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7128 SW GONZAGA STREET STE 110 �r. i ? i sl i ` i + I V N OQ N O N N a1 N `1 N O l a i i � I 1 I i i I i 71'28 SW Gonzaga Street#110 I CITY �� ,�� BUILDING PERMIT Y PERMIT#: BUP2001-00280 DEVELOPMENT SERVICES DATE ISSUED: 8/6/01 13125 SW Hall Bivd..Tiqa-,-d. DR 97223 (503) 639-4171 PARCEL: 2S101AC-00900 SITE ADDRESS: 07128 SW GONZAG,A S1 110 SUBDIVISION: F'AHLISCH/GONZAGA PROFESSIONAL ZONING: MUE BLOCK: LOT: 015 JURISDICTION: TIG REISSUE: FLOOR AREAS _ EX'rERIOR WALL CON_STRUC_TION _ 1 CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COPA SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W OCCUPANCY GRP: B TOTAL .AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 24 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MF.ZZ?: REQD SETBACKS _ _ REQUIRED _ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y BEDRMS: BATHS: MIP SURFACE: PRO CORR: Y PARKING: VALUE: $ 25,000.00 Remarks: Commercial TI '1356 square feet Owner: Contractor: ROCKY MOUNTAIN LAND LLC JOSEPH HUGHES CONSTRUCTION,INC 7128 SW GONZAGA 7035 SW HAMPTON TIGARD, OR 97223 TIGARD, OR 97223 Phone: Phone- 624-7100 Reg #: LIC 45645 _ FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Mechanical Permit Require PLCK CTR 7/31/01 $184.15 27200100000 Electrical Permit Required Plumbing Permit Required 5PCT CTR 7/31/01 $22.66 27200100000 Framing Insp PRMT CTR 8/6/01 $2.83.30 27200100000 Gyp Board Irisp FIRE CTR 8/6/01 $113.32 27200100000 Susp Ceiing Insp Final Inspection Total $603.43 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All wor 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 the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987 You may obtain a copy of these rules or direct questions +.o OUNC by calling (503) 246.669�Qerl 6 2;-2 344. Permittee �'z- - Signature: / C� Is4ed By: Call 639-4175 by 7 p.m. for an Inspection the next business day Building Perrait Applicationnq Date received: / , 1 Permit no.: Akeev-er nuc cf� City of Tigard \, Address: 13125 SW Nall Blvd,Tigard,OR 97223 Plpject/appl.no.: Expire date: V Cr�y.,Jlif;urJ -\ Phone: (503) 639-4171 Date issued: By: Receipt no.: O Fax: (503)598-1960 1 Case file no.: Payment type: Land use approval: 1&2 family:simple Complex: n U I &2 family dwelling or accessory U Cornmercial/industrial U Mule-lain ly J Ne" cmisutiction U Demolition U Addition/alteration/replacement Wrenant improvemen+ U Fire sprinkler/alarm U Other: _ 1 1 Job addre.s: Bldg.no.: Suite no.- Lot: Block: Subdivision: Tax map/tux lot/account no.: Project name: T A A4 ,4 Description and location of work on premises/special conditions:_p�ZT t 7 Name: ( L_ — Mailing address: ,Z/ , _ 1 & 2 family dwelling: City: , State• ZIP: 9 7 2Z Valuation of work........................................ $ Phones fia�: - - E-mail: No.of bedrooms/haths................................. - --- — - Total number of floors........................... Owner's representative: ,,,,,, Phow!: l,t — E-mail: New dwelling area(sq. ft.) .......................... _------_--._._ �1 Garage/carport area(sq.ft.) ........................ Name: S„T /,�� ,— Covered porch area(sq.ft.) ...1..................... -- Mailing address: '?c) 4 Deck area(sq.ft.) ........................................ City:_/jiy r J[a �5tate ZIP: 71 Z Other structure area(sq. ft.)......................... — Phonc:(y �- Fax ��, ?-nutil: CommercinlYindustrisl/multi-ftamily: Valuation of work...'