7128 SW GONZAGA STREET STE 200 N
Oct
N
G�
n
7
N
p1
w
CA
ro
cD
r«
N
O
O
ti
I
i
I
7128 SW Gonzaga Street#200
��� �� TIGARD
����® BUILDING PERMIT
PERMIT#: BUP2000-00379
DEVELOPME14T SERVICES DATE (:,SUED: 11/7/00
13125 SW Hall Blvd., Tigard, OR 97223 (50,0 639.4171 PARCEL: 25101AC-00900
SITE ADDRESS: 07128 SW GONZAGA ST 200 - $30.00
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 015 JURISDICTION: TIG
REISSUE: FLOOR AREAS _ EXTERIOR_WALL CONSTRUCTION
CLASS DF WORK: ALT FIRST: sf N: S: E: W:
1 YPF OF USE: COM SECOND: sf _ PROJECT OPENINGS? _
TYPE OF CONST: 5N st N_ S. E: W:
OCCUPANCY GPP: B TOTAL AREA: 0.00 sf ROOF CONST FIRE RET?
OCCUPANCY LOAD: 33 BASEMENT: Sf AREA SEP. [RATED:
STOW HT: ft GARAGE: sf OCCU SEP, RATED:
BSMT?: MEZZ?: REQD SETBACKS REQUIRED
FLUOR LOAD: psf LEFT: ft RGHT: It FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 30,000.00
Remarks: Commercial TI
Owner: Contractor:
ROCKY MOUNTAIN LAND LLC .JOSEPH HUGHES CONSTRUCTION,INC
12540 SW 68TH PKWY SUITE B 7035 SW HAMPTON
TIGARD, OR 97223 TIGARD, OR 9722.3
Phone: Phone: 624-7100
Reg #: LIC 45645
FEES REQUIRED INSPECTIONS _—
Type By Date Amount Receipt Mechanical Permit Require
Electrical Permit Required
PLCK GTR 9/12/00 $100.74 27200000000 Framing Insp
FIRE CTR 9/12/00 $61.99 27200000000 Gyp Board Insp
PRMT CTR 11/7/00 $370.58 27200000000 Susp Ceiing Insp
5PCT CTR 11/7/00 $29.65 27200000000 Final Inspection
(additional fees not listed here)
Total — $789.34
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. A!I work will be done in accordance with approved plans
Phis pennii will expire if work is net started within 180 days of issuance, or if we 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 Yot!
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987.
Pe rm itee
Signatur� __,_
Issued By: }7r1. C� -- -----
Call 639 4175 by 7 p.m. for an inspection the next business day
13MY OF TIGARD Commercial Building Permit Application Plan Che
1312E SW HALL_ BLVD. Ten nt Improvement Recd B
Date Rec'd "� G
TIGARD, OR 97223 Date to P.E. '//
(503) 639-4171 Date to Dmit S i t l
Print or Type Per #DS
�� 79
Related SWR#"1r`"�
Incomplete or illegible applications will not be accepted called./L�_
Name ofLDevelopment/Project Existirg Building New Bu(ding
Job the GC,,%-.fAA#, �ro�+eSS•nr� � e!-
Address Street Address-- Suite Building
-11245 SW Cam: a 0 - Data _
Bldg# cIty/State Zip Existing Use of Building or Property:
aI-7 2 C 2
Na ne -
Proposed Use of Building or Property:
PropertY �4 t-►-C
I Owner Maiiing Address Suite
12 614 0 No. Of Stories:
City/Slate Zip Phone
o _g"222 �7d -SSSS Sq. Ft. Ot Project. rr ,,
Occupant N 1e _—�_— S tet- .
P Occupancy Class(es)
- Name
Contractor Aos h N h� 1 nL �TYpe(s) of Construction
Prior to permit Mailli�g Address Suite 5
N
Issuance,a copy Will this project have a Fire Suppression System?
of all licences `7E.>-2,5 Sl+t t•{oma r` Yes Q No ❑
are required If Clty/Stale Zip Phone Americans with Disabilities Act(ADA)
expired In C O.T.
database T► d,01Z. e4 2.Z 2 -71oo Valuation X 25% = $ Participation
Oregon Const.Cont.Board Lic.# Exp,Date Complete Accessibility Form
--
Name 4 S la OZ Project Valuation Y $
l O . L� `7aL'IJfy
Architect Cor4cr � A�rJ^;{e�}�+P►�.•►a.5 Plans Required: See Matrix for number of sets to submit
Mailing Address Suite 1 on back
513 t l w
City/State Zip Phone I hereby acknowledge that I have read this application,that the information
given is rorrc+ct,that I am the owner or authorized agent of the owner,and
_ 0,4AA4 Ok• 01120-1 2--2'5 ?355 that plans submitted are in compliance with Oregon State Laws.
