16280 UPPER BOONES FERRY ROAD-2 ADDRESS.
20ms.-Lril
I1:\records\microflm\targets\buiIding.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-3171 -- --- -
BLIP
T.
-Date Requested__ - -_-- AM_____-PM ---_- BLD
Location-_� -_ -_ -_-_ Suite -- -_-- MEC _----__._-.--W_--
Contact Person _ --�-_ Ph PLM -_
Contractor '.-�.�,r�z, - __ _ _- Ph _ ���?- jJ 3.s SVIiR
.-
BUILDING Tenant/Owner _ _ -- - El_C
Retaining Wall ELR
Footing Access'
FPS
Foundation -----
Ftg Drain SGN
Crawl Drain [inspection Notes: -�--- --
Slab __. --------- --- -- SIT _
Post&Beam
Ext Sheath/Shear -- --
Int Sheath/Shear
Framing --- - ---- -- —----
Insulation
Drywall Nailing ---
Firewall
Fire Sprinkler - - -- --- - --— — -------- --------
Fire Alarm
"usp'd Ceiling
Root
Misc: __ _ -- ------ ---_---- ---- ...- --
Final --
PASS PART FAIL ------- -_-- - --- ZZ ----_-
PLUMBING
Post& Beam
Under Slab
Top Out
Water Service --- -----
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL -
MECHANICAL
Post& Beam ------ ---- -
Rough In
Gas Line ------ ---- - _--- ..----
Sm.oke Damper,
Final --
PASS PART FAIL
ELECTRICAL
Service _. -- — --- -
Rough In
UG/Slab -- -- -----
Low
------ ------Low Voltage
Fire Alar
(n ---- - ---- -- — — _ --
F� T
P SS PART FAIL _--_-�- --------- ---— -
Backfill/Grading --- - --- ----_.__
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ -required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE: _ ] J Unable to it-pect no access
Fire Supply Line
i
ADA r "-
Approach/SidewalkDate Inspector Ext ——
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the Job site.
7 CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
13125 SW Hall Blvd., Tigard,OR 97,923 (503)639.4171 RESTRICTED ENERGY
PERMIT #: ELR98-0194
DATE ISSUED: 07/27/98
PARCEL: 2SI13AB-01201
SITE ADDRESS. . . : 16280 SW UPPER BOONES FERRY RD #BLD.
SUBDIVISION. . . . iFANNO CREEK ACRE TRACTS ZONING: I—L
BLOCK. . . . . .. . . . . : LOT. . . . . . . . . . . . . .. JURISDICTN,. 1IG
Project Description: Electrical addition
------_
A. RESIDENTIAL------------ B. COMMERCIA1---------------------------------------
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . - CLOCK. . . . . . . . . . . . MEDICAL. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: 1111 HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL_ :X
INSTRUMENTATION. : OTHER. . -. 1111
TOTAL # OF SYSTEMS: I
Ownert. FEES
FLIR type amount by date reept
16280 SW UPPER BOONES FERRY PRMT $ 40. 00 8 07/27/98 98-307701
TIGARD OR 97224 5PCT $ 2. 00 R 07/27/98 98-307*701
Phone #:
Contractor: -------------------------------------------------------------------------
HONEYWELL INC It 42. 00 TO,rAL
1.5495 SW SEQ.ULj;H
E-JE 100 ------ REQUIRED INSPECTIONS --------
PORTLAND OR 97224 Ceiling Cover Low Voltage Insp
Phone #: 968-3333 Wall Cover Elect' l Final
Reg #. . : 000578
T�,S permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work wit' he done in arcordatire with approved plans. This permit will expire if work is not started within IN
days of issuance, or if work is susp�ndpd for more than 180 days. ATTENTION: Oregon last requires you to follow rule adopted by the
Oregon Utility Notification renter. Those rules are set forth in OAR 952-*1--0010 through OAR 952-01-0180. You may obtain copies of
these rules or di ct question to OW at (9@3)246-198'01.
