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9600 SW OAK STREET STE 350 to N O O N O t� x y rr It W N O 9600 SW Oak St #=ASO CITYO F T I GA R D CERTIFICATE OF OCCUPANCY �., DEVELOPMENT SERVICES PERMIT#: BUP2001-00463 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 12/27/20n1 PARCEL: 'IS135BU-00100 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 09600 SW OAK ST 350 SUBDIVISION: ;.SHBROOK FARM BLOCK: LAT':005 --CLASS OF WORK: AL-1 ----- - —____.._____--.-----_.-- TYPE OF USE: COM TYPE OF CONS'TR: % OCCUPANCY GRP: OCCUPANCY LOAD. TENANT NAME: REMARKS: Tenant improvement Owner: ASA PROPERTIES, INC BY PAUL DEVILLE PO BOX 2110 HONOLULU, HI 56802 PhonL-: Contractor: SUMMi-i CONSTRUCTION PO BOX 10345 PORTLAND, OR 97210 Phone: 223-9703 Reg#: LIC 63249 This Certificate issued 01/29/21)(12 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use under which the refere,tced permit was I95ved. BUILDING INSPECT - - — i3UILD OFFICIAL — — --- T4i--- POST IN CONSPICUOUS PLACE �� w(Gy�� _ BUILDING PERMIT PERMIT #: BUP2001-00463 DEVELOPMENT SERVICES DATE ISSUED: 12/27/01 13125 SW Hall Blvd., Tigard, OK 97223 (503) 639-4171 PARCEL: 1S135BD-00100 SITE ADDRESS: 09600 SW OAK ST 390 SUBDIVISION: ASHBROOK FAPM ZONING: ( P BLOCK: LOT: 005 JURISDICTION: T!G 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: 5N sf N: S:� E: W: OCCUPANCY GRP: TOTA'_ AREA: 0 (n) Sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: GARAGE: Sf OCCU SEP. R^TED: STOR: HT: ft BSMT?: MEZZ?: _ READ SETBACKS _ _REQUIRED FLOOR LOAD: PSI` LEFT: ft RGHT: ft FIR SPKL: 5MOK DET: DWELLING UNITS: FRNT: rt REAR: It FIR ALRM : HND1GP ACC: BEORMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 8,250.00 Remarks: Tenant improvement Owner: Contractor. ASA PROPERTIES, INC SLJMMII CONSTRUCTION BY PAUL DEVILLE PO BOX 10345 PO BOX 3110 PORTLAND,OR 97210 H9POLUL��87_ Phone: 223-9703 one. Reg#: LIC 632.49 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Electrical Permi: Required l Plumbing Permit Requivrd PLCK CTR 12119/01 $84.x1 27200100000 Framing Insp FIRE CTR 12/19/01 $51.88 27200100000 Gyp Board Insp PRMT CTR 12/27/01 $129.70 27200100000 Susp Ceiing Insp 5PCT CTR 12/27/01 $10.38 27200100000 Final Inspection _ I Total $276.2.7 ! This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Ore,nn Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may nhtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2344. Permittee Signature: ---- Issued By: --- Call 639-4175 by 7 p.m. for an inspection the next business day Building Permit Application rrcceived: Permit no.: _�U City of Tigard P•ojecVappl.no.: Expire date: Ciryu/Tii,�nrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: Rt no eceip .: tt, Fax: (503) 598-1960 Case file no.: Payment type: > Land use approval: _ _ 1&2 family:simple Complex: Z 0 I &2 family dwelling or accessory U Commercial/industrial U N-lulti-family U New construction U Demolition (; U Addition/alteration/replacement Tenant improvement U Fire sprinkler/alarm U Other: _ ion sui I%INFORMATIONA, Joh address: J Bldg.no.: Suite no.: )a L,ot: _±B Block: Subdivision: _-- 'lux map/tux lot/account no.: Project name: ..�� —_-----�—---- — i T)esc ' tjon and Ice;cion of work on preises/special conditions: — 1 ' (Floodplikin'.sept'llecapacify,sot ars etc.) �J Mailing address: 1 & 2 family d"elling: city: N61_41L.0� State ZIP: (j' Valuation of work........................................ b-- Phone: Fax: I.-nlad: No,of heurooms/baths................................. �_- Owner's represent ativc: _ 'Total number of floors................................. Phone: Fax F:mail: — New dwelling area(sq, ft.) ..........................APPLICANT _ Garage/carport flea(sq. ft.)