Engineer Name
CSAGSignature of O . t Date
N ,nt.a.r-ti w_
Mailing Addr(ss — Suite ��,/ _ im 1C
32t 14f 4yE 4 4_4--J�I, Contact n N#P6 Phone
City/State Zip Phone _. _. � ,� !� 1t5 1 46-76 -8585 E,w-+• AZ
9u,-i4"A UQ. 1-1 20`f
—� -- - FOR OFFICE USE ONLY
Indicate type of work New r'Addition O Demolition O I Map/TL# Land Use:
Accessory Structure O Foundation Only O Alteration O
_ Repair O Other O _ Notes.
Description of work:
TIF'
CO-n.v"erg A,\
Note: Site Work Permit Application must t recede or accompany Building I�
Permit Application
c�. tiy
I ICOMNEVVTI DOC (DST) 5/98
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED
application. For an electrical submittal, the application must contain the
signature of the supervising eleztrician before plan review will be conducted.
After plan review approval, Plans Examiner will contact the applicant to request
additional plan sets for distribution purposes. (Copy fur Contractor, City,
Washington County, Tualatin Valley Fire & Rescue)
Total # of
TYPE OF SUBMITTAL Plarns, KEY.-
Subrnitted
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 & 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 (Now, Add, or Alt) 2 � Add = Addition
B & F & M & P & E 3 Alt = Alternation to Existing
(New , Add) Building
*8 or B & M (Alt) 1
*B & M & P (Alt) � 3
�g & M & P E(Alt) �+3
"C-3 & RSI & P & E & t=(Alt) -- - 3
NOTES-
'Shaded areas designate ALT submittals only.
I\dsts\fonnsVnatr)(corn doc 10/30/98
September 26,2000
CITY OF TIGARD
Rocky Mountain Land LLC
12540 SW 68`x'Parkway—Suite"B" OREGON
Tigard,Oregon 97223 � 7
RE: Gonzaga riotessional Center BUP#2000-00379
7128 SW Gonzaga MEC#2000-003676
Dear Applicant:
Your plans for a proposed tenant improvement have been reviewed for compliance;the follow items require your
attention.
Area of Rescue Assis,,ance
Your proposal reinuves the required area of rescue assistance.Provide details on how you will overcome this.
OSSC,Section 1107.
Fire Life Safety
I. The occupant load requires two(2)exits,(OSSC,Table l0A).Separation of these exits shall comply with
(OSSC,Section 1004.2.4),one-half the diagonal,and 1004.2.2,which states egress shall not pass through a
storeroom. Provide details on how you will comply.
2. Under the provisions of OSSC,Section 1004.2.2(Exception 3)a corridor will be required complying with
OSSC,Section 1004.3.4. Secondly the stairs shall become an extension of the corridor: this requires the
stairwell to be one-hour rated. Provide details.
3. Fire-block concealed spaces in accordance with OSSC,Section 708.Provide details.
4. Detail 211 --A Portion of the reception counter shall be accessible.Provide an area 36"wide and not more than
36"above floor grade.OSSC, Section 1108.4.7.2.Provide details.
5. The sink in the kitchen shall be accessible. Provide details.OSSC,Section 1109.11.
Mechanical
The application is incomplete. Provide details
Energy Code
Provide Oregon Non-Residential Energy Code forms 5a through 5c,and related work sheets.
Provide two(2)sets of revised drawings,to include the egress path through the first floor.
If you have questions,please call me at 639-4171 X392.
