Travel DENT IAL UNIT.- ___TAME SRVC/FEEDERS-.---_ ----.._MISC:ELLANEOUS--- - 1000 SF OR LESS. . . . : 0 0 - c'_00 amp. . . . . . . : 0 PUMFI/IRRIGATION. . . . : VI EACH ADD' I_ 50013F. . . : 0 201. - 400 amp. . . . . . . : 0 SIGN/OUT I._INE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL.-/PANEL.. . . . . . . : 0 MC)NF. HM/ SVC/FDR. . : 0 601+81TIps..-1000 volts. : 0 MINOR LAPEL ( 10) . . . : 0 - SERV I C'E'/FEEDE:R-- ---- -.-•--BRANCH CIRCUIT"S---..._..- __---ADD' L I NSF�ECT I ON --- 0 _ 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPE:CTION. . . . . : 0 .7:'01 400 amp. . . . . . . 0 1 st W/O SRVC.:: OR FDR. : 0 FIER HOUR. . . . . . . . . . . : 1 401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CTNC: 0 IN PLANT. . . . . . . . . . . 0 601 - 1000 amp. . . . . : 0 --------------------PLAN REVIEW SECT T 1.000+ amp/volt. . . . . : 0 ) = ('S RECEI`' 'Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Permit r10(: Phone (503) 639-4171 Date Issued FAX (503) 684-7297 Issued by CITY OF TIGARD TDD No. (503) 684-2772 Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development 2411 .4jY jj /lav}_L Number of Inspections per permit allowed Address t Zf `J 5i,_� Cr�err�fi- - INC, Service included Items Cost(ea) Sum City/State/Zip / / e--S-./ (zL-) Gi 4s. Residential• per unit 4 �— 1000 sq It of less $11000 Name (or name of business) Each here!f sq h or gonioonn tthenal $2500 1 Commercial Residential❑ Limited Energy $26002 -- Each Menul'd Home or Modular Dwelling Service or Feeder $68 00 2a. Contractor installation only: 4b.Services or Feeders Installation,allerahort or relocation 2 Electrical Contractor_ . k_-P,i it 200 amps or lose $60 00 2 Addres I .-' U R i �-„ �f 201 amps to 400 amps $8000 2 401 amps to 600 amps $120 00 2 City , State_C.L_ 4-M2,1L. 601 amps to 1000 amps $180 00 2 Phone No. 2- - `I Over 1000 amps or Vohs $34000 2 Contractor's License No. 74;1 ,rt je c < Reconnect only $5000 Contractor's Board Reg. No. A ?4i< _iL 4c. Temporary Services or Feeders —]�� 4 ImIallahon alteration or relocation ? Signature of Supr. Elec'n / J(f..'t �-��rY 200 amps or lone $5000 -- 201 amps to 400 amps $7500 License No. _ Phone No. Z may _ 401 amps to 600 amps —'— $10000 �3x Over fi00 amps to 1000 volts 2b. For owner Installations: °- 4d. Branch Circuits Print Owner's Name New alteration or oxtenston per panel Addressa)The tee for branch circuits with City State_ Zip _ ` purchase of"mice or foods, Are. Each brnnrh circuit $500 Phone No. _ b)The lee lot branch circuits Wltheut The installation is being made on property I own which is purchase of service or boder Are. Fust branch not intended for sale, lease or rent. $$600 Ea,:h additional al brenen circuits5 00 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 3. Plan Review section (if required): Lnch pump or irrigation circle $4000 Each sign or outline lighting $4000 Signal circudls)or a landed energy Please check appropriate item and enter fee in section 58. panel,aAeratton or extension $4000 4 or more residential units in one structure Minor Labels(10) Simon Service and feoUer 225 amps or more System over 600 volts nominal 41. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N E C Chapter 5 Per Per Hour hour on +'•of, —� t,�,`,of, In Plant Submit 2 sets of plans with application where any of the above -_T apply Not required for temporary construction services. 5. Fees: NOTICE 5a. Enter total of above lees $ 5%Surcharge(05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b.Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORE IS Subtotal COMMENCED >) ❑ Trust Account 0 $ 4S /(�1, Balance Due $ CITY OF TIGARD DEVELOPMENT SERVICES EL[:*CTR1rnL. PERMIT 13125 SW Hall Old, Tigard,OR 97223(503)6394171 RESTRICTED ENERGY PERMIT #: ELR98-0268 D()TF. Tc;SL.IFD- 09/21 /93 r,nR(',E[,.: S 101 AB -014 00 TF ADDRESS. . . ; 121 6B SW GARDEN PIL #BLD RDIVTsTr)N. . . . :CROW PARK E.117 ZONINB:C-0 OCK. " LOT. . . . . . . . . . . . . ..0 02' JURISDICTN: TIC) oJer * " " ' ' * Descv-iption- Add protective signaling RESTDENT AUDIO & STEREO. . . AUDIO & STEREO. INTERCOM & PAGING. . BURGLAR ALARM....: 1!OILJ7-R. . . .. . . . . . . . LANDSCAPE/TRRTGAT. . EARA 9E OPENER. . . . Cl_OCV.. . . . . . . . . . . : MEDT CAI... . . . . . . . . . . . .. HVAC. . . . . . . . . . . . . .