......................... _ Name: Z 'aCovered porch area(sq.fr.) ......................... �� Mailing address: Deck area(sq.ft.) .................... ...... ........... _ -- � . �--- City: -�— Stag 7.1��(� Other structure area(sq. ft.)............. Phone 223— mail: Commercial/industrial/multi-family: Valuation of work... $_ Existing bldg.area(st, t .) .......................... "'"1� �?— Business name: G .� New bldg.area(sq. ft.) Address: Number of stories. ... .............. _ -- Sta ZIP: Type of construction... ......... ...................... Fax: L /I E-mail: -- Occupancy group(s): l"Aisting: —_-�-- C'CB no.: �1 Z New: City/metro lic.no.: '3' Notice:All contractors and subcontractors are required to he — licensed with the Oregon Conatnrction Contractors Board under Name: CJF provisions of ORS 701 and may be required to be licensed in the r - jurisdiction where work is being performed.If the applicant is Address: — exempt from licensing,the following reason applies: City: { Stat 7.IP: _— -- — Contact Fa-<„2� 2 t F-marl: Phone: 2 O1S Name: I Contact person: Fees due upon application ........................... Address: Date received: City: State: LIP: Amount received ..................__ .......... $^_-_ Phone: --LVax. I F-mail Please refer lit Ire schedule. hereby certify I have lead and examined this application and the (No i all jurivlicaplease call accept credit tarda,pleacall jurisdiction for more information attached checklist All provisions of laws and ordinances goveming this I U viva U MasterCard work will be comnlied Pied herein or not. I J credit card nambet —l--L--- f Rpites Authorized sign tri :�' ' D te: M' — Narne or caidhoirkr asshown on credit card Print name: _ — — Cardholder signature — Amount Notice:This permit appiL7:ition expires if a permit is not obtained within 180 days after it has been accepted as complete. a0-4611 tatUCOMI Coll)I erclal 1'larl Submittal Requirement Matrix Cite of Tigard TYPE OF SUBMITTAL # of Flans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 2 Builc'ing 1* Fire Protection Sy`t.em 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. fter 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 plates. "*"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. 1:\d9ts\form9\C7M-matrix.doc 911.4/01 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP �Ov DU Received Date Reque1ste-d__�_ _ `� AM_—_— PM _ BUP — Location (�fJCJ : C-� Suite _3LS MEC Contact Person ._ _— 2i1 — Ph(---) 2-:-2- 3 7-'Y' y 3 PLM _... ----- Contrac _ Ph(—) ?If ej- SWR 62k JeO IL Tenant/Owner __ _T -- ELC I ---- ELC Foundation Access: t Ftg Dram ELR� ✓ - Crawl Drain SIT Slab Inspection Notes: - Post&Beam _-_-_-_ Shear Anchors i-ia& irA roy a�S��%/ Z. �v- � Ext Sheath/Shear --- ----.---- Int Sheath/Shear Framing ----- — - -- ---. . Insulation Drywall Nailing - - - `- Firewall _ Fire Sprinkler ---- Fire Alarm Susp'd Ceiling ------ `- — _-- Roof Other:--- ----- - -------_ --- ART FAIL -- _ F'os eam Und"b -� ----- - — Rough-In Water Service --- ---- ---- - anitary Sewer Pain Dr ins Catch Rasin/Manhole - storm/Drain --_._---------- _._�-_--- ------ Sh Pan S PART FAIL M_E_C_ANICAL _-- Post& Beam Rough-In -- Gas Line Smoke Dampers Final PASS PART _FAIL — — --- ------------ -- - -- ELECTRICAL— —_ Service Rough-In ---- UG/Slab Low Voltage —___ - -_-.__---_ --------_- -- - - Fire Alarm Final ❑ Reinspection fee of$ required before next inspection. Nay at City Hall. 13125 SW Hall Blvd. PASS PART FAIL Please call for reinspection RE:� 77 L, Unable to inspect- no access Fire Supply Line- r ADA Date / TJ Illspe@tdr - ------_.