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1211jb SW GARDEN PL BLD 3
\ CITY OF TIGARD _ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2004-00023
DATE ISSUED: 1/21/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S101 BB-01400
SITE ADDRESS: 12180 SW GARDEN PL BLD3
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: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ _FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 - URINALS: GREASE TRAPS:
LAVATORIES. 2 OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: f,
DISHWASHERS: RAIN DRAIN: ft
Remarks;: Plumbing fixtures: --
F _ _ FEES _— --
Owner: _ Description Date Amount
SPIEKER PROPERTIES LP I'L11N11i1 I'crnut I rc 1/20/04 $99.60
4380 SW MACADAM AVE STE 100 1TAXI R%State Surrhan 1/20/04 $7.97
PORTLAND, OR 97201 =_
Total $107.57
Phone
Contractor:
VALLEY PLUMBING + HEATING INC
PO BOX 64
GALES CREEK, OR 97117 REQUIRED INSPECTIONS
Rough-in Insp
Phone : 503-357-0606 Final Inspection
Reg#: LIC 103628
MFT n00n25un
PLM 34-2421111
This permit is issued subject to the regulations contain?d in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be clone 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 aoopted;by the ^i,-gon
klkl)Issued By: - r ����'�_ _ �__ Permittee Signature:_ //
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the t ex .business day
/ CITY OF T'IGARD - SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2004-00019
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/21/04
SITE ADDRESS; 12180 SW GARDEN PL BLD3 PARCEL: 2S10166-01400
SUBDIVISION: PARK 217 ZONING: ( -(,I
BLOCK: LOT: 002 JURISDICTION: 11(i _
TENANT NAME: CELERITY ENERGY
USA NO FIXTURE UNITS: 19
CLASS OF WORK: ALT DWELLING UNITS:
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL 1 YPE: BUSWR IMPERV SURFACE:
Remarks: 1.2. EDU increase.
Owner: - — -- ----FEES _
SPIEKER PROPERTIES LP Description Date Amount
4380 SW MACADAM AVE STE 100
PORTLAND,OR 97201 1SWUSA) Swr Connect 1/21/04 $2.880.00
�SWUSASwr Connect 1/2.1/04 $000
Phone: -
Total $2,880.00
Contractor:
Phone:
Reg#:
ff Required Inspections
I
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 purcha7 a" ap and Side Sewer" Perm
ISSUed by: � (i c� > f �- Permittee Signature: C 5
- - --
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business d
Ituilding Fixtures -
PI: ihiny, Permit , pplieatit►n
City of Tigard Received Pemtt Nu.:
Date/B : —� r
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone' 503.639.4171 Fax: 503.598.1960 Dale/B : Uther Pernnt Nq ,Vj�0
24-Hour Inspection Line: 503.639.4175 Date Ready/B,, ® SL('Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Suppienieniallnfurmrtlon
TYPE OF WORK FEF* SCHEDULE
❑New construction ❑Demolition Fors ectal inform use checklist.
--
Description I QtyLa. Total
Addition/alteration/replacement ❑Other: New I-2-ramlly dwellings(includes 100 It.fur ouch utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 249.20
❑ I-and 2-family dwelling ❑Commercial/industrial SFR(2)b,'h 350.00
❑Accessory building ❑Multi-family SFR(3)bath 399.00
Each additional bath/kitchen 45.00
❑Master builder ❑Other:
Fire sprinkler(_sq.ft) I Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: ) UAQOC N PL Catch basin or arca drain 16.60
City/State/ZIP: TtCv (�P- Drywell,leach line,or trench drain 16.60
Suite/bidg./apt.no.: Project name- Pri Footing drain(no.linear ft.: ) Page 2
Manufactured home utilities 1
Cross street/directions to job site: � a 10.
Manholes 10 60 GO
Rain drain connector 16.60
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewe (no.linear ft.:_) Page 2
Sdbdivision: Lot no.: Water service(no.linear ft: _) Page 2
Fixture or Item
Tax map/parcel no.: /( I� _ /,/yG>L
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16,60
— Dishwasher 16.60
❑ PROPERTY OWNER ❑ TENANT Drinking fountain W60
Ejectors/sur•p 16.60
Name: �� (� �� �" c.t �. � Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone:( I Fax:( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
— Ice maker 16.60
Business name:
_ Interceptor/grease trap 16.60
Contact name: Medical gas(value:$ �) Page 2
Address: Primer 11,.60
City/State/ZIP: Roof drain(commercial) 16.60
Phone:( ) Fax: :( ) Sink/basin/lovatory ,3 16.60
Tub/shower/shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: V p�`P , �� jj Water heater 1660
Other:
Address:
Subtotal
City/Stele/ZIP: �r)�
5 ]CI—' Minimum permit fee: $72.50
PPIne:(5 )�l -1 W Fax:( ) 1, Residential backflow minimum ermit fee• $36.25B f7 Z Plumbing Lic.no.: Zc,(? Pg Plan review (25",L of permit fee)
State surcharge(806 ol'permit fee)
Authorized signature: /' i TO fAL PERMIT FEE "l
Print name: Rt 7 Date _tv This permit application expires If a permit Is not obtained within
180 days after It has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i�nuilding�P"ut%\PLMF-PermitAppdoc 12/03 4404616T(IOWCOM/WEE)
f'ItlmhinL, Permit Ahpiication - City oi-"Tigard
Page 2 - Suppicmental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty FCC(Ca) Total Square Foota e: Permit Fee:
Footing drain-I"100' 55.00 0 to 2,000_ $115.00
Footing drain-each additional 100' 46.40 2,001 to 3,600 $160,00
3,601 to 7,200 _ $220.00 _
Sewer-I st 100' 55.00 7,201 and greater $309.00
Sewer-each additional 100' 46.40
Water Service-Ist 100' 55.00 Medical Gas S steins:
WaterService-eachadditional 100' 46.40 Valuation: Permit Fee:
Storm&Rain Drain-Ist 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each
Qty. Fee(ea) TWal additional$100.00 or fraction thereof,to and
Fixture or Itetn including$10,000.00.
Commercial Duck Flow Prevention Device. 46.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to
minimum permit fee$36.25 27.55 and including$25,000.00.
Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
each additional$100.00 or fraction thereof',to
Inspection of existing plumbing or and including$50,000.00.
specially requested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.201'or
Subtotal: each additional$100.00 or fraction thereof.
Fixture Work:
Are you capping,moving or replacing existing fixtures? If
"yes",please Indicate work performed by fixture. Failure to
accurately report fixtures could esult in increased sewer fees*.
uantit b Fixture Work Ferformed
Re dice
Fixlu- Type: Newl Moved Existing Capped Comments regarding fixture work:
Baptistry/Font
Beth -Tub/Shower -- --- -- --- - ----- - -_ --
-Jacuzzi/Whirlpool --
Car Wash -Each Stall
-Drive Thru - - -
Cu idor/Water Aspirator ---- ---
Dishwasher -Commercial
-Domestic
Drinking Fountain
Eye Wash
Floor Drain/sink -2"
.3"
•4"
Car Wash Drain
Garbage -Domestic
Disposal -Commercial *Note: if the fixture work under this permit results in an
-industrial increase of sewer EDUs,a sewer permit will be issued and
Ice Mach./Refri .Drains
Oil Separator(Oas Station fees assessed for the sewer increase must be paid before the
Rec.vehicie Dump Station plumbing permit can be issued.
