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12700 SW NORTH DAKOTA STREET STE 120 OU 31S ViOHda H1210N MS 00M i W Q F- O S O Z N ti N 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&