__..__.-_--Ext -- Approach/Sidewalk Other. Final DO NOT REMOVE this inspection record f C the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISIONBusiness Line: (503)639-4171 P(,l BLIP r� Received �ZO Date Requested __—._ AM PM - BLIP Location �- —- _Suite MEC Contact Person Ph(� ___) Q_L36_ PLM 00 Z 6Z Contractor-._. Ph( ) l - �d 5'S SWR _ BUILDING Tenant/Owner _ ELC — Footing ELC Foundation Access: Ftg Drain �� f~� ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam -- -- -� A--- -.�-------- --- 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 --- - -----v-�- -- Catch Basin/Manhole Storm Drain ---- -------- - `-- _ - Shower Pan -- Other: ASS PART FAIL _._-- ANICAL_ _ Post&Beam — Rough-In Gas Line Smoke Dampers _-- Final PASS PART FAIL ---- -_ -._—- -- - ----__-- - ELECTRICAL Service -- .—_- ---- - ----� Rough-In --- - --.-_-_—�.-- -- ------ UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$__. _._-.required before next inspertiun. Pay at City Hell, 13125 SW Hall Blvd PASS PART FAIL Please call for reinspection RE:.- Unable to inspect- no access- Fire Supply Line .01. �-- ADA O 1... _ �' Ert _ Approacn/Sldewalk Dtlrb - - I!oat"=ctcar -- Other: Final DO NOT RENO-7#VE !,ispection record from the job site. PASS PART FAIL CITY OF TIGARD 24 Hour BUII,�;ING Inspection Line: (503)639-4575 MST INSPECTICN DIVISION Business Line: (503)639-4171 BLIP - - - - --- - Received Date Requ sted_ __ AM _ ___-____ PM - ____.____ BUP G/ ,- Location —Suite �—_ MEC -_- — Contact Person — Ph( ) PLM _.._ Contractor -__ _-- Ph( _.) _3� 31_ SWR . BUILDING Tenant/Owner _ _ _- _ EL(; Footing EI-C Foundation Access: Fig Drain ELR Crawl Drain _ Slab Inspection Notes SIT -- Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - --_ _-- Firewall Fire Sprinkler - -- Fire Alarm — Susp'd Ceiling -- ---------- --- -- ___T Roof Other: Final PASS PART _FAIL PLUM6ING— —T_-- ^- ---___-- -- Post&Beam Under Slab - - - - -- Rough-In J Watei v^rvice / Sanitary Sewer Rain Drains - - - _--- - Catch Basin/Manhole Storm Drain Shower Pan Other: - --------- . Final � PASS PART_FAIL - ---� ^- -- MECHANICAL Post&Beam Rough-In — Gas Line Smoke Dampers — — Final PASS PART_FAIL -- ELECTRICAL Service - — Hough-In UG/Slab Low Voltage Fir larm m L] Reinspection fee of$ -_.required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. A PARI- FAIL SITE' F-1Please call for reinspection RE: - ___ Una►�le to inspect-no access Fire Supply Line / ADA Ext Date ! ,1 '�t� Inspectnr ! `Q Approach/Sidewalk - --- - Other: Final [DO NOT REMOVE this Inspection record from the Job site, PASS PART FAIL_ #I CCITY�� _ ELECTRICAL PERMIT PERMIT#: ELC2001-00653 DEVELOPMENT SERVICES DATE ISSUED: 12/26/01 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135BD-00100 SITE ADDRESS: 09600 SW OAK ST 350 SUBDIVISION: ASHBROOK FARM ZONING: C F' BLOCK: LOT : 00 JURISDICTION: TIG Protect Description: Install 2 branch circuits. TI _RESIDENTIAL UNIT TEMP SRVC/FEEDERS ___,_ MISCELLANEOUS F 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANE- HMI SVC/ FOR: 601+amps - 1000 volts: MINOR LABEL (10): _ SERVICE/FEEDER _ _BRANCH CIRCUITS _ ADD'L INSPECTIONS T 0^-- 200 amp: W/SERVICE OR FEEDER PER. INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 anip: PLAN REVIEW 3_ECTION 1000+ amp/volt: >=4 RES UNITS: _ ^� > 600 VOLT NOMINAL: _Reconnect onjIL SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:_ Owner: Contractor: ASA PROPERTIES, INC WILLAMETTE ELECTRIC INC BY PAUL DEVILLE PO BOX 230547 PO BOX 3110 