* DATA/TEL-E t:OMM. . : NORSE Cnl-A-S. . . . . .. . . . VACUUM qYS)TEM. . . . s FIRE At-ARM. . . . . . : OUTDOOR L.ANI)Sr LITE: OTHER: HVAC.. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :X INSTRUMENTATION. : OTHER-- i'ami- # OF" SYSTEMS- J �1 ....... FEES !- ABOUT TRAVEL, types AMOUnt by date recpt 168 SW GARDEN PLACE PRMT $ 40. 00 GEO 09,1211/1.38 98-30931(- 9ARD OR 97P23 SPCT $ 2. 00 GED 09/Pi/98 98-30931 one if. ritractor.- .-S SECURITY /MAS TECH TNr $ 4�P. 00 TOTAL. ..:)0 SW BARBYR BLVD BOX 1. 1.9-243 REQUIRED INSPECT"ONS �RTLP\IV OR 971.2'.103 1.0w Voltage Inr'[1 one 306-0958 Elect' l Final. q #. 1.2 59 2 1 .s persit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other -licable laws. All work will he done in accordance with approved plans. This ptrffit will expire if work is not started within 1K days of issuance, or if work is suspended for sore than W days. ATTENTION: Oregon law requires you to follow rule adopted by the Oregon Utility Notification CFnter. Those rules A�-p set forth in OAR through OPIR 952-00I-0080. Ynlj say obtain copies c' these rules or direr s-rmittpe Signati.tr INSTALLATTON ONLY- ------- The installation is being made on property I nwn which is not intended for sals, leise, or rent. OWNER' S STGNIPTURF: T)r)TF- ---CON'T RAC TOP INSTAI-LAT T ON "GNATI..)RE OF SUPR. ELECIN- DATE L..I.CENSE NO: -+-+.4.++ V4-+++++++•h 4-++++,++4+++-4-+..++-§-+4++++4-+++4-+++4-+-f............I.......4.,+.+++++++++4-+4 Call 639 -4177 by 7.,00 P. M. for --RTi i.nsliortion needed the next hi.tsiness day -1 f+++++++++44-•F 1 1--+4-++--4,+ 4-+-'-++++++++++ 4-++-J-++++....4+-++4-++++++++4++4-+++-+-++f CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: 13125 SW HALL BLVD Date Recd: TIGARD OR 97223 PRINT OR TYPE V- 503-639-4171 X304 Permit# i �l� F- 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd _ WILL NOT BE ACCEPTED ^� Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL ONLY --7 Restricted Energy Fee....................................... $40.00 All of i q (� �,,Q I (FOR ALL SYSTEMS) JOB Street Address Ste# ADDRESS L lb4 GL,,) �t Check Type of Work Involved Ci9 Stale Zips Phone# ❑ Audio and Stereo Systems r Na e ❑ Burglar Alarm OWNER Mailing Address ❑ Garage Door Opener City/State 7_ip Phone# ❑ Heating,Ventilation and Air Conditioning System* Name ❑ Vacuum Systems' M Ab p ❑ Other CONTRACTORailing Addre's 02 SAoLi MIC. TYPE OF WORK INVOLVED -COMMERCIAL ONLY (Prior to issuance a y/-, atei Phone# Fee for each system.............................................. b40.00 copy of all licenses ) - 112 ?4b•41/5 d (SEE OAR 918-260-260) are required if Oregon onlr. Urd Lic # Exp Date expired in C.O.T I Ci,ZI 5-,q.2-e-V Check Type of Work Involved data base). Eleiyal Contr Lic # Exp Date c07(i — r/� L D-riv ❑ Audio and Stereo Systems C O T or Metro Lic # Exp Date r2 F-1 Boiler Controls Owner's Name ❑ Clock Systems OWNER - Mailing Address APPLICANT ❑ Data Telecommunication Installation City/State Zip Phone# ❑ Fire Alarm Installation This permit is issued under OAE 918-320-370 This applicant agrees to make only restricted energy Installations(100 volt amps or less)under this ❑ HVAC permit and to do the following: ❑ Instrumentation 1. Only use electrical licensed persons to do installations where required. Certain residential and other transactions are exempt from licensing ❑ Intercom and Paging Systems These have asterisks('). All others need licensing; 2. Call for inspections when installation under this permit are ready for ❑ Landscape Irrigation Control' inspection at 503.639-4175; ❑ Medical 3 Purchase separate permits for all installations that are not ready for an inspection when the inspector is out to inspect under this permit; Nurse calls❑ 4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting' inspector are done,and, Protective Signaling 5 Assume responsibility for calling for a final Inspection when all of the corrections are completed ❑ Other Permits are nontransferable and non-refundable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. Number of Systems The person signing for this permit must be the applicant or a person No licenses are required Licenses are required for all other installations authorized to bind the applicant 1=_as' lure ENTER FEES S 5%SURCHARGE(05 X TOTAL ABOVE) $ [oy Authority if other than Applicant -- TOTAL I\dstslresele doc 7197