Shower -Clang
-Stall
sink -Bar/Lavatory _ Ouantity Total
-Bradley Is metric or riser diagram is required if fixture(luatitity
-Commercial _-_ total is>9.
-Service
Swimming Pool Filter
Washer-Clothes
Water Extractor Plan It.riew
WaterCloset-Toilet Plan review is required if fixture quantity total is_ ).
Urinal
Other Fixtures;
i\nuildmg\PermhB\PLWPe mitApp din 3101
Accumulative Sewer Tally Parcel# 2S101BB-01400
Tenant Name: Celerity Energy _ This SWRA 2004-00019
Site Address: 12140 SW Garden Place This PLM# 2004-00023
Fixture Value Previous Previous Credits Capped Fixture Fixture Ne v New
# value capped off value added added tctal total
count off#s count # value _#s values
Ba tiso /Font 4 0 0 0 0 0
_Bath-Tub/Shower 4 0 0 0 0 0
-Jacu7zi/Whirl ool 40 0 _ U 0 0
Car Wash-Each Stall 6 _ 0 _ 0 0 0 0
-Drive through 16 _ 0 0 0 0 0
Cuspidor/Water Aspirator 1 0_ 0 0 U 0
Dishwasher-Commercial 4 _ _ _0 0 0 0 0
-Domestic 2 0 0 _ 0 0 0
Drinking Fountain 1 0 0 _ U 0 0
-Eye Wash 1 0 0 0 0 0
Floor Drain/Sink-2 inch 2 U _ 0 0 0 0-
3 inrh 5 0 0 0 0 0
4 inch 6� _ 0 _ 0 0 0 0
Car Wash Drn 6 0 0 0 0 0
Garbage Disposal
Domestic(to 3/4 f 1P) 16 0 0 _ 0 0 0
Cornmercial(to 5 HP) 32 0 0 0 0 0_
Industrial(over 5 HP) 48 _ 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Oil Se (Gas Station) 6 _ 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower-Gan (per head) 1 _ 0 _U _ 0 _ 0 0
-Stall 2 0 0 0 0 0
Sink-Bar/Lavatory 2 0 0 2 4 2 4
Bradley 5 _ 0 0 0 0 0-
Commercial 3 `0 _ i 0 _ 0 0 0
Service 3 0 0 1 3 _1 3
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes _ 6 0 0 0_ 0 0
Water Extractor 6 I 0 _ 0 0 0 _ 0
Water Closet-Toilet 6 0 0 2 '12 � 2 12
Urinal 6 _ 0 _ 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 5 19 5 19
Current Fixture Value 19 divided by 16 = 1.2 Current EDU 1 EDU = $ 2,400
Previous Fixture Value 0 divided by 16= 0.0 Previous EDU
Change 19 divided by 16 = 1.2 over (under) $ 2,880.00
Enter EDU Change Here 1.2
Notes:
Signature: r 2 T L 4 C% Date: Z co -&J—/—
Building
/—Buildin Division
Note The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher
which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges•
1:IBuilding\Sewer TallylSewerTallySheet.xis 11/19/03
CITY OF T'GA R D _,BUILDING PERMIT
PERMIT#: BUP2003-00703
DEVELOPMEN"f SERVICES DATE ISSUED: 12/30/03
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639.4171 PARCEL: 2S101BB-01400
SITE ADDRESS: 12180 SW GARDEN PL BLD3
SUBDIVISION: PARK 217 ZONING: C-G
BLOCK: LOT: 002 JURISDICTION: TIG _
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 2,590 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf ____PROJECT OPENINGS?
"TYPE OF CONST: 3N sf N S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 2,590 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 25 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft
GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: _ _ REQ_D_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: PPO CORR: PARKING:
VALUE: $ 51,000.00
Remarks: Tenant Improvement Mechanical, Plumbing and Electrical permits required
Owner: Contractor:
SPIEKER PROPERTIES LP C SCHIEWE & ASSOCIATES INC
4380 SW MACADAM AVE STE 100 1024 NE DAVIS ST
PORTLAND, OR 97201 PORTLAND,OR 97232
Phone:
Phone: 503-234-6617
Reg #: LIC 54105
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
1I0 '11 Irl hermit Fee 12/30/03 $476.27 Insulation Insp
III IPI NI Pln Its 12/30/03 $309.58 Gyp Board Insp
Susp Ceiing Insp
I:\S) s"„State surrharl 12/30/03 $38.10 Final Inspection
�I�I'SI Fl S Pln Its 12/30/03 $190.51
Total $1,014.46
This perm't is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Cedes
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 more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-66Qr or 1-800-332-2344.
Issued By:
Permit tee
Signature: '4z , ��—
\ Cali 639-4175 by 7 p.m. for an inspection the next business day
0-T
Building Permit Application
City of Tigard Date/Bea ?jd D Pemtit NO. _0,e W i3
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revitw
IF
Phone: 503.639.4171 Fax: 503.598.1960 Date/g Other Permit:
Inspection Line: 503.639.4175 AWL Date Ready/By: Juru 0 See Attached Checklist for
Internet: www•ei.tigard•orAIS Notified/Method: Supplemental information
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑New construction ❑Demolition
Permit fees*etre based on the value of the work performed, i
_— Indicate the value(rounded to the nearest dollar)of all }
❑Addition/alteration/replacement ther T equipment,materials,labor,uverhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application,
Valuation: S
❑ I-and 2-family dwelling ontmercial/industrial -
[l!accessory building
❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITF. INFORMATION AND LOCATION Total number of floors:
Job site address: 1-24 TSO �.?�"� Co OC,J JA/Or`L New dwelling area: square feet
City/State/ZIP: -TJ(.,/J72-10 , ee_ Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: CJ,&(,BIZ I r _ Covered porch area: square feet
Cross street/directions tojob site: U U Deck area: square feet
Other structure area: square feet
_ REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: e Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this a lication.
Valuation: S _ -5 I d D
eY4ce US/5w— --- Existing building area: square feet
New building area: square feet
0-'PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: 7 20 S V4 f"93,J S%E a' 410 Occupancy groups: S
City/State/ZIP: 0v9.TL,*,O vRL -17?—C)'5 Existing: / es
Phone:( ) Fax:( ) New:
PPLICANT ❑ CONTACT PERSON NOTICE
Business name: M/(-Qgtp asss/C..-i ew'? P' /� G All contractors and subcontractors are required to be
Contact name: (���.JE M/L ✓ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: -76,9-0 5-LJ *,./xt, wa ST S%E /20 jurisdiction in which work is being performed.If the
Ci /Stete/Z1P: t�/Z -7 7 e 7 2 applicant is exempt from licensing,the following reasons
City/State/ZIP: �14�/I>';,� apply:
Phone:( ) Fax::( )
E-mail:
CONTRACTOR
sines name: FjC _ `t. 'f' /i t/zS BUILDING PERMIT FEES*
Address: 10 2- Nt �/�U/5 Please refer tofee schedule.
city/state/zIP: PO4rc,+'0 , (nift _
— Fees due upon application
Phone:( I Fax:( )
Amount received
CCB lic.: &:3 --
Date received: _---J
o ' K4.gna This permit application expires if a permit Is not obtained
�jy�' Dater within 1811 days after It has been accepted as complete.
nt ame: t ALJ �2�� *
Fee methodology set by Tri-County Building Industry
Service Board.
l tnuiidinatPermitntBUP-PemdtApp doe 12/03 440.4613T(i I/0:1COKWER)
Building Division
Plan Submittal Requirement Matrix
Commercial & Multi-Family- New, Additions or Alterations
Cih�of Tigard
Type of Submittal # of Pans
(Includes new,additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing(site utilities) 2
Building 1
Fire Protection System 3**
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor,City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
* For over-the-counter commercial tenant improvements,submit 2 sets of plans.