TIGARD, OR 97281 HONOLULU, HI 96802 Phone: Phone: 624-3631 Reg #: LIC 75059 SUP 1965S ELE 34-283C r _ FEES Required Inspections _ Type By Date Amount Receipt Ceiling Cover Wall Cover PRMT CTR 12/26/01 $53.50 2720010000( Elect'I Final 5PCT CTR 12/26/01 $4.28 2720010000( Total ` $57.78 J 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. T-its permit will expire N work is not stL ded within 180 day3 of issuance,or if work is suspended for more than 180 days. ATTENTION: Orego,i law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions in Permit Signature: Issued By: OWNER INSTALLATION ONLY The installation is being made or, property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: —. CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: (�') 1 a 0,) ' . DATE:--- LICENSE ATE: -LICENSE NO: _ .Ll jam;1j — Call 639-4175 by 7:00pm for an Inspection the next business day Electrical Permit Application — Date received; ' (,,-p I Permit n.... 3 tt City of Tigard Project/appl.no.: Expire date: City(of 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: _ NORM= LI I &2 family dwelling or accessory 0 Commercial/uncia.in 0 J Multi-family 66'fenant improvement U New construction U Addition/alteration;n•placement U Other: U Partial .110111 SITE IN I ORMATI�j Job address: q G $Z3 U h K C f Bldg.no.: I I t.tite no.:'S►t) I Tax map/tax lot/account no.: Iart: Block: Subdivision: Project name: P I Z W e f Description and location of work on premises: Tc� ,w T 2 ns a. Estimated date of completion/inspection: pee Mat Business name: ,,cx(h t fie, New reddentfal-dngkormrdN-fandlyper^,c c: Dernailon qty. (ca.) 'Ictal no.insp Address: 2' dwelWrgunh.Includes altached garage. City: , StateCi^- I ZIP: Z t 3 Serdcelnclurk4: Phone: ; Fax:(.zy zti p E-mail: 1000 sq,it.or less Each additional 500 sqft.or portion n:ietcut _ CCB no.: fu j•'t Elee.bus,lie.no: 3V Zh.3 Urnitedenergy,residential i 2 City/ tiro lie.no.: 15 4 _ Limited energy,non-residential 2 �+ (2-14 01 Foch manufactured home(itmodular dwelling Si na�re of su ry n electrician(required) hate Service and/or feeder Sup.elect.name(prim): f 'Licensel'10: /e,4,r Services or feeders-Installation, alteration or relocation: 200 amps or less 2 Name(print): 201 amps to 401 amps _ 2 --- 401 amps to 600 amps _ 2 Mailing address: _- 601 amps w (x1 10amps` 2 tate: ZIP: over 1000 amps or volts_ 2 City: S Phone:_ I E-mail: Reconnect only I Owner instm.'ation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to installadou,aheralion,orrelocation: or O)RS 447,455,479,670,701. 200 amps to 2 201 amps to 401.1 nrnps 2 Owner's si mature: Date: 401 it)6ouamps 2 Branch circuit%-new,alteration, or extension per panel: Name: _ A. Fee for branch circuits with purchase of Address: i service or feeder fee,each branch circuit 2 City: _ State: ZIP:ZIP: B. Fee for branch circuits without)nn,hnu• 6 i k` ? - of service or feeder fee,first brant h ccuit: I y Y� Phone: Pax: G-mai L' Fachadditionalbranchcircuir 2 Mlae.(Service or feeder not included): 0 Service over 225 amps•connmercod U Health care facility Each pump or irrigahun circle 2 U Service over 320 amps-rating of 1&2 U Hazardous location Fach sign or outline hithlint ? familydwcllings U Huildinp over 10,000 square feet rout o, Signal circuits)or a limited energy panel. - U System over 600 volts nominal more residential units in one structure alteration,or extension*_ 2 U Building over three stories U Feeders,400 amps or more •Oestri tion: U lkcupau lond over 99 persons U Manufactured structures or RV park Eich oddittonal Inspecllon over the allowable In any of the above: U Fgres0ightingplim U OTher - -_.