Sincerely,
Ro ert U. Poskin,CBO
Senior Plans Exam aer
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD (503)613.1-2772 --
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - --�
BLIP
Date Requested - U' /—AM--.—PM —__ BLD ---�—�
Location /.Z�_ <�_ Suite --_�� MEC
Contact Person _— Ph — PLM —__--
Contractor Ph SWR
rBUILDING Tenant/Owner ELC _
Retaining Wall EI_R ���/� - C7G00
Footing Access: FPS
Foundation —
Ftg Drain SGN
Crawl Drain Insp3ction Not3s: --
Slab - SIT
Post&Beam
Ext Sheath/Shear -------
Int Sheath/Shear
Framirid --- - --- .. --
Insulation
Drywall Nailing d9 ---- —
Firewall
Fire Sprinkler --- --
Fire Alarm
Susp'd Ceiling -- --—
Roof L
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 1. —
PASS. PARfi' FAIL
F,TRICAl
Service
'ikough In
UG/Slab _
Low Voltage
Jrs,Alarm
Fin
P IRT FAIL
E
Backfill/Grading
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ required b0ore next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Unahle to inspect-no access
Fire Supply Line ( J Please call for reinspection RL. I J P
ADA
Approach/Sidewalk
Other Date _ 2 / Inspector ---c Ext
---
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYO F T i G A R D - MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: ME"2001-00070
13125 SW Hall Blvd.,Tigard, OR 97223 (503) i,39-4171 DATE ISSUED: 2/26/' 1
PARCEL: 2S101 AC-00900
SITE ADDRESS: 07128 SW GONZAGA ST 200
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 015 JURISDICTION: TIG
CLASS OF WORK: Al-1 FLOOR . uRN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATER: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 3 HP: - DOMES. INC:IW
-- --�- — -� 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
OU
GAS PRESSURE: 50 + HP: CLO
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN >=100K BTU: <= 10000 cfm: - OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Remarks: Alteration & Ductwork
Location of work -rear half of Pollard Hosmar Architects
Owner: FEES
ROCKY MOUN rAIN ' IAND LLC Type By Date Amount Receipt
12540 c1 W 68TH ^::dVY SUITE B PRMT (-,TR 2/26/01 $72.50 272001000f
TIGAR11, OR 97223 PLCK C',TR 2/26/01 $18.12 2720010000
5PCT CTR 2126/01 $5.80 2720010000
Phone:670-8585 Total $96.42
Contractor:
OREGON COMFORT HEATING INC
HUGHES, RON
PO BOX 190 REQUIRED INS_PE_CTIONS _ _
EAGLE CREEK, OR 97022 Mechanical Insp
Ninone:650-2933 fax Duct Inspection
Reg #:LIC 00042519 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work wil! be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rule.; or direct questions to OUNC by calling (503)246-9189
Issue By: L� Permittee Signature: L-
Call (503) 639-4-175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
— --i
Date re '7 �� Permi o.. -00076
City or Tigard ProjecUappl.no.: Expire date:
Citygf1rigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: ___ ____
Building permit no.:
e
79LU]
&2 family dwelling or accessory U Commerzial/industrial U Multi-family )Tenant improven7ent
ew construction Cl Addition/alteration/replacement ❑Other:
RIMEW.
i
Job / ��' ( [ Zsal/o,4 Indicate equipment quantities in boxes below. Indica!e the dollar
Jaddress:
ob a dreno. Suite no.. 2Gy value of all mechanical materials,equipment,labor,overhead.
BldgT1x map/tax lot/account no.: _
profit.Value$ I4S'c=-c)"'
Lot: Block: Subdivision: *See checklist for important application information and
Protect name: [./ �/ G jurisdiction's tee schedule for residential permit Ice.
City/county: TIIW ZIP: 7ZZ3 t
. t
t t
Des tion ano location/of work on premises:. 9W zP-1call _
jt -/PC�X�f11/_ _lLLY.u�Ge+� IIY'(l`:1.) I III iII
Est.date of COnlpletlon/InspCCtlon: Desert on Ory. Rrs.onh Rl..onh
C:
Tenant improvement or change of use: Air handling unit CFM^_ _
Is existing space heated or conditioned?&Yes U No Air conditioning(site p an require )
Is existing space insulated'?XS Yes U No teration of extrting HVAC system
i Bot er compressors
State boiler permit no.:
Business name' }1P ,_Tons BTU/H
Address: ` �C_ Fire/smoke damper. uct smo ce eteclors
QZZ cat pump(site pla,;requ—Te3�— __
City:ft—.i
? nstal rep ace urnac urner BTUPhon �-CZz4 Fa -M)L�o'-i%U E-mall' Including ductwork/vent liner U Yes U No
CCB no.: ;5-1 Instal rep ac re ocate heaters-suspended,
City/metro lic•no.: �/� —�— wall,or floor mounted
Name(please print): / //(� 111 cot fora lance of er than furnace
e gent on:
t Absorption units _ BTU,'H
Chillers— HP —_
Nam.: OIL. L "L.-S Com ressors HP
Address: /96 .nv ronmenta ex aunt an vent at on:
City: State: _ I Z.I P:V4TZ. Appliance vent
Phon S: c''1 Z/ Fa E,Sa E-mail: )ryerex oust
oo s,Type I res. itche azmat
hood fire suppression system
Name: ` N"ztw Exhaust fan with single duct(bath fans)
:xhaust systema art from heattn or C 2
Mailing address: uel piping an st ut on(up to 4 outlets)
City: Stale: ZIP: Type: - LPG __ N(3 Oil
Phone: I'a X: h.-mail Fuel ti ping eac a itiona over out cls
rocesspiping(schematic required)
Numlh rofoutlets
Name: L. r I A 10 LI I t /r WIR appliance or equipment,
Address: _ Decorativeflreplace —
City:
State: ZIP: nsert-type
0o stov pe et stove
Phone: Fax: Email other:AVA30&.-A,j��WLX
Applicant's signature: Date' 2* C ter:
Name(print): jc1�
— Permit fee.....................$ _.