. eu:.g'............. ' �.i%ting bldg.area(sq,ft.) Business name: .......................... v - Address: New bldg.area(sq.ft.) r(.r .. / Stat n ZIP: y ZZ Number of stories....................................... ` Cype of construction dZ _- Phone: •,A 7/OCJ Fax:65; T to :)* -mail: �: CCB no.: 4 S [„(t Occupancy group(s): Existin New: City/nmt-u lie.nc" Notice:All contractors and subcontractors are required to he LM licensed with the Oregon Construction Contractors Board under Nvm_e: ��) �{ ,• provisions of ORS 701 acrd may be required to he licensed in the Address: ,� Z, — jurisdiction where work is being performed. If the applicant is (City: lStat 2 ZIP:4 exempt from licensing,the following reason applies: Contact prison:(3N)I r) `'h&-j•• ,i Plan no.: --- Phone:�j. Cj� 5 Fax: -1,� `j ` E-mail: — Name: Contact person: Fees due upon application ......................... . $ Address: __ Date received: _ City: y State: Amount received ......................................... $ Phone: Fax: I E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions•xep credit cards,please call jurisdiction for more information. attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard Credit card number work will be complied ,use t spgffid herein or not. --- --Expires Authorized signature:=� t ,' C _ Date: �� Now of c"oldrr u shown on crtdit card — Print name: 14 1Ali ✓L(dtL �. t'ardholder sia alwe Amount Notice:This permit application ex ires if ape s not obtained within 180 days after it hies been accepted as complete. wo-,46t,(MUCOM) r�u P Pc ti l a, loft �3(r'�� , x •30 ll;,�- COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Flans Examiner will contact the applicant to request additional plan sets for distribution purpose.; (tor Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). ------------ - - -- --- Total # of TYPE OF SUBMITTALPlans KEY: Submitted_ S = Site Work (must include S (New, Add or Alt) 4 location of all ceasible parking) B (New, Add or Alt) 1* B = Building F = Fire Protection System F (New, Add or Alt) 3** 2 M = Mechanical M (New, Add or Alt) P (New, Add or Alt) P = Plumbing E (New, Add, or Alt) _�2 E = Electrical New = New Building Add = Addition Alt = Alteration to existing building *For over-the-counter commercial tenant improvements, submit 2 sets of plans. ""New" requires that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. I\fists\fon.i:\matrxcorn.doc 10/27/00 CITY OF TIGAIRD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -----— BUP Date Requested 1 AM PM BLD Location .� Z - Suite � L' _ ME. Contact Person Ph V., =`' �r �/ PLM Contractor Ph _ SNR - -- BUILDING Tenant/OwnerELC <. Retaining Wall v — ELR Footing A.cess: Foundation FPS _ Ftg Drain I SGN Drawl 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 ----- -�-�� —Z_ PUMBING Post&Beam Under Slab _e 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 ELECTRICAL Service _ - RoughIn UG/Slabb - - --- Low Voltage PASS PART FAIL Backfill/Grading - Sanitary Sewer Storm Drain ( j Reinspection fee of$ mquired before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Unable to Inspect-no access Fire Supply Line )Please call for reinspection RE: I 1 P ADA Approach/Sidewalk Date/ / Inspector `�� '� Other Ins �Fc.or yt _..Ext - -_ Final PASS PART FAIL DO NOT REMOVE this inspection ;ecord from the job site. CITY OF TIGARD BUILDI' + INSPECTION DIVISION MST 24.Hour Inspection Line: 639-417;, Business Line: 639-4171 --- BUP Date Requested _ — Z_AM PM BLD _ Location7 / f Suite O MEC _ Contact Person Ph 3 1— U,S7h'2— PLM ._�,UU/ e& �(a0 Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes. SGN 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 1------ - r PASS PART FAIL PLUMBING Post& Beam -- , Under Slab Top Out ----- Water Service Sanitary Sewer Rain Drains &AN—ICAL - PPART FAIT_ -- ---�— Post& Beam -- Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL - - - Service Rough In UG/Slab _ Low Voltage Fire Alarm Final PASS PART FAIL SIT E 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:T_ [ )Unable to inspect-no access ADA / -- Approach/Sidewalk Date t Other � � Inspector / { �V`P. Ext Final PASS PART FAIL CCD NOT REMC]VE this inspection record from the job site. CITY O F TIGARD - ELECTRICAL PERMIT- RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2001 00237 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSU— : 9/24/01 PARCEL: 2S101 AC-00900 SITE ADDRESS: 07128 SW GONZAGA ST 110 SUBDIVISION: PAI-ILISCH/GONZAGA PROFESSIONAL ;ZONING: MUE BLOCK: LOT: 015 JURISDICTION: TIG Project Description: Low voltage for data/voice and security. A. RESIDENTIAL __ B.COMMERCIAL_ AUDIO & STEREO: AUDIO &S;EREO: INTERCOM & PACING: BURGLAR ALARM: BOILER: LANDSCAPE/IRQIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: _ TOTAL # CF SYS'�FMS: __7 _�•_ Owner: ` Contractor: F,OCKY MOUNTAIN LAND LLC GREENLINE INC 7128 SW GONZAGA PO BOX 230755 TIGARD, OR 97223 TIGARD, OR 97223 Phc no: 503-670-8585 Phone: 968-1978 Reg #: LIC 103033 ELE 34-397CL FEESIns Required pections Voltag Type By Date Amount Receipt Low yo — FElect I Finae Inspection PRMT CTR 9/24/01 $150.00 2720010000 5PCT CTR 9/24/01 $12.00 2720010000 Total $162.00 This Permit is issued subject to the regu!ations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. AI! work will be done in -ccordance with approved plans. This permit will expire if work is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules.are set fsr h in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or-dlirect question to OUV-- at (503) 246-1987. Issued by Permittee Signatures _ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE:----.— CONTRACTOR ATE:-- _CONTRACTOR INSTALLATION ONLY - SIGNATURE OF SUPR. ELEC'N: (7) DATE'------- LICENSE NO: Call 639-4175 by 7:00 P.M. for an Inspection needed the next business day Electr►cal Permit Application Datereceivcd�� Permit no. / City of Tigard Project/appl.no.: Expire date: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: K Receipt no.: Phone: (503) 639-4171 — Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: U I &2 family dwelling or accessory Ortommercial/industrial U Multi-family enant improvement U New construction U 4dditinn/alterntinn/replacement U Other: U Partial Joh address: F) G ._ lfldp, no.: j Suite nu.: //U Tax Help/arse lul/acco rn no.: Lot: Block: Subdivision: - Prosect name: _ .% S QPAJ Description and location of work on premises: DAf7 7/G r ��/t Estimated date of completion/inspection: ( a. _ Job no: !4r Mas Business name: �y z r,.( f — Description Qty. (:a.) total no.hrsp New residential-single or multi-famlly ler Address: P.0, apt lC,�.3o dwellingtmll.lnclu.ln altacledgarage. City: Slate: ZIP: 5enicclncluded: Phone: (1?*71) Fax: E-mail: IWO sq.r.ar less - - - CCB no.: 1()_;C 3 Elec.bus. I ic.no: - Each additional 500 sq.ft.or portion thereof Limited energy,residential City/metro tic o: Limited energy,non-residential L 2 Each mraufaetured home or modular dwelling Si nature ofTuperviiOng electrician(required) Uat Service and/or feeder 2 Services orfeeden-installation, Sup.elect.Warne(prion ::;A-1 ✓ - I icense no:37j 4 SJC. alteration or relocation: _A�amps ess 2 Name(print): 00 amps 2 - - --- 00 amps _ 2 Mailing address: _ 6)I amps to I(xl0omps _ 2 Cily:_ State: Z1 P: _ Over 1000 amps or volts 2 Phone: I l?-mail: Reconneclonl _ I Owner installation:The installation is being made on property I own 1'emporaryservices orfeeders which is not intended for sale,lease,rent,or exchange according to installation,alteration,orrelouAnn: ORS 447,455,479,670,701. 2201 amps or 2 01 amW)ps to 400 mops 2 Owner's si nature: _ Date: 401 to 600 ams --�— 2 branch circuits-new,alteration, or extension per panel: Name: __ _ A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: ZIP: B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Each additional branch circuit: Mise.(Service or feeder not Included): U SCr1'ICCuvcr:25nml,n nnnnu•tctal U Health-care.facility Each pump or irrigation circle U Service over 120 amps-rating of 1&2 U Hazardous location Each sign or outline lighting '- family dwellings U building over RON)square feet four or Signal circutt(s)or a li•nited energy panel, U System over 600 volts nominal marc residential units in one structure alteration,or extension" 2 U Building over three stories U Feedem.400 amps or more *Description: -I.L LIQ xT U Occupant load over 99 persons U Manufactured structures or RV park Eich additional InspttKllon over the allowable In any of the above: U F ilress/lightingplan U Other - _ _ — Perinspection Stlbtaill r_sets of plans with itm of the alcove. Investigation fee The above are not applicable to temporary construction service. Other Permit fee.....................