__.__-------_____.__ perins ectien _ F--T—Z submit__acts of pians with any of the above. tillation fee The above are not applicable to temporary construction service. Other Not all)u'd%dkrinm oLvept cmdh cards,plane call jurisdiction fa more infonwk,n. Notice:This permit application Permit fee.....................$ U Visa O MasterCard expires if a permit is not obtained Plan review(at 76) $ T r _- crrelit card number:._—_- ----_- I L-- within ISO days after it has been State surcharge(8%) ....$ Ezplres accepted as complete. TOTAL .......................$ Rim of can of r u shown on c--ra-ilt c�iid -' $ _ Cardholder tl6rnature��--� Amount 440.4615(6n0Uft'OM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total y Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less $145.15 4 ❑ Audio and Stereo Systems' Each additional 500 sq ft or portion thereof $33.40 _ 1 ❑ Burglar Harm Limited Energy _ $75.00` Each Manufd Home or Modular Dwelling Service or Feeder _ $90.90 A ? ❑ Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ _ $80.30 2 201 amps to 400 amps $106.852 ElVacuum Systems' 401 amps to 600 amps $160.60, 7. 601 amps to 1000 amps _ $240.60 2 ❑ Other Over 1000 amps or volts $454.65— 2 Reconnect only _— $66.85 — 2 Temporary Services or Feeders TYPE OF WORK iNVOLVED-COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system........................................................ $75.00 200 amps or less _ $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.3: 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, sea"b"above. Audio ars.'Stereo Systems Branch Circuits New,alteration or extension per panel ❑ Boller Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder lea. Each branch circuit $665 2 ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder tee. First branch circuit $4685 Each additional branch circuit $6.65 HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or Irrigation circle $53.40_ Each sign or outline lighting _ $53.40 ❑ Intercom and Paging Systems Signal circult(s)or a limited energy panel,alteration or extension $75.00 ❑ i.andsrape Irrigation Control' Minor Labels(10) $125.00 Each additional Inspection over M ❑ Medical the allowable in any of the above Pei inspection - _ $6250 ❑ Nurse Calls Per hour $62.50 In Plant r $73.75 ❑ Ou'dnor Landscape Lighting' Fees: [] Protective Signaling Enter total of above fees $ Other 8%State Surcharge $ g —_______Number of Systems 25%Plan Review Fee See`Plan Review"section on g No licenses are required Licenses are required for all other Installations front of application _ --- - --- Fees: Total Balance nue g Enter total of abo%iR tries $ ❑ Trust Account#. _. 8%State Surcharge $ Total Balance Due $ i:\dsts\formr'alc-fees.doc 06107/01 CITY OF TIGA,RD PLUMBING PERMIT 200 DEVELOPMENT SERVICES PERMIT #: PL /27/01 -00669 DATE ISSUED: 12/27/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S135BD-00100 SITE ADDRESS: 09600 SW OAK ST 350 S1113DIVISION: ASHBROOK FARM ZONING: C-P BLOCK: _ _ LOT_005 JURISrJICTIUN: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS. MOBILE HUMS SPACES: TYPE OF I1SE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP. FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES_ _ _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: TUB/SHOWERS. SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Add 1 new lavatory, replace 1 lavatory, and add 1 new water cicset. _FEES Owner: Type By Date Amount� Receipt ASA PROPERTIES, INC PRMT CTR 12/27/01 $12.50 27200100001 BY PAUL DEVILLE 5PCT CTR 12/27/01 $5.80 27200101"01 PO BOX 3110 --- _ $78.30 HONOLULU, HI 96802 _Total Phone 1: Contractor: _ ADVANCED PLUMBING CHUCK MCALLISTER PO BOX 593 REQUIRED INSPECTIONS PORTLAND,OR 97207 Rough-in Insp Phone 1: 503-478-9735 Top-out Insp Reg #: LIC 140302 Final Inspection PLM 37-477PB 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. Issued By: Permittee Signature: ! '-_ ,_ .