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9370 SW GREENBURG ROAD STE 413-1 �� i �� w v n �� \1 t�; � �� 3 CITY OF TIGA►RD �R�:��N January 29, 20r"t Dave Fife Willamette Electric Inc. P O Box 230547 Phone: (503) 624-"631 Tigard, OR 97281 Fax- (503)624-2938 RE: ELECTRICAL PLANS REVIEW Dcar Mr. Fife: Project Information Permit: ELC 2004-00023 Tenant: Dr. Jia Address: 9370 SW Greenburg Rd. This plans review is based ori the 2002 edition of the National Electrical Code (NEC). The plans received on January 16, 2004 for this project have been reviewed and are approved for construction subject to the following: 1. The approved plans includint all schedules, calculations, specifications, and reports must be available at theJob site for the field inspector at the time of inspection. 2. Changes to the approved plans shall be submitted and must be approved by the City before the installation covering the changes can be inspected It I can be of any additional assistance, please feel free to contact me at (503) U6.4-9036. Sincerely, Herb Stabenow vians Reviewer c: file 13125 SVvcHh Blvd„ Tigard, OR 97223(503)639 4111 TDD(503)684-2772 — �I TY OF TIOARD _—..ELECTRICAL PERMIT PERMIT ff: ELC2004-00023 DEVELOPMENT SERVICES DATE ISSUED: 2/3/04 13125 SW Hall Blvd., Ti-iard, OR 97223 (503) 639-4171 PARCEL: 1512013-02800 SITE ADDRESS u9370 SW GREENBURG RD 413 ZON NG: ;-P SUBDIVISION: PP1991-018 BLOCK: LOT : 001 JURISDICTIO& TIG Project Description: Electrical TI RESIDEN IAL UNITTEMP SRVCIFEEDERS w MISCELLANEOUS 1 1000 SF OR LESS:— _ 0 200 amp: PUMPlIP�UGAIION: EACH A-,)n1'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps - )00 volts: MINOR LABEL (10): SERVICE/FEEDER _ BRANCH CIRCUITS __ ADD'L INSPECTIONS 0 - 200 amp: WISE'.✓ICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: !1 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000•- amplvolt: >=4 RES UNITS: >600,VOLT NOMINAL: Reconnect only: SVC/FDR—225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor. FRANKLIN COMMONS ASSOCIATES WILLAMETTE ELECTRIC INC BY NORRIS+STEVENS Pr)BOX 230547 520 SW 6TH STE 400 TIGARD,OR 97281 PORTLAND,OR 97204 Phone: Phone: 503-624-3631 Reg#: LIC 75059 Still I'rh F'ES ELI: Description Date Amount Regrrired Inspectiuns I I-I.I'loi l-I FLU I'ermrt i n.l $120.00FE -` — — L!.I'Lt'hI I Lt' Pln Re% r $30.00 ugtI FiI r\X18"oSiate Surcharge (14 $9.60 ct'I Final Total $159.60 This Permit is issued subject to the regulations contained in the Tigard Minicipal Code,State of OR.Specialty Codes and all other applicable lawF All work will be done in accordance wi!h approved plans. This permit will expire if work is not started within 180 days of issuance,or 0 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to`nik,w 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 obt.:n copies of these rules or direct questions to OUNC at(503)246.6699 or 1-800-332-1344. �^4 , _ Permit Signature: Issued By: OWNER INSTALLATION ONLY _ The installation is being made on property I own which is not intended fog sale, lease, or rent. OWNER'S S!3NATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATUPE O':- SUPP. ELEC'N: DATE: LICENSE NO: ___ -�- Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit AMIfic tion ' ' ' � Received '/ Electrical s- n 2 Y _— Date/By: / / Ort_ 4 _ Permit Na:GL�1?DO CityCit of Tigard ` Planning Approve Sign g Date'B : _ _ Permit No. 13125 SW Hall Blvd. �j ��, Plan Review Other Tigard,Oregon 97223 b l Date/By: Permit No.. Phone: 503-639-4171 Fax: 5 8 9F� Q _ Post-Review Land Use '7�_" G- � P Date'B Case Na Internet- www.ci,tigard.or.us s `v CIMERontact Ju See Page 2 for 24-hour Inspection Request: SOj , � Name/Method