Not anjurtulietilma txept credit cants,please toll jurisdiction for more Information' Notice:Thisermit application P PP Minimum fee................$
U visa U MasterCard ' expires if a permit is not obtained plan review(al
c'rcai+ ¢rd number:—______ --- -- Exp/ i within 180 days of.:r it has been Stale surcharge(8%) ....$
-
Nnnx of c¢rdhuldrr¢.t drown on cicdil—_-—arT -- $
accepted as complete. TOTAL .......................$
Cardholder signiturt Amount 4404617(61000 M1
MECHANICAL PERMIT FEES
COMMERCIAL_ FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
_ ----- Dascription: a-- Price Total
F$5,00',
OTAL. VALUATION: FEE: - Table 1 A Mechanical Code _ Qty (Ee) Amt
1Au' '^00.00 Minimum fee FL: J 1) Furnace to 100,000 BTU
.00 $10,000.00 $72.50 for the first 3i,,0uj.00 and I Includingducts&vents 14.00
$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+
fraction theroof,to and Including Includingducts&vents 17.40
$10 000.00. 3) Floor Furnace
$10,001.00 to$25,000.00 $148,50 for the first$10,000.CO and Including vent 14.00
$1.54 for each additional 5100,00 or 4) Suspended heater,wall heater
fraction thereof,to and including or floor mounted heater 14.00
250-00-00. 5) Vent not included in appliance permit
$25,001.00 to$50,000.00 $379.` for the first$25,000.00 and _ 6.80
$1.45 for each additional$100.00 or 6) Repair units
fraction thereof,to and Including 12.15
$50 000.00. Check all that apply: Boiler Heat CA I
$50,001.00 and up - $742.00 for the first$50,000.00 andor
$1.20 for each additional$100.00 of For items 7-11,footnotes below. Com • Pump
CoAd
fraction thereof.
- 7)<3HP;absorb unit 14.00
to 100K BTU -
ASSUMED_ VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb 15 6C
Value Total unit look to 500k BTU
Description• Ql Ea Amount g)15-30 HP;absorb 35.00
Furnace to 100,000 BTU,including 955 unit,5-1 mil BTU
ducts&vents _ 10)30-50 HP;absorb 52.20
Furnace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU _ -
ducts&vents 11)>50FIP:absorb 87.20
Floor furnace Including vent _ 955 unit>1.75 mil BTU
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
10.00
floor mounted heater -----445
Vent not Included in appiicance13)Air handling unit 10,000 CFM+ 17.20
ermit -- 805
Repair units 14)Non-portable evaporate cooler 10.00
<3 hp;absorb,unit, 955
to 100k BTU 15)Vent fan conructed to a single duct 6.80
3.15 hp;absorb.unit, 1,700
101k to 500k BTU 16)Ventilation system not Included In 10.00
15-30 hp;absorb.unit,501k to 1 2,310 a liar ermit
mll.BTU 17)Hood seg d by mechan.cal exhaust t40 30-50 hp;absorb.unit, 3,4001-1,75 mil.BTU _ 18)Domestic,Incinerators 1
>50 hp;absorb.unit, 5,725
>1.75 frill.BTU _ --I 19)Comm:rclal or Industrial type Incinerator 69.95
At r handlin unit to 10 OOU cfm 858
Air handlin unit>10,000 c1m 1 170 20)Other units,including wood stoves
858 10.00
Non- ortable eva orale cooler
Vent fan connected to a single duct 446 21)Gas piping one to four outlets 5.40
Vent system not Included in 656
a Ilan Do ermit 22)More than 4-per outlet(each) 1.00 _
Hood served by mechanical exhaust 1 670 Minimum Permit Fee$72.50 SUBTOTAL: $
Domestic Incinerator
Commercial or Industrial Incinerator 4,590
Other unit,including wood stoves, 656 8%State Surcharge $ )
Inserts,etc. 380
Gas I in 1-4 outlets 25%Plan Review Fee(of subtotal) $
Each additional outlet 83 Required for ALL ccrnmercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE:
VALUATION: --� -�
other In, and Fees:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72 50 per hour
2 Inspections for which no fee is specifically indicated (minimum charge-half hour)
$72.50 per hour
3 Additional plan review required 7y changes,additions or revisions to plans(minimum
charge-one-half hour)$72 50 pur hour
'State Contractor Boller Certification required for units>200k BTU.
"Residential AIC requires site plan showing placement of unit.
