9600 SW OAK STREET 4TH FLOOR-1 H001A Hit 1S)Ido MS 0096
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9600 SW OAK ST 4THFLOOR
CITY OF TIGARD
RD ELECTRICAL PERMIT -_
J CITY /''1 PERMIT P ELC2004-00819
( DEVELOPMENT SERVICES DATE ISSUED- 12/29;2004
13125 SW Hall Blvd.,Tinard. OR 97223 (503)639-4171 PARCEL: 1S135BD-00100
SITE ADDRESS: 09600 SW OAK ST 4TH
SUBDIVISION: ASHBROOK FARM .ZONING: C-P
BLOCK: LOT: 005 JURISDICTION: TIG
Project Description: (3)branch circuits(separate overloaded circuit.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS_ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: _ PUMP/IRr)GATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HMI 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 FOR. 1 PER FOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVC/FDR>-225 AMPS: CLASS AREAISPEC OCC:
Owner: Contractor:
ASA PROPERTIES.,INC OREGON ELECTRIC CONST/GROUP
BY PAUL DEVILLE• 1010 SE 11TH AVE
PO BOX 3110 PORTLAND, OR 97214
HONOLULU,HI 96802
Phono: Phono: 503-535-2652
Reg#: LIC 203
SUP 4460S
FEES _ ELE 26-95C
Descript;on Date Amount
Required Inspections
[ELWAT]ELC Permit 12/29/2004 $60.15
;
[7AX18%State Surcharge 12/29/2(0 $4,81 Rough-in
.� Elect'I Final
Total 664.96
This Permit is issued subject to the regulations contained in the T;gard Municipal Code,State of OR.Specialty Cortes and all other applicable laws.
All work will be dore in accordance with approved plans. This permit will expire if work is not started within 189 dp+—j of issuance, or Hwork is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to 01 INC St(503)
246-6699 or 1.800-33 2344.
CL
Issued By: �, � Permit Signature:_
N OWNER INSTALLAYION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent. -
J
OWNER'S SIGNATURE: _ DATE:_,
r+2
—i CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ DATE:
LICENSE NO:
Call 6394175 by 7:00pm for an Inspection the next business day
^.EC-26-2004 03:43FWI PROP-OR ELECTRIC SERVICE 5035352763 1-946 P,001/O01 F-465
1J1�.�• HO• a
City of Tigard! Rerxiral
` �d
1312 SW Ha! Blvd Tigard,OR 97223
POeOtyaerls yNsee.it
Phone. 503.63947Fax: 503.598.t0ECE
C J
---------
Inslr:ction Line: 503.639.4175 ` l"r
Interact www.ci.tlpard.or.us tiodlirNllNdrod:_ rerv..u.a
M4
-- — ywr. — PLAN RM EW
New construction —19 A""l�r�a�iyQlrxtOefa Plewc check an du*apply
[]Service oyer 225 amps,oomm'I pHerardous loaatioo
Dwnelaion ❑Service over 320 amps-rating El Bulldog over 10,000 s t.R.,
of 1-and 2-IkW ly dwcllinp 4 or--lore stow n.-sidential
❑System over 600 votes nominal units in one tttri
[3 ]-and 2-fimily dwelling ®CommettudAnduA iul ❑Accessory bulldbtg (] o
Building over three suxi� []Peedcro.400 nM�or mnyr-
El
MuldAmily ❑Mastcr builder [�Ofttcr: ❑Occupant load ever 99 panvr►s ❑MrnuOmcu d avucttrrt or
_ JOA 9ffE INFORMATM AND LOCATION 0EWcs%AW1tIn9plan RV park
Job no--.82652lob site address:9600 SW Oak --- ❑�&C:1 a(heility Ovtlter
Submit,_sets of plans with eery of ter.above-
*M TipM,OR 97223 The shave we not applicable to temporary conovction smvicx.
1pM SCIMDULE
Sulfc/bidpJapL no.:4th floor Ptojeet mune:Aahlaemd College R,R'T' �-
_r—
Cross s"Wdirections tD job site:Near 217/Greenberg Rd. New reddestW Nvpls.or waWbi ily dwelling ank
lododes atrscYed
1,000 .!t,or kw 145.13 4
Subdivision: Lot no.: F.a etde!'I 500 sq.>t.a pottiest 33.40 1
United cin",maiden iid 75.00 2
Tax m tact)no.: _ _ Limiu e dwgy,-test-resklendd 75.00 _ 2
DESCIRTIM OF WORK mmdbcoxW or modulw
dwell MY=gWor 90.90
Separate overlowded circuit on 4rh floor. Servie"or-lade t Iestallelloa,ell""MO e,■.d/or I dot d"
100 stops or lar _.=;: 80.30 2
Q PROfi'Ii:0lT7f OWNER --�. Ll TM"NT — 201 aw to 400 rope 106.85 2
401 wraps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address; Over 1000 MW or voles 454.65 2
Reconnect only 66.85 1 2
City/9tatdw: Temporary services or f4eder s hmisinalinn,Ntersdoe,aaftr
Phone:( ) Fax.( ) r201
00 or Icss __-� 66.85 1
Owner installation-This Installation is behig made an proprtty that T own which is not tamps to 400mom- 100.30 2
intended for vale,lease.tient,or r+xchange,according to OILS 447,449,670,and 701. 401 amps to 600 rap, 133.73 2
Owner Signature: lute: Drseek ckttdls-now.alttrafiam or Ktension, pond
.0 APPLICANT ❑ CONTACT PlERKIN A.Fee ler branch circuits with
seMor or feeder[be.etch 6.65 2
Business name: benchcf�It
-- B.Fee for btw .