IsSi-ted by�� Permittee Signature i P((
--------OWNER INSTALLATION
The installation is being made an property I own which is not intended for
sale, lease, at, rent.
OWNER' S SIGNATURE: DATE
-------------------------CONTRACTOR INSTALLATION
SIGNATURE OF SUPR. ELECINt N __�� DATE-
L I CENSE NO:
.....................4...................................*.................4-++ f
Call 639-4175 by 7:00 P. M. for an inspection needed the next business day
.....................4•.......f.............................................
■
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPfcZtA'Fld Recd by: ^�'�«
13125 SW HALL BLVD Date Recd: *7;� -2-7
T1GARD OR 97223 PRINT OR TYPE J UL 2 7 199F
Permit#:
V- 503-639-4171 X304
F - 503-684-7297 INCOMPLETE OR ILLEGIBLE APP�IjQ�&�VELOPME.N' Cust.Call'd: —
WILL. NOT BE ACCEPTE6
Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL
Restricted Energy Feo........................................ $40.00
F11
" (FOR ALL SYSTEMS)
JOB Street Address J blow Check Type of Work Involved
ADDRESS
,pity/Slate Zip Pho e# El Audio and Stereo Systems
'' 42 r'
Name IBurglar Alarm
Garage Door Opener'
OWNER Mailing Address
CZIP
❑ Heating,Ventilation and Air Conditioning System'
ity/State Phone#
_ -- Vacuum Systems"
Name
Other_---_----
CONTRACTOR Mailing Addirgis TYPE OF WORK INVOLVED -COMMERCIAL
(Prior to issuance a ty! late Zip P one# Fee for each system.............................................. $40.00
copy of all licenses 17 Al __Y30 p (SEE OAR 918-26G-260)
are required if Oregon Corti.l5rd Lic.# Exp.Date Check Type of Work Involved
expired in C.O.T.
data base). Electrical Contr.Lic.# Exp.Date Audio and Stereo Systems
C.O.T.or etro Lic # E p.Date
L, y' 1 Boiler Controls
Owner's Name ❑
Clock Systems
OWNER - Mailing Address ❑
Data Telecommunication Installation
APPLICANT
City/State Zip Phone# r
L � Fire Alarm Installation
This permit His under OAE 918••320-370.This applicant agrees to HVAC
make only restricted energy installations(100 volt amp:ur less)under this
permit and to do the following Instrumentation
1 Only use electrical licensed persons to do installations w sere required. �
Certain residential and other transactions are exempt from licensing. rL Intercom and Paging Systems
These have asterisks(') All others need licensing; r�
Landscape Irrigation Control'
2. Coll for inspections when installation under this permit are ready for
LJ
Inspection at 603-63941175; Medical
3 Purchase separate permits for all installations that are not ready for an �] Nurse Calls
inspection when the inspector Is out to inspect under this permit;
4 Assume responsibility for assuring that all corrections required by the
Outdoor Landscape Lighting'
inspector are done,and, ® Protective Signaling
5 Assume responsibility for calling for a final inspection when all of theOther
corrections are completed. Q -
Permits are non-transferable and non-refundable and expire If work Is not
started within 180 days of issuance or If work is suspended for 180 days _ __—Number of Systems
The person signing for this permit must be the applicant or a person No i censes are required Licensee nrp required for all other installations
authorized to bin-I the applicant
FESS:
ENTER FEES f ��
Sig atur hh
5%SURCHARGE(.05 X TOTAL ABOVE) $
rzal .�r�ti Lt� l� —— r0TAL t—y j n
Authority if other than Apt,licant
i vesele doc 12196
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested. 4-61 -9 F //�� (AA..M. P.M. — MST:
Location: 2AOmoi(� x.3(1 fTU- v -- BIJP:
Tenant 4- Suite: Bldg: _ MEC:
Contractor: Phone: Q::�L PLM:
Owner: 'hone _ LC:
R: C 7-0,;L
BUILDING BLDG(con'() PLUMBING MECHANICAL SITE
Site Post/Beam Post/Beam Post/Beam Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing 'Top out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Ilood/Uuct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
cur�-}�� /�.