** "New"fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NiCET level "3"technicians.
i:\Building\Forms\COM-PtenSubReq.doc 12/24/03
12/30/05 Tlii 10:54 FAX 503 244 0417 MILDREN DESIGN GROUP PC OUZ
--(1) 20 GA. 3h" METAL STUD
WHERE TOP OF WALL TO STRUCTURE-, BRACING TO STF UCTURi, WITH
ABOVE IS LESS THAN 5'-9" PROVIDE (2) #8 SHEET MI-TAL S(:REWS A [
(1) BRACE AT 8'-0" 0/C 1-0 ONE EACH END; PROTIDE D&(JBLE STUD
SIDE ONLY, STAGGER SIDES. WHERE BRACE WHEN DI; TANCE TO
DISTANCE 1S GREATER THAN 5--9", STRUCTURE ASCIE 1S GREATER
PROVIDE BRACES EACH DIRECTION THAN 5'-9".
T 8'-0" 0/C BRACING TO BE PROVIL LD
, WHERE DISTANCE BETWI-EN
45
PERPENDICULAR INTERSECTING
WALLS OR HORN ONTAL BRACING
BETWEEN WALLS EXCEEDS 8'-0"
(DO NOT ERTEN[ BRAC!VG INTO
EXPOSED STRUC "URE APEAS)
SUSPENDED CE1L 'NG
L 1, " x 1 x 15 GA x T_
3" WITH (4) #8 SCREWS -- CASING BEAD U530 200-��
EACH SIDE
— ATTACH STUD 'fl'ACK DIRECTLY
TO GRID
%" GYPSUM 801RD EACH
SIDE SECURE TC STUDS
- --- WITH TYPE 'S' ` CREWS AT
5-7" O/C
3X" 25 GAUGE KETAL
STUDS AT 2'-0' 0/C
--BOTTOM TRACK TO FINISH
FLOOR WITH PONDER DRIVEN �
ANCHORS 4'-0" 0/C j
---- 4 RUBBER BAS TYPICAL /I
2 Wall to Suspended Ceiling 'z""_ ~
A2 3"-1'-0"
1o1d
Celerity Energy Date: 30 Dec ember 2003
Drawn by Checked by.
Details BK _ WEM
MILDREN DESIGN GROUP,P.C. Revisions! Sheet R1- k2-1 of: I
ARr-I T M-TU t8 • SPACE PLAN"G 1. 30 December 2003 Job Num}ler. 103304
7G,N1 S.W.Beveland,Suite 120 General Revision - —
7223 8692 MILDREN DESIGI GROUP. F :, 7003. ALL
Tigard,Oregon 9
15f1A1 944-722 RIGHTS RESM,.0
CITY OF
T'G A R D v ELECTRICAL PERMIT
PE10MIT#: ELC2004-00034
DEVELOPMENT SERVICES DATE ISSUED: 1/26/04
1312.5 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 2S101BB-01400
SITE ADDRESS: 12180 SW GARDEN PL BLD3 ZONING: C-G
SUBDIVISION: PARK 217
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: JOB NO.61964
Tenant Improvement
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: Y 0 - 200 amp: PUMPARRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/ FUR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICEIFEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION:
201 400 amp: 1st WIO SRVC OR FDR: / PER hOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 arnp: PLAN REVIEW SECTION
1000+ amp/volt: _ —4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVCIFDR—225 AMPS: CLASS AREA/SPE'OCC:
Owner: Contractor:
SPIEKER PROPERTIES LP FRAHLER ELECTRIC CO
4380 SW MACADAM AVE STE 100 11860 SW GREENBURG RD
PORTLAND,OR 97201 TIGARD,OR 97223
Phone: Phone: FX 639-4673
Reg #: 16Ii9-4627 37410
��_ — .---- SUP 1816S
FEES III 34-13C
Description Date Amount
Required Inspections
�GLI'lt!�11� I.LI I'crnut I `r.iii $126.85 a — —
[TA Xj S"r,Srutc Surchurgw I n1 $10.14 Ceiling Cover
Wall Cover
Total ` $136.99 Elect'I Final
This Permit is issued subject to the regulations contained in the Tigard Municipal Code.State of OR.Specialty Codes and all other af.'rlcable 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 ff wr r is suspended
for more than 180 days. ATTENTION: Orr'gon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246.6699 or
1-800-332-2344.
�—
Issued 8y: 1�a-�. Permit Signature: ..-�
_ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for safe, lease, or rent.
OWNER'S SIGNATURE: DATE:—
CONTRACTOR
ATE:CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:----------
LICENSE
ATE:__ -_^_LICENSE N O: — _�.—__� — -- ------- ----- - -----
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Date received Permit no.: ' IP -pr,,J3(�
city of Tigard Pmject/appi. no.: Expire date:
City-f Tigard Address: 13125 SW Hall Blvd,Tigard,ORV97223 (UUP Date issued: BY Kept no.:
Phone: (503) 63911171
Fsx: (503) 595-1960 Case file no.: Payment type:
rlry c)I rlc;A�u
Land use approval:
;Jobaddress:
&2 family dwelling or accessory CS CommercinVindustrinl U Multi-family U Tenant improvement
w con9truetion (3 Addition/allelalitm/replaceinent UOther.._U Partial
12080 SW GARDEN PLACE Bldg.no.: 3 Suite no.: Tex map/tax lottaccount no.:
Block: Subdivision: PARK 217
Project name: C ERIT Description and location of work on premises: 'rFNANT IMPROVEMENT
Estituated date of cont letirnhaa ection:
.lou no: 61964 _ Fee raw
FRAHLER ELECTRIC COMPANY Doyrrtptiurt .. TttW seal
Wip
Ausiness morns: Neo mlderMal-dogk or rrra►H-faaol;)per
Address: 11860 S' EN OAD dwrafrrRanh.Includes ettnrhed►,entre.