Contact name: wUhMW sere�trecdcr fee, ' 46.85 Y .8 S 2
Addrt:stl: Each"01 brwtnit ckouit _ 6.63 13.301 2
City/Stun/Zlt': rservice or ia4dar sot Wed -
53.49 2
Phone:( ) pmt :( ) Ptanp ar hr�ion circle
IL _ SI oroutlinel _ $3.40 2
IL &snail: - Signal _ t(s;or
Henergy Imo.alteration,or
CONTRACfQR
to exremlon.Dcsorftrc: Paps 2 2
Ek"Iness name:Oregon Electric Construction _ _RPA _
J Addre m:1010 SE I Ith Ave. w d0°° a0o"alM above
� of tic
m City/statcIzIP:Portland,OR 97214 pct hour p ter win 62.30
U - Induseial pawn hour 73.'1
WlfyliiBa
Phone:(M)234-9400 Fax-(904)935--2763
R1ZCY>ttt[.AL P1yR1110'I' '
CCD Liu.: 203 _77EleeMcal Lic.: 26A5C .Lie.: 4460S Subtotal
Sttlnv.Met tricien signature.requited: r Ptan tavlew(2516 of permit tae)
P!Irrt name: k . KEN Dale: 1Ir
Sate surdops(856 of permit tins)
---- -- TOTAL PERMIT FEE
Authorized sipahtre: 7tF,prrwk>tppeo. WxjFkW It a pm*Is std eblah"wRMa ten
days allor It has baa n4tgr.d n,I ON Ia
Print name: Datr: ' Fte leefodakW wt by itWft ty Swil iaB b mhw&Y Ssrvke bf wd
••14M do 01, r'iw oar eeenh allowed.
CITY OF TIGARD 24-Dour
BUILDING Inspection Une: (503)639-417': � MST
INSPECTION DIVISION 13usiness Line: (503)6::9-4171 �—
BUP
Received Date R ested___�` AM_ PM __ BUP
c r� .,,,, ` .
Location �LG LJ _.- _`--__-- r"7lt.�suite.� q ) MEC
Contact Person __ _ �Ph( ) — Pt M
Contractor _ _ Ph(—) SWR _
BUILDING Trnant/Owner i - ELC '�4Q -0,0
Footing ELC
Foundation Access: "-
Fog Drain la ELR _
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam `Z__.-
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear
Framing
....sem.
Insulation
Drywal!Nailing
Firewall
Fire Sprinkler --- - - - -
Fire Alarm
Suep'd Ceiling --- — - —
Roof
Other.
Final
PASS PAr;T FAIL
►� NGILUMBI __
Poat&Beam _ y
Under Slab
Rough-In
Water Service ---------_ — _
Sanitary Sewer
Rain Drains — --- -
Catch Basin/Manhole
Storm Drain -
Shower Pan
Other: -
Final
PASS PART FAIL
MECHANICAL
Post&Beam
Hough-In
IL Gas Line
a Smoke Dampers — --- —
Final
PASS PP.RT FAIL —— - --- ---
ELECTRICAL
Service �'—
m Rough-In
W UG/Slab
Low Voltage
Fire Alarm
S PART FAIL Reinspection fee cf$ —___required befnre next Inspection. Pay at City Hall, 13125 SW'Hall Blvd.
SR Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line i
ADA !
Aaproach/Sidr+walk D Ext_.
Other:
Final DO NOT REMOVE this Inspectlen Irelea d rn the 1n > new
PASS PART FAIL
0`1Y OF TIGARD
DEVELOPMENT SERVICES PERMTRICAL PERMIT
PERMT't #: ELC97--0232
13125SWHall Blvd.,l7gard,OA97223 (503)W4171 DATE ISSUED: 04/15/97
PAf'CEL: 1S135BD-00100
SITE ADDRESS. . . :O96O1) SW OAK ST 114TH
SUBDIVISION. . . . :ASHBROOK FARM ZONING:C—P
BLOCK. . . . . . . . . . : LOT. . . . . ., . . . . . . . :5 JLIRISDI("TION: TTG
Project Description: instl Pl branch c',rcuits
----------------•---------------
_-RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS----- ------MTSCELL-AMEOUS------
1000 SF OR LESS. . . . : 0 0 — 200 ampi . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 5O0SF. . . : 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : V1
L..IMITED ENERGY. . . . . : 0 401 — 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
---SERVICE/F'EEDER---- ----BRRNCH CIRCUITS-- --- ---ADD'L INSPECTIONS—-
0 — 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 — 400 amp. . . . . . : 0 1st W/0 SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 — 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 20 IN PLANT. . . . . . . . . . . : 0
601 — 1000 amp. . . . . : 0 -------------------PLAN REVIEW SECTION________________
1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : ID SVC/FDR )- 2225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: ----------------------------------------------------- FEES ----------- _-----
CEDARLAKE COMPANY typo amount by date reept
1331 WASHINGTON ST PRMT f 135. 00 TAT' 04/15/97 97-293264
VANCOUVER WA 98660 SPCT $ 6. 75 TAT 04/15/97 97-293264
Phone #:
Contractor: ----------------------_—_—___—____--__—...___-----..-_____— __—_—__
:DINNER ELECTRIC INC f 141. 75 TOTAL
5150 SW PROSPERITY PK
REQUIRED INSPECTIONS
TUALATIN OR 970622 Ceiling Cover UnderOrou"d Cove
Phone #: 638-5028 Wall Cover Electsl Service
Reg #. . : 000147
This pereit is :sued subject to the regulations contained in the _
Tigard hunicipal Code, State of Ore. !p*cialty Codes and all other perm i t t sy Signature
applicable laws. All Mork will be done in accordance with /
approved plans. This penit will ehrpire if Mork is not started
IL � within 10 days of isswncc, or if Mork is suspended for tore
h than IA! days. Is5ia4d Sy
---- ------------------------OWNER INSTAILATION ONLY------
Thp installation 4-s being made on property I own which is not intended for
J sale, Lease, or rent.