I',dsts\forms\mech-fees.doc 10/11/00
CIT', OF TIG14RD BUILDING INSPECTION DIVISION MST
24•-Houf Inspection Line: 639-4175 Business Line: 639-4171 -
BUP
Date Requested -------AM-----PM -__— SLD
Location -i y .5w �c, ��; tri. Suite _ MEC
Contact Person _.____ Ph _ PLM vJ-Cc c/Gs
Contractor ____ Ph — _ SWR
BUILDING Tenant/Owner —_ —.T ELC —
Retaining Wall ELR _
Footing Access FPS
Foundation - -
Ftg Drain SGN
Crawl Drain Inspection Notes
Slab SIT _
Post&Beam
Ext Sheath/Shear - -.-- --- --
Int Sheath/Shear
Framing - -
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler -- - --
Fire Alarm
Susp'd Ceiling
Roof �w
Final
PASS PART_ FAIL.
Post&Besm
Under Slab
Top Out
Water Service
Sanitary Sewer _
reit s ------------- - -
PPART FAIL
A NLI C A L
Post&Berim
Rough Ir —
Gas line - - ...------- ---- -- -- -_ .--- _ ��-
Srnoke Damoers
Final - - - -
PASS PART FAIL
ELECTRICAL --� ------ - -- ------ -
Service - - ---
Rough In
UG/Slab -----.---- ------ --
Low Voltage
Fire Alarm - -- --
Final
PASS PAR,r FAIL ---- -- _��. --- --SITE
Backfill/Grading - -- -
Sanitary Sewer
Storm Drain I J Reinspection fee of$ _required before next inspection. Pay at City Hall. 13125 SW Hell Blvd
Catch Basin r J please call for reinspection RE: ( ]Unable to inspect-no access
Fire Supply Line -
ADA � F I
Approach/Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL DO OT REMOVE this inspection record from the job site.
ELECTRICAL PERMIT-
CITY OF TIGARD
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#' ELR2001-00009
13125 SW Hall Blvd.. Tira, ,,(' OR 97223 (503) 639-4171 DATE ISSUED: 1/16/01
SITE ADDRESS: 07128 SW GONZAGA ST 200
PARCEL: 2S 101 AC-00900
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 015 JURISDICTION: TIG
Proiect Description: Tenant Improvement
A. RESIDENTIAL _ B. C_OMMLRCIAL_
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE. ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS;_1_
Owner: Contractor:
ROCKY MOUNTAIN LAND LLC GREENLINE INC
12540 S'/V 68TH PKWY SUITE B PO BOX ?:10755
TIGARD, OR 9722.3 TIGARD, OR 97223
Phone: Phone: 968-1978
670-8585 Reg#: LSC 103033
ELE 34-397CL
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 1/16/01 $75.00 2720010000 Wall Cover
5PCT CTR 1/16/01 $6.00 2720010000 Elect'I Final
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specie / Codes
and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is
not Started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0080 You n:ay obtain copies of these rules or direct questions to OUNC at (503)
46-1987
Issued by I�Pi � - Permittee Signatures -?"?T... /�"<��/�
OWNER INSTALLATION ONLY _The installation is being m _e on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'NDATE:
LICENSE NO'
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
electrical Permit Application
—�
loate"received: I U/ Permit ncl..
pity Of Tigard Project/appl.no.: Expire date:
City of7'igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 pate issued: By: Receipt no.:
' Phone: (503) 639-4171 - --
Fax: (503) 598-1960 Case file no.: I Payment type:
Land use approval;
U I &2 family dwelling or accessory Commercial/industrial UMulti-family U"Tenant improvement
U New construction U Addition/allrrtlilmhrhlaccmcnt U Otho+ _ U Partial
Jobaddress: J ���� Itl,lu�11
.: Tax mr.p/tax lot/account no.:
:. .
L,ot: Bios,. Subdivision:
Prvjcct name: B_& Description and location('work on premises: PATAIVOI CE-CAW IG--
Estimated date of cont letion/ins ection
Jot)no: _ I+r Moa
Business 111111iL/�� 1eri lli-inn qth (ea.) Ictal no.imp
New residetrlial-singk o or nudti-ufamily per
A 30,1 _ dwelling unit.Include%attached garage.