State: Cr, zlr: 97223 9ervltrinchrdrd: 4
City: _ TIG lost&i e.for Ir99 __ _
Phone: 6C9�7' Fax: _ E-mail: -
S]G.[� Each aflditional 500 aq.tt,or onion thereof _
CCB no.: 37410 1 Elec.bus.lic.no: 34-1X Limited—residential 2
City/metrolic. _ Lhnheden _non-reside_ntiol 2
�aJ 2a;_47�% �jta 01/20/O4 _. Each mnnufhctured home or modular dwelling
Date Service and/or feeder 2
Signature of mpervhring electrician (requited) 9errleenor/ceders—InstaWHon,
Sup.elect.name(print). F„ �a, 1{1.,ER License no: 8165 altrrntlonorraloc■Hon;
200 amps tx k9e 1 80.3 z -
--
Name(print): 201 amps to 400 amps _ _ - -
401 em�a to 600 tpLt9_-- 2
Mailing address: __ 601 amps to 1000 amps Z_---
City: State: ZIPOver l oti0 amps or volts 2
ittrcorutect only
Phone: .._—W Fax: �~ E-mail: _-
7eerporerY eervlees or feeder s-
Owtler installatirnc The htstallation is being made on property I own IrfehdloHon aherntbn,orrelaeatloa:
which is not intended for sale,lease,rent,or exchange according to ZoliS or k99
ORS 447,455, 479,670,701. 201 am to 400 amps 2
Owner's si lune: Date: 401tV600amps2
Itrnnch elreuhs-orn,alternHoa,
Miss of erten+ion per panel:
Name: A. Fee for blanch circuits with ptrchaWe of
Address: _ — service or fonder tee,each branchcecvit_ -- ?
City: Male: ZiP: B. Fee fbr branch circuits Widnes purchase
-- of entice or feeder fee,first branch circuit 7446
2
Phone: F; fi-mail: Each additional branch circuit:
llfine.(Service or feeder not Included):
Each pump or irrigation circle 2
Cl StrvlC! over 225 amps-a mnwreinl 1 f IenNtt csre fncility Each of outline lighting 2
O Service over 320 amps rating of 1 d2 U Thuardons location
Wally dwelling+ U Building over lu,o00 square Feet four or Signal circuit(s)or a limited energy panel.
U Syme Over 600 volts nominal mom residential tants in one ahtchav attention, or extension' --- 2
u BuNitill over three stories U Feeder.400 amps or more *Description:
O occoq ant bad over 99 persons U Manuflrchoed structures or RV park 1 nen addttloonl it"t, ton over the a0owablr to any of the above:
•Egm,1111ghting plan U Other: Per iaspec6on
SublaH sets of plum With nn!of the above. Investigation fee
-Me above are not applicable to IemporwY cotntraction senice. Other
Permit fee......................S8,2—
Not til Wstlk-cions accept roedit cads,plane call)rniadietion tar mom Inronnatinn. Notice: This pertnit application Plan review(af oie)
U Visa U MasterCard exphe#if a patrnit is not obtained a T--
Cradh card tmmbet __ ----- —
�., within 180 day#atter h has been Stole surcharge(8%).....5 �i-
Gxpiraa accepted as complete. TOTAL.........................$ r.I .99
N nae o eardhnlda n aht,"an it card s
—c.r�ia e.T—.Tgmttse- 440-A67513 16/00/COM
Amount
i
CITY O F TI A(V=ARD �-- ELECTRICAL PERMIT-
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2004-00025
13125 SW Hall Blvd.. Tiqard. OR 97223 (503) 639-4171 DATE I�7UED: 2/3/04
PAK�EL: 2S101 BB-01400
SITE ADDRESS: 12180 SW GARDEN PL BLD3
SUBDIVISION: PARK 217 ZONING: C-G
BLOCK: LOT: 002 JURISDICTION: TIG
Proiect Description: Limited energy for data telecommunications system. Job No. 61983
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 SYSTLMS:
Owner: Contractor:
SPIEKER PROPERTIES LP FRAHLER ELECTRIC CO
4380 SW MACADAM AVE STE 1U0 11860 SW GREENBURG RD
PORTLAND, OR 97201 TIGARD, OR 97223
Phone: Phone: I•X (09-4673
Reg #: I.b(i'�)-403374111
Still 18165
FLE 34-13('
FEES — Required Inspections _
Description Date AmountLow Voltage Inspection
I:LI'RM'I'� I?Llt Permit 2/3/04 $75.00
Elect'I Final
ITAXR"'o Stute Surchart 2/3/04 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipai 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc
Is ed by � C1L.✓1�41 _
Permittee Signahrre
_ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not Intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:_
CONTRACTOR INSTALLATION_ONLY__
SIGNATURE OF SUPR. ELEC'N _ — DATE:---
LICENSE
ATE: __LICENSE NO: — -
Call 639-4175 by 7:00 P.M.for ar. inspection needed the kiext business day
Electric jVWliention
Date received: Permit no.:
City Of l igar4t, 1004 PMjecdni no.: date: —
t'a, ,d 7lxurr; Address: 13125 SW Full Blvd Tigtttd.OR 97223 Date issued: B^ Receipt no.:
Phone: (503) 63941jhY of 1 I(�IARG
F' A: (503) 598-19 Cr;se file no.: Payment type:
13UILDING DIVISION
Land use approval:
U I & 2 ftrrnily dwelling or accessory 61Commeminl/industrial UMulti-family U Tenant improvement
U Ncw constnte•lion U Additionlallcrntion/replacement U Other: ._ U Partial
Job nddress: I SW GRADEN PLACEBldg.no.: Suite no.: Tax Map/tax 1ot//oeolmt no.:
Lot: —-d
k: Subdivision_:
Project namei"[Y ENERGY Desceiption and locaaticI of work on premises: TEL :OM OU LETS
Estimated date of completion/ins cction:
Job71m- 6983 BusI-II..ER ELECTRIC COMPANY tt>AerfNb" Qtr• t� Teal .e.Im Hi iM rnlN-Gaw per
dd60 SW GREENBURG ROAD �restna..+t.lna.+rs"n.rlwell,CityARD state: OR ZIP: 97223 Smrk•errrleded!
Phone. - Fax: - E-mail: 1000 .n or leas — 4 —
Eli additional 500 sq.R.or Portion thereof
CCB no.: 37410 Elee,bus.lic.no: 34-13C United energy, residential 2
City/metro�h_c.._.n_o_�.' � -Limited energy, non !ydeatfal _ 2
/G�✓ G�/
-01/29/04 Rech merstfac."ued home or modular dwelling
signalure of supervising electrician (required) Date 9ervicc sad/or feeder __
Liceme no: peyr{eesor/eeAere'1"st"IlaMon, t
Sup.elect.nnme tprint) R. "IteretlonorneleceMo"
AM amps or k!sF 2
Name(print): 201 amps to 400 snaps --- 2
- _--- 401 am m 600 amps —
Mailing address: 601 smv4 to 1000 MW _
City: State: ZIP: over Itsui amps rx volts
Phone:-^ Fa><: E-mail. Reconnect
Owner installation• The installtdinn is being made cm property 1 own 'f emporwn genleesrpr/eerle••
r•,gewllwllwn,wlrer"fMi reloeaNe"r
which is not intended for sale.lesse.rent,or exchange according Iu tK,empg or leen _ -_-,_ 2
ORS 447,455,479,670,701. 201 amps to 400 2
Owner's a, tUIe: Date: 401 to 600 amps 2
ar"relr etrreMe-ren,elMutstrow.
or extrusloe per permit
Name: _ A. Fc•' ro,branch cirruitq wisp ii of
Addrell9:` service or fetxirr fee,each brunch circult 2
---
City: — - State: Z1P n Fee fro branch cimuhs wtlpot0 Pure ex
_ - — of service or feeder fee,first breach circa: —2—
Phone: -- -� Fat F-mail: Each-1A.61, d Itrnteh circuli i
Mrer.(%rrvirr or terder not IndedrA):
U Service over M amps-cnnrmrercW
U tleehh-carr With, Eacit punp or irtip iar circle — 2 _
- ---
U 9ervier over 120 amps-ni inR of 1 h2 U Illm"Im, locatil n Each sign or outline fighting 2
_
famih d..ellinlm J R,diditat over 1tlmx)stli feel four m signal circrdlts)or a limbed energy Panel. 1 75. 2
U 9yskrr over 6m voltq nominal mmr residential imih in one strrrettor aketeti_on, or extensino'— —
U rcullttinp over over slorieq U Frrdm,4tal mrgn or more *Description: -
U o"upant bad over 90 perwms U Mnnufhchned On Kit""or RV park F chod 1tb""IlmprlMoamertheallenr"hlehn.otNsesbovveri - -
U F. e-Wh Minp Pim, U tnher ---_---._- -__-_ _-- -- Per ins tioin
Submh getsof shoe"1111 s i offer above. Inve. ' etion far _
11e move are mot nWilemble to fespecwy ceaefretlFela service.