Supplemental Information. v�� TYPE OF WORK PLAN REVIEW Please check all that apply) New construction DemolitiC': Service over 225 amps- health-care facility --- Addition/alteration!replacemen t Other: commercial �Iluzardous location ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, CATEGORY OF CONSTRUCTION I&2 family dwellings four or more residential units in _1 &2-Family dwelling Corrl_mercial/Industrial ❑System over 600 volts nominal one structure Accessory Building Multi-Famil ❑Building over three stories ❑Feeders,400 amps or mor _� ❑Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder Other: ❑Egress/lighting plan ❑Other- JOB SITE INFORMATION and LOCATION Submit_sets of plans with any of the above. The above are n7oiJifilicable to temporary construction service. Job site address: < 4 J0 i'ld FEE"SCHEDULE Suite#: Bld ./A t.#: L•Ar)/„ Ulff, Number i l Ins ertions per permit allowed Project Name: .. a Descri tion Qn Fee(ea.) Total Cross street/Directions to OyV site: New reSWPONYI-single Or multi-family per dwelling unit.Includes attached garage. Service Included: '000 sq tl or less _ 14;.15 4 Each additional 500 3q It.or portion therxf 33.40 1 Limited energy. 0 residential 75. Subdivision: Lot#: 2 Limited energy,non residential 75.0 2 Tax mapiparcel #: Each manufactured home or modular dwelling DESCRIPTION OF WORKservice and/or feeder 90.90 2 Services cr feeders-Installation, ('. 1 r r c F aIteration or relocation: 20 amps or less 80.30 2 -- --- 201 amps to 40 amps 106.85 2 401 amps to 60 ams 160.60 2 ROPERTY OWNER TENANT 601 amps to 1000 amps _ 240.60 _ 2 Over 1000 amps or volts _ 454.65 2 Name: j�yJlw-��}, 1Y�p Reconnect only _ 1 66.85 2 Address: w '�-Frt R' Temporary services or feeders-installation. afteration,or relocation: City/State/Zip:_ _ 10 9.94 _ 21J0 am s or less 66.85 1 Phone: Fax; 201 ams to 4(N)ams 100.30 2 401 to 600 ams 133.75 2 APPLICANT _Y CONTACT PERSON Branch circuits-new,alteration,or Name: extension per panel: —" A.Fee for branch circuits with purchase of Address. _ service or feeder fee,each branch circuit 6.05 2 City/State/Zip: B Fee for branch circuits without purchase of service or feeder fee,first branch circuit 46.85 �6�" 2 Phone: __- Fax:--- Each additional branch circuit 6.65 2 E-mail: Misc(Service or feeder not included) CONTRACTOR Each ump or irrigation circle 53.40 2 Each stn or outline lighting 53.41) 2 Job No: 1, cf/ Signal circuit(s)or a limited energy panel. alteration,or extension Pae 2 2 Business N^tae: (.A/' t/d r-F 1 1 f (. rt /i c l Descriptions Address: / e s i) , Each additional Inspection ovrr the allowable In any of the abtrse: City/State/Zip: Per inspection per hour Imin I hour) 1 62.50 Phone: a G Fax: ` )3 6�'v i t Imesti ation fee Other CCB Lic. #: (^j;5 O5 `� Lic. #; 3 1/- Z1?3 G _ Electrical Permit Fees* Supervising electricianf Subtotal S signature requited: 't Plan Rex tew, 254'o of Permit Fee) S _ 30" Print Name: Lic. #: !" Stat( Surcharge 1,81o of Permit Fee) $ _TOTAL PERNVT FEE 1 $ Authorized u l Notice: This permit appilcatiun expires if a permit is not obtained within Sigrature: _ Date: 2~ ____ 180 da)s after it has been accepted r.,a,.mplete. 'Fee metlmdolog-s-of by Trl-Coun.