$ t D No all lutisdictions sccepi credit cards,please call juticdtcnon lar more inform Ilan. Notice:This permit application U Visa U Masterce expires if a permit is not obtained Plan review(at _ 96) $ y t reau cud number:----- within ISO days after it has been State surcharge(8%)....$ 0 "plfeS accepted a, complete. TOTAL $ ,Q D Name of cardbol r a shown on credit cud _ S t'ardholder signature --._^ Amount - 44n-4615(6toatCOM) 1 ELECTRICAL PERMIT FELo, LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED -RESIDENTIAL Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspecti-ns er perndt allowed (FOR ALL SYSTEMS) rrvice included: Items most I otal I Check Type of Work Involved: Residential -per unit 1000 sq ft.or less _ $145.15 _ _ 4 ❑ Audio and Stere-)Systems" Each additional 500 sq ft.or portion thereof °J3 40 1 ❑ Burglar Alarm Limited Energy $7500 _ Each Manufd Home or Modular ❑ Garage Door Opener' Dwelling Service or Feeder $90,90 2 Services or Feeders ❑ Heating,Ventilation and Air G nditioning System' Installation,alteration,or relocation 200 amps or less $Y0.30__ 2 201 amps to 400 amps $108.85 2 ❑ Vacuum Systems' 401 amps to 600 amps $160.60 2 601 amps to 1000 Imps — $240.60 2 Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMFRCIAL ONLY Installation,aueration,or relocation Fee for each system............................ ................... ......... $75.00 200 amps or less _— $66.85_ 2 (SEE OAR 818.260-260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps +__— $133 75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see"b"above. Audio and Stereo Systems Branch Circuits ❑ Boller Controls New,alteration or extension per panel a)T he fee for branch circuits with purchase of service or ❑ Clock Systems /seder lee. f- -- ach branch circuit $6 66 Data Telecommunication Installation h) 1 he fee for branch circuits without purchase of Sol vice ❑ Fire Alarm installation or feeder fee. First branch circuit $46.85 7 HVAC Each odditional branch circuit $6.65 Miscellaneous L] Instrumentation (Service or feeder not included) Each pump or Irrigation circle _ $5340 ❑ Intercom and Paging Systems Each sign or outlir a lighting — $53.40 Signal circuit(s)or a'imited energy panel,alteration or extension $75 00 _ ❑ Landscape Irrigation Control' Minor Labels(10) $12500 Medical Each additional Inspection over ❑ the allowable in any of the above ❑ Nurse Calls Per inspection $62.50 I'er hour $62.50 in Plant _ $73.75 — _ _ /utdoor Landscape Lighting' Fees: [11 Protective Signaling Enter total of above fees $ Other --- B%State Surcharge $ _ Number of Systems 25%Plan Review Fee See'flan Review"section on $ No licenses are required Liuhnsus ale rronulred fcr all other inste4stions fr,int of application --- I — Total Balance Due $ Fees: — Enter total of above fees $ ❑ Trust Account# —_— — 8%State Surchargt $ Il Total Balance Due $ All New Commerclal Bulldings regttlre 2 sets of plans. i\dsts\formSklC-fees doc 08/30/01 CITYOF T I GA R D ELECTRICAL PERMIT #: ELC2001{ DEVELOPMENT SERVICES DATES UIED: 82001 X0412 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-41'11 PARCEL: 2SIOIAC-00900 SITE ADDRESS: 07128 SW GONZAGA ST 110 SUBDIVISION. PAHLISCH/GONZAGA PROFESSIONAL ZONING: MUE BLOCK: LOT : 015 JURISDICTION: TIG Proiect Description: Installation of 8 branch circuits. RESIDENTIAL UNIT TEMP_SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: e EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL. (10): SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 7 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NO_MINAL Reconnect onlyi_-- SVC/FDR >= 225 AMPS CLASS AREA/SPEC OCC: Owner: ir. -- -- ROCKY MOUNTAIN LAND L.LC I.A- t LECTRIC INC 7128 SW GONZAGA 4326 SE WOODSTOCK TIGARD, OR 97223 STE 518 PORTLAND, OR 97206 Phone: 