—..._: Call (503) 639-4175 by 7.00 P.M. for an in--pection needed the nexttitisiness day Plumbing Permit Application - -- Datereceived;/� S %/O/ Permitno.; /�"2001-, 04 City of Tigard Sewer permit no.: Building permit no.: Address: 1:3125 SW Hall Blvd,'I'igard,OR 97223 Cityo/Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503)598-1960 Date issued; _ By: 1k)I Receipt no.: Land use approval: /-'ri f 0n�• ��'`'�• Lase file no.: Payment type: U 1 &2 family dwelling or accessory ommercial/industrial U Multi-family \, Tenant improvement ❑New construction A(ldition/alteration/replacenicnt U Fool service U tither: CA k Description 121}'. Fee(ea.) Total Job address: C _ — — --�� New 1-and 2-family dwellings.,Illy: Bldg,no.: Suite no.: � ,�� —� (includes 100151.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath _ Lot: JBIock: Subdivision: — SFR(2)bath Project name: SFR(3)bath --- City/county: _ ZIP: Each additional hath/kitchen Description and location of work on premises: Siteutilities: Catch basintarea drain _ Est.date of completion/inspection: Drywells/leach line/trench drain _ Footing drain(no.lin• ft.) Manufactured home utilities Business name: (/��vt C _<1 _ r 041 V/ - Manholes Address: f9 3 Rain drain connector City: Stateot ZIP: Sanitary sewer(no,lin.ft.) Phone: ` Fax: E-mail: _ PL Sturm sewer(no.lin.ft.) _ Water service(no.lin.ft.) CCB no.: Q C1 Plumb.bus.reg.no: J -4 Fixture or Item: City/metro lic.no.: n 72 bsorption valve Contractor's representative signature: Backnowfireventer _ Print name ✓ I( r- bate Backwater valve Basins/lavatory J� _ Clothes washer Name: — Dishv•asher Address: Drinking fountain(s) City State: ZIP: E'ectors/sum Phone: r;, E-mail7 o cion tank ix sewer ca Z�� _ Floor drains/floor sinks/hub Name(print): Garbage disposal Mailing address: _ _— Hose bibb _. City: — State: ZIP_ ce maker Phone: I E-mail: Interceptor grease trap Owner installation/residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),hasin(s),lays(s) Owner's signature: __ Date: Sum Tubs/shower/shower pan Urinal r _ Name: ,_ Water closet Address: Water heater _ City: ��— - State: ZIP: Other: Phone: Fax: E-mail: I Total Minimum fee................ Nd dt)urisAicaam accept credit code,please call jurisdiction for slues idotmatim. Notice:This permit application Plan review(at — 9h) g U Visa U MuterCard expires if a permit is not obtained '�— _ State surcharge(8'1r?)....$ -- • �D Credit card number:___ �—— e Irea within 190 days after it has been p accepted as complete. TOTAL .......................$ Name d o d r a shown onC, It card s Cardholder elgiatms Attu 4Q-4h161~'0M1 PLUMBING PERMIT FEES: PRICE i%TAL New 1 and 2-family dwellings only: FIXTURES (individual) QTY ea rkMCUNT (includes all plumbing fixtures in PRICE TOTAL Sink 1660 the dwelling and the iirst100 ft. QTY (ea) AMOUNT 16.60 _for each utility conneSilon) — Lavatory /,ru�� / ( L ;L _ One 1 bath $249.20 Tub or Tub/Shower Comb 1660 Two(2)bath _ $350.00 Shower Only 16.60 u Three 3 trach_ �_ $399.00 — Water Close: 16.60 — — SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 -!nor Drain/FloorSink 2" 1600 _ 3" _ lsso PLEASE COMPLETE: 4" — 16.60 Water Heater O conversion O like kind 16.60 Quantic TG—pl Performed Gas piping requires a