% Bull,'ing Industr% Sets Ice Board. (Please print name) c'DstsTemut rom-wFlcPermitApp,doc 01 03 CITYOF 1 I G A R D _ MECHANICAL PERMIT � DEVELOPMENT SERVICES PERMIT#: MEC2004-00013 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/14/04 PARCEL: 1 S 126DB-G28U0 SITE ADDRESS: 09370 SW GREENBURG RD 413 SUBDIVISION: PP1991-018 ZONING: C-P BLOCK: LOT:001 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN EVAP COOLERS: TYP." OF USE: COM UNIT HEATERS: VENT FANS: 3 CICCUPANCY GRP: B VENTS W/O ADPL: VENT SYSTEMS: STORIES: _ BOILERS/COMPRESSORS_ _ HOODS: FUEL TYPES _ 0 - 3 HP: — DOMES. INCIN: 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: _ AIR HANDLING UNI-S CLO DRYERS: FURN >=100K BTU: 1<= 10000 cfm: `— OTHER UNITS: > 10000 cfm: GAS OU1 LETS: Remarks: Relocate 4 supply diffusers,add(Z) Owner_ - - FEES FRANKLIN COMMONS ASSOCIATES Description Date Amount 9Y NORRIS + STEVENS 520 SW 6TH STE 400 I TA X I ti Stcite Surcharl 1/14/04 $5.80r PORTLAND, OR 97204 IMI.Cill Permit Fee 1/14/04 $72.50 Phone: Total �v $78.30 Contractor: OREGON HEATING +A/C INC PO BOX 397 DUNDEE, OR 97115 REQUIRED INSPECTIONS Phone: 538-2051 Mechanical Insp y Duct Inspection Reg#: LIC 125815 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is n)t started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adc-ted in tF a Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 Issued By: fit. Permittee Signature: A Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Meellia ical Pei-mit ,AimliciltiolnFOP,,01FI&E USE ONLY Received City U1) i igard Date/By: 13125 SW Hall Blvd.,Tigard,OR 97223 Ilan Review �- Phone: 503.634 1171 Fax: 503.598.1960 ar' Date/By: Other Pernur. Inspection Line: 503.639,4175 Dale Ready/By' 1u_ru, 0 Sec Page 2 lar Internet: www.ci.tigard.or.us m Notified/Melhod: (c Supplemental Infnrvmullon Y� TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechunical permit 1'ees•are based on the value of the work ❑New construction [Q Addi.ion/alteration/replacement perfortaed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition [1 Othi:r: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/ VSTEMSFEES" l El1-and 2-family dwelling [}Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. "futul JOB SITE INFORMATION AND LOCATION Heatin coolln Air conditioning or heat pump Job 511e address: C-.%' ' < re uires site Ian showin lacement)— 14.00 City/Stale/ZIP:71%rte Furnace 100,000 BTU(ducts/vents) 14,90 3 j�— Fumace 109,0004 BTU(ducts/vents) 17.90 Suite/bldg./apt.no.: Project name: Gas heat pump 14.00 { Cross street/directions to job site L � _ Duct work 14.00 W— - - H dronic hot waters stem 14.00 Residential boiler(radiator or h•rdronicl 14.00 Unit heat1rs(fuel-type,not electric), { in-wall,in-duct,suspended,etc. I&OU Flue/vent for any of above 10.00 f, Subd vision: Lot no.: Other: 10.00 Tax map/parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 Log lighter as 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 Chimne /liner/lue/vent 10,00 ❑ PROPERTY OWNER TENANT Other: _ 10.00 Name: t - Environmental exhaust and ventilation Range hood/other kitchen Address: a ui ment 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 _ — Single-duct exhaust(bathrooms, Phone:( ) Fax:( ) toilet compartments,utility rooms) 6.80 (] APPLICANT �NTACT PERSON Attic/r-ewlspace fans 10.00 Other: 1J.00 Business name: _ Fuel piping—_ Contact name: r— $5.40 for first four;$1.00 for each additional r Furnace,etc. _ Address: Gas heal pump City/State/ZIP: Wall/suspended/unit heater _ Phone:( ) c-' —�Fax::( ) Water heater ��r_s. �_ Fire lace E-mail: Range CONTRACTOR Barbecue -- Clothes dryer(gas) Business name: G� • " 4 I ,•tTi 11 -__ , 1� Other: — Address__Ljo___dw1r Ste ! MECHANICAL PERMIT FEES" City/Stale/ZIP: r" tet--— / Subtotal ` ,effsslyt.i„�t=--- -f--�`— _ Minimum pet mit Ice(S72.50) Phone:( ) �e .— 9�i Fax:(T3 Plan review(25%of permit fee) � CCB Iic.: C�! State surcharge(81ofpermit fee) �( — TOTAL PERMIT FEE " ? This permit application expires Ira permit Is not obtalned wlthin 180 Authorized signature: __ days after It has been accepted as complete. Print name.