503-670-8585 Phone: 775-3479 Re #: LIC 00056527 SUP 3088S ELE 26-569C FEES Required Inspections--_-- Type nspections ___Type By Date AmoUnt Receipt Ceiling Cover + PRMT CTR 8/20/01 $93.40 2720010000( Wall t'ICover 5PCT CTR 8/2n!01 $7.47 2720010000( Total $100.87 — --- j _ This Permit is issued subject to me regulations contained in the T card Nlunidpal C de State of OR Specialty Codes and all other applicable laws All work will be done in ac::dance with approved plans This permit will expire if v ork is not started within 180 days of issuanoe,or 1 work is suspended for more than 160 days ATTENTION Oregon law requires you to follow rules adgpted by the Oregon Utility Notification Center Those rules are set forth in OAR 9ti2-001-0010 through OAR 952-001-0080 You may obt"pies of thei#,f�les ordirect questions to OUNC at(503) 246-6699 or 1-8f 1-J32-2344 Permit Signature: sued E3 — hA za y . zv — — _- 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: T CONTl3ACTOR jNSTAt,4ATJON OPWY j(SIGNATURE OF SUPR. FLEC'N: �,__ Li- DATE: LICENSE NO: Call 639-4175 by 7:00pn for an inspection the next business day Electrical Permit Application "Wiereceived: Q/ Permit no..:Ei! t City of Tigard Project/appl.no.: Expiredate: u y r,//i�;a rel Address: 13125 SW Hall Blvd, .igard,OR 97223 Date issued: By: Receipt no.: (' —- Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: LUNw&2 family dwelling or accessory U Commercial'industrial U Multi 1,111111v X'enant improvement construction U Addition/alteration/replac•erneill A i)tln•t __ U Partial Jolt SITE INFiUMATION Job address: , U-) lild n. Suite no. Tax map/tax lot/account no.: L.ot: Blocl: Subdivision: - -- Ile _----_- —_ Project name: ( C Doscriptinn and location of work on premises: _ Estimated date of co mplclionhnspection 1 t f Mn Max Job no: _ 1)Mscription (ry. (ca.► fatal no,Insp Newrccadential-sinRkormulti-fandlyper Address: E_ ,c ST dwelling unit.includes anached Karage. City: 1 p! C Stater, ZIP: L' Strrlceincludcit: 4 Phot►x: E-mail: I(NNI5li it ur less ouch additional Soo sq.ft.or portion thereof CCB no.: 5EIeC.bUS,11C.no: Limited energy,residential 2 C,ly/metro tic.no.: _ Limited energy,non-residential 2 Eu.4 manufactured home or modular dwelling -- - 4n k;gz r feeder 2 S{gn�,ui% On til _ eders-Installation, Sup.elec..name(print). / I icrnse no relocation: css 00 amps 2 Name(prlid): -.---- 401 ampsto 600 amps 2 Mailing address: _ 601 amps to IOW amps 2 City: State: LIP: Over 1000 amps or volts 2 Phone: Fax: E-mail: Reconnect only I Temporary aervkm or feeders- Owner installation:The installation is being made on property 1 own (nstaB.tirat,altentlon,nrredncaunn: which is not intended fr r sale,lease,rent,or exchange according to L40110 a amps or less 2 URS 447,455.479,670,701. 1 amp;to 400 amps 2 Owner's signature: _ Date: 600 amps 2 Branch clrcults-new,alteration, or extenslon per panel: Name: A. Fee for branch circuits with purchase of Address: J service or feeder fee,each branch circuit 2 Cil - - - B. Fee for branch circuits without purchase 2 y; Slate: ZIP: of service or feeder fee,first branch circuit. E-mail Each additional branch circuit: Me.(,4err1ce or feeder not Included): Bach pumpor irrigation circle 2 -_ O Serval uvr L'S anq,ti c„t„rr1i•r,rirl _I II,•alth-care facility Ear•hsig 1oroutline lighting 2 U Service over 320 an.ps-raring of 1&2 U Hazardous location family dwellings U Building over 10.000 square feet foul or Signal circuits)or a limited energy panel, U System over 60(1 volts nominal more residential units in one structure alteration orexlension• 2 ❑Building over three stories J Feeders.400 amps or more •lkscri tint _ U Occupant load over 99 person, ❑Manufactured structures or tZ V pari Bach additional Inspection over the allowable to any of the abort. U Egress/lightingplan U other: _ Perinspection r Subtnll-�sets o`I tens with■ny of the abcn e- Investigation fee The.ibot a are not applicable to temporary construction service. other Permit fee.....................