OWNER' S SIGNATURE: _ DATE:
W ----------- - ------------CONTRACTOR INSTALLATION ONLY--------------- .--------__--
S I QNATURF OF SUPR. ELEC' N: DATE:
LICENSE NO:
Call for inspection — 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Phone (503) 639-4171 Date Issued _- --
CITY�F TI4AiP® FAX (503) 684-7297
TDD No (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Cor.�plete Fee Schedule Below:
Name of Development ek we S Number of Inspections per permit allowed A
AddrEss ! 4,00 W• L y4 Service included. Items Cost(es) Sum
city/State/Zip AeAr d �L- 43. Residential -per unit
1000 sq. R or less $11000 4
Name (or name of business) Each addltlwai 500 sq n or
portion thereof $25.00
Commercial Residential ❑ Lh*ed Energy $2500
E00Mtinurd Home or A4odutw
Dwelling Service u Feller $88.00 2
2a. Contractor installation only: 4b. Services or Feeders
Electrical Contractor t C` E C "��t Installation,alteration,cN ro -stlon
200 amve or less 380.00 2
Address O S .- 201 if ,:s to 400 amps $8000 2
CStet® Zip 401 amps to 800 amns $12000 2
3 801 amps to two amps 3180.00 2
Phone No. .-(�y.__g S e. Over 1000 sn"or vons $340.00 _^_ 2
.Job NO. Reconnect only -- $50.00 2
contractor's license NO. 4c./S Zr 4c. Temporary Services or Fwda�
Contractor's Board Reg. NO. �.� Installation,alteration,or relocation
Signature of Supr. Elec'n l 240 amps or lees 2
License No. q yPhone No. o 2V1 amps 10 400 a" s $5000 2
401 amps to 000mp"a $75 00
Over Loo amt..to 1000 volts $10000 -
2b. For owner Installations: see"b"above
Print Owner's Name 4d. Branch Circuits
New,alteration or extension per pane
Addressa)The f"for branch circuits w,"city State Zlp -� purchase of Service or hedor r". 2
Each branch cacull $8.00
Phone No. h)The fee for branch clrculle wf hoW
The installation is being made on property I own which is purchase fte.L 2
Fast branch r $35.00
e
not intended .or sale, lease or rent. Eacn ads.+, m1 ai$rbr anch clrcult ta.0o
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if reyulnew.11: Each pump or arlgstron cirde $40.00 2
, Each sign or o#AIWW pp " $40.00 �-
Signal cacult(s)or a limited energy 2
4 Please check appropriate Rem and enter fee in section 5B. panel,alteratlon or extenakon $4000
a 4 4 or more residential units in one structure M'nor I.abets(10) 3100.00
Service and leerier 225 amps or more
System over 500 volts nominal 41. Each additional Inspection o'rer
Classified area or stricture containing special occupancy tl a allowable In ary of the abtrre -J_
as desLribed in N.E.C. Chapter 5 Per Inspection $35.00
Per hour $55.00
_
Submit 2 sets of plans with application where any of the a"vR In Plant S5500
Wapply. Not required for temporary construction services. 5. ages:
J NOTICE 5a. Enter total of above fees $ /3�
5%Surcharge (.05 X total fees)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
Subtotal �
Enter 25%of line A for
AUTHORIZED IS NO'i COMMENCED WITHIN 180 DAYS,OR IF Sb. RI,n Review H required (Sec.3) _
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS $
COMMENCED. Trust Account 4
am„rn $
Balance Due s
CITti OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phare: 6394171
Date Requested: J �� _ _ A.M, P.M. MST:
Location: 4 BLIP:
Tenant: AA Suite: Bldg: _ MEC:
Contractor: / `ll FLO _Phone: PLM:
owns: -- � Phone: _ _ ELC: 0
_ SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICA SITR �—
Site Post/Beam Post/Bemn PogYBeam ver, tce Sewer/Stcrm
Footing Tonf I1ndF1/Slab Rough-In Ceiling Nater I.ine
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hocxl/fluct Reconnect Vault
Bsmt lamp Drywall Stam Furnace Temp Service MISC.
Mascmry Ceiling Rain Drain A/C LTG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found IN Heat Pump Low Volt
Approv-d Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Appnn ed Not Approved
FINAL FINAL FINAL FINAJ FINAL
Of-Of-Ma 9 r{EA 4), s
CjE'11- IN G
to _
ED
w
0 Call for rein.Tection� Reinspection fee of S_ t_required before next inspection O Unable to inspect
Inspec
tor: Page of-
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line:6394175 Business Phyte: 639-4171
We Requested: �U / f _—_— -- A M. ✓ P.M.— MST: ---
Location:, — - — — BUP:
Tenant: stpte /� -B�ldgp _� MEC: _--
C'ontractm: Phone: �'" t✓�/n _ PLM.