--� i _ Fee methodology set by Tri-County Building Industry Semice noard i eau. ApermiukMEC Pemm,Ap,duc 12101 440-4617T(I 1/024%'wEa) CITYOF TIGARD _ BUIL_DINGPERMIT DEVELOPMENT" SERVICES DATEEIS UIED: 11123 0404 00022 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S126DB-02800 SITE ADDRESS: 093'0 SW GREENBURG RD 413 SUBDIVISION: PP1991-018 ZONING: C-P BLOCK: LOT: 001 JURISDICTION: TIG REISSUE: _ FLOOR AREAS _ _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N:� S: E: W: TYPE OF USE: COM SECOND. sf _ __ PROJECT OPENINGS?__,____ TYPE OF CONST: 3N sf N:� S: E: v W: OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RE)? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP, RATED: BSMT?: MEZZ?: RLOD SETBACKS _ REQUIRED _ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACS: BEDRMS: BATHS: IP-P SURFACE: PRO CORR: PARKING: VALUE: $ 24,000.00 Remarks: TI, remodel existing dental space. Owner: Contractor: FRANKLIN COMMONS ASSOCIATES BNK, CONSTRUCTION INC BY NORRIS + STEVENS 10730 SE HWY 212 520 SW 6TH STE 400 PO BOX 66 PORTLAND, OR 97204 CLACKAMAS, OR 97015 Phone: Phone: 557-1085 FAX Reg #: 6ffr'F0866 00003941 Q7�5 FEES -_� LIC REQl11RD51NSPECTIONS Description Date Amount Mechanical Permit Require I fit I I I.0) I' mit Fee 1/23/04 $273.70 Electrical Permit Required I AXI H"„Sla!r Surrhar! 1/23/04 $21.90 Plumbing Permit Required Framing Insp Ilit'PPI N11 11111 RN 1/23/04 $177.91 Gyp board Insp 11.1 Sl PI S 11111 16, 1/23/04 $109.48 Final Insper•tion — Total $582.99 This permit is issued subject to the regulations contained in the Tigard MUnicilzal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accor.anee 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 yoi1 to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001A) OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by ca3i (503)246 6699 1 800-332- 4. G I�sued By: — Pe ftittes Signature: Call 639-4175 by 7 p.m. for an inspection the next business day BuilLiltlg Permit Application Receives' perniit No.: a� City of Tigard Rece v : l�P 3y"o 13125 S nN Nall Blvd.,Tigard,OR 972.'.3 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other permit, Inspection Line: 503.639.4175 Dale Ready/By: Jura 0 See Attached Checklist For Internet: www.ci.tigard.or.us Notilied/Method: I Supplementallnrormalion TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to tine nearest dollar)of all Addition/alteration/replacement ❑Other: equipment,materials,labor,uverhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El1-and 2-family dwelling Commercial/industrial Valuation: $ _ ❑Accessory building ❑Multi-family Number of bedrooms: _ ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site eddress: 7Q f ul 6 etNA0Ai - New dwelling area: squarc feet City/State/ZIP: /L / Garage/carport area: square feet Suite/bldg./apt.no.. r� i 3 Projcct name: odeAlYt Covered porch area: square feet Cross street/directions to job site: G/(yk ezIf Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: 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 application it/70 Pt L E X i f 1rx,,vL J�S-f /TflL valuation: _$ �, 40 0 to 5 d-- Existing building area: square feet G New building area: /g square feet ❑ PROPERTY OWNER TENANT Number of stories: 2 Name: W r,` _�� Type of construction: Address: W G/1 j� Occupancy groups: �. City/State/ZIP: G -4'A.A — Existing: — Phone:( ) Fax:( ) New: K APPLICANT ❑ CONTACT PERSON NOTICE Business name: C�/y 7 All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board _ — under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed.If the Cit /State/ZIP: applicant is exempt from licensing,the following reasons Y apply: Phone:( ) Fax: :( ) E-mail: -- _ CONTRACTOR Business