$ .�• Na all jurisdictions sccepi credit cads.please call jurisdiction for mrxe information. Notice:This permit applica( f ion Plan it review(al %) $ — U Visa U MasicWanf expires if a permit is not obtained __ _ ��__ within 190 days after it has bt:en State surcharge(8%)....$ + Credit cord numtmet-------- Expires ( $ accepted as complete. TOTAL ................ 1 Name of csnlhou—shown credit card s t'tadhulder sigmtnure Amount "Yo IS ns"WoM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee..................................................... $75.00 Number of Ins ections per permit allowed )I (FOR ALL SYSTEMS) Service included: Items Cost Total y Check Type of Work Involved: Residential-per unit ,l 1000 sq it or less _ $145.15 —^ q Audio and Stereo Systems Each additional 500 sq fl or portion thereof $33.40 t L] Burglar Alarm Limited Energy $75.00 Ear Manufd Home or Modular l� Garage Door Opener' Dwelling Service or Feeder $90.90 Services or Feeders L] Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 artlpb $160 60 2 Other 601 amps to 1000 amps $240.60 _ 2 Over 1000 amps or volts $454.65 2 only o Reconnect $66.85 _ 2 Temporary tonlyServices or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Fee for each system.......................................................... $75.00 Installation,alteration,or relocation SEE OAR 918-260 260) 200 amps or less $66.85 — 2 201 amps tc 400 amps $100.30 2 Check Type of Work Involved: 401 amps to 600 amps $133.75 2 yp Over 600 amps to 1000 volts, Audio and Stereo Systems see"b"above. Branch Circuits Boller Controls New,alterabon or extension per punol a)The fee for branch circuits Clock Systems with purchase of service or feeder fee. Each branch circuit $6.65 Data Telecommunication Installation b)The fee for branch circuits without purchase of service F-1 Fire Alarm Instailation or feeder tee. First branch circuit $46.85 HVAC Each additional branch circuit $6.65 ///1 Miscellaneous Instrumentation (Service or feeder not Included) Each pump or irrigation circle $53.40 _ Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s)or a limited energy Landscape Irrigation Control` panel,alteration or extension $75.00 Minor Labels(10) $125.00 Medical Each additional Inspection over the allowable in any of the above Nurse Calls Per inspection $62.50 Per hour $62.50 In Plart __ $73.75 Outdoor Landscape Lighting' Fee::: [_] Protective Signaling �7. Enter total of above fees $ Other 8%State Surcharge $ y i _ _Number of Systems 25%Plan Review Fee ' No licenses are required Licenses are required for all other installations See"Plan Review"section on $ front of application Fees: Total Balynce Due $ �-7 Enter total of above fees $ L.J Trust Account q 8%Slate£urcharge Total Balance Due $_ ---_-- i 4ists\fom►sklc-fees.doc 10/09/00 CITYO F T I G A R® PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00400 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/24/01 PARCEL: 25101 AC-00900 SITE ADDRESS: 07128 SW GONZAGA ST 110 SUBDIVISION: PAHLISCH/GONZAGA PROFESSIONAL_ ZONING: MUE BLOCK: LOT: 015 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 HEATr-RS: 1 CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB;SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: PlumLing tenant inprovement. Installation of(1) new sink and (1) new nater heater. FEES Owner: — Type By Date Amount Receipt ROCKY MOUNTAIN LAND LLC PRMT CTR 8/24/01 $72.50 27200100000 7128 SW GONZAGA 5PCT CTR 8/24/01 $5.80 27200100000 TIGARD, OR 97223 =_ Total $78.30 Phone 1: 503-670.8585 Contractor: ASSOCIATED PLUMBING CO P O BOX 301362 PORTLAND, OR 97230 REQUIRED INSPECTIONS Rough-in Insp Phone 1: 331-0582 Top-out Inso Reg #: LIC 57890 Final Inspection PLM 26-412PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of (JR. Specialty Codes and all other applicable laws. All work will be done in accordance with approve:j plans. This permit will expire if work is not started within 18P