Permit fee ......................5 _
Not all Jttrhdit-done seew.redh Ceram,plane all"dietoe kr tibio innemedon Notice: 'Ellis Pmrrni application Plan tevim,(at -
U vise U Masmercard expires if n rennit is riot nMnirmct e
within I Rli dnvs Olen it has hcf-n ;tale surcharge
Credit sent Immlxr, ..----_.---- -__. ---
- ncroPtell as complete. TOTAL.........................5 ZS 1
Nir..•ofar o ereeihowron it-mrd s
U.,Aoi err eit1"t __ Amount
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
-- -- TYPE OF WORK INVOLVED-RESIDENTIAL ONLY'
Complete Fee Schedule Below: Restricted Entergy Fee...... ............................... 375.00
Number of Ins ectlorm par ermlt allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total I Check Type of Work Involved:
Residential-par unit
1000 sq.ft.or Was ___ $145.15 _ 4 Audio and Stereo Systems'
Each additional 500 eq fl.or
portion thereof $33.40 1 Burglar Alarm
Limited Energy ^-�_ $75.00
Each Manui'd Horne or Modula, Garage Door Opener'
Dwelling Service or Feeder
$t10 90 -- 2 El
Services or Fsaders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteratiof,or relo:atiou
200 snips or less .30 --- 2 Vacuum Systems'
201 amps to 400 amps $1 10606.05 ?
401 amps to 600 amps $160.60 — 2
601 amps to 1000 amps ---^- $240.00 2 Other----_-__-- _+_----
Over 1000 amps or volts $45465 _ _ 2
Reconned only $66.65 2
Temporary Services or Feeders TYPE OF WORK INVOLVED-COMMERCIAL ONL11f
Fee for each system......................................................... X75.00
Installation,alteration,or relocation SEE OAR 91P,260-260)$66.65 - -- 2 (
200 amps or less
201 amps to 400 amps $100.30 -- 2 Check Type of Work Invaved:
401 amps to 1300 amps $13375_ 2 YP
Over 600 amps 10 1000 volts,
ses"b"above. Audio and Stereo Systems
Branch Circuits Bolter Controls
Now,alteration or extension per panel
a)The fee for branch circuits
witlr purchase of service m Cloc k Systems
feeder tae.
Each txanch circuit $6 65 2 Data Telerxrnrnunication Installation
b)The fee for branch drer:ils
without purchase of service Fire Alarm Installation
ur leader nae.
First branch dicutl $46.6.5 --_- r� HVAC
Each dddillunal branch urcuil . $6.65 -- I 1
Miscellaneous Instrumentation
(Service of feadel not included)
Each pump of ungatfon circle $53.40_ Intercom and Paging Systems
Each sign of outline lighting $5340
Signal ureult(s)of a limited energy
panel,allsralion of axtensrun $75.00 Landscape Irrigation Control'
Mmur Latxrls(10) 8125.00 _ rl
Medical
Each additlunal Inspection over
l.J
the allowable in any of the above Nurse Calls
Pei brapeclion T_- $62.50
Per hour 14250
In Plant $73.75+ n Outdoor Landscape Lighting'
Fees: Protective SlgnRling
Enter 13!01:]f aboVi tae} S CJ Other__ -- -- - --
8%State Surcharge $ � - Number of Systems
26%Plan Review Fee No licenses are ragrrVed I"rises we required for all dtxx Instatlollons
Sae`Plan Revfev/ section on
fit"of appiicabon ---
Fees:
Tata!Balance Due $
.'- Enbr total of etwvs fess
❑ True t Account 0 -
- _-- ------- B%State Surcharge
------ ---�-- Total Balance Due 5----All New Commercial Buildings require 2 sets of plants
i\dsts\fonns\dc-fees.doc 071054)1
MECHANICAL PERMIT
IGARDLATY OF TPERMIT#: MEC2004-00031
DEVELOPMENT SERVICES DATE ISSUED: 1/27/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 VARCEL: 2S101BB-01400
SITE ADDRESS: 12180 SW GARDEN PL BLD3 ZON'NG: C-G
SUBDIVISION: PARK 217 LOT: 002 JURISDICTION: TIG
BLOCK:
FLOOR FURN: EVA
P COOLERS:
CLASS OF WORK: ALT UNIT HEATERS: VEN1 FANS:
TYPE OF USE: COM VENTS W/O APPL: VENT SYSTEMS:
OCCUPANCY GRP: B HOODS:
STORIES: BOILERS/COMPRESSORS DOMES. INCIN:
FUEL TYPES w HP:
-- 3 - 15 HP: COMML. INCIN:
MAX15 - 30 HP:
MAINPUT: BTU REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: 1 <= 10000 ctm: GAS OUTLETS:
> 10000 cfm:
Remarks: Rcl)lacc existing ()ol'top unit,ductwork an(l hath I-II, S10, 00-- t -_
FEES _ _—
Owner: Date Amount
rDescription_SPIEKER PROPERTIES LP1/27/04 $231.50
4380 SW MACADAM AVE STE 100 1'crnnI I'cc $18 52
PORTLAND, OR 97201 „5tatc tiur�hart 1127104 $57.88
N I Plan K0 1/27/04
Total $307.90
Phone: —
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE REQUIRED INSPECTIONS
PORTLAND, OR 97222 - —
Mechanical Insp
Phone: 233-6911 Duct Inspection
38868 Misc. Inspection
Reg #: l-IC Final Inspection
ate of
re
This permit is issued subject to the regulations containedaccordance
rdlan elgard Mullicipal with approved plans.s1 TthiS perOmit wSlhexpire if otic is
er�jalty Codes
and all other applicable laws. All work wall be doregon law
not started within 180 days of issuance, or if work�UlilispNroaficat on ed for more
Ce�teanThose180 arules are set forth in00AR 952-001-00
requires you to follow rules adopted in the Oregon
ry
Issued B ` c. GC tt L� c e Permittee Signature:
y'P
Call (503) 639-4175 by 7:00 P.M. for inspections needed& ne business day
Mechanical Permit Application FOR OFFK7E USE ONLY
Received
Cky of t'i and /�y Pemut No.:
13125 SW I lall Blvd.,'rigard,OR 97223 Plan Review
Phone: 503.639,4171 Fax: 503.598.1960 Date/By: Otho Permit
Inspection line: 503,639.4175 Date Rcady/By: Jult ® see I'ogc 2 fur
Internet: www.ci.tigard,or,us Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
Mechanical permit fees•are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labur,overhead,and rofit.