name: `( e Y/ _ BUILDING PERMIT FEES* Address: p _,�< G �/ p Please refer ro fee schedule. City/State/ZIf. G .t G A /�r�/�f�/ - � / 7 Fees due upon application Phone:(!,'O�j lri 4%k Ftx:(�'Q� �lr7'r�� _ Amount received CCB lie.: /Q 7 $r r i Date received: Authorized signature: This permit application expires if a permit Is not obtained — within Igo days after It tins been accepted as complete. [Print name: d Z L C_ ,( /�Q(,✓ �,/. Date: ' 3 7 0 • Fee methodology set by Tri-County Building Industry Service Board. IUnuildinonPermfunBUP-PermaAIJPdoc 12t0n 440.4el]T(I110MONIVE8) Building Division flan Submittal Requirement Matrix coninwi-cial & Multi-Family- New, Additions or Alterations Licity-O Type of Submittal #of Plans (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 I Fire Protection Syst.;m 3** Mechanical 2 Plumbing(building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of ti completed application and pans. 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 sys!ems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "Y technicians. iABuildingTorms\COM-Plan Sublkeq.doc 12/24/03 CITY OF TIGARD PLUMBING FERMIT DEVELOPMENT SERVICES PERMIT #: PLM2004-00032 13125 SW Hall Blvd., Tigard, OR 97223 (503) E39-4171 DATE ISSUED: 2/5/04 PARCEL: 1 S126DB-02800 SITE ADDRESS: 09370 SW GREENBURG RD 413 SUBDIVISION: PP1991-018 ZONING: C-P BLOCK: i LOT: Qt)1 v JURISDIC110N: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME PACES. TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS: 3 OCCUPANCY GRP: B FLOOR DRAINS: ; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: ^SINKS: URINALS: GREASE TRAPS: LAVATORIES: 5 OTHER FIXTURES: 2 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing TI, capping (3)2"floor drains. Other fixtures are: (1)primer R (1)vac pump. FEES Owner: Descript'. Date Amount FRANKLIN COMMONS ASSOCIATES BY NORRIS + STEVENS J I'Ll1�11iJ I'crmil Fee 2/5/04 $371.60 520 SW 6TH STE 400 li'I.Mt'LNJ clan Rcr ie 2/5/04 $92.90 PORTLAND, OR 97204 ITAXi 8"i titan Sm,:hart 2/5/04 $29.73 Total $494.23 Phone : Contractor: WOLCOTT PLUMBING CONTRACTORS PO BOX 2607 GRESHAM, OR 97030 REQUIRED INSPECTIONS Underfloo./Underslab Phone : n(,-'-178i Top-out Insp Reg #: 1 1( ,x l Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 1 CO 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 Is ped By: Permittee Signature: \4 Ca;: 150'M(639-4175 by 7:00 P.O. for an inspection needed the next business day TY� �� I� /� �D _ SEWER CONNECTION PERM;I' DEVELOPMENT SERVICES PERMIT#: SWR2004-00024 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISJUED: 215/04 PARCEL: 1 S126D13-02800 SITE ADDRESS; 09370 SW CRFF NBURG RD 413 SUBDIVISION: PP1991-018 CONING: IG BLOCK: LOT: JURISDICTION: TIG, TENANT NAME: OR, WENDI JIA USA NO: FIXTURE UNITS: i3WELL!NG UNITS: CLASS OF WORK: ADD TYPE OF USE: COM NO. OF BUILDINGS, INSTALL TYPE: BUSWtZ IMPERV SURFACE: Remarks: .6 EDU increase _ Owner: FEES FRANKLIN COMMONS ASSOCIATES Description Date Amount BY NORRIS + STEVENS --- 520 SW 6TH STE 400 [SWUSAI Swr Connect 2/5/04 $1,440.00 PORTLAND,OR 97204 [SWUSAI Swr Connect 2/5/04 $0.00 Phone: Total $1,440.