days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adop+ed by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. issued By' ,�^ tC _,t=.3��,L�.'r 1 Permittee Signature: L r� -- Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application Date received:f'r"-"�� Permit no.: 1m t-OO�cL^ City of Tigard Sewer permit no.: Building permit no.: I'igard,OR 97223 Citrn/7'igarJ Addrrss: 13125 SW Hall Blvd,' Project/appl.no.: Expiredate: Phone: (503) 639-4171 Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: Case file no.: Payment type: Qom^ __�_-- 61;Il U 1 &2 Gamily dwelling or accessory l�Commercial/industrial U Multi-family Tenant improvement U New construction U Addition/al teration/replace me ni O Food servi(r --- 1 ' 1 1 I)escri tion QI Fee(ea.) 'Iblal -y Job address: r//v2 �. ✓- ( c,,z•2 _ New I-and 2-family dhellings only: J Bldg no. I Suileno.: (includes 100 ft.for each tit i[it yconimction) Tax map/tax lot/account no.: SFR(I)bath Lot: Block: Subdivision: 17/A A SFR(2)bath _Project name: elth 1.5CAI SFR(3)bath �ay7 ZIP: Each additional bath/kitchen City/county: ) Description and h cation of work on premises:_v_ — Catchsiteu basin/ 'f:1 �J�r F/Do✓ -_ Catch basin/area drain -- Drywells/leach line/trench drain _ Est.date of completion/inspection: Footing drain(no.lin.ft.) 1 Manufactured home utilities ' Business , ` Manholes - - Address: l pX D 2Rain drain connector City: . State:C, ZIP: 2 7.:?, Sanitary sewer(no.lin.ft.) ^ Fax: Email: Storm sewer(no.lin.ft.) Phone: -p 2- 3 'O Water service(no.lin.ft.) CCB no.: U Plumb.bus,reg.no: °►✓- 1.2)°B Fixture or item: City/metro lic.no.: JjE&/ Absorption valve Contractor's representative signature: Back flow prcventer (� Print name: c:e'na Nil Date: -2 I-o; Backwater valve Basine/lavatory Clothes washer Name. - 5� ,�' _ - Dishwasher _ -- Address: _ — Drinking fountains City: _ _l tate: Z1P: Ejectors/sump -- Phone: Fax: E-mail: Expansion tank Fixture/sewer cap Floor dram floor sinks/hub Name(print): Ab 5C-A. J Garbage dis sat. Mailing address: �SJ�t< 3�l>rC /00 Hose bibb City: ` Statc.:0�- ZIP: lee maker Phone: Fax: ail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Prittler(s) will he made by rile or the maintenance and repair made by my regular Roof drain(commercial) emplovee on the property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s) (tamer's signature: Date: Sump Tubs/shower/shower pan Urinal — Name: Water closet _ --- Address: _ Water—heater City: _ State: ZIP: Other: Phone: Fax: E-mail: Total _ Minimum fee................$ Not all Jurisdictions accept credit card,.plense .It Jutisdiclion fix mcxe Information. NoIICC: lltis permit application Plan review(at g U Visa U MasterCard expires if a permit is not obtained �d State surcharge(9%,) ....$ Credit card number ._—.— — F.npires within 180 days after it has been TOTAL .................. ....$ Z P _ accepted as complete. Nun,of cardholder as shown on credit card S —— — ('ardholder signature -- -- 441)46I6 IMxllCOMI amount we, , PLUMBING PERMIT FEES: -� PRICE TOTAL New 1 and 2-famlly dwellings only: FIXTURES (individual) QTY ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the ffrst100 k. QTY (ea) AMOUN'r lavatory -� 16.60 for each utilityconnection)-.. __ ne 1 bath $249.20 tub or Tub/Shower Comb 16.60 _O_ L._�---� —- -- - - -- Two 2 bath $350.00 Shower Only 16.60 Thrb ees ath $399.00 Waver Closet 16.60 - ---__-- SUBTOTAL I�rinal 16.60 8%STATE SURCHARGE — Dl:hwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL —� l.aundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" 1660 PLEASE COM PLETC: 4"— 1660 _ Water Healer O conversion O like kind 1660 Quantityb Work Performed Gas piping requires a separate mechanical I Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink z _ MFG Home New San/Slrrrm Sewer 4640 Lavatory Tub or Tub/Shower Hose Bibs 16 60 Combination _ _ Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Other Fixtures(Specify) 16 60 Urinal _ Dishwasher _ Garbage Disposal _ Laundry Room Tray Washing Machine