City: TJ& la Statc I.IP: Servicelnclwkd:
_ I(xOs f1.or less _ 4
Phone: - _ _. E-mail: g ----Each additional 500 sq.fl.or portion thereof _
CCB no,: 103016BI Ice.bus lic.no: 7�11�. JC( (� Limitedenergy.residential 2
Cit /metro lic.no.:
City/metro Limited energy,non-residential 2
Each manufactured home or modular dwelling
u�
'c-- - -- Service ancUor feeder 2
Signal of supervising electrician(required) but
Sup.elect.name(prinU: Licenseno: Services or feeders-Installation,
alteration or relocation-
lllk200 1 OWNERRTV 200 anipsor less 2
Name(piing; 1"o201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 12,Sqo Al>V 4) 601 maps to 1000 amps 2
City: Slate: ZIP: 0vt r I(NN)amps or volts 2
Phone: Fax: I E-mail: Reconnect only — — I
Owner installation:The installation is lining made on property 1 own Temporary seri Ices or fredern-
which is not intended for sale,lease,rent,or exchange according to Installaupn,alteraticro,orrelocation:
ORS 447,455,479,670,701. 2Mainpsbrless_ 2
201 amps to 4M amps 2
Owner's signature _ Dale: 401 to6(N1amp's 2
Branch circuits•new,sheralion,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
Oily: Stale: ZIP: i Fee forhrnnchcircuits without purchase
— — of service or feeder fee,first branch circuit: 2
Phone: I . , C-mail
liar ;-fdrttonal branch circuit:
MR.I Service or feeder not Included):
U Service over 225 amps-commercial U I lealth-care facility Each f urpp or irrigation circie _ ,
U Service over 320 amps-rating of I&2 U Hazardous location Exch sign or outline lighting
familydwellinps U Building over 10,O(K)square feet for,.o S gnat circult(s)or a limited energy panel.
U System over 600 volts nominal more residential units inonestructure :.:.eration,orextension*
�J ?
U Building over three stories U Feeders,400 amps or more •11tescri tion
U(kcupant load over 49 persons U Manufactured structures or RV park Hoff sddi$lonsl Inspection over the allowable In any of the above:
U Egress/lighungplan J t Nher: I'cr iosp�clibn E:=
Submit__tela of plana with any of the above. Investigation fee
s'
The above are not applicable to Iernporatry condruction service. other
iclims weep,credit cards,plea a0)unalieioa r...III("i►snelRuuan. Notice I his permit application Permit fee.....................$
U Visa _0M1vt*,Card_ - expires ifit permit is not obtained Plan review(at _ IT) $
Credit card number: _ 1 / within 180 days aper it has been
'tc.me of car�rnldrr u on credit Slate surcharge(8%) ....$ _
E>plree
accepted as complete. TOTAL .......................$ 91.JU
� card
Cardholder signature Amours __% 441-4615(MVI(•OM)
Electrical Permit Fees: Limited Energy Fees:
-- -- -- -------- - -� --"——" TYP- OF WORK INVOLVED -RESIDENTIAL ONLY
Schedule --- $75.00
Complete Fee �chedtale Below: Restricted Energy ee.............••••••••••••••••••••••••••
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved.
Residential-per unit $145 15 4 �� Audio and Stereo Systems
1000 sq ft or less
Each additional 500 sq.ft.or $3340 I Burglar Alarm
portion thereof -- $75 00
Limited Energy ❑
Each Manufd Home or Modular Garage Door Opener'
Dwelling Service or Feeder $9090 _
m
I I Heating,Ventilation and Air Conditioning Syste '
Services or Foedors
Installation,alteration,or relocation $80.33 2
200 amps or less --- 2 Vacuum Systems',
201 amps to 400 amps $106.85
401 errps to 600 amps $ -3060 2 Other
$240.60 _ 2 I�
801 arrpr to 1000 ampg � � $454 65 2
over 1J`j0 emps'or voitt $66 65 — 2
Recon rect only -- TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Tempo ary Services or Feeders $75.00
Fee for each system............ .......................... ..................
installa ion,alteration,or relocation $66.85 2 (SEE OAR 918-260-260)
20C amps or less -
20 amps to 400 amps $100,30$133 75 Check Type of Work Involved.
4(1 amps to 600 amps
C ver 600 amps to 1000 volts, Audio and Stereo Systems
see"b"above.
Branch Circuits Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits Clock Systems
with purchase of service or
feeder fee. $6 65 Data Telecommunication Installation
Each branch circuit -- -
b)The fee for branch circuits Fire Alarm Installation,
without purchase of service
or feeder fee. $46 85 f '1
First branch circuit $6 65 — lJ HVAC
Each additional brand i circuit _
Miscellaneous Q Instrumentation
(Service or feeder not Included) $53 40Intercom and Paging Systems
_
Each pump or Irrigation circle — -
Each sign or outline lighting — $5340 -
Signal circult(s)or a limited energy , $75 00 —•7S� Landscape I,rigatlon Control'
panel,alteration or extension $175.00 _
Minor labels(10) - E] Medical
Each additional Inspection over
the allowable in any of the above Nurse Calls
Per Inspection $62.50
Per hoar — $62.50 Outdoor Landscape Lighting'
In Plant $73.75
Fees: Protective Signaling
Enter total of above fees $ , -15. F-1Other _— -
H%State Surcharge $ ` Ib .----L---Number of Systems
25%Plan Review Fee $ No licenses ere required Licenses are required for all other iWallations
See"Plan Review"section on
front of application - ---- Fees;
Total Balance Due $ a'• Enter total of above fees $_75'0 _
C� Trum Account#_. — _ 8 State Surcharge =— 6•�
- - - Total Balance Due
i:klsts\formsklc-fees.doc 10/09/00
CITYOF TIGARD PLUMBING PERMIT
/5/01
DEVELOPMENT SERVICES PERMIT#: 0-00465
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/5/01
1/5101
PARCEL: 2S101 AC-00900
SITE ADDRESS: 07128 SW GONZACA ST 209
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 015 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPuSALS: MOBILE HOME SPACES:
TYPE OF USE: CUM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES_ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS.