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires, The Agency does not guarantee the accuracy of the side sew-.,r laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distanc3 given. If not so located,the Ingtoiier shall purchase a"Tap and Side Sewer" Perm Issed by: _ Permittee Signature:, Call (50 639-4175 by 7:00 P.M. for an inspection needed the next business day Accumulative Sewer Tally Parcel# 1S126DB-02800 Tenant Name: Dr. Bei idi Jia This SWRt 2004-00024 Site Address: 9370 SW Greenbury Rd. #413 This PLM# 2004-00032 Fixture VWuu Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off#s count # value #s values j'7a�tisa y,�int 4 0 0 0 0 0 ,.cath-Tub/Shower 4 _ 0 0 _ 0 _ 0 0 -Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash- Foch Stall _6 _ 0 _ 0_ _ 0 _ _ 0 0 -Drive through 16 0 _0 _ 0 0 0_ Cuspidor/Water Aspirator _ 1 0 0 0 0 0 Dishwasher-Commercial 4 0 0 00 0 Domestic 2 _ 0 0 0 0 0_ _ Drinking Fountain_ 1 I 0 _ 0� 0 _ 0 _0 _ Eye Wash 1 0 0 0 0 1 0 Floor Drain/Sink-2 in-h 2 0 3 6 0 -3 -6 3 inch 5 0 _ 0 _ 0_ 0 0 _ 4 inch 6 0 0 _ 0_ 0 0__ -Car Wash Drr 6 0 _ 0 _ 0 _ 0 _ 0 _ Garbage Disposal Domestic(to 314 HP) a 0 ' 0 _ 0 0 0 Commercial(to 5 HP) 32 0 0 0 0_ 0 Industrial(over 5 HP) 48 0 Y 0 _ _ 0 0 0 Ice Machine/Refrigerator Drain 1 _ 0 _ _ 0 _ 0 0 0 Oil Sep(Gas Station) 6 0 0 _ 0 0 0 _ Rec. Vehicle Dump station 16 0 0 _ _ 0 0 0 Shower-Gang(per head) _ 1 _ 0 0 0 ` _ 0 0 - Stall 2 0 U 0 0 1 0 Sink- Bar/Lavatory 2 0 0 _ 5 10 5 10 _ Bradley 5 0 0 _ 0 0 0 Commercial_ _ 3_ 0 0 0 0 0 -Service � 3 0 0 U �0 � 0 Swimming Pool Filter 1 0 0 0 0 0 _ Washer-Clothes 6 0 0 1 _ 6 1 6 _ Water Extractor 6 0 0 0 0 0 _ Water Closet-Toilet 6 0 0_ 0 0 0 _ Urinal 6 0 '0 0 _ 0 0 Previous EDU Count 0 _ 0 Capped EDU Credit 0 TOTALS 0 0 3 b 6 ;6 3 1 10 Current Fixture Value 10 divided by 16 = 0.6 Current EDU 1 EDU = $ 2,400 Previous Fixture Value 0 divided by 16= 0.0 Previous EDU Change 10 _ divided by 16= 0.6 over (under) $ 1,440.00 Enter EDU Change Here 0.6 Notes: �' . Signature: ,OLS ';' t04tt1 z z1- & Date:; 6--CJ Building Division Note: The property owner shall retair the ORIGINAL sewer tally record. It credits exist, this document will serve as a voucher which must b^ submitted to the City of Tigard Building Division to redeem credits towards futures stem development charges. i:\Building\Sowertally\SewerTallySheet.As 11/19/03 03/06/01 TUE 14:41 FAX 503 598 1960 CITY OF TIGARD Z002 Plumbing Permit A. llr�n City of Tigard � ( Uatereceived:� � Permit no.- � Address:13'$5 SW Hall Blvd,Ti 217U� Sewer permit no.: Building permit no.: City ofTigard Phonc: (503)639-4171 5WM1- Froject/appl.no.: xp da!,;: Fax: (503)598-1960 0�( Date issued: Receipt no.: ` Land use approval: Ca 6�15 Case file no._ J Payment type:ffiglo �v U 1 8e-2 family dwelling or accesscry I Commcrcial/indusl+ial U Multifamily U Tenant improvement ❑Now construction V.Addiiic n/alteralion/replacerncnt ❑Food service U Other: ��•�� t 1 t (� Jobaddress: �uX '- Rw ��. — Uc.c-i tion _ Ot Pcc(ca. total Bldg.no.; C VLA/ Suite no.: /9' 3 Nen I-and 2-family dwelling%only: Tax map/tax lot/accountno.: - (includes 1000.frreachutitityconnection) SFR(1)bath Lot: Block: Subdivision; SFR(2)bath �- Project name: ,Q . /1f Win/'1-/ •J14 SFR(3)bath City/county: �&' b ,ZIP: Each additionalnit>/kntcneti Description ani,location of work on premises: _ SiteutWtles: .r Catch basin/area drain Est.date of completion/ipspection: Drywells/leach line trench dra-'n-"- - STUM •ooting drain(nn,lin.ft.) Manufactured home utilities Business name; L,4r4z 4LO / jtwt, C Manholes Address: D M , KJY Rain drain cortnector City: c(j L CF State:OV, ::IP: Q Sanitary sewer(no.lin.ft.) Fax: -,jS111 E-mail: _Sturm sewer(no,lin. t.) CCB no. Z ¢j _ Plumb.bus,reg.no:-.?6 ?p jig Water service(no,lin.ft.) Fixture or]terns City/metro lic.no.: "Z / •�--�--- A"sorption valve Contractor's representative signature: )ttu.a 6li1t 1C.�r! Back(1nn preventer Print name: hni s L, 4 r,n n,'A Dite:///0 C If Backwater valve Basins/Invatory Name: Clothes washer __ J .