separate lnnchanical Fixture Type: New Moved ,iced Removed/ ermit. _Capped MFG Home New Weter Sanica 4640 Sink _MFG Home New San!Slorm Sewer AR 4n Lavato Tub or Tub/Shower Hose Bibs 16.60 Combination � Roof Drains 16.60 ^Shower Only _ Drinki.n Fountain 16.60 Water Closet Urinal Other Fixtures(Specify) 16.60 --- Dishwasher _ Garbage Disposal Laundry Room-rra — ---}- Washing Machine Floor Drain/Sink: 2" Sewer-1st 10055.00 3" Sewer-each additional 100' — 46.40 4" Water Service-1st 100' 55.00 Water Heater Water Service-each additional 200' 46.40 Other Fixtures _ _ Sed ) —� Storm&Rain Drain-1 st 100' 55.00 — Storm&Rain Drain-each additional 100' I 46.40 Commercial Back Flow Prevention Device— — 46.40 -- Residential Backflow Prevention Device- 27.55 -- Catch Basin 16.60 — Inspection of Existing Plumbing or Specially 62.50 Requested Inactions _—_ __ er/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 — --- — GreaseTraps _ 1660 �—.__ — ----- ---.--- QUA_NT ITY TOTAL Isometric r'riser diagram is required If Quantity I otal Is >a _ —"— "SUBTOTAL 8%STATE SURCHARGE — _5i'Po — -- — `"PL.AN RE` IEW 25%OF SUBTOTAL Re cared nLily If fixture t loW TOTAL `Minimum permit fee Is$72 50•B%state surcharge,except ResMential Backflow Preventlon Device,which Is$36 25 4 B%state surr:herge ``Ali New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for pian review. iAdststforrns\plm-fees.doc 12126101 CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SVVR2001-00332 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/27/01 SITE ADDRESS; 09600 SW OAK ST 350 PARCEL: 1S135BD-00100 SUBDIVISION: ASHBROOK FARM ZONING: C-P BLOCK: LOT: 005 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: 8 CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .5 EDU Increase: Previous fixture value of 32.4, for an EDU of 20.3; plus new fixture value of 8, for a total fixture value of 332, or 20.8 EDU. Owner: _ — FEES ----- ASA PROPERTIES, INC BY PAUL DEVILLE Type By Date Y Amount Receipt _ �_— PO BOX 3110 PRMT CTR 12/27/01 $1,150.00 27200100000 HONOLULU, HI 96802 Total $1,150.00 Phone: --- --- -- Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 clays from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located. the installer shall purchase a "Tap and Side Sewer' Perm Issued by: `—_ ___� ��, Permittee Signature: .` v Call (503)839-4175 by 7:00 P.M. for an inspection needed the next business day Accumulative Sewer Tally Tenant Name: PL19 )EST_ This SWR# Address: 9GnD S�d_g� ��__ — This PLM#:�200/� Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value Capped off value added# added #s total Count off#s count value values Baptistry/Font _ _ 4 - Bath-Tub/Shower _ 4 _ -Jac_uzzi/Whirlpool 4 Car Wash- Each Stall 6 -Drive Through 16 Cuspidor/Water Aspirator 1 Dishwasher-Commercial4 — -Domestic d 2 Drinking Fountain 1 _ Eye Wash 1 Floor Drain/sink-2 inch 2 _ 3 inch 5 - -- _ — -4 inch 6 — Car Wash Drn 6 --- Garbage Disposal 16 Domestic(to 3/4 HP) _ — Commercial (to 5 HP) 32 Industrial(over 5 HP) 42 _ — Ice Machine/Refrigerator Drains 1 -- OII Se Gas Station 6 Rec.Vehicle Dump Station 16 Shower-Gang(Pei head) 1 ---- -Stall _ 2 Sink-Bar/Lavatory 2 --- -Bradley 5 -Commercial 3 - -Service 3 — - Swimming Pool Filter 1 _ - Washer-Clothes 6 Water Extractor o 6 _ -- — Water Closet-Toilet 6 Urinal _ 6 — — TOTALS � - 7.5� EDU Total fixture values:�� Z ..____divided by 16 =• v�Q. HISTORY PLM#a0a0-00/33 EDIT# Ap,3 SWR#,;)oeO--&Q-90 PLM# EDU# SWR# _ _PLM#per-D�003�_ EDU# Ao - SWR#94 -oc��Z PLM# EDU# SWR#__ _ PLM# EDU# _ SWR# PLM# EDU# SWR# PLM# EDU# SWR# — PLM# EDU# SWR# iAdsts\swnaly.doc