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEW(-R LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of(1) new sink and (1) new water heater.
_ FEES
Owner: Type By Date Amount Receipt
ROCKY MOUNTAIN LAND LLC 5PCT CTR 1/5/01 _ $5.80 27200100000
12.540 SW 68TH PKWY SUITE B PRMT CTR 1/5/01 $72.50 272.00100000
TIGARD, OR 97223 --- � —
Total $78.30
Phone 1: 670-8585
Contractor:
ASSOCIATED PLUMBING CO
P 0 BOX 301362
PORTLAND, OR 97230 REr)UIRED INSPECTIONS
Top-out Insp
Phone 1: -'11-0582 Final Insrection
Reg#: LIG 5?R9,,
PLM 26-41-,-PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
1 Permittee Signature:
Issued B y
rt Call (503) 639-4175 by 7:00 P.M. for an inspectioo needed the next business day
12--21-200 1 1 :4SAM FROM ASSOCIATED PLBG. 331 0561 P. 3
... � ...rte
tSA25 SW HALL BLVD. Commercial and Residential
T!GARD, OR 97223 Dile Recd
--
503) 639-4171 Dale to P E.
Dale to DST, _
Permit -LI
Print or Type Related SWR 0
Incomplete or illegible applications will not be accepted Called_ log-;1V-e0 ' r �
Name of DevelophlentUP(o)er:t FIXTURES (Individual) Qty Price Total
Job lr">he. r% /GG L'�ea/ Sink —--
6-60
Address street Address Suite — Lavatory 16,60 I
e02 ON2 a -200 Tub or Tub/Shower Comb. 16.60
Bldg 0 Cily1slate Zip Shower Only 18,60
ti ar Or.
Name Water Closet 16.80
elm,+ Urinal 16.66
Owner Mailing Address Suite Dishwasher 16 60
— - Garbage Disposal 1660
CilylState Zip Phone Laundry Troy 16 60
Name Washing Machine 16.60
poflald (Z k" ►� FloorDrain/Flow Sink 2' 16.60
_
Occupant Mailing Address Suite 3" 16.60
7115 S,IJ, ��c►123�f,� 200 4. -- 1x,60
City/State ZIP Phone _
?1_ ID/ Water Healer o conversion O like.kind ' 16.60
Name Gas piping requires a separate mechanical permit.
(� b. MFO Home New Water Service 46.40
55UGa D�¢at _ �uN1 !1?
Contractor Mailing Address ASuite MFC Home New San/Storm Sewer 46.40
pig G'► '2 Hose Bibs 16.60
Prior IV permit CitylState Zip Phnne Roof Drains 10.60
iS$Uer
nce,a opy
Pig ry � or. �7,�q 3 I-D S�2 Drinking Fountain 18.60
nl all liaemesare Oregon Const r nt Bowel I-c.f Exp Date
required it 5 e5 9(J //—o �_
-p4 Other Fly.tuies(Speciry) 21.75
I expired in COT Plumbing Ua .4 Exp Date
database A! _- 4 12
Name pp —
Architect Ca St` bf J3er,+"av1 Sewer•1st100' --
or Mailing Address5ulte 5.00
Sewer-each additional 100' 46.40
3 ,W 13=� ST, �o�
City/..tale Zip Phone Water Service•1st 100' _ 55.00
Engineer rtic� r.