Owner:_ (i Phone: ELC: 1 7
– O
SIT:
BUILDING BLDG(can't) PLUMBING MF,(WANICAL CAL ) SITE
Site Post/Beam Post/Boun Post/Beam Cover Sewer/Storm
Footing Roof UndFi/Slrb Rough-In ' tog Water Line
Slab Framing Toy Out Gas Line Re►gh-In UG Sprinkler
Foundation Insulation sewer f lood/Duct Reconnect Vault
"snit Ihunp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C U(;Slab
Shea-'r,Cabo Fire Spl Ir/Alm Crawl/Found Dr Heat Pump
Approved Approved Approved Apptuved
Appr/Sdwlk Not Approved Not Approved Not Approved ved Not Approvext
FINAL FINAL FINAL FINAL FINAL
a
m
w
Cl Call for reinspection C]Reinspection fee of S _requital before next inspection 0 Unable to' qwt
t
Inspector:- �u s2 ZT— r< _ lite:_.�G? 1 '� Page_L of
CITY OF TIGARD BUILDINC INSPECTION DIVISION MST
34-Hour Inspect!on Line: 839-4175 Business Line: 838-4171 --
BLIP _
^Date Requestedt AM_Y_PM SUEIL
Location '7 "-e ' r ` M'cC
Contact Person � i ph 79 L20PLM
Contractor Ph SwR
BUILDrNG Tenant/Owner ELC 9-7--001221
Retaining Wall ELR
Footing
Foundation FPR
Ftg Drain SGN -
Crawl Drair. Expired/Research/Request - -'--
Slab SIT
Post&Beam --- -------
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler _
Fire alarm
Susp'd Ceiling
Roof
Misc: -
Final
PASS PART FAIL
PLUMBING
Post&Beam -
Under Slab
Top Out - ` --
Water Service
Sanitary Sawer '—
Rain Drains
Final
PASS PART FAIL � r_ "�
MECHANICAL
Post&Beam - —
Rough In
Gas Line — -----------
Smoke Dampers
Final - -- -
PASS PART FAIL
Service
Rough In w
UG/Slab
Low Voltage
Fir.Alarm
grl
A5 PART FAIL
i g
Backfill/Grading -----
Sanitary Sewer
Storm Drain [ j Reinspection fee of$` required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE: [ ]Unable to inspect-no access
Fire Supply Line
ADA ( .�..,�_
Approach/Sidewalk
Other Date � Ext
P�+' (/ Ins ector E_ — _
Final
PASS PART rAIL.j DO NOT REMOVE this Inspection record from the job -31te.
CITY OF TIGARD
DEVELOPMENT SERVICES B"JILDING PERMIT
13125 SW HAIL BJv� ngerc",ORS''O' 'a1191835-4179
PERMIT #. . . . . . . : BUP97-0132
DATE ISSUED: 03/18/97
PARCEL: 1S135BD-00100
SITE ADDRESS. . . : O%,00 SW OAK ST #4TH
SUBDIVISION. . . . : ASHBROOK FARM ZONING:C-P
BLOCK,. . . . . . . . . . . LOT. . . . . . . . . . . . . :5
--------------------------------------------------------------------------------
REISSUE: FLOOR AREAS---------- EXTERIOR WALL CONSTRUCTION--
CLASS OF WORK. :ALT FIRST. . . . : 0 sf N: S: E: W.-
TYPE
:TYPE OF USE. . . :COM SECOND. . . : 0 sf PROTECT OPEN I NGSI---•--------
TYPE OF CONST. -214 1400 . . . : 0 sf Ns S: E: W.
OCCUPANCY GRP. :B TOTAL--------: 0 sf ROOF CONST: FIRE RET7:
OCCUPANCY LOAD: too BASEMENT. : 0 sf ;'?EA SEP. RATED:
STOR. : 0 HT: 0 ft GARAGE. . . : 0 sf OCCI I SEP. RATED:
PSMT? : MF_ZZ?: REOD SETBACKS-------- REQUIRED-----------._---._
FLOOR LOAD. . . . : 0 ps f LEFT: 0 ft ROHT: 0 ft FIR SPK'I'.:N SMOK DET. . :
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:Y HNDICP ACC:Y
AF_DRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
V AL LIE. $: 31000
Remarks: Tenant improvement - interior wall changes for the entire fourth floor
nwner: --------------------------------------------------- FEES --------------
ASA PROPERTIES type amount by date reept
31.9 SW WASHINGTON #320 PRMT $ 197. 50 B 03/1®/97 97-291895
PLCK $ 128. 38 B 03/18/97 97-291.89E
PORTLAND OR 97204 FIRE_ $ 79. 00 B 03/18/97 97-291.896
Phone #: PP4- 6642 SPCT $ 9. 88 B 03/19/97 97-291895
Contractor: --------------------------------
BOYD INCORPORATED
DF,TEAN & CO
I P01 E FL SEGUNDO BLVD
FI_. SEGUNDO CA 9Oc:45 -------------------------------------
Phene #a $ 414. 76 TOTAL
Reg #. . : 074504
------- REQUIRED INSPECTIONS --------
rhis peroit is isst.ied subject to the regulations contained in the Framing Insp
Tigard Municipal Cod,,., State of Ore. Specialty Codes acid all other Gyp Board Insp r
applicable laws. All work Mill be done in accordancz with µ__
approved plans. This peroit will expire if work is not started
within 180 days of issuance, or if work is suspended for sore
OFC than 180 days.
J Permittee Signature:
.a —
Call for ii spection - 639--4175
CITY OF TIGARD
DEVELOPMENT SERVICES BUILDING PERMIT
AILIMM 13125 SW Hall Blvd.,l7gnrd,QA 97223 (503)639-4171 PERMIT #. . . . . . . : BUP97--0132
DATE ISSUED: 03/18/97
PARCEL: IS135BD-00100
SITE ADDRESS. . . : 09600 SW OAK ST #209
:SUBDIVISION. . . . : ASHBROOK FARM ZONING:C-P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5
-----------------------------------------------------------------------------------
REISSUE: FLOOR AREAS---------- EXTERIOR WALL CO`:STRUCTION-
CLASS OF WORK. :ALT FI.RST. . . . : 0 sf N: S: E: 14:
TYPE OF USE. . . :COM SECOND. . . : 0 of PROTECT OPENINGS?----.-------
TYPE OF CONST, :2N 1400 . . . . 0 sf N: S: E: W:
OCCUPANCY GRP. :B TOTAL-------: 0 sf ROOF CONST: FIRE RET?:
OCCUPANCY LOAD: 100 BASEMENT. : 0 sf AREA SEP. RATED:
STOR. : 0 HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED:
BSMT?: MEZZ?: REOD SETBACKS--------
FLOOR LOAD. . . . : 0 ps;f LEFT: 0 ft RGHT: 0 ft FIR SPKL:N SMOK DET. . :
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:Y HNDICP FICC:Y
BEDRMS: 0 BATHS: 0 IMP SURFACE: N PRO CORR: PARKING: 0
VALUE. $: 31000
Remarks : Tenant improvement - interior wall changes
Owner. ----___.____._.___----___________________.___------___-- FEES ------•---------
ASA PROPERTIES type amount by date rer_pt
319 SW WASHINGTON #320 PRMT $ 197. 50 B 03/18/97 97-291896
PLCK $ 128. 38 B 03/18/97 97-291896
PORTLAND OR 97204 FIRE f 79. 00 B 03/18/97 57-291896
Phone #: 224-66422 SPCT $ 9. 88 B 03/18/97 97-291896
Contractor: -------___—__--_---_—_____—__—_
BOYD INCORPORATED
DEJF_AN & CO
1201 F EL SEGUNDO BLVD
EL. SEGUNDO CA 90245 _____________________----_-—_---.____--
Phone #: $ 414. 76 TOTAL
Req #. . : 074504
------- REQUIRED INSPECTIONS
This perait is issued subject to the regulations contained in the Framing Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Gyp B o a rL+ Insp y _
applicable laws. All Mork will he done in arcordance with
approved plans. This perait will expire if work is not started
within IN days of issuance, or if work is suspended for more
than 10e days.