&F, — Dishwasher f�~ Address: Urin'king tountain(s) Z City: State: ::1P: E'ectors/sum Phone: Fax: Email Expansion lank _ Fixture/sewer cap Name(priFloor drains/floor sinks/hub l Mailing address: Garbage disposal,. / Hose Bibb City: _ State• GIP: Ice maker _ Phone: Fax: Interceptor/grease trap Owner instal lation/resilden►ral maintenance only: The actual installation Primer(s) ; a ! will he made by me or the maintenance and repair made by r. regular Roof drain(comm employee-on the property 1 own as per ORS Chapter 147. Sink(s), asin(s) ays(s /(i G^ ,►rj Owner's si natut Due: _ L' 0-1P l ! �r' 6d Tubs/shower/shower pan Urinal _ Name: - Water closet Address: water heater _ City: - J—� State: LIP: Other. Phone: Fax. - E-mall: Tota [Ncm.0 jwiadletim occapt enNut endo,pleae call iorlkacsoo for more in omuuon. Minimum fee................a 7/ Notice:This permit application Platt review(at"•' 46) S Viae O MosterCatd expires if a permit is not obtainedut cora oemr.r. __L�_ within 180 days after it has been State surcharge(846)....S ._ Expires accepted as corn,tete. TOTAL.......................$ z> None c o u shown on Mil ear p t `' —carititioklat dpraare Art oan 4404616(lr10a2'0:4) BnK (Construction, Inc. General Contractors Bill Ludwig President Motile: 503-888-0 201 10730 SE Hwy. 212 Clarkamas, OR 97015 PH: 51)3-557-0866•FX: 501557-1085 ludwig I(r bnkconstruction.com www.bnkconstruction.com OR I a;m10755', WA LIC 04NKC'01055NP f CITY OF T I G A R D CERTIFICATE OF OCCUPANCY r.� DEVELOPMENT SERVICES PERMIT#: BUP2004-00022 NUAWIM 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/23/2004 PARCEL: 1 S126DB-02800 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 09370 SW GREENBURG RD 413 SUBDIVISION: PP1991-018 BLOCK: LOT:001 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 3N OCCUPANCY GRP: B OCCUPANCY LOAD: TENANT NAME: DR WENDI JIA REMARKS: TI, remodel existing dental space. Owner: FRANKLIN COMMONS ASSOCIATES BY NORRIS+ STEVENS 520 SW 6TH SST-E400 PphoeND55R1g72p AXr 557-0866 Contractor: BNK CONSTRUCTION INC 10730 SE HWY 212 PO BOX 66 Cl ACKAMAS�OR1 97015 Phone: 557-0800 Reg#: MF 1 000039.1! LI( 1074;55 This Certificate issued 3/1 /20114 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 des a,r 'c a group, occupancy; and use udder which the reference' permit w BUILDI G INSPECTOR i BUIL- NG FFICIAL POST IN CONSPICUOUS PLACE CITY OF TIOARD 24-Hour BUILDING Inspection Line: (501)639- 75 MST INSPECTION DIVISiOrl Business Line: (503) 9- 1 Received _ Lat Requested _ AM_-_----_ PM _- -_.. BUP -7O �„-- __ MEC Location _ e-�' 5ulte_ --- - --- -- Contact Person —_ - --- -- ! ll_ ?h PLM ---- ------ Contractor __ _. -- Ph l ) ---- SWR -------- - BVFLDINA Tenant/Owner _ - ELC Footing ELC - - Foundation Access: -� Ftj Drain ELR - ---- --- _ Crawl Drain -- —--- Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing ---- --- Insulation _ Drywall Nailing Firewall Fire Sprinkler — Fire Alarm Susp'd Ceiling - Root — --_ --- Othe ' ---- - - n SS PART FAIL - -_BING _- --- t ost& Beam Under Slab - Rough-In Water Service - - -- Sanitary Sewer Rain Drains -- -- -"-"-- Catch Basin/Manhole Storm Drain Shower Pan Other: -- ----- --- - - Final ---- PASS PART FAIL. — MEC_HANICAL -- Pos!& Bearn -- Rough-In -- —— - Gas Line Smoke Dampers Final PASS PART FAIL -- ELECTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm Final F-] Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL r1 PA Please call for reinspection,'IE:— L_I E:— _ _ Unable to inspect-no access SITF;-e Supply Line ADA Dated � Inspector -�' ---- -Ext Approach/Sidewalk Other Final DO NOT REMOVE this Inspection record from the job site. r .SS PART FAIL CITY OF TIGARD 24-Hour RUIL.DING Inspection Line: (503)639-4175 MST INSPL%;TION DIVISION Business Line: (503)639-4171 14 BUP — - ------- Received`� „S y Date Req ested_ 1a AM PMS 2 — BUP _�- Location _—SuiteL _��''_�� MEC _ Contact Person —__—___ _ h( .