17,202 .?;1 — $'55 Water Service•each additional 200' 48.40
Describe work to be dune Storm&Rolm Drain-1s1 100' 55.00
New O Repair O Replat..(-with like kind Yes O No O Storm&Rain Drain-each additional 100' d6A0
Residanlial O Cumrnercial ig� _--
Addilional description of wnrk — Commercial Back Flow Prevention Device 48.40
Residential Backnow Prevention Device' 27.55
Catch Basin 16.50
Are you capping,moving Or replacing any fixtures? Insp of Existing Plumbing or Specially Requested 7250
Yes O No O Inspections _ par/hr
If yes,see back of form to indicate work performed by Raln Drain.shingle family dwelling 65.25
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 16.60
WORK COULD RESULT IN INCREASED SEWER FEES. ANTiTY TOTAL
I hen-by arknowiedge that I have read this application,that the information Isane+nc nr Mer eWpram a requMed a ANTIry Totalis •e
Seven is cerrecl,that I am the owner or authorized agent of the owner.and
that plans aubmilted are in compliance with Oregon State Laws. 'SUBTOTAL
L
gna 'a o OwnarfA ht Datta
)_ 8% SURCHARGE
Contact rson Name Phone
V)-05-3-2- '"PLAN REVIEW 26%OF SUBTOTAL p
TH US S249.71% Regueed only h fixture qty total is,9 8 r J
TOTAL 1
r 'Ntnlmum permh tee is$72.50•9%surcharge,except Resitlenial BarMkn.Ptevenikxh
Device vthkih is 119e,:5+a%sun'lharde
—All New CnmrnzKlal Buildings rsqure plans with Itnrnetric or nser diagram and plan rcvww
dfriVrAnSyfkmapp_rev�a[SV80.y
L> �fL 14I I Accumulative Sewer Tally
G�
Tenant Name i" d05 1lid— This SWR#
Address: 7/Ag bty ( A)A, 2_6 �r, �U This PLM#: ,,UOD -DO
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped oft value added# added #s total
Count off#s count value values
Baptistry/Font 4
Bath -Tub/Shower 4
-Jacuzzi/Whirlpool _ 4 _.— -_— --- -------
Car Wash_- Each Stall _ 6 -- --- ---
Drive Through 16 ---
Cuspidor/Water Aspirator 1 ----
Dishwasher- Commercial 4 -
- Domestic 2Drinking Fountain
_Fye Wash -----
Floor Drain/sink - 2 inch 2 --
3 inch 5 _
4 inch 6 _ ---
Car Wash Drn 6 — ----
Garbage Disposal 16
Domes•i:(to 3/4 HP) —
Commercial (to 5 HP) 32 --
_- Industrial (over 5 HP' 48 _-._ --- - -- -
Ice Machine/Refrigerator Drains 1 --
Oil Sep(Gas Station) 6 ----
Rec. Vehicle Dump Station 16 ---
F-hower-Gang (Per Head) 1 —� —_ _--- — -- -
-Stall 2 --
Sink -Bar/Lavatory 2 -
Bradley 5- —
Commercial 3 tib-- - ---
Service _ 3 -- -- ---Swimming Pool Filter 1 -_ _ — -- ----
Washer-Clothes 6 --
Water Extractor 6
Water Closet - Toilet 6 ---
Urinal 6-
TOTALS _TOTALS -
Total fixture values �� —__divided by 16 _ _�- __.ESU �' /"` �-t��'
HISTORY_ --
_PLM# ED_U# SW_R_# _ PL��I# _ EDU# SWR#
PLM# - EDU# _ SWR# _— PLM#___ f EDU#_-___ SWR#
PL.M# —__ EDU# SWR# PL!M# J ECU# SWR#
PL.M# EDU# SWR# - PLM# EDU# / SWR# _
i\dsts�swrtaly docLMJ
Cl_RTIFICAfEOFO(:CUPANCY
CITY OF TIGARD
DEVELOPMENT SERVICES PERMIT#: BUP2000 00379
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 11/07/2000
PARCEL: 2S 101 AC-00900
ZONING: MUE
JURISDICTION: TIG
SITE ADDRESS: 071''p SW GONZAGA ST 200
SUBDIVISION: BEVELAND NO 2
BLOCK: LOT:015
CLASS OF WORK: ALT
TYPE OF USE: COM
TYPE OF CONSTR: 5N
OCCUPANCY GRP: B
OCCUPANCY LOAD: 33
TENANT NAME:
REMARKS: Commercial TI
Owner:
ROCKY MOUNTAIN LAND LIC
12540 SW 68TH PKWY SUITE B
TIGARD, OR 97223
Phone: 670-8585
Contractor:
JOSEPH HUGHES CONSTRUCTION,INC
7035 SW HAMPTON
TIGARD, OR 97223
Phone: 624-7100
Reg #: LIC 45645
I
This Certificate issued 111/19/21101 grants occupancy of the above referenced building or
portion thereof and confirms that the building has been inspected for compliance with the
State of Oregoii Specialty Codes for the group, occuppncy, and use,under which the
referenced permit was issued.
FIMILDING INSPECTOR BUIL I OFFICIAL
POST IN CONSPICUOUS PLACE