Shcar/Sheath Fire Spklr/Alm Crawl/I'olnl Dr heat Pump o PRe O/ / ���/ ,
Approved Approved Approved pprov Approved
Appr/Sdwlk Not Approved Not Appioved Not Approved ed Not Approved
FINAL FINAL FINAL FINAL.
C3 Call for reinspection D Reinspection fee of S___.—required before next inspection O Unable to inspect
Inspector:—�_v_ 111te: "` _9 Page of
CPA
Page No. 1 CASE HISTORY FOR CASE NO.: BUP97-0505
FLIP
16280 SW UPPEP BOONES FERRY RD
05/13/9,
Action Description Req/ Schd/ End/ Action Noted Disp By Update Upd
Code Sent Done Dane Date 3y
------- ------------------------------ -------- -------- -------- ----- ----- ---------------------"-- ---- --- --------
Br1PC005 Application received / / / / 10/29/97 RECD JD 10/30/97 BON
nUPCo08 Permit created / / / / 10/30/97 DONE U 10/30/97 BON
BUPCO10 Check for prcl. restri,t. / / / / 10/30/97 PASS B 10/30/91 BON
BIJPCO12 Plans routed to Plana Examiner / / / / 10/30/97 SENT B 10/30/97 BON
BUPCO26 Approved Plane routed to DST6 / / / / 10/30/97 APPR RDP 10/30/97 FDP
BUPC090 (F) Ready to issue / / / / 10/11/97 PASS JSD 10/31/97 JD
BUPC100 (F) Issue permit / / / / 03/11/98 noticed never issued. mailed permit to MAIL JT 03/12/98 JT
contractor
could not locate an application or any
plane. 'ran, r�orge, Hap do not know,
either does rill???
BUPC100 (F) Issue permit / / / / 03/31/98 PASS B 03/31/98 DST
RUPC793 Sprinkler Rough-In 10/30/97 / / 03/12/98 PASS TLP 04/08/98 J•H
BUP^784 Sprinkler Final 10/30/97 / / 03/12/98 tan said work was inspected. TOM JT 03/12/98 JT
BUPC960 Case Finaled / / / / 03/12/98 PASS TLP 04/08/98 J*H
CITY OF TIGARD
DEVELOPMENT SERVICES BUILDING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : BUF'97-0505
DATE ISSUED: 03/31/98
PARCEL: c_S113AB-01201
SITE ADDRESS. . . : 16:::80 SW UPPER BOONE S FERRY RD
SUBDIVISION. . . . : FANNO CREEK ACRE TRACTS ZONING: I
BLOCK. . . . . . . . . . . I._OT. . . . . . . . . . . . . . JUR I SDI CT I ON:TI G
---------------------------------------------------------
REISSUE: FLOOR AREAS---- ---- -- EXTERIOR WALL CONSTRUCTION-
CLASS
ONSTRUCTION-CLASS OF WORK. :FE'S FIRST. . . . .
0 s f N: S: E: W
TYPE OF USE. . . :COM SECOND. . . : 0 s f PROTECT OPENINGS?——-----_-
TYPE OF CONST. :3N . . . ; 0 sf N: S: E: W.
OCCUPANCY GRG'. :B TOTOL--- --; 0 sf ROOF CONST: FIRE RET?:
OCCUPANCY LOAD: 0 BASEMENT. : 0 Sf AREA SrP. RATED:
STOR. : 0 HT: 0 ft GARAGE. . . : 0 sf OC(::U 1 P. RATED:
BSMT?: ME Z9: READ SETBACKS-------- REQUI f,— --_-------- ----___----
FLOOR LOAD. . . . : 0 ps f LEFT: 0 ft RGHT- 0 ft FIR SPKL:Y SMOK DET. . :
DWELLING UNITS: 0 FRNT. 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:
BEDRMS: III BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE.. $ : 580
Remarks : Fire suppression system
Owner: --______._____________.__-_-___--_____._.___.___.____.____. FEES
F'ACTRUST type amol-rnt by date recpt
1.5350 SW aEDUOIA P'KWY PRMT t, 25. 00 JD 1O/29/97 97-30048'
PORTLAND OR 97224 `JPC f s 1. 25 JD 1O/29/97 97-30048':)
FIRE $ 10. 00 JD 10/29/97 97--,300489
Phone #: 624-7787
Cant r,act or: -----------------------------
Ff RESTOP CO
9384 SW TIGARD ST
TIGARD OR 97223
Phone #- 620-614O E 36. 25 TOTAL.