CATEGORY OF CONSTRUCTION Value-
— — RESIDENTIAL EQUIPMENT/SYSTEMS FEES"
❑ I-and 2-family dwelling ❑Commercial/industrial [7 Accessory building For•special injor•ntnfion use checklist.
❑ Multi-family ❑ Master builder ❑Other: Description Qty_. Ea. Total
3JO 91TE INFORMATION AND LOCATION Heatio coolln
Air conditioning or heat pump
Job site address: d t../ 1p R DGay Nhe_t, (requires site plan show ag placement) 14.00
City/Slate/ZIP: h%P_ Furnace 100,000 BTU(ductsrvetim) 14.00
-- Furnace 100,000+BTU(ducts/vents) 17.90
Suitelbldg./apt.no,: Project name_ _leI Ty Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
H dronic hot waters stem 14.00
Residential boiler(radiator or
--� v h dronic) 14.00
_—_ Unit heaters(fuel-type,not electric),
in wall,in-duct,suspended,etc. 10.00
Flue/vent for an of above 10.00
Subdivision: Lot no.: _ Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION Of WORK Water heater 10.00
Gas fireplace 10.00
7',CU 4711 14,1 �W 1 r� I Flue vent for water heater or gas
�h� fire lace 10.00
Tk t�3 tJ7"1 O✓ t_ '� f7 L1� /V Lo li hter as) 10.00
_��N5 -_ -- Wood/pellet stove 10.00
Wood fireplace/insert 10.00 _
Chimne /liner/flue/vent 10.00
[I PROPERTY OWNER TENANT - Other: 10.00
Name: Environmental exhaust and ventilation
-----— -- Range hood/other kitchen
Address: equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
---.--— -- --- Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawls ap ce fons 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5,40 for first four;$1,00 for each additional _
Furnace,etc.
Address: Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Fax: : Water heater
Phone:( ) -7 ( ) —
_ Fireplace
E-mail: flange
CONTRACTOR Barbecue _
Business name: '+ A5�� Clothes dryer(gas)
OT N _. Other:
Address: -� S� 7'���Q y�v MECHANICAL PERMIT FEES"
Subtotal _
City/State/ZIP: 7 Minimum permit fee(572.50)
Phone•:(S►3) �3�.(��N Fax: )�3�_9�7 Plan review(259%ofpermit fee) $i
CCB Iic.: ��'_ — State surcharge(80No of permit fee)
TOTAL PERMIT FEE 7,
C-C? This permit application expires If a permit Is not oblalned within 180 '
Authorized signature: days after It has been accepted as complete.
Print nam ,=+!tjyty_ t..r Dale. ,�,��/ Fee methodology set by Tri-County Building Industry Service Board
1%Buildi-1\Permitx\MBC-P�arr=tApp�doe 12/0-7 440.4617T(II/02/C'OM/WE13)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to$2,000.00 _ Minimum fee$72.50
$2,001.00 to$5,000.00 $72.50 for the first$2,000.00 and$2.30
for each additional$100.00 or fraction
_ thereof,to and including$5,000.00.
$5,001.00 to$10,000.00 $141.50 for the first $5,000.00 and
$1.$0 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10.001.00 to$50,000.00 $231.50 for the first$10,000.00 and
$1.35 for each additional$100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and
$1.25 for each additional$100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up Y $1,396.50 for the first$100,000.00 and
$1.10 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\13uilding\Permits\MLC-PermitApp.doc 12/03 2
ELECTRICAL -
CITY OF TIGARD RESTRICTED EN RIGY
DEVELOPMENT SERVICES PERMIT#: Et_R2004-00018
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 1/27/04
SITE ADDRESS: 12180 SW GARDEN PL BLD3
PARCEL: 25101 BB-01400
SUBDIVISION: PARK 217 ZONING: C-G
BLOCK: LOT: 002 JURISDICTION: TIG
Proiect Description: Low voltage HVAC.
A.RESIDENTIAL B.COMMERCIAL_ _
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPE=NER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
_ TOTAL# OF SYSTEMS: 1
Owner: Contractor:
SPIEKER PROPERTIES LP PROTEMP ASSOCIATES INC
4380 SW MACADAM AVE STE 100 807 NE COUCH
PORTLAND, OR 97201 PORTLAND, OR 97232
Phone: Phone: 233-0911
Reg #: ELE 26-1 n63CRE
LIC 38868
Still 261 31'Fl,
FEES Required Inspections
Description Date Amount Low Voltage Inspection
11111W 1 I:L R Pcrinit 1/27/04 $7500 Elect'I Final
I 9"b State Sill Chart 1/27/04 $6.00
Total $81.00
Thi,, Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all ether applicable laws. All work will he done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 0010 throuC
Issued by k1l( Y (i et td Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
rONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ DATE.:
LICENSE NO: ^
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
Elcctr' -alk EAM nn FOR OFFICE USE ONLY
City of Tigard Received 7- Zb
y H ry 2'f1(I Date/Il O Permit No.• ��L7 a1L.gym
13125 SW Ifull Blvd.,T STI Z1.Ill Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 DatefB : Other Permit.
Inspection Line: 503. V7bF TIGARD Date Ready/13y: luris ® see Pact i for
Internet: www 611 NOlifiedMCUlt1I supplenuvttal Information
6IN ,DlVlSIQN _ —
TYPE OF WORK PLAN REVIEW
Please check all that apply
--
❑ New construction Addition/ulteralinn/repm
laceent
❑ i
_ ❑Service over 225 amps,cumm'I ❑Ilazarduus location
[ )T_DenwlrUon ❑Other' []Service over 320 amps ratio
❑lluildng over I0,000 sq.ft.,
CATEGORY OF CONSTRUCTION of I-and 2-family dwellings 4 or more new residential f
I-laid 2-family dwelling F-1 Commercial/industrial ❑Accessory building [I system over 600 volts nominal units in one structure IJ
❑Building over three stories ❑Feeders,400 amps or more
Mullt-family ❑ Master builder ❑Other: []occupant load over 99 persons ❑Manufactured structures of
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
--�� - ❑Health-cart facility []Other:_„T -
Job no.: Joh site address:
2 « .- Submit 1 sets of plans with any of the above.
City/State/ZIP: ?'~ The above are not applicable to temporary construction service
Suite/bldg./apt.no.: Project name: FEE' SCHEDULE •.
CCG Eia Description Qly. Fee. total
Cross street/directions to job site: New residential single-or multi-family dwelling unit.
Includes attached garage.