Floor Drain/Sink: 2." Sewer-1st 100' 55.00 3- Sewer-each additional 100' 46.40— 4" __ I Water Service-1st 100' K,00 Water Heater Water Service-each additional 200' 46.40 Other Fixtures _ (Specify) Storm&Rain Drain-1 sl 100' 55.00 Storm&Rain Drain-each additional 100' 4640 Commercial Back Flow Prevention Device 46.40 — Residential Backflow Prevention Device' 27.55 Calca Nasin 16.60 J — inspection of Existing Plumbing or Specially 72.50 Re ueslod Ins actions perthr — COMMENTS REGARDING ABOVE: Rain Drain,single family dwntiinq 65.25 _ carcase Traps 1660 — QUANTITY TOTAL — Isometric or riser diagram is regwrnd if —_—' _Quantity Total is >9 'SUBTOTAL — -- 8% STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required only it fixture gly total Is>9 TOTAL $ *Minimum permit fee is$72 50•8%state surcharge,except Residential Backflow Prevention Device,which is$76 25+9%state surcharge .'All New Commercial Sul;llngs require plans with Isometric or riser diagram and plan review i-\dsts\farms\plm-fees.dor. 101000 CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00246 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/24/01 SITE ADDRESS; 07128 SW GONZAGA ST 110 PARCEL: 2S101AC-00900 SUBDIVISION: PAIILISCH/GONZAGA PROFESSIONAL ZONING: MUE BLOCK: LOT: 015 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: ALT DWELLING UNITS: 1 TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: EDU increase of .2 EDU's for installation of one new sink. Owner: -- -- —'-- -- FEES ROCKY MOUNTAIN LAND LLC 7128 SW GONZAGA Type By Date Amount Receipt TIGARD, OR 97223 PRMT CTR 8/24/01 $460.00 27200100000 Phone: 503-670-8586 — Total $460.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days frorn the date issued The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling((5 246-1987 Issued by. Permittee Signature: C, L-i--- Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business d*T'- Accumulative Sewer Tally Tenant Name: Sf�D O K This SWR#_ `?E //O This PLM#: O/ ' ', ,�,, Address:._Waf Su — F rti-ire Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value 'tapped off value added# added #s total Count off#s count value values Baptistry/Font —_ — 4 -- - Bath Tub/Shower — Jacuzzi/Whirlpool — 4 ---- Car Wash - Each Stall 6— — __ Drive Through _ 16 __ — --- Cuspidor/Water Aspirator 1 - Dishwasher-Commercial 4 - -Domestic_ 2 - -- --- — Drinking Fountain 1 — _�ye Wash 1 Floor Drain/sink - 2 inch 2 - 3 inch 5 4 inch 6 -- _ _ Car Wash Drn ( — ---- Garbage Disposal 16 Domestic(to 3/4 HP) _-- Commercial(to 5 HP) — 32 — — — — — -- Industrial(over 5 HP) 48 --- Ice Macy ine/Refrigerator Drains 1 — Oil Sep(Gas Station) - Rec.Vehicle Dump Station 16 — Shower-Gang(Per Head) 1 -- Stall 2 — Sink-Bar/Lavatory— 2 — -- Bradley 5 '— Commercial _ 3 - - -Service 3 — Swimming Pool Filter 1 -- Washer- Clothes 6 — Water Extractor _ _6 Water Closet-Toilet 6 - — Urinal _ 6 TOTALS Total fixture values_�---divided by 16 = EDU S• ,elf //V_rvlduS EGU S, O7 f ./9 - S , t�(, S. �' a•1 oi) 41016 HISTORY --� SE d-l—'_ . _PLM# EDU# SWR# _ PLM# l EDU# SWR# _P_LM# EDU# SWR# PLM_# EDU# SWR# PLM# EDU# SWR# PLM#_ EDU# SWR# PL.M#i -- EDU# SWR# PLM# EDU# SWR#— Wstslawrtaly doc CITYOF TIGARD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2001-00280 13125 SW Hall 'Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 08/0612001 PARCEL: 2S101 AC-00900 ZONING: MUE JURISDICTION: TIG SITE ADDRESS: 07128 SW GONZAGA ST 110 SUBDIVISION: UAHLISC:H/GONZAGA PROFESSIONAL BLOCK: LOT:015 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 24 TENANT NAME: REMARKS: Commercial TI 1356 square feet Owner: ROCKY MOUNTAIN LAND LLC 7128 SW GONZAGA TIGARD, OR 97223 Phone: 503-670-8585 Contractor: JOSEPH HUGHES CONSTRUCTION,INC 7035 SW HAMPTON TIGARD, OR 97223 Phone: 624-7100 Reg#: LIC 45645 This Certificate issued 10/03/2001 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use under which the referp, ced permit wat issued. BUILDING INSPECTOR BUILDING OFFICIA POST IN CONSPICUOUS PLACE