Reg #. . : O00638
--REDU 1 RED ACTIONS or I NSF'ECT I ONS-----
This permit is issued subject to the regulations contained in the Sprinkler Rol.rgh-
Tigard Municipal Code, State of Ore. Specialty Codes and all other Spr i nk 1 er Final
applicable laws. All North will be done in accordance with
approved plans. This permit will expire if work is not started
within 198 days of issuance, or if work is suspended for more
than 198 days. ATTENTION: Oregon law requires you to follow the
rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952-801-8818 through OAR 952-80101387.
You many obtain a copy of these rules or direct questions to 61W,,
by calling (503)246-1997. _
G='er^mittee Signat..fre : Iss1_red RY•
+++++++++4•+++++++++..++a.+........++++++++.+++.+++.+i.....++++++++++ 4--F+++++++++
Call. 639-4175 by 7:00 p. m. far an inspection needed the next b ..ness day
++++t++++++.+-}-....4+4++++-f......... ....4•+-F+++4++++4 t+t+t{........1-....f....i.+++4
Iff—=ff
CITY OF TIGARD
DEVELOPMENT SERVICES BUILDIr1G PERMIT
13125 SW Hall Blvd,, Tlgard,OR 91223 (503)639.4171 PERMIT #. . . . . . . .. BUP9 7--0:`.)05
DATE: ISSUED: IZ13/1 1/96
IDPRCE.L: c:511:;ALS-01L01
_illk: ADDRESS. . . : 1621x0 aW UP -,E:R BOONES FERRY ND
SUBDIVISION. . . . : F=ANNCJ CRLE::K ACRE. TRACTS ZUNING: I--L
BLOCK. . . . . . . . . . : I_C]T. . . . . . . . . . . . . .
JURISDIC'TI0N: I-Ib
RE I13SUE.: -_-- FLOOR WALL CONSTRUCT IUIJ
CLASS OF WGRK. :F PS FIRST— . - 0 s f N: S: E: W:
T YPFE OFF USE.. . . :GOM :7[:C0IQD. . . 10 s f PRO T EL-"T
-FYF'E: OF C:C)NS-f. :3N . . . : 0 sf Ns S: E: W:
OCCUPANCY GRI-1. :13 TC]TFaL_- ___ _. ..._: 0 St R10OF- CONST : F I RI_ RET? :
OCCUPANCY LOAD: 0 BASEMENT. : 0 sf ARLA SEF'. RATED:
S1 OR. : 0 FIT : 0 9 t; GARAGE_. . . : k occu SL-•F'. RAT-EE):
B5M'T? = ME.ZZ? : RE_UD SE:•TB(4Cl4a--•---. -
FL00R LOAD. . . . : 0 f LEFT : 0 ft RGHI s 0 c FIR SPK.L: Y SMOK DF.T. .
n14ELLING UN1'f8; 0 17RI'4 : 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:
-DRMfS: 0 Bf41 1+�)- 0 IMP SURFACIL: 0 PNU CORR: PARKING: 0
1LUE. $ : 580
eMar,t(s : Fire suppression system
1-+1GTRUST type amot.rnt by date i'ecpt
15350 SW SEQUOIA F'KWY PRM•T $ 25. 00 JD 10/29/97 �"r- 3004b9
PURI-LAND OR 97,='L4 _r6 .JU 10/29/ 37 97- -1100489
FIRE $ 10. 00 JD 10/29/97 97-300489
Phone #: 6 .4-778
FIRESTOP CO
9384 5W TIGARD ST
T IGARD OR 97c-:-'123
F-'m(in e #: bc.'O--6140 ! 3b. 25 IO AL
Req #. . : 00063E3
REc.UlJ I FiE D INSPECTIONS
--_--.
This permit as issued subject to the regulations contained in the 5frrxnkIer Ro1_tyh -
Tigard Municipal Code, State of Ore. Specialty Codes and all other Apr i n k I et- F i na 1
applicable laws. Ail work will r• done in accordance with
approved pians. This permit wa' expire a work as not started ---
within 180 days of issuance, or if work as suspended for morethan 180 days. ATTENTION: Oregon law requires you to follow the --
rules adopted by the Oregon Utility Notification Center. Those
rules are set forth an OAR 95(,-001-0010 through OAR 95240101987,
You many obtain a copy of these rules or direct questions to OIJNC _,— .—__..-__r _ --
by calling 1503i246-1987. - ------- ------- —'-
ev-mittee Sign �}atIAt-e : _ . ass _rrcJ By `
+++.+•++++++++++++ F•+ +++++++++++i+ ++++++++4+•+++++++++4++++++++++•i r++ ++44 +•+4++•+i•+
(-;a11 639-4175 by 7 :00 P. m. f'01- an inspur_t ion needed the next blAsiness day
4-+4--++++++-+4.4 +++4+++++4+-+4+ 4 -+4-+++444- +++++4++++++++++++++4.4• H++++•+++4.+++++++++++
n
7
l�
Fire Protection Permit Application Plan ChF:ck0 1
6V("
CITY OF TIGARD Commercial or Residential Recd Fy
13125 SW HALL BLVD. Date Recd G�
Print or Type Date to P E. 1/3
Incomplete or illegible apt
TIGARD, OR 97223 plications will not be accepted Date to DST 0-q7
(503) 639-4171 Ext. 304
Permit#
Called U 1/r' 1�•t-P
r
Name of Developrr,ent/Pro)ect 2� Type of System (Complete A or B as applicable)
JobI�A�TIz'trS Bus/ 5S lrN> �-' A Sprinkler Wet Dry CJ
Address, Address 11 I G,, �_ _ —
li'vi , 5W- t�PPrl gooF'� R Standpipes
Narrie /j Ha
AWIT9tf S 1 zard Group
Owner Mailing Address Additional _/5-35-0- 5 - SrQtan�n �'�!`� — Information Density
City/Slate ate Zip Phone
�O�T s�D 0) • ro'L4- 7 197 Design Area
— — Name r-t -. —
_�_ K. Factor
Occupant Mailing Address f _ _
PPi � rf � A_1) Sprinkler Project Valuation
City/State Zip Phone _ SgJ
— B.) Fire
COT Business Tax or Metro# Exp Date Alarm _
Submittal Shall Include Battery Calculations YES ❑
Contractor Name
(Sprinkler or 6/rr. p �L- Individual Component YES
Alarm Company) Mailin ddr s Cut Sheets
(Prior to permit '(11 a, %(,"h 8.1) Fire Alarm Project ValuF.tion $
ll
issuance applicant Cty/State Zip Phone _
muarovda°" U, _`�77Z3 bt°'�O/4o Project Valuation Subtotal (A & or B) $
contractors iicansa State Const,Cont. Board Lic.# Exp, Date
informaton for 6394t, i
Permit tee based on valuation $
COT database). COT Business Tax or Metro# Exp.Dale (see chart on back' 7
__ �— - 5% Surcharge $ G��
Name /S/J !J/ 1A _ _
— FLS P_lan Review 40% of Permit $
Architect Mailing Address L4 ' vE __
TOTAL
Ci
Zi _/Stat p Phone ___ ,
oRf��d'P0 16• Plans required Submit three sets of plans,including a vi i map and
Describe work A.)New O Addition O Alteration Repair O the location- the nearest hydrant -- _