1,000 sq.R.or less 145.15 4
Subdivision: Lot no.: Ea.add'I 500 sq.fl.or portion 33.40 1
-- - Limited energy,residential 75.00 2
as map/puree)no.: Limited energy,non-residential 75.00 2
DESCRIPTION'OF WORK Each manufactured or modular
i-- -`- _
dwelling,service and/or feeder 90.90 2
Services or feeders installation,alteration,and/or relocation
200 amps or less 80.30 2
❑ PRO!'ERTY bWN T ❑ TENANT 201 snips to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Adds Over 1,000 amps or volts 454.65 2
_. _ --- - - ----- - --- Reconnect only 66.85 _ 2
City/State/ZIP: 'temporary servicer or feeders instt,llatlon,alteration,and/or
relocation _ _
Phone:( ) Fax:( ) _ 20n-imps or less — 66.85 I
Owner installation:This installation is being made on property that 1 own which is nal 201 0,.;s to 400 snips 100.30 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701 401 amps to fi00 amps 133 75 2
Owrcr signature Date: Branch circuits-new,alteration,or extension,per panel
❑ APPLICANT `�--V_ ❑ CONTACT PERSON A.Fee for branch circuits with
-- service or feeder fee,each 6.65 2
Business name: branch circuit
- ------- -- — -- B.Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
- ----� each branch circuit
Address: Each add'i branch circuit 6.65 2
City/State/ZIP: Miscellaneous(service or feeder not Included)
Pump or irrigation circle 53.40 Phone:( ) �- - - _ Fax: :( ) Sign or outline lighting 53.40 1.
Signal circuit(s)or limited-
CONTRACTOR energy panel,alteration,or
- --------- ---- extension.Describe: Page 2 2
Business name: �
J .Q iz '�P.. - ----
Address: r h _ Each additional Inspection over allowable In any of the above
179�_ S_ C /.-7 tQ-;�- _- ____ _ ____..—_- Per inspection 62.50
City/State/ZiP: r� a Investigation per hour(Ifar min) 62.50 it
C�7'G wti r.7
Phone:( 'y ► 9 f 1 Fax:( �3 j -� Industrial plant per hour 7 t 75
3 23 3•C� S e?�t6'`�7G _ ELECTRICAL PERMIT FEES*
CCg Lic.: 6 Electrical Lic.a4qC)4 Supry^I a Subtotal I
Suprv.Electrician signature,required: Plan review(25%of permit fee) -
State surcharge(8%of permit fee)
Print name: �rT Date: ---
TOTAL PERMIT FEF. 10
Authorized signature: This permit application expires if a permit is not ubtained within 1911
— -- days after it has been accepted as complete
Print name: bate' • Fee methodulogy set by Tri-County Building Industry Sct%i,c Hoard
-- - •'Numbet or inspections per permit allowed
i 11uildina!PermitfI:1( Fetmi1Appd,x I2103 440.4615TI I IYON-0M,1VnB
Flectrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined...... $75.00
Check Type of N1 ork Involved:
❑ Audio and Stereo Systems*
[ ] Burglar Alarm
❑ 6arage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
F1 Vacuum Systems*
[] Other:
COMMERCIAL WORK ONLYI'`''
Fee for each commercial system....................... $75.00
(SEI:OAR 918-200-260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Dire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
[� Medical
❑ Nurse Calls
❑ Outdoor landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses Are required
for all other installations
11 11,,�„1 11, r....... ., I I
ELECTRICAL PERMIT-
CITY OF TI OARD
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2004-00029
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE !SSUED: 2/11/04
SITE ADDRESS: 12180 SW GARDEN PL BLD3
PARCEL: 2S 101 BB-01400
SUBDIVISION: PARK 217 ZONING: C-G
BLOCK: LOT: 002 JURIGDICTION: TIG
Proiect Description: Low voltage.
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:
INSTRUMENTATION: OTHER: ALARM X
_ TOTAL#OF SYSTEMS: 1
Owner: Contractor:
SPIEKER PROPERTIES LP OMNI WIRE INC
4380 SW MACADAM AVE STE 100 15621 SE MORRISON
PORTLAND, OR 97201 PORTLAND, OR 97233
Phone: Phone: 503-2(,l-8789
Reg #: LIC 151222
t-LE 26-1132('1.E
SUP 3525.11.1:
~ FEES A Required Inspections
Description Date Amor.rnt Low Voltage Inspection
I I I)RM'I J 1;I.K I'crnut_ 2/11/04 $75.00 Elert'I Final
I AXI R"S State 2/11/04 $6.00
Total $81.00
This Permit is issued subject to the requl3tions contained in the Tigard Municipal Code, State of OR Specialty Codes
and all other applicable laws. All wot k will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699. z , / ,
Issued b� �/r11�[Q ,t� ,✓i�Cr Permittee SignatureV�*?-1 c l }��tc.C� ["0ac�•---
_OWNER INSTALLATION ONLY
I lie installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ DATE:
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection neederl the next business day
02/09/2004 12:1,2
4 ED AL-INK CMMUTAICATIOIJS PAGE 01
�Iql, ical A a >lon
City of Tigard F�� U 20U� Dail/Flee !/_d L� PermitN-;—
13125 SW Hail Blvd„Tigard,OR 97221 Platt Review (cher Pcm is
Phone: 503.639.4171 Fax: 503.598��. " pF T IGARD
InnpecKianLine 503.639.4175 DIVISI�(' DoeRealy/By: 1,+�+ Bl SerPole2for
Internet: www.ci.tigstd.or.us BUILDING Noufiod/Method: Sapplemeatd Information
TMOFWOA1L PLAN REVIEW
New wnstnteKion Please check all that apply:
❑Addition/stteration/replacement
❑So:rvice over 225 amps,wnun'I ❑tlazarduus location
❑Demolition ❑Other: ❑Service over 320 amps-rating ❑Buildng over 10,(00 sq.ft.,
CA IOB COfVIt'MVCI101V of I-and 2-family dwellings 4 or more new residential
❑System over 600 volts nominal units in one structure
❑ I-and 1-family dwelling Commercial/industrial ❑Accessory building ❑Building over three stories ❑Feeders,400 amps or more
❑Multi-hunily ❑Master huilder_ ❑Other: ❑Occupant load aver 99 pet:sons ❑Maaufudurrd struchues or
JUS ffm II It IMATIDN A"LOCATION QGgreWlightingplan RV park
❑health-care facility ❑ether
Job no.: Job site address: rJ CailIC I.RL. Suhmit-1 sets of plans with any of the above.
City/State/ZIP. �� (!_� (L 7 Z23 The above are not applicable to temporary construction service.
Cel e r1� r-r..�/ � •
5uitfp/bl 1/apt.no.: -:�3 Projcd ntune: F _ Fre. r.,at ••
�'•_ Unrri Hon Qry• _
Cross strcct/dircctlons tojob elle: New residential slatile-or multi-family dwelling oath
Includes attached garage.__
1,000 sq.ft.or less 145 15 4
(�no,; Fa.add'I 500 sq.ft,or portion 33.40 1
Subdivision:
Limited eneq{y,residential 75.00 _ 2
Tux map/parcel no.: _ Limit oil energy,non-residential 75 00 _ 2
999CRIPTION OF WORK Each manufacifi or modular
-- dwcllm�scrvic c and!or tixd_cr __ 90 9(1 2
Services or feeders installation,alteration,and/or relocation
200 amps or less 811.30 2
20!amps to 400 amps 106.85 2
j] PROPRItTV bWNF.R '�-- TFNANT 401 amps to 600 amps 160.60 2
Name: 601 amps to_I,000 snips _ 240.60 - 2
Address: -- (?vest 1,000 amps rr volts 454.65 2
_._ -- -- Re Cal only _ 66.85 2
City/Stme/'LIP: Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fax:( ) -_ _ 200 strips or less 66.83 _` I
Owner installation:This installation is being made on property that I own which is not 201 amps�to 400 amps 100.30 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,,int]701. 401 amps to 600 amps 133.75 2
Owner signature: _ Date: _ __ Branch clrcrlte- new,alteration,or extension,per panel
-- 0 ,ilWLW NT -d CONTACT PRISON A.Fox:fix branch circuits with
- service or fiWer ree,each 6,65 2
Business name: branch circuit _
-- A.Fee for branch circuits
Contact name: w ahnwr service nr fowler fee.