�) / _l63.1PLIV, Contractor _ Ph( ) SWR BUILDING _ Tenant/0, ier _ LC 2-3 Footing ELC Foundation Access: — -T Ftg Drain ELR Crawl Drain _ Slab Inspection Notes: SIT Post&Beam Shear Anchors - `- E-M 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 - - - --_ - -- - -- - - - -- --- —-- MECHANICAL Post& Beam Rough-In Gas Line Smoke Dampers - - ---- --- - Final PASS PART FAIL - -_ - -- -- --- _ ELECTRICAL Service - --- -- - __ --- Rough-!n UG/Slab Low Voltage F - - F LJ Reinspection fee of$_�____ required before next inspection. Pay at City Nall, 13125 SW Hall i3i:d. PASS PART FAIL E] Please call for reinspection RE -_- __---- Unable to inspect-no access Fire Supply LineADA n �/ Approach/Sidewalk Date.-� '� f l� Inspector �r � __ Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PARE FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (5 9-4175 INSPECTION DIVISION Business Line: (5 3 - 171 MST BUIP / r, ✓ -. Received Date Requested.. P "_ _�� _ AM—______ PM_--_ BUIP Location —_.__---_ 13 6) �oG�l��i;_ .- Suite MEC Contact PersonPh PLM dJG 3 -� --- (._------ ) - - Contractor-- --- -- Ph (— ) 0 o b �0� SWR .------- --- ---- _ BUILDING Tenant/Owner ELC Footing Foundation — ELC Access: Ftg Drain //__ -- r Crawl Drain (� ,� oil �� d0. � V4_ s�G ELR Slab Inspection Notes: SIT Post&Beam - Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - - - - - - Firewall Fire Sprinkler - -- -- - ---- Fire Alarm Susp'd Ceiling - - - - - - �_— Roof Other: - - - Final PASS PART FAIL PLUMBING Post&Beam Under Slab --- Rough-In Water Service — - - - -- — - -- +�'----- - - - --- Sanitary Sewer Rain Drains --- ---- —Catch Basin Basin/Manhole Storm Drain — Shower Pan Fin ----------- AS HART FAIL. � ------- - HANICAL -- -- --- --- Post& Beam Rough-In -- �- - Gas Line f Smoke Dampers - - - -- - -- - - — Final PASS PART FAIL - - - -- _.. ---- --- - — ELECTRICAL Service Rough-In UG/Slab -- - - - - Low Voltage --------- ---- — Fire Alarm Final Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall lilv(i PASS PARI FAIL SITE _ �] Please cell for reinspection RE: ___ Unable to mshw,r iie ;ik,f s Fire Supply Line ADA Approach/Sidewalk Dsts.4� /)_� Inspector'� - Ext Other: % F;l.il DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspect:,)h Line: (503) ",,175 INSPECTION DIVISION Business Line; (503) 3@f4171 MST B � Received -- Date ..-1--sted _`3 l�_.� AM__�PM____ BUP _ Location ____ _ � ,�_f—,____ ' _Suite_C_/a �� —_ MEC JUo 0 Contact Person -_ --/_��__ _. Ph _) FRI ��`7! PLM —_— Contractor— -____-- -__-_ __---- - -- Ph (-----_-_-) _____ --_._.-_ SWR — __-- BU LDING Tenant/Owner _----_— ELC �.— Fo ting ELC -----._._. .-------- Fo ndatio Access: A _ Ftg rain L Hyl � .�OIYnCXyl� �(aE ELR ---- - - Cra I Dr n Sla Inspection Nates: SIT Pos & eam She r nchors Ext ath/Shear Int S ath/Shear Fram g _ - - - -- ---- - - -- Insul ion D a Nailing - -- Fir a Fir Sp 'nkler ---- Fir Ala 1 S p'd C iling ---- - --- ------ R of al ASS PA FAIL PLUMBING _ _ -- -- -- Post&Beam Under Slab - - -- Rough-In Water Service --- - i — Sanitary Sewer Rain Drains - - — Catch Basin/Manhole l� Storm Drain - - Shower Pan Other- Final therFinal — PASS PART FAIL MECHANICAL Post&Beam Rough-In — --- - -- _ Gas Line S e Dampers - --- - I PART FAIL -- CTRICAL Ser ice Rough-In UG/Siab Low Voltage -------- -------- ---- Fire Alarm Final [� Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW.Hall Blvd. PASS PART FAIL SITE Please ca for reinspection RE:- - [] Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Date ^?/�_ __- Inspe4ftir - Other: Finan DO NOT REMOVE this Inspection record from ii:e Job site. PASS PART FAIL