Perini+ tee Si iatx_ire:
Call for inspection — 639-4175
clic o1 T194wd 131 Ys'sw(tall Mal rued.OR sy
15031 i30AM
Jobsite Address: 9 fi3O 0 0a,s S t
Tenant: Traveler SultepFoutth floor
Valuatioli; $ 319000.00
Owner. ASA Properties
Address: 319 SW Washington #320
Portland OR 97204
Telephone: 503-224-6642
Contractor: Boyd incorporated
Address: 1201 E. E1 Segundo Blvd.
E1 Segundo CA 9024 5 Type of constr: T,I•
Telephone: 360-694-8000 Occupancy Class: 11-N
Contractors License• Q 0 7 4 5Q 4 Sprinkler? yes No x x
(attach capy of currant Oregon kense)
Sq. Pt, Of Project:_14.On n
Contact name &telephone: i p f f. R.Raandal
360-694-8000 Story (1st, 2nd, etc.): Fourth
Architect a Engineer: Cedaria ,e comoanv.
Proposed Use: Of f i ca
Address: 1331 Washington S t.
Previous use: Of f ire
_ Vangg yer WA 98660
Note: Plumbing & mechanical plans must
Telephone: 360-694-8000 _ be submitted at time of building permit
application.
JOB DESCRIPTION: Tenant Improvement
360-694-8000
(Applicant Signature &Telephone Number)
Received by: Dnie Received:
1:TCMT1.00C (DST) 10M
PERI ffS Account Description Amount AnK Pd. Qaiance Due
Building Permit (BUILD)
Plumhing Permit (PLUMB)
Mochardcal Permit (MECN)
Mate Tax (TAX) p>
Rldg,
Plumb,
Mach.
Plan Check (PLANCK) VS .7
S AL
Bldg. �..�. .
Plumb. �s
Mach.
Sew-4t Connection (MUSH)
Sower Inspection (3WINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TiFA)
Mass Transit TIF %774M
Commercial TIF Mr-C)
Industrial TIF (774)
Institutional TIF (TiF.is)
Office TIF MF-O)
Water Quality (WOUAL)
Water Quanity (WOUANT)
Fire Life Safety (FLS) !
i --
Erosion Cntrl Permit (ERPRMT)
i
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS:
momnmoc (o" ,ow
®YER THE COUNTERWIC)
(attachment to Submittal Criteria)
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISED STATUTE(ORS)447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related facilities shall be
made to insure that the path of travel to the altered area and the restroom,telephones and drinking
/ fountains are readily accessible to individuals with disabilities,unless such alterations are disproportionate
to the overall alterations in temp of cost and scope
(2) Alterations made to the path of travel to an shared arse may be deemed disproportionate to the overall
alteration when the cost exceeds t.venty-five Far-cent(25X).
1
THEREFORE; Each submittal for a building permit sholi Include this form providing the following
information. [Excluding re-roofing, mechanical and electrical permit applications]
VALUATM of all renovation, alteration or modification being done
excluding painting, wallpapering. [1) $ 31.000.00
nulftP)t 25% Barrier removal requirement. --.25—
BUDGET
_,.25_BUDGET FOR BARRIEi: REMOVAL (2) $ 7. 7 50.0 0
The dollar amount of the @UDM established on line (2) in the computation above shell be spent
providing the accessible elements in the following order;
1- An accessible mute connecting the building to accessible pedestrian
walkways, and the public way. $'Coo costly(see attache
[including but not limited to curb ramps,detectable warnings,
marked crossings,ramps handrails and lendings).
2. Not less than one accessible parking space. $Done in previous T. I.
(including but not limited to adjacent access aisle,signs and curb ramp (see attached)
connecting with the accessible route).
3. Accessible entry or entries. $ n_00
[including but not limited to romps,handrails,landings,
door sill height,door width and door hardware].
4. An accessible interior route to the altered area. $ 4,650.00_
(including but not limited to door-ways,maneuvering
clearances,door hardware and stsirwaysl.
IL 5. At least one accessible restroom for each sex. $ 3, 1 )0. 00
IOC ----------
6. At least one accessible telephone where public phones
are provided. $
m 7. When drinking fountains are required, fifty per-cent but
0 not less than one shall be accessible.
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8. Additional accessible elements such as stor-Age, reach ranges,
alarms, etc . N/A
TOTAL: shalLequal line 2 of Value C4moUULiQIL $ 7, 750. 00
i:lotc4.doc(DST)
I
Boyd
Incorporated
100 East i3th Street • Suite D • Vancouver. Washington 98660 • Tel (360) 694-8000 • Fax: (360) 694-0174
March 10, 1997
Aim Funk
Plans Examiner
City of Tigard
13125 SW Hal! Blvd.
Tigard,OR 9.1223
Re: Plaza West
Fourth Floor
%00 SW Oak Street
Dear Mr. Funk
We offer the following information regarding the above referenced project.
1. Accessibility
A. To our knowledge barrier removal of this office space is in compliance with
OSSC, Section 1113.1.1 and ORS 447.241 (4).
B. To our knowledge all barriers have been removed from the parking area. The
previous tenant improvement prq* 1pha Engineering( permit #BUP95-
0534 ), completed all possible update quired by current ADA standards.
C. Die to existing elevations a Wheel Chair Ramp of approximately 100 L.F.
would be required at a cost of$46,862.00(see attached cost breakdown).
This is excluding the cost of additional path of travel requirements that may be
associated with the installation of a ramp. The cost of ramp liir exceed the
total cost of the tenant improvements.
D. This project consist of the installation of 22 ea. ADA or building standard
ADA approved door lever hardware.
E. Attached are three(3) Parking Lot Flans showing existing handicap
co
accessibility.
C7
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March 10, 1997
Boyd Incorporated
Plaza West, Fourth Floor
Pa;3e 2
2. Fire and Life Safety
A. Attached are three (3) Floor Plans including the corridor/lobby areas showing
access and fire routes. Corridor walls and ceiling will be modified to meet a
one(1)hour fire rating, including installation of 20 minute doors and frames,
fire dan pens and fire rated light enclosures.
B. Both entcv doors have met previous code requirements. Should these need to
meet more ccrrent standard, please have your inspectors check for
compliance and we will upgrade should it be necessary.
3. Fire Alarm
A. This building has a built-in Fire Alarm System that has central monitoring by
Advanced Services. The elevator lobby has automatic sarety doom;that
close in case of fire(see attached Fare Alarm System Inspection
Certification and Deficiencies Compliance Report).
Should you have any questions or require additional informattk'n please do not hesitate to
call.
Respectfully,
Boyd Incorporated
OC
Jeff Randall
Project Manager
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COST ANALYSIS TO PROVIDE ADA RAMP 0 PLAZA WEST
ARCHITECTUARL& ENGINEERING FEES $3,00000
DEMO& REWORK LANDSCAPE IRRIGATION $3,000.00
EXCAVATION&SHORING ;10,000.00
DISPOSAL OF SPOILS $2,000.00
FORM, PLACE & FINISH CONCRE i"E $15,000.00
STRIP&CLEAN FORMS $750.00
FURNISH& INSTALL HAND RAIL ;6,000,00
PAINT HAND RAIL $1,000,00
SUBTOTAL $40,750.00
CONTRACTORS FEE 15�( $6,112.50
TOTAL W,862.50
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CITY OF TIGARD BUILDING INSPECTION DIVISIONT
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 SUP 01
Date Requested -&S/60 60 PM BLD
Location_ �W uite .MsaL�- MEC
Contact Person �Y1 ,i/lt�Q Phi 3-?�_$�__ _ PLM "►
Contractor Ph _. swR
A AY
IL Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPA
Ftg Drain SGN
Crawl Drain Inspection Notes: , .LJC � l7 .
Slab _ SIT
Post&Beam
Ext Sheath/Shear I --T--
Int Sheath/Shear
Framing �?-
Insulation (I
Drywall Nailing YL < --
Firewall
Fire Sprinkler - -
Fire Alarm - r C�Aj I
Susp'd Ceiling -- —
Roof /
M1, -- _
1 ASS ART FAIL -0---� ���
WIMM—SING Cj 2 Q d (� ap
Post&Beam
Under Slab _
Top Out
Water Service _
Sanitary Sewer —
Rain Drains --
Final
PASS PART FAIL ---
MECHANICAL
Post&Beam ---------- -----
Rough In —
Gas Line ---! -`-�-
Smoke Dampers _-
Final - --- -�— ---- --'
PASS PART FAIL
ELECTRICAL --------
a Service �� --- -- -
Rough In
N UG/Slab ----
y Low Voltage --- ----v-_ __ - ------
F3 Fire Alarm
Final
m PASS PART FAIL --- _-- ---------- --
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SITE
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Backfill/Grading ---
Sanitary Sewer
Storm Drain [ ]Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Unable to Inspect
Fire Supply Line I Z f"-ase call for reinspection RE -no acces
,_ _ [ 1
ADA . y{— -�
Approach/Sidewalk Date / _ Q Inspector �� �-`"`�~ Ext ,
Other -f---�f-�- - --__
Final
PASS PART FAIL DO NOT REMOVE this Inspeetlon record from the Job site.
Vr.w i u.0
kpd Mini f rWnw Vacs d^Planning
�T�Cary nwioatm Systems Dmv w
a� i�6 PLAN CH6ZK 00. : cl
Lkw"Corpor"m ToWphom DATE RRC19TVMD,.—w2'a/ /
[)iphrbe SyAwm OrpprruMsan 9019%4181
322 Noft Spay way 801292 0011 n�
SOLake City ut84116 P/C DEPOSIT PAID:_ o� .,r...r ..
This is to certify that the axtached d sets of plans have been subsitt •d for plan
check pursuant to the Oreson'Structural Code and Fire 6 Life Safety Code, �y`rditiun.
t �
PROPERTY OWNER �S S
OWNER'S ADDRESS: '?� `SW (J1
CONTRACTOR: _ —
JOB ADDRESS: j4'Q,0 Sy-j Dc� LOT NO. a MAV.
DESCRIPTION OF WORK:
A royal. lte uired ,! IIV' SPECIAL NOTES
p 1#014
p f�0i.ssue
�anni De t.
(S'")j1;i*ineer1ns Dept. () WIOW Plain/Sensitive Lands
(;�Ure District O$wer Availability nI
Other Other 6h, rec Ue�
Item! Required
0 Litt of subcontractors C1
Obusiness Tax
�isloptZ�tioas
0Treue# Details
CL r) p-
0 Parkins Plan i..
N
0 Landscape Plan
m O Other
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CONMNTS:
ex trlhc
BYi ,
Summit Construction
A DIVISION OF SUMMIT INDUSTRIES,INC.
P. 0. BOX 10345• PORTLAND,OREGON 97210- PHONE 223.9703
November 10,1987
Mr. Brad Roast
13125 SW Hall Blvd.
P.O. Box 23397
Tigard, Oregon 97223
Mr. Roast:
RE: Unisys Corporation per phone conversation 11-4-87
Unysis put in for a $46 ,000 .00 permit value and the actual job
contract was for $25,852 .00 ( ace enclosure) . Their value was
based on complete budget, including furniture, moving expense
of movers, etc.
According to the actual job bid figures, the permit fee was
too high. This is a request for a refund of the overpayment.
Building permit $7096
Job & location: Unisys, 9600 SW Oak, Portland, Oregon97223
Thank you for your attention on this matter.
Sincerely, --
Doug Stroud
Enclosure
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ED
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WASHINGTON COUNTY FIRE DISTRICT NO. 1
20065 S.W. Blanton St. • Aloha, Oregon 97007 • 503*49-8577
September 28, 1987
Mr. David Fuller
Unisys
9600 S.W. Oak Street
Portland, OR 97223
Dear Mr. Fuller,
RE: Tenant Modification
Portland Marketing
The plans you submitted to the City of Tigard for review for the
tenant remodelling for the above-noted tenant have been reviewed by
this office and the following regal rements and specifications are
required.
1. Double Door Hardware: Where exit doors are used in pairs,
approved automatic flush bolts shall be used on the Qecondary
leaf. The door having the automatic flush bolts must have no
door knob or surface-mounted hardware. The unlatching of any
leaf must not require more than one operation.
(UBC Sec. 3304)
2. Firest_opping: In all wood-framed wall and partitions, fire-
stopping consisting of 2-inch nominally-sized lumber or other
approved materials must be installed at all floor and ceiling
levels. Penetrations in this prescribed firestopping to accom-
modate wiring, plumbing and other similar utility runs must be
packed with noncombustible materials in an approved manner so as
to prevent the passage of flame.
a (UBC Sec. 2516)
3. Automatic Sprinkler Plans: Plans ci ferred to and examined
by this office contain no provisions for the alteration or
installation of automatic sprinkler system. Not less than
-i three sets of plans for the installation shall be submitted to
m this office for approval prior to installation.
W
-J It. Approved Plans on Job Site: One set of approved plans bearing
the stamps of the Tigard Building Department and this office must
be maintained on the project site throughout all phages of con-
struction and must be made available to building and fire inspec-
tors for reference during required construction inspections.
(UBC Sec. 303)
STOP FIRES—SAVES LIVES
Mr. David Fuller
September 28, 1987'
Page 2
5. Certificate of Occupancy Required: Prior to the use and oc-
cupancy or other written instrument of approval must be obtained
from the City of Tigard Euildi.ng Department.
(UBC Sec. 307)
If I may be of any further, assistance to you, please do not hesitate
to call me.
Sincerely,
WASHINCT COUNTY FIR tISTRICT NO. 1
Bert Pang
F e-marshal
ssw
cc: City of Tigard
Inspector Ray
NOTE TO INSPECTOR: This plans review covered the remodel of a tenant
space in the Portland Marketing Consolidation Area, second floor and
4th floor. Minor alterations to the interior development consist of
the movement of a set of double doors, the installation of temporary
office space utilizing office dividers of not more than 5'911 high, and
the development of an interior room on the second floor. The fourth
floor is the installation of doors in roan 427 and the removal of
partitions in room 431 with the construction of a wall. in that area.
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- -- -- -- BUILDING PERMIT
CITY OF TIGARD YRRMIT k0. :1�:'
••••• ur►rs xBBUEm- -
COMMUNITY Dr1 ROP�1�DWARTMENT
�s�sw.�wr+a.ro.M.fMR.*�.o�NwMs�1�M�n
aOB ADDRssB: ST_-- — LT,
TAI MAP/LOT
Lm Uas: BSTBACKs
WT 81219: __ _-- VALUATION: -
TV0rT: -_-- ------
/EN. / or>. OWULMNITS: LIM -_ RICHT:
BORIC CLASS: _-_
UU TYPB: C"n e->C-t N0.iIIDROOIIB _--
0008T.TYPt: N0.1�AT1lt8: -
OI7G'UP,W!.t '2
OQCtTP.LOAD:
TOTAL AItt+1►: A
lvT-
NO.STORItB: AM SPAR:
HRI6"�11T: _ - Y/D: OWW.SWAR:
Tams ALAWAt
79AM LOAD
�.A�BBS:
M&T TYPIA: -
PLAN Cmm BY:
RXNARKB:. __ ___ RUMgm OT NO. _
- LAST 121=8 — -
SWAM P1 wml_ -
NK44r
QJL' 9(vdb j W, T. TRiiBt J `'.� S ;2 4-
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1A^'^j� T 1 o�' RQ DET! B 6
nan Ta
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DIM TIRN! CFANM:
T Addrtss - sDc (sTORM).
A - SDC (STRW) _-
A -- --
C ---- --- ")c -11§6 P1tRPAIb Z `Q
T Phones
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d. TOTAL;17
F1 9:1,T �U iw> - PJQ'AD_ T RRCRIPT MO. .-.-. --
=QMRRD INSPRCT70"S
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FOUNDATION MALI.. RAIN AWNS
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IAKa C11TT DIVISION BUYER DATE OF ORDER TYPE Or-ORDER
985 SLC tP-10-21 fort w1l
S'. OPLIER CODE DEFENSE PRODUCTS GROUP 11 ANOPERAYINO UNIT OF VSRRYCORPORATION PAGE 1 OF 3'
SUNT*CO-01 a
SHOW PURCHASE O,IDER NUMBER ON ALL PACKAGES AND DOCUMENTS CONFIRMING
vbMMI7 CDNSTRUCTION H Unisys CORPORATION -- --
2130 N.M. YORK STREET I DEFENSE SYSTEIE'S DOCK 83
PORTLAND P COMMOINCATSONS STSTEAS 61VISION
DR 97210 322 NORTH SPERNT WAY (2200 VEST)
O SALT U4KE CITY
AT1 ENl iUN: OT 84-116
L HM E� FHElGHT: FUB: SHIP
'wM T NUMBS D - PiER��t-- ec� ► tVIA:
DESCRIPTION REQUIRED DELIVERIES
TEm VENDOR PART NUMBER RV DATE OUANTIIIY UM UNIT PRICE "�•
.OTE SOURCE: YRIITEN t
0 .. 00"001s.s0r404ilwa0����.�•.a«�.��eris��r���l�ta��.7►��1�'E1'.�I r�l�r�wf+« �ifi-i r�tilri lr: .
001 CONSOLTOATED MARKETING CBILTRRYq EiR11'• 25852.0
PORTLAND OFFICE PLANS SERVICE DATES OTrr10—i'T' TMRU 17-11-4,50
TO BE PAID ON APPROVAL OF A VALID INVOICE
Y
E FOLLOMIN6 SPECIAL PROVISIGXS APPLY TO ILL STEN. ON"& AJRCNASE 61109114
U.S. GOVEANRENT ExFORT CONTROL'S - TN OWN MNOVt*uvt iw oft *mm"wev X14 r`
SELLER ARTICLES/TECHNICAL DATA] IDENTIFIED AS 10JECT TO, NS tXPORT
CONTROLSo FOR SELLER'S USE IN CONNEGITIOX UI?H Pf&FONPAIICV U110F TNj.i
PURCHASE ORD EC* THEN SELLER 15 •RESO'ONSIILE POR`'Cbl1P ' ltCf' tYT .r
APPLICABLE U.Se GOVERNMENT ExPORT INUL muest;
PAPTS 121-130;000 DIRECTIVE 5130*ZS AND AMM OfrN!11 965% MOV11WNENT:'
REGULATION APPLICABLE TO THE DT=CLO•VOWEXPOAT 15F AkrICLtS1TEtbMitAL
DATA TO FOREIGN NATioms ouil r,um mw itAAlf• 'cuixth''111+'uEIIIyt�°'
APPLICABLE TO C1TItENS' IDR CANAO4' #Rt'fOWlr:BN'r11� N�N� NN'itM L� L P•;.•
REFUL( TIONS) . BUYER RESERVES THE AIGHTp TO TNA FEXT&T 46 SPECltlta ON
THE FACE OF THIS OROERt TO OBTAIN ANV 119597AN• VaS*1 OdI*NNNINT Ji'PORT
APPROVALS9 LICENSES CERTIf1CAT1If*' A :'0NJ>i°U'iIINCtlS�`S ''" " "" fit c+..ry a
NERCURT CONTAMINATION - THc PARTS FUNNIISHtO' UNMEA TWTS C019TRACT $NALL '8E
FREE FROM MERCURY CONT-01PINA41010,
SEND INVOICES T0:
UNISYS CORPORATION
****** CONINNUED ON Newe"Mo 11akiiis* „• . .
SALT 3 USE TAXES MINE-SOIA AND UTAH - TOTAL VALUE:
—`---- MINNf SOT OIRr(•PAT nfnMlT I,r In"o P X91 ANf11IIAH PFRWT
IMP,-R1ANT SELLER NO,TI NO 0 904 1351
Do N01 HILL•+NYSMINNEIIITA.OR UI AN IA+
IS SUB,FCT TO DEFENSE PRODUCTS is AOifv TO PAY ANI ItPIICAeIf TAX,jF(`T I. IO VHF.STAIF ,Ilr snIFR QUALITY CONTROL REQUIREMENTS AS
- '-:CATIONS.If ANY pLCPEPANCIES EXIST -R RFLIFVTn.tt RF^.PMGipILITV TIJ COU[fr TAX
rI 41 rNSE PRODUCTS GROUP SPECIE CATgNS SAY:S USE TAX 01rI1N THAN ANNNISOTA.UTAH INDICATED ABOVE MUST BE ADWF.RED TO
I SPECIFICATIONS DEFENSE PRODUCTS
•I^AIIDNS "ALL APPY PACXINI'.SLIP
Ar_" IF Nl)EXFMPTION STATEMENT APPEARR ON THIS ORDER ADDRESS ALL IR'QUIRES TO:
I 1- 1 Oft P D L ANY APPLICABLE TAX
"Al" N AI L PAC.ARt I ANO
ORDER CERIIrIEn FDR NATIONAL Atx,ENANCE OF TINS fKJT>cwue ofoa CONSTRurES CER IrICATX7NrTNE BUYER: LLOiI) 0sT1P R
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(S-QNII OF THE DEFENSE PRgNTIES AND OpOr^ABLE DRAWXVOR R►ECIFiCATNH/S.STAN}>AnM+ -IF PUROHASE PHONE: 8Q1 r�59ir4 2 2•
.STEM REGULATION IIS CM PART]SO{
' "ON THIS PORCNABE ORDER A.1 ACCEPTANCE-THIS ORDER EXPNER .�•_ __ —
,.VAYF IISf ANDEROOVA\NMFNT STATEDHEMIN FNYADpTIONALO:IuU%FSI�MTZ�"PPRp OSEDTBYSILu1 MAIL STA: 02,006
1 115 uNOf R 5100 NEUTARE NO WTIIT'FN .OBJECTED TO AND HERESY PEJSCTEO THIS PURCHASE DRIER b SUBJECT
!Ir rIr In IKFFNSE P"OOUCTR ORIYJP T O T'IE TERMS AND CONDITIONS ON Ti REVfAW HEREOF
BIGNEBY.
n BUYER DATE
AUTHORIZED YEN"REP.
;.4;'REV.4195) VENDOR COPY