46.85 1
each branch circuit
Address:_ _ __ __ 1 ech_add'I branch circuit _ 6.65 _ 2
City/State/ZIP: A Miscellaneous(service or feeder not included)
- - - Pump or itriEtimt circle 53.40 2
Phone:( ) fax Sign(it outline lighting - - 53.40 2
E-mail: Signal circuit(s)of limited.
CONTRACTOR anergy panel,alicrwtion,or
extension Descritwc. ' Page 2 "fie, -' 2
Ilusiness name: !m N i l2 N C' j+"' — --
Address: 1('0521 I SE M�I5oo Sr� Each additional Inspection over allow,]'i in an of the above
__ Per inspecdon 62.50
Ci /State/ZlP` Invcsti ation per hour(I hr min) 62.50
11
ry 7� — Industrial plant per hoar 73.75
Phone:(may S) ��an:(� ) 5 �` � ELIRCfRICAL PERMIT F'W
.��++�c •
CCB LIC.: 1 Z Electrical Lir:.:2�'1(32 Suprv.(_ic.: ,?I LEA __ Subtotal $ -
Suprv.Electrician signature,required: ��- r " U - ' - t' Plan review(25%ofpermit fee)
Print name: C ) Date: 2- �p - State surcharge(8%nfpennit fee)
Tam•PERMIT FEE I
Authorized signature: TMe permit application eipiren if•permit h not obtained within IRM
- day%after it bas been accepted as complete
Print name: Date: far uv IhodolrgN col by it-/bnnty nodding fnhhntry Service Roard
— -- - — - ••h,nntn't rl MIN-,1-TI,art PrlWO nll,"I'd
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP _
Received c�/17_' � _ Date Requestd, ��a AM__.. —'-D PM D BUP --- -
Location _ _,� —__JCC- /K—_— Suite �J� MEk --- - -
Contact Person - '�IkJC44 Ph PLM —--- ----- ----
Contractor _-- ��v___�_- --___.-._— Ph (—__—) ---- SWR
BUILDING Tenant/Owner _ _ — - LC J
Footing ELC
Foundation Access:
Ftg Drain ELR ---
Crawl Drain
Slab Inspection Notes: SIT
Post 1£Beam ___ -----
Shear Anchors
Lxt Sheath/Shear --- -----
Int Sheath/Shear -
Framing - - - -. - - -- -- --
Insulation --�'
Drywall Nailing - - - - -- -_ - - -
Firewall
Fire Sprinkler - - ---- ----
Fire Alarm
Susp'd Ceiling -- --- -
Roof
Other. __._ _ ------- --------- -
_.____
Final
PASS PART FAIL
_ +— M----- ----
PLUMBING
Post Beam
Under
Slab --
Rough-In
Water Service - - - — ----
Sanitary Sewer
Rain Drains - ---- -
Catch Basin/Manhole C) 4
Storm Drain -----
Shower Pan -----
Other:
Final
PASS PART FAIL - -�--- -- --- -
MECHANICAL
Post& Beam
Rough-In
Gas Line
Smoke Dampers - ----- -�
Final
PASS PART FAIL - -- ---- -
ELEC7RIC_AL � R v r,J a c��c� A 4C _
Service �? —' CiyU'� � _ JA
Rough-In ,,_
UG/Slab
Low Voltagey ✓' v f `' �B Y -
-------- ---
larm C
Fi*99
_- 1 Reinspection fee o1$_ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ART FAIL
SITE-- Please call for reinspection RE:_ - - �� Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date, Inspector Ext
Other:-_
Final DO NOT REMOVE this Inspection record from the Job 41te.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection, Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
BILIP
Received li!!�._--_ Date Ryuested -. AM PM ______ __ BUP
Location . _t�1�s,� _ - _64� q(:P-_Suite �__
Contact Person Ph PLM ------------
Contractor _-_- _ ✓�� ? Ph(�) SWR
BUILDING Tenanb'Owner 'Q� L��/ ELC
-- ------- --
Footing
Foundation ELC
ACC@5S:
Fig Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam -- - -S/K /L �7� -
Shear Anchors - _ --- - _-- --
Ext Sheath/Shear
Int Sheath/Shear
Framing - -- - - ----- ------ -
Insulation
Drywall Nailing - __ _- - --------
Firewall
----Firewall
Fire Sprinkler -- -------- ---
Fire Alarm
Susp'd Ceiling - - - ---- ---- - —�__—_.._
Roof
Other. - - -- - -
Final
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab -- ----
Rough-In
Water Service -- --- —
Sanitary Sewer
Rain Drains - ----- - ----
Catch Basin/Manhole
Storm Drain -
Shower Pan --� — - -----------
Other. -
Final
PASS PART FAIL --- --
CH ICAL
Post& Beam --- -- - — -- --- -- --- -- -------------
Rough-in --.— - -- --- -- - ---- -
Gas Line
SrvOrDampers __- - ---- -- -
in
A PART FAIL - ------ --- ---- --- - - - -
TRICAL
Service - --^
Rough-In _
UG/Slab -�
Low Voltage
Fire Alarm
Final Reinspection fee of$ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE F-1 Please cell for reinspection RE: _ n Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date_ _ Inspector + -Ext
Other:
Final DO NOT REMOVE thps 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
1-7
Received ___ Date Requested a-" AM PM2��_ BUP
Location 5 '� Suite l _ MEC
Contact Person Person 1 8 � �� Ph( ) L/6-7 PLM
Contractor —_. PhSWR —
BUILDING _ Tenant/Owner ___-._ _ — ELC
Footing ELC
Foundation ACCESS:
Ftg Drain ELR
Crawl Drain - SIT
Slab Inspection Notes: ---- --� �-
Post&Beam
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear _
Framing --
Insulation
Drywall Nailing -- - -
Firewall
Fire Sprinkler -1V----
Fire Alarm _ -
Susp'd Ceiling
Roof _—
Other:
Final
PASS PART FAIL _ -
Post 8 Beam
Under Slab
Rough-In _
Water Service - - -- - - - —
Sanitary Sewer _
Rain Drains - --
Catch Basin/Manhole
Storm Drain ---- _-___ -- -
Shower Pan _-
Other: —, - - - ---
in -- --
SS RT FAIL
_ CAL ----- - --
Post& Beam
Rough-In ---- - — ----
Gas Line _
Smoke Dampers -
Final
PASS PART FAIL -
ELECTRICAL _ ---
Service
Rough-In ---- - -A---
UG/Slab
Low Voltage — -
Fire Alarm
Final Reinspection fee of$ ___required before next inspection. Pay at City Hal!, 13125 SW Hall Blvd
PASS PART FAIL
SITE [] Please call for reinspection RE:- _
Unable to inspect-no access
Fire Supply Line
ADA �'f
Approach/SidewalkDate � 11-710 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL