12700 SW NORTH DAKOTA STREET STE 120 OU 31S ViOHda H1210N MS 00M
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12700 SW NORTH DAKOTA STE 12R
CITY of TIGARD
DEVELOPMENT SERVICES
13125 SWHail Blvd.,T19W,OR97W (W)W4171 ELECTRICAL PERMIT –
RESTRICTED ENERGY
PERMIT 4a EL R96-0336
DATE ISSUEDt 10/29/96
PARCELs 1S133AD-16200
SITE ADDRESS. . . : 12700 SW NORTH DAKOTA ST #120
SUBDIVISION. . . . : MLP94-0013 ZONYNGtC–P
BLOCK. . . . . . . . . . : LOT. . . . . — . . . . . . 1003
Project Description: REt STARBUCK' S
DATA TELECOMMUNICATICN INSTALLATION
--------------
A. RESIDENTIAL--------- B. COMMERCIAL----------------------------------------
RUDID & STEREO. . . : AUDIO b STEREO. . = INTERCOM & PAGING. . s
BURGLAR ALARM. . . . ; BOILER. . . . . . . . . . t LANDSCAPE/IRRIGAT. . t
GARAGE OPENER. . . . % CL.00K. . . . . . . . . . a a d+w-�bt:- MEDICAL. . . . . . . . . . . . t
HVAC. . . . . . . . . . . . . : DATA/TF-LE COMM. . tX NURSE CALLS. . . . . . . . t
VACUUM SYSTEM. . . . s FIRE ALARM. . . . . . tX,p ;,n OUTDOOR LANDSC L ITE t
OTHER: : : HVAC. . . . . . . . . . . . t - PROT'ECTIVE SIGNAL. . :
INSTRUMENTATION. t 1 . ., nTHER. . t to
TOTAL # OF SYSTEMSs 1
Owner: ------------------------------------------------------ FEES -----------------
STARBUCK' S type amount by data recpt
12700 SW N DAKOTA #120 PRMT f 40. 00 TAT 10/29/96 96-295855
r,.aN ,, �4r •...��,;,.:,,a.a{�ww 5PCT f 2. 00 TAT 10/29/96 96-285855
TIGARD OR 97223
Phone #i
Contractors --------------------------------------------------- ----------------
SELJRITYLINK f 42. 00 TOTAL
5110 NE SANDY BLVD
---- --- REQUIRED INSPECTIONS
– - --- --
PORTLAND OR 97223 Elect' 1 Service
Phone #: 503-288-3430 Elect' l Final '-
Reg #. . : 55060
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. specialty Codes and all ether Perm a S i g n a t u r
applicable laws. All work will be done in r.ccordasn:e with
approved plans. This poi At will expire if work is not started
within IN days of issuance, or if work is suspended for more �
IL than IN days. sued B
INSTALLATION ONLY– ---------------------------
t! The installation is being made on property I own which is not intended for
sate, lease, or rent.
OWNER' S SIGNATURES DATES
13
0 .--------------------_–_.--CONTRACTOR INSTALLATION ONLY-----------------------------
lu
J SIGNATURE OF SUPR. ELMO Ns DATEt
LICENSE NO:
Call for insspec':i on – 539-4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard,OR 97223 PERMIT#_ _6
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUED l X� `'
�
TDD No. (503)684-2772
CITY --
OF TIOARD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Q-100 5 vJ Aoaij V axon - Sh I
Address RESIDENTIAL—Restricted Energy tee. . . . . . . . .
,�i Q� _qj1,1� _ (FOR ALL SYSTEMS)
City State Zip Check Tree of Work Involved:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDAM E AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 1FA)DAYS OF ISSUANCE(IR IF WORK IS SUSPENDFD FOR
1110 DAYS. ❑ Burglar Alarr„
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
1_ ' ❑ Heating,Vei-ilation and Air Conditioning System'
Contractor Sstur• �N iDype—A r^"fcd4L_ ❑ Vacuum Systems'
Address 5110 IJSM saQ 1 ❑ Other_ _
DatetQ�j. � __ COMMERCIAL—Fee for each system . . . . . . . 140.00Q.QQ
--4-7 r� (SEE OAR 918-260-260)
Property Owner—Smit-`C CrtrZ} *wTW416�-_-- Check ype of Work Invallyad;
Contractor's Board Reg. No. old S S O b ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone _�� _' 3�✓��_— __-.— ❑ Clock Systems
3. OWNER APPLICATION Data Telecommunication Installations
(� ❑ Fire Alarm Installation
_ STAtLIb4r.�S `osr�ii, 519-1}x_3 ❑ HVAC
Print Owner's Name ` Phone No ❑ Instrumentation
IZ 1 Sw1 t.+O�H 1�RIGOTA — ❑ Intercom and Paging Systems
Address g g �
`T,4rrK* 00L. Landscape❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 9111.320-370.This applicant agrees to make only ❑ Nurse Calls
I restricted energy installations(100 volt amin or less)wider this permit and to do the ❑ Outdoor Landscape Lighting"
following
1. Only use electrical licensed persons to do installations where required.(Certain ❑ Protective Signaling
residential and other transactions are exemt from licensing.These have ❑ Other
p
12 astprisks(') All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
`- for inspection at 503-h39-4175. ❑ Number of Systems
(5' 3. Purchase separate permits for all installations that are not ready for inspection
when the inspector is out to inspect under this permit. •No licenses are required, licenses are required for all other Installations.
4. Assume responsibility for assuring that all corrections required by'he inspector —---- --
(' are done,and
W S. Assume responsibility for calling fnr a final inspection when all of the 55. FEES
corrections are completed. /� `�,
The pers i;signing for this permit must he the applicant or a person a. Enter Fees $ 1119.OV
allthori - to hind the applicant.
0. 5%Surcharge(05 x total above) $ O`r
Signature TOTAL- $ /R.6P
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT -
19125 SW Hall Blvd.,flgud,OR OW (503)6*4171 RESTRICTED ENERGY
PERMIT #s ELR96-0308
DATE ISSUED: 10/09/96
PARCEL: 1S133AD-16200
SITE ADDRESS. . . : 12700 SW NORTH DAKOTA ST #12Q1
SUBDIVISION. . . . : MLP94-0013 ZONINOeC-P
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . s003
Project Description: Tenant Improvements Audio/Stereo System
----------------------•-------•----------------------------------------- ----....-�.....-
A. RESIDENTIAL---------- B. COMMERCIAL---------------------------- -____--.�-__
AUDIO & STEREO. . . s AUDIO & STEREO. . s X INTERCOM 8 PAGING. . s
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . s LANDSCAPEo'IRRIGAT. . s
GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . s
HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHE Rs ss HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . e
INSTRUMENTATION. : OTHER. . s : s
TOTAL_ # OF SYSTEMS s 1
Owner: -------------------------- -------------------------- FEES ----------------
PACIFIC CREST PARTNERS type amount by date recpt
911 OAK STREET PRMT $ 40. 00 JDA 10/09/96 96-284967
5PCT $ 2. 00 JDA 10/09/96 96-284967
HOOD RIVER OR 97031
Phone #:
Contractor: _--------------------•-----------------------.--------------------------
FRIBERG ELECTRIC CO $ 42. 00 TOTAL
4636 N WILLIAMS AVE
------- REQUIRED INSPECTIONS -------
PORTLAND OR 97217 Wall Cove"
Phone #: 503-288--5161 Elect' 1 Final _
Reg #. . e 1329
This perait is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all ether Perm i t ee Signature
applicable laws. All Mork Mill be done in accordance with -
approved glans. This petit will expire if Mork is not started '
within 191 days of issuance, or if Mork is suspended for we
than 198 days. Issued y
------------------------------
OWNER INSTALLATION ON-Y -.__---.-__-_--__.-______--__-_
IL The installation isbeing made on property I own which is ri3t intended for
Hsale, lease, or rent.
N OWNER' S SIGNPTUREs DATES
--------------------------- ------------
---CONTRACTOR INSTALLATION ONLY--------------
---
3
W SIGNATURE OF SUPR. ELEC' N: DATES
J
LICENSE NO: _
Call for inspection - 639-4175
A
• Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. Q 00/� O
Tigard,OR 97223 PERMIT#t -1 9
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUEDAf
TDD No. (503)684-2772
CITY OF TIOARD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Addr RESIDENTIAL—ReRR ALL SYSTEMS)Fire. . . . . . . . . �.OQ
�O (FOR ALL SYSTEMS)
City State Zip Check Tyne of Wn&involved:
PERMITS ARE NON-TRANSFERABLE AN[ NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
160 DAYS. �j ❑ Burglar Alarm
2. CONT
OR APPLICATION A46ur46 ❑ Garage Door Opener"
❑ Heating,Ventilation and Air Conditioning System*
Contractor ,lCst, type _ L] Vacuum Systems"
4t-2
Address
' ❑ Other
Date ,� _-1 �—- COMMERCIAL—Fee for each system . . . . . . . . .
(SEE OAR 918-260-260)
Property Owner � j `[ t� >i�' ,L�� Type of Work Involved;
Contractor's Board Reg. No. /,j �f" -Audio and Stereo Systems
Boiler Controls
Phone Z �J •��� _ ❑ Clock Systems
J. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 918-320-370.This applicant agrees to make only ❑ Nurse Calls
restricted energy installations(Ion volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting*
following
1. Only use electrical licensed persons to do installations where required.(Certain 11 Protective Signaling
residential and other transactions are exempt from licensing.these have ❑ Other
IiL asterisks(').All other. need licensing).
2. Call for an inspection when all of the installations under this permit are ready
F for inspection at 503-639.4175. 11 Number Of Systems
} 3. Pwchase separate permits for all Install;-tions that are not ready for inspection
5 when the inspector is out to inspect under this permit. •No licenses are required. Lkmzs are required for all other instal6tkms.
4. Assume resp onsibiliN for assuring that all corrnctinns required by the inspector -- ---- -— ---
_ are done,and
5. Assume responsibility for calling for a final inspection when all of the 5. FEES
Jcorrections are completed. �)
The person signing for this permit must he the applicant or a person a. Enter Fees $ /y
authorized to hind the applicant.
h. 5% Surcharge(.05 x toti-1 above)
- mo
Signature TOTAL $
Authority if other than applicant
ENFRGAP.CHP
PERMT
CAL
CITY OF TIGARD PERMITI#: ELC96I061"
COMMUNITY DEVELOPMENT DEPARTMENT DATE: ISSUED: 09/27/9E,
13126 3W NMI Bkd.Tigard.Or"M 07223.0100 (603)6304171
PARCEL: 1 S 133�AD - �,000
'=F f)DDRE!'r. . . : 12740 SW NORTH DAKOTA ST ii 1;'4'+
7);
09.04/99 M38 12500 934 ;297 CITY OF TIGARD 4002/003
Community Development ELECTIUCAL PERMIT/AUCATION
13125 -SW 1-10 Blvd. r
Tigard, OR 97223 P*rmR#
Date Issued z 5-q(0
-
Phone(303)6394171 -"
CITY OF TIOARD FAX(503)W7297TDD No. (603)684-2772
Inspection (503)$394175
1. Job Addmss: I. Complete Fee Schedule Below:
Name of Development r,11✓l- �5 Hp„enr arkep do 0 porper,*shoo
Address I27 �,Ul `?w /.1 (�v /� I _o yrhhen�rhdufaeF sear coer(m) Sure
City/Stata/Zip6;p j�j�►Z_ �._ 4a. Reaitualal .ear Wo
Name(or name of business) '-ZAV-' r K `� _ ew���soo04s.PWWOWW Woe
Commer w;Q: Residential Stop aaaoo
- fowl tae�ert wiw&rUwdr _
2a. Con"ctorinsW/ation only, Do"lowwow sum
41L s.rvlow or Pwadwo
Electrical Contractor% J -��-� sawroom arnowardw
Ad cress L J, 3 a t sae
CRY`• _ Stata-SCEL ZIp O K 12- _ m,or"to aea.�.
Phone NO. Z7 3 2 SSlaawrel www trp000 a
oh.IQW ORM or lieu
Job NO. R.wr*+.e�wr _ Mae �,+ a
oontrtctor's license NO. c57,4
Contractor's Board Rag �_ _ j ^or Feadm
Signsture of Supr. Eis.:'n _ a am"or b r a
aor..r.w 440 W" `- mop —�-- r
License No. _- S Phone No 0 2 ,Il 2- heti.A.w soo.w.
�,,C MPTR(1 n R ou S TAX- , own,M mae to/W@ hMa Simon
2b. For owner lnal jlaflons: ■S Ir 411W
Print Owners Name k er"slt Cbwft
nes issue&.room leer ago
Address e)the In to raalm melte raw
KYmomme OWL
-- — ate- - nP—_----.- Path ball Woo
Phone No a rhh.a,re► ,�euee.rrMwrr t
The Installation Is being mads on property 1 own which Is � arrestaom Sam :
nut Intended for sale,lease or root saa► �e m"
Ohmers signature—� M.miseaaanaaas
(Bandon or lloso r not Adoidem a
3. Plan Review section (if requlrsao: lbab rw.R"+.ohm show
thea OF rr ars nt rriaa
Name chock approprlaown anti stns►Ire In saetlon t>& P FW.e~
ea ireoorm or awro sw — Mae a
4 of more nwntenssl wft in orte atrltlUas tlherLe ra(lo) Woo00
Sorvioe and Nader 22b amps a moor --
at.Erroh aadWonM r oxer
CClandeddanis or aa'urtrae ca Wkhing spnoso eatuoaney the
Man
allaviddo In any nt w 1s
as dwcrOW In N.E.C. Cxhaplsr 5 P*bwOWN% an
.03
U) Snbrnit t feta of plans with apphatdon wlwro sn)r of Pts soon! in Pun _w mop
apply. Not required for aunporary conveneeftm sarv4esr. IL F*":
J NUT)CK Oa-Enlr rotas Of choirs tons s SU
C0 sa%awthe (Os X bed fees)
PI MITS(SECCM'E VOID IF YVORK r)R CONrRUCT)ON So~ '
lu AUT110R1710 M NOT COMMENCED VffnfIN 1L0 OAYtI,OR IF PMn Ratr�w ( � —
..J CON"UCTION OR WORK IS SWIREMNU OR AYANDONIM FOR EubbM I `��` l----
A PEArOD OF iso DAYS A-1 AW ATUNE AFTER WORK IS Cl1! -----
COMMTNCFD ++.�..h+. Cl Trust A000urrt 0 �/IVBane aur qa -F4
,Oo
_...
-'4 0 C>(,&.
z6" `
�xISTwc? sI&/%/,AGE
i STAROUCK
I
COFFEE
- « 40 , 40R7k N w «
i
x, 75
v
pp
NTERNAL ILLL1,41 CAN SIGNAGE
(VISIBLE ONE* SIDE ONLY) , 4 6 (� p
^ f DESIGN 8Y TENANT do SIGN COMP,
NY
� TEMAfjVT
M
o
�. NSW TLr1AMT PLAN � CLEANERS GREAT CUPS
' CaEL. �xprEso r !fit
78W1Fft 16" so CMU MLASTER W/ (4) #6 VERT,,'
C h
POWER C0N)UlT
j
TTM
� +. ,. � .. . .-_. .__ « ..... .,� C:L�q►.*-GET=S —--' ... '
� � �t�.AT GL t!r'S —�----P�.GG t.. E�RS�Eb•
�e x�S T,rJ G► r-1dV u M ei�(T �Tre-u��r�Gt-E y'�
1
ltd38M
Tuss Aur DtspuT%IWc :7 j o OCC[DWML Avs![es S Suns.WA sJ[j• TcL iK za j [[z a i Aoo fir; 3154 Fr r aoi 129 It 2 j E,
('3TY 4F TIGARD
T _
RESTRICTED
COMMUNITY DEVELOPMENT DEPARTMENT ELECTRICAL FSEERI
13126 SW Hal 6W.Tlpvd,Or"00 S7t23N"S (SM 639.4171 PERMIT #:
ELR96( O286
DATE ISSUED: 09/19/96
PARCEL: 15133AD-16200
SITE ADDRESfi. . . : 1,2700 SW NORTH DAKOTA ST #120
ZONING:C-P
SUBDIVISION. . . . ; MLP94-0013
LALOCK. . . LOT. . . . . . . . . . . . . :0O3
ProjectoDescription- RE: STARPUCK' S
-----------------------•----
A. RESIDENTIAL-- B. COMMERCIAL---- -- INTERCOM & PAGING. . :
AUDIO & STEREO. . . s AUDIO R STEREO. . s
BURGLAR AL.ARM. . . . I BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . I CLOCK. . . . . . . . . . . s MEDICAL.. . . . . . . . .
HVAC'. . . . . . . . . . . . . • DATA/TELE COMM. - I NURSE CALLS. . . . . . . .
VACUUM SYSTEM. . . . : FIRE ALARr' . . . . . : OUTDOOR LANDSC LITE:
OTHER: . .
HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : X
INSTRUMENTATION. : OTHER. . s s :
TOTAL # OF SYSTEMS: 1
_-_- FEES
Owner: ------------------------ dept a recpt
PACIFJC CREST PARTNERS type amount by
911 OAK ST PRMT $ 40. 0iP DRA 09/19/96 96-284151
GiPCT $ 2. 00 DRA 09/19/96 96-284151
HOOD RIVER OR 97031
Phone #: 503-386--6333
---------------
-----------
9ECURITYLINI; t; 42. 00 TOTAL
5110 NE SANDY BLVD
-•-•----- REQUIRED :N5PECTIUNS -
Ceiling Cover Elect' 1 Final
PORTLAND OR 97223
Wall Cover
Phone #: 503-•288-3430
Req #. . : 55060 '
This permit is issued subject to the regulations ^ontained in the
Tigard Municipal Code, State of Ore. Specialty Cod's and all other er1m ee Signature
applicable laws. All work will be done in ac^_ordance with
approved plans. This permit will expire if work is not started `
within ?88 days of issuance, or if work is suspended for more - - -
sued By
--
than 188 days.
� -______- --nWNER INSTALLATION ONLY-•------------
a The installation`is being made n property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: DATE s
--f.;ONTRACTOR INSTALLATION ONLY-----•__------________
iOs-��•.J, DATE s
W SIGNATURE OF SUP R. ELEC N s
J
LICENSE NO:
Ca.? 1 for inspection - 6:39--4175
p Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # E L-Q oa00&
Phone (503) 639-4171 Date Issued -
CITY OF TIQARD FAX (503) 684-7297
TDD No. (503) 664-2772
Inspection (503) 639-4175
1. Job Address: / / 4. Complete Fee Schedule Below:
Name of Development l C e,1 (' `�.1� Number of Irnpecdom per parmtt allawad
Address 700 S N. D kah !140 Service included: Items Cost(es) Sum
City/State/Zip_ J(a 972 4s. Residential -per unit
T 1000 sq. R. or less $110.00 4
Name (or name of business) S-ta( ks G F1W Each additional 500 Lq ft.or -
portion thereof $25.00
Commercial Residential F] LlmMed Energy $2500 _ 1
Each Mar,urd Horne or MtWuisx
Dwelling Service or Foods r $86.00 2
2a. Contractor installation only:
_ 4b. Services or Feeders
Installation,ellensilon,or relocation
Electrical Contractor f 200 amps or less 2
Address 201 amps to 400 amps -- $80.00 2
City_ St e_�_ Zip pyZ i!� em amps to IOD earn. $80.00 2
601 erne to 1000 amps $leo.00 2
Phone No._ -3 y _- Over 1000 amps or wile $340.00 9
Reconnect only --- $50.00 2
contractor's license NO. �6 �_ �G 4c. Temporary services or Feeder
Contractor's Board Reg. No. 0 5-5-V 6 0 Installation,alteration,or retocatla
Signature of SLipr. Elec'nA 4& 200 amps or less 2
400
License No. 7",TF Phone No 1 201 amps to am amps $50.00 2
401 amp.to oo amps _� $76.00
Over 600 nnps to 1000 volls s10o.00
2b. For owner installations: see"b"above.
4d. Branch Circults
Print Owner's Name _ New,.Mention or wension per pans
Address e)The fee for branch cirures I"
City p State Zi prm mase of SWWea or Baader M. 2
--- - Each branch cNcull $5.00
Phone NO. _ b)The fee for branch circuits wfdwd -
The installation is being made on property I own which is Firpurcbranch aarvlreo►flaada►tw. 2
not intended for sale, lease or rent. Each
branch circum $ae 00
Each sddMbnat branch ekcuM $5.00
Owner's Signature 4e. Miscellaneous Ic
(Service or feeder not Included) 2 2
3. Plan Review section (if regaired): Each pump or"atlan ekcte $40.00 2
Each sign or outeno writing Won
Signal cirmll(s)or a INrMted energy ``�' 2
Please check appropriate Item and enter fee in sflction 68. panel,aeention or extension $10.00 Vr��
IL __4 or more residential units in one structure Minor Labels(10) -_ $100.00
R __Service and feeder 225 amps or more
System over 600 volls nominal 4f.Each additional inspection over
T Classified area or structure containing special occupancy the allowable In any of tl:e above
as described in NEC Chapter 5 �- PerInspection $35.00
hf-ur
Per hour $55.00
In Plant $55.00
m Submit 2 sets of plans with app!lcntlon where any of the above
apply. Not required for temporary construction services. 5. Fees:
J65. Enter total of above fees S Qf 00
NOTICE 5%Surcharge (.05 X total Mee) s 1. 60
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN '180 DAYS, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review If required (Sec.3) s
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal s -
COMMENCED. ...T «K ❑ Trus!AWount N
r m•rr $
Balance Due 00
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT SUED . . . . : PI-1196 0237
DATE ISSUED: 09/17/96
12126 SW H&N Blvd.Tigard,Oregon $72274199 (WM B7H171
PARCEL: 1 S 133AD-16200
c)ITE ADDRESS. . . : 12700 SW NORTH DAKOTA ST #I 2
SUBDIVISION. . . . : MLP94-0013 70NINGt C—P
BLOCK. . . . . . . . . . : LOT. . . . . . . .. . . . . . :003
---------------------------------------------------------------------------------------
CLASS OF WORK. . :ALT GARBAGE: D I SPOSCiLS. : 0 MOB I I_E HOME SPACES. : 0
TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACF'FLOW PREVNTRS. , : 1
OCCUPANCY GRP. . :B FLOOR DRAINS. . . . . . : 2 TRAPS. . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 1 CATCH BASINS. . , . . . . : 0
FIXTURES-------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
Sl NKS. . . . . . . . . . . 3 URINALS. . . . . . . . . . . . 0 GREASE TRAVIS. . . . . . . s 0
LAVATORIES. . . . . : 2 OTHER FIXTURES. . . . : 1
TUB/5HOWE.RS. . . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. . : 2 WATER LINE (ft ) . . . : 0
DISHWASHF_RS. . . . : 1 RAIN DRAIN (ft ) . . . 0
Remarks : Tenant Improvement : Starbi-ick' s
Owner-: ---------------- FEES --------------_
PACIFIC CREST PARTNERS type amount by date recpt
911 OAK ST PRMT $ 123. 00 DST 09/17/96 96--283890
PLCK $ 30. 75 DST 09/17/96 96-283A90
HOOT) RIVER OR 97031 SPCT It 6. 15 DST 09/17/96 96-283890
f-hone #:
Contractor: ------•----------------.--------
LONTRACIOR NOT ON FILE
Phone #: f 159. 90 TOTAL
Rpq #. . .
-------• REQUIRED INSPECTIONS •-------
This permit is issued subject to the regulations contained in the RoL:gh in Insp _
Tigard lunicipal Coae, State of Ore. Specialty Codes and all other Top•-out Insp _
applicable laws. All work will be done in accordance with Mi sc. Inspection
approved plans. This permit will expire if work is not started Final Inspection _
within 19 days of issuance, or if work is suspended for mere
t'an 180 days.
Ilex-mitt.ee Si.gnat _ire
I =s t_t e d 8
W� Call for inspection - 639--4175
J
C��lc✓ c6 C/L-
City of Tigard PLUMBING PERMIT_APPLICATION Planck/K1.90 c-,
13125 SW Hall Blvd. Permit # r••94- Oe34
Tigard, OR 97223 oSP14�Er
(r 9&-n-35"F
(503) 639-4171
V411MINIMUM $25.00 PERMIT PEE+ST. SURCHARGE
F- M"�"+ " New Shale gamily Resldences Only
A""' c ❑ 1 BATH HOUSE$140.00 ❑2 BATH HOUSE$195.00
JobCCy-i ;)�7 /��./�Ak--41W 03 BATH HOUSE$225.00
Address CWOV109r; Fee includes all plumbing fixtures in the dw*UV and the first 100 feet
c' - 23 of water service, sanitary sewer and storm sewer. Sae fees below.
Nwm Iw awr.+Mw...l FIXTURES QTY PRICE ANT
ky 1 r/( _ Sink - 9.00 00
w.My Ad*- Lavatory - 9.00
Owner // OA K_ � c : / Tub or Tub/Shower Comb. 9.00
WAM A' Shower Only 9.00
OJ'F1' rlvt:r hoc water Closet Ad
�j
Dishwasher
Garbage Disposal 9.00
I
Occupant A,*w. ►�•• W.shing Machine 9.00
ZZo3 kcf- /CI S. L_ Floor rain '3rN� 9.00 I Ql
CWWAft 11► Water Heater 9.00
' t -de0A .. ` / Laundry Room Tray 9.00
Urinal 9.00
1/ r_' OY C 4) Other Fixtures (S ) 9.00
MOM As oh.n. 9.00 .0
C�ntractor ,
/C' A 20iG 7* //&` 900
Gy/MM. zr 9.00
!C I ;A Sewer tat 100' 30.00
SIM.ne"11-�. Cry s..T.N.. Sewer-as. Addit 100' 25.00
Water Senlre lot 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service as. Addit. 200' 25.00
information given Is correct, that 1 am the owner or authorized agent of
the owner, that plans submitted are In compliance with State laws, that Storm d Rain Drain 1st 100' 30.00
1 am registered with the Construction Contractor's Board, that the Storrs 6 Rain Drain Addit. 100' 25.00
number given Is correct. (If exempt from State registration, please
give reason aelow.) Mobile Home Space 25.00
Back Flow P-evention
Device^,,Antl-Pollution Device 9.00 Q•�d
sw-N• *^«>...MI DM. Any Trap or Waste Not
Conirectet; to a Fixture i 9.00
Describe work neAN7addition 0 alteration repair Q Catch Basin 9.00
to be done residential Q non-residential AO Insp. of Exist. Plumbing - 40.00/hr
Specialty Requested Inspections 40•00/hr
Q. Existing use of
t3: building or priperty k - Rain Drain, singe family dwelling 30.00
N Residential backflow prevention
devices 15.00
Proposed use of y
J building or property RfrA1(- - 5UC '
� '(Except ras/dardal backflow
pnwen9on devices)
WJ NOTICE *Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5%SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED PLAN REVIEW 28'11.OF SUBTOTAL
TOTAL ly
Special Conditions
Date Issued by- _
.CITY OF TIGARD SEWER :ONNECTIOWR9E,-�c398
PERM I'r
PERMIT #. . . . . . . :
COMMUNITY DEVELOPMENT DEPARTMENT DATE 15SUED s 09/1' '/96
13125 BW Hal Blvd.Tigavi,orpon 9722308199 (603)6*4171
PAkRCEL: 1 S 133AD-162CAO
ri I TE. ADDRESS. . . : l.700 SW NORTH DAKOTA ST #120
SUBDIVISION. . . . : MLP94-0013 ZONINGS C-P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ..003
TE:'I\IANT NAME. . . . . s STARBUCK' S
USA NO. . . . . . . . . . : FI XTL 7 E UNITS. . . : 33
CLASS OF WORK. . . :ALT DWELLINC UN:TS. . : 2
TYPE OF USE. . . . . :COM NO. OF BUILDINGS: 0
TNSTALL TYPE. . . . :BUSWR IMPERV SURFACE: 0 sf
Remarks : RE: F'LM96-0237 StarbUck' s
Owner: --------------------------------------------------- FEES --------•------
PACIFIC CREST PARTNERS type amount by date recpt
911 OAK ST PRMT $ 4400. 00 DST 09/17/96 96-283888
HOOD RIVER OR 97031
Phone #:
Contractor: ---.------•---•-----------------
CONTRACTOR NOT ON FILE
Phone #: $ 4400. 00 TOTAL
------- REQUIRED INSPE'_TIONS -------
This Applicant agrees to comply with all the rules and regulations
of the Unified Sewage Agency. The permit !xpires 180 days from —
the date issued. The total amount )aid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer' Permit and the Agency will instal lateral.
armittee SignatLrrem
4 eri
By:
ILCall for inspection - 639-4175
F-
J �
Tenant Name: —�'►Z+rLo -cK s Accumulafte Sewer Tally -
Add,e.ts: I c oa '--J N Taa KIT a /e''v This PLM/:&-Ne-o e 73
Fixture Valve Previous# Previous Credits Capped Fixtures, Rxasee Now New
Value Capped off vokra added I added total h total
Count on#e count value vakrea
Baptistry/Font 4
Bath-Tub/Shower 4
Jacu:/Wh I 4
Car Wash-Each Stall 8
-Drive Through 18
Cuspidor/Water Aspirator 1
Dishwasher- Commer 4 14
-Domest 2
Drinking Fountain i
Eye Wash 1
Floor Drain/sink 2 Inch 2
3Inch 5
4 Ini h 8
-Car Vash Drain 8
Garbage Disposal 10
Dom Ito 3/4 HPI
Comm Ito 5 HPI 32
Ind lover 5 HPI 48
Ice Machine/Rehi erator Drains 1 _
Oil Sep i0se Station) 8
Recreational Vehicle Dumv Station 18
Shower-Ga (Per Herl) 1
Stall 2
Sink-Bar/Lavatory 2
Bradley 5
Commercial 3
Service 3
Swimming Pool Filter 1
Wisher, Clothes 8
a Water Extractor 8
Ir
H Water Closet, Toilet 8
U)
Urinal 8
m
TOTALS 3
W Total fixture values: divided by 16 = EDU
HISTORYu�
PLM/ EDU# SWR# PLM• EDU# SWR#
PLh1# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
ILDING
IT
CITY 8F TIGARD T #. . . . . PE P.M
PERMIT #. . . . . P
. . e BU
MMUNM DEVELOPMENT DEPARTMENT DATE ISSUED: 09/17/96
13126 tw Hal level.T4Wd,Orpon 67M.6166 (6301 OU4171 PARCEL: 1 S 133AD-16200
SITE ADDRESS. . . : 122700 SW NORTH DAKOTA ST #120
SUBDIVISION. . . . : MLP94—0013 ZONINGeC—P
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . .003
-- -- —
r�EISSUE: FLOOR AREAS------------ EXTERIOR WALL CONSTRUCTION—
CLASS OF WORK. :ALT FIRST. . . . : 1245 sf N: Se E: W:
TYPE OF USE. . . :COM SECOND. . . 1 0 sf PROTECT OPENINGS?--•--------
TYPE OF CONST. :5N . : 0 s f Ns 63 E: Wt
OCCUPANCY GRP. :B TOTAL-------: 1245 sf ROOF CONST: FIFE RET?s
OCCUPANCY LOAD: 27 BASEMENT. s 0 sf AREA SEP. RATED:
STOR. : HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED:
HSM'T? : MEZZ? : REDD SETBACKS-------— REQUIRED---------------------
FI-OOR LOAD. . . . : 0 ps f LEf=T s 0 ft RGHT: 0 ft FIR SPKL s Y SMOK DET. . :N
LWELLING UNITS: 0 FRNTs 0 ft REARS 0 ft FIR ALRM:N HNDICP ACCsY
BEDRMS: 0 BATHS: 0 IMP SURFACEe 0 PRO CORR:N PARKING: tr
VALUE. $ -. 75000
Remarks : Tenant Improvement : Starbuck' s (No seating permitted prior to Condition
al
Use approval from the planning department ) .
Owner: — — — ----------------------------------- FEES --------------
PACIFICCREST PARTNERS type amount by date recpt
911 OAF'. ST Pl_CK f 232. 70 JSD 06/05/96 96-2282530
FIRE f 143- 20 JSD 08/05/96 96-282530
1400D RIVER OR 97031 PRMT f 358. 00 DST 09/17/96 96-284073
?hone #: 5PCT $ 17. 90 DST 09/17/96 96-284073
TIF f 4647. 00 JSD 09/17/96 96-284021
Contractor : ------------------------------- --
WILCOX CONSTRUCTION INC
4111 AVE N
FDMONDa WA 98020-3115
Phone #: 206-774-4185 $ 5398. 80 TOTAL
Pell #. . : 011319
--•----- REQUIRED INSPECTIONS ---•----
fhis permit is issued subject to the regulations contained in the Framing Insp
Tigard Municipal Code, State of (ere. Specialty Codes and all other I n s u 1 at i on Insp _._....,._....._
appli^able laws. All work will he done in accordance with Gyp Board Insp
approved plans. This permit will expire if work is not started S�tsp Cei ing Insp
IL within 188 days of issuance, or if work is suspended for more
than 180 days.
—
C7
,. ,teei By :
Call for inspection — 639-4175
,r
Commercial Building PeMiltARIication
City of Tigard
73125 SW Had Blvd.
Tigard, OR 97223
(503) 639-4171
Jobslte Address:
1>}4
Tnnant: _ L/ Sufte 0 9 _Use only
Valuation: Roe
owner: Map B TL*_ ��( 3 ;114
Address:
AD royals Reoulnd
Phone: i tk Ta . .:
other
contractor: WANNINNE
,
/ Pct >, k�j £ r1_rpM,f ;; —,are
Address: _l �i �l
eld Type of const: r
Phone: Occupancy cleat►:
Contractor's License �) o`r t sprinidered? Yes fNo/
(attach copy of curtnt Oregon llcen.e) Sq. ft. of proloct:
Contact name & phone:,.ilt-�"l � = 1�p
SWAJ1jd, etc.) 1
Proposed use:
Architect/Engineer: ,7 '�3UC Il�� fU ' 1
P'svfous use:
Address: �'� ,fefta 11,4v 5,
q_- 5�. � / � Nate: Plumbing & mechanical pians
must be submitted at time of
rnbuilding permit appkation.
H Phone:
JOB DESCRIPTION:
Applicant Signbh re &J60ne number-
Received
umberReceived by: --- -L- Data Received: ��C - •. .�.
c'
Permit 0 Account Description Amount Amt. Pd. Bal. Dui
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECN)
State Tax TAX)
Bldg:
Plumb-
Mach:
v
Planheck (PLANCK)
Bldg:\\\ _
Plumb:
Mach:
Sewer Connection (SW )
.tower Inspection (SWINSP) ..�
Parks Dev Charge (PKSDC) _ w
Residential TIF MF-R) _
Mass Transit TIF (TIF4Wn
Commercial TIF (TIF-C)
Industrial TIF (TIF-I)
Institutional TIF (TIF-IS) _
Offlcs TIF (TIF-0)
IL Water Quality (WQU L)
oy
i Water Quantity (W ANTI
J Fire Life Safety (F S)
m
0 Erosion Cntrl Permit (ERPRMT)
W
_1
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS:
'il
C4TY OF TIGARD MEPERMIT
PERMIT
• CAL
r4TECOMMUNITY DEVELOPMENT DEPARTMENT DT SUED . • • • : MEC96-0281
riTE ISSUED: 09/17/96
101"BW MAN Is".Ilpm,peon 97!!!•61" (600)6204171
PARCEL: 1S133AD-16200
43I1E ADDRESS. . . : 1700 SW NORTH DAKOTA ST #120
SUBDIVISION. . . . : ML.P94-0013 ZONING: C-P
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . 100 1--�
- -
LLASS OF WORK. . :ALT FLOOR FURN. . . . s Q, EVAP COOLERSe 0
TYPE OF USE. . . . :COM UNIT HEATERS. . : 0 VENT FANS. . . : 1
OCCUPANCY GRF'. . :M VENTS W/O APPL: 0 VENT SYSTEMS: 0
ST'ORIES. . . . . . . . .. 1 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES------------- 0-3 HP. . . . : 0 DOMES. I NC I N: 0
: /GAS/ / / 3-15 HP. . . . : 0 COMM!. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . a 0 REPAIR KNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . a 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . 0 CLO DRYERS. . : 0
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. i 0
FURN < 100K RTU: 0 <= 10000 cfm : 2 OAS OUTLETS. : 1
FURN ) =100K BTU: 0 ) 10000 cfms 0
Rem,Arks: 'Tenant Improv3ment : Starrbuck' s
Owner: ----------------------------------------------------- FEES --_-_---------
PACIFIC CREST' PARTNERS type amount by date reept
911 OAK ST PRMT t 25. 00 JDA 09/17/96 96-284073
PLCK $ 6. 25 JDR 09/17/96 96-284073
HOOD RIVED OR 97031 5PCT $ 1. 25 JDA 09/17/96 96-28407 I
Phone #:
Contr-actor: ------------------------------_-
WILCOX CONSTRUCTION INC
123 4TH AVENUE, N
EDMONDS WA 98020-3115 -------------------------------------
Phone
------------------------------.-----
Phone # - :z15 -774-4185 f 32. 5(b TOTAL
Ren #. . : 011219
-- ----- REQUIRED INSPECTIONS -------
This persit is issued subject to the regulations contained in the Gas Line I n s p
Tigard Municipal Code, State of Dre. Specialty Codes and all other Mechanical Insp
applicable lams. All work will be done in accordance with Final Inspection
approved plans. This perait will expire if work is not start!d
within 180 days of fcsuance, or if work is suspended for sore
than 180 days. — ^
! ,o) mittee Signature : —�
':, I..I e d �Y• �W..��LaC,�L5C.5r�!�(C'" ___.,__ �T_.r_____ � ..—�._-__..__..._._.__ Y__—_.
Call for inspection — 639-4175
City of Tigard MECHANICAL PERMIT PlancWRec. * (6_6'?
13,125 eve Hall Blvd. APPN Permit S M `me (0-or8f
Tigard, OR 97223 ('� },
(503) 639-4171 �� IV�� Y �11! L
Table 3A Mechanical Coda CITY PRICE AMT
Job 700 ,t�. O Zd 1) Pwn* Fee -o. -o- 10.00
AddlesaLIP
PCiApof 0"2 7z 2 2) SupplernerMal Permit 3.00
umace to
_1PV �p� J`l 1) W. ducts A vei ft 6.00
_ Furnace 100.000 BTU+
Owner IoAk 2) W. duds 3 vena 7.50
Floor umancs
f�(Z'i - ✓ ;� 7 O .►► kid. vent 6.00
FA"40 / er, won r
*AQ( Ge nGYo Sl x/ /S 7$ 4) or floor mounted heater 6.00
Occupant VW not Ind. in
X31 5) appOarae pemt 3.00
r
�l6) 000lMq, absorption unk 11.00
- ' or gyp, pump,
�[ L L ,5 s 7) to 3 HP;atxiorp unk to t00K BTU 6.00
or comp, host pump. air cond.
Contractor 2h v ,��w 6) 3.15 HP;absorp unk to 300K BTU 11.00
or comp, host pump, a
9) 15.30 HP;absorp unk .5.1 mit BTU 15.00
Orr WA.Ta Or Wnp, halt pump, .
10) 30-50 HP; absorp unk 1-1.75 mil BTU 22.50
hereby as Oe that I have read s application, that the Boller or cwV, heat pump,
a .
Information given is correct, that I am the owner or authortzea 11) >50 HP; absorp unk 1.75 rnN BTU 37.50
agent of the owner, that plans submitted are in compliance with Air handlingunit to d
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50 7
Board, that the number given is correct. (If exempt from State Aii hand*Vun
it
registration, please give reason below.) 13) 10,000 CTM 4 7.50
on poftble
14) evaporate cooler 4.50
___Veint fan connectedI
15) to a single duct 3.00 /
----Ventilation sya m not
16) Included in appliance pem* 4.50
HM served by
17) mechanical exhaust 4,50
Describe work new an a n repair ommerc a or us
to be done resid� al 0 non- identisl s 18) type incinerator 30,00
Existing use of Other Le., woodstovo, water
IL building or property F 7-4) 19) heater, solar, clothes dryers, etc. 4.50
K
NProposed use of
building or property L' •,
20) Cites piping one to four outlets 2,00
�. rla/(, [
Type of fuel -oil O natural gas LPG Q elec,rlc 0
21) Moro then 4-1K outlet (e*0) 2.00
OD NOTICE 1z
W Minimum Fee$25.00 SUBTOTAL
'j PERMITS BECOME VOID IF WORK OR CONSTRUCTION ALL
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 6%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 26%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTALI 7!!i�_]V
Special Conditions
Data Issued by
MitO<mIMDfTN/ECIMMT
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC96-0537
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUEDt 09/24/96
171N•VII Mal§hN.Tlese/,tlVOW 91 *6116 (ion 004171 PARCEL: 1 S 133AD-16200
I�S I TE ADDRESS. . . : 12 700 SW NORTH DAKOTA ST #120
SUBDIVISION. . . . : MLP94-001- ZONING:C-P
BLOCK. . . . . . . . . . i LOT. . . . . . . . . . . . . :003
Project Description: Tenant Improvement : Starbuckrs
__--.__
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS---__
J000 5F OR LESS. . . . : 0 0 - 200 amp. . . . . . . 1 0 PUMP/IRRIGATION. . . . t 0
CACH ADDrL 500SF. . . : 0 201 - 400 amp. . . . . . . 1 0 SIGN/OUT LINE LTG. . * 0
l_IMITED ENERGY. . . . _ : 0 401 - 600 amp. . . . . . . : lb SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. t 0 MINOR LABEL (10) . . . : 0
------SERVICE=/FEEDER------- ----BRANCH CIRCUITS----- ----ADDrL INSPECTIONS-•-•-
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 40 PER INSPECTION. . . . . : 0
-.01 - 400 amp. . . . . . : 1 1$t W/O SRVC OR FDR. : 0 PER 14OUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADDrL BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 ------____.-•-___-•- -FLAN REVIEW SECTION-------------.......__
1000+ amp/volt. . . . . : 0 ) =4 RE-3 UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . t
Reconnect only. . . . . : 0 SVC/FDh ) s 225 AMPS. . :X CLASS AREA/SPEC OCC. :
Owner. --------------------------------------------------- FEES ----------------
PACIFIC CREST PARTNERS type amount by date recpt
911 OAK 91' PRMT $ 280. 00 CJS 09/17/96 96-284037
SPCT $ 14. 00 CJS 09/24/16 96-284307
HOOD RIVER OR 97031 PLCK $ 70. 00 CJS 09/17/96 96-284037
GIhone #s
Contractor! --------------•---------------------------------------•-----------•-------
I'RIDERG ELECTRIC CO f 364. 00 TOTAL
463E N WILLIAMS AVE
-------- REQUIRED I NSPECT I ON3 -------
PORTLAND OR 97217 Ceiling Cover Underground Cove
Plione #: 503-•288--5161 Wall Cover Elect' l Service
Req #. . : 1.329
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Dre. Specialty Codes and all other Permittee Signature
applicable laws. All Mork 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 tore
than 180 days. I ssi.ted By
___-.-----_ INSTALLATION ONLY------------------------
The installation is being made on property I own which is not intended for '
IL -,ale, lease, or rent.
a OWNER' S SIGNATURE: �. �__._.. -- _._ DATE:
r _._._.--.----_._----_--.---__--CONTRACTOR INSTALLATION ONLY---------------------------.---
3 IGNATURE OF SUPR. ELECTN: DATES
J I_I CENSE NO:
Catll for inspection — 639--4175
,r.
C
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
i Tlpard, OR 972M Planck/Rec. 0 96- 40'3'7 C.40-
Permit #
Phone (503) 639-4171 Data Issue
CITY T10ARD FAX (503) 684.7297 ISSUAd by
TDD No. (503)684.2772 Ca.ti.-�/ r�sru�.
Inspection(503)839-4176 9- (d- fe
I. Job Address: 4. Complete Fee Schwlu/o Below:
Name of Davelopr►an 14C .5{�sll: Wobatr aN 1n p-oft por pornM Marred
Address /��a� _S C') iV "7,41-
Afton S.lvlo.w,oMrd.d: reams seal..) sun+
City/StatelZlp . a. Reams wd-w WIN
10000 @,WIN" $11@m
Name(or name of business) S 1 RVCfCS EGA aww"d No p.h..r
AAs"0Nw.1 we" +
Commercial a Resldentim❑ ta"s.e E'"ti+ $1s@o
Gosh—-d-aa"n W Msadr f
o.S 81-«Fee" is1.N
Zi. Contractor Installation only: 4b.s«w6w.or FeWo
ko.Electrical Contractor l G'4R/G A',�`�,,,"W b" 'K'�00"�" 11w,n i
Addre pl al"10 aoo amps "Doc e
X01�" ti 000 arnpa $11940 !
(city. State Zip 101
r DO
Phone No. /G OW 1 o~,.ms wr�au =own i
Contractor'sUarlae nra�vad 0* t1lom
Contractor's 9oarc 09. N- o �
,a.Tsanpsrsry farvreaa or$sedan
Signature of Sulx. Elec' �•ro•� a " won e
Ucense No, ' P one No -i. ! 201'"""°'00""p' MAO t
—1 O Mr in aw a"ya f1N,N
Orp a00 anpo U low VOW
2b. For owner Installations: M*V aft
4d.Branch CxroWte
Print Owner's Name N".mss,„”or a,a,w W pono
Address _ y IV*c..w.tow 6ra,+r wo
City _ State Zlp of or rad►aft
� � 4oQr
Phone No. b)T w how bow ml dnaft arNaw�� Mae The Installation is being made on property I own which is *"?A.so
eh�or hodw*a l�sm i
not Intended for sale,lease or rent E"ad*b"o br."d�e�ew ----
Omer$Srpnatrre 41 Mbowanaew
(Ssrvioe or teedw not WkWoo t
S. Plan Review section (if required): Each awe w m qWoo oma.
Fad,dpn or euar" from
PIMss ohsok afproprlMe Nem"aNar fee M motion ss. pow,an•railm •erste" Nom
4 or mme mole% W units In one/tuMn Maar Labob(10) $10000
Sim &W Ov do M arrips or mato
Syebm ow am volts nonl11w sl.Enh additlert•1 krpeoft am
CIIK111W aroo or slnlotue Comm"spoder 000upancy Male ieb11 In my of ft*ow
IL as descTbed In N.E.C.Chapllr 6 Par k'p'06 $160
Par how 014/
1"Pimp 1$@.N
Submit 2 soft of plane WO appNoelion wham any of ft @bow
appy►. Ifs raqulred to lowworary eomirmosm serdosa. S. Fees: CP--
NOT" M Enter ww of ebms sm ;
sstlroharos(.os x toed b") $ __ •
�1 PERMITS BECOME VOID IF WORK OR CONSTRUCTION �,Enlar tax of Arlo A far
AUnIOWED Is NOT 00 ENCED WITHIN 190 DAYS.OR IF �-
W CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Putt RaMew if 1 Ilod( •s) _ 22
J A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS sdMow :
COMMENCED. ❑ Trod Aocsunt A >F
Balanlae dt�9 S �L �"'O'
jCP
CITY OF TIGARD BUILDING ' SECTION DIVISION MST _
24-Hour Inspection Line: 639-4176 Business Line: 639-4171 SUP
Date Requested/D AM PM OLD
LocationZZ-ZooScJ Suits /Z.n MEC
Contact Person _ oeV Ph _ �—.S/Yo/ PLM —
Contractor l?�.�.�� Ph SM
BUILDING — Tenant/Owner _ ELc.
Retaining Wall ELR �d D� �
Footing Access: FPS
Foundation 5/4160-
Fig Drain SON
Crawl Drain Inspection Notes:
Slab SIT
Post d Beam
Ext Sheath/Shear
Int Sneath/Shear
Framing
Insulation
Ur/wall Nailing o'
Firewell
Fire Sprinkler
Fire Alarm AUQ
Susp'd Ceiling
Roof
Misc:_
Final
PASS PART FAIL —
PLWONG
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
IL ELECTRICAL
Service
F- Rough In Ut a
N UG/Slab �JL �to
Low Vopage l''
Fire Alarm
m Fi
ASS PART FAIL —
Waw
J
Backfill/Grading
Storm D Sewer required befnm next Inr, P at C Hall, 13125 SW Hap Blvd
Storm Drain ( ]Reinspection fee o S_. _m4 rte^• � �
Catch Basin [ ]Please call for reinspection RE: _ [ ]Unable to Inspect-no access
Fire Su. my Line
ADA
Approach/Sidewalk Date 5P Inspector � � —Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this II Mon reewd 1M+at>A Me job *It&