to be done
B.) Basement O HoodNent O Sprey Booth O
Complete Partial O Exitway O 1 hereby acknowledge that 1 have read this application,that the information given is
correct,that I am the owner or authorized agent of the owner.and that plans submitted
Additional Description of Work. are In compliance with Oregon State laws
Signature of Owine fAgent Date
A.)In ExistingBuildingNew Building p
Building ct Person Name Phone LO4� f�
Data 8.1 Commercial Residential p Ent��, F.41��d�/ L
FOR OFFICE_ USE ONLY: _
No.of stories: Plat# Map/TL#:
I
l at'
Sq.Ft' ---- _
Occupancy Class Type of Construction
Notes
I\FIRESUPR DOC (DST) 8/96
CITY OF I.LGM
BUtLOING PE MIT FEES
TOTAL
STATE BUILDING
VALUATION OF PERMIT F.L.S. TAY, PERMIT
PROJECT FEES (40%) (5%) FEES
1-1500 25.00 10.00 1.25 '16.25
1,501-1600 26.50 10.60 1.33 38.43
1,601-1,700 28.00 11.20 1.40 40.60
1,701-1,800 29.50 11.80 1.48 42.78
1,8011-1,900 31.00 12.40 1.55 44.95
1,901-2,000 32.50 '13.00 1.63 47.13
2,001-3,000 38.50 15.40 1.93 55.83
3,001-4,000 44.50 17.80 2.23 64.53
4,001-5,000 50.50 20.20 2.53 7323
5,001-6,000 56.50 22.60 2.83 81.93
6,001-7,000 62.50 25.00 3.13 90.63
7,001-8,000 68.50 27.40 3.43 99.33
8,001-9,000 74.50 29.80 3.73 108.03
9,001-10,000 80.50 32.20 4.03 116.73
10,001-11,000 86.50 34.60 4.33 125.43
11,001-12,000 92.50 37.00 4.63 134.13
12,001-13,000 98.50 39.40 4.93 142.83
13,001 4,000 104.50 41.80 5.2.3 151.53
14,001-15,000 11050 44.2.0 5.53 160.23
15,001-16,000 116.50 46.60 583 168.93
16,001-17,000 122.9,G 49.00 6.13 '17763
17,001-18,000 128.50 51.40 6.43 186.33
18,001-19,000 134.50 53.80 6.73 195.73
19 001-20,000 140.50 5620 7.03 203.73
20,001-21,000 146.50 58.60 7.33 212.43
21,001-22,000 152.50 61.00 763 221.13
22,001-23,000 158.50 6340 7.93 22983
23,001-24,000 164.50 65.80 8.23 238.53
24,001-25,000 170.50 68.20 853 247.23
25,001-26,000 175.00 70.00 8.75 253.75
26.00 ,-27,000 179.50 71 80 8.98 , 260.28
27,001-28,000 184.00 73.60 9.20 26680
28.001-29,000 188.50 75.40 9.43 273.33
29,001-30,000 193.00 77.20 9.65 279.85
30,001-31,000 197.50 79.00 9.88 286.38
31,001-32,000 202.00 80.80 10.10 2.92.90
32,001-33,000 206.50 82.60 10.33 299.43
33,001-34,000 211.00 84.40 10.55 305.95
34,001-25 000 215.50 86.20 1078 312.48
35,001-36,000 22000 88.00 11.00 319.00
36.001-37,000 224.50 8980 11.23 325.53
37,001-38,000 229.00 9160 I 11.45 332.05
1 TIRESUPR DOC (DST) 8/96
Page No. 1 CASE HISTORY FOR CASE NO.: ELR98-0082
FLIP
IG280 SW UPPER BOONES FERRY RD
05/13/98
Action Description Req/ Schd/ End/ Action Not-,on
Code Sant Done pone Disp By update Upd
Dat" By
ELRC001 Application Received 03/19/98
RECD GRO 03/19/98 GEo
ELRC007 Permit Created / / 03/19/98 DONE GEO 03/19/98 GSO
ELRC500 (F) Issue permit 03/29/98 PASS G$O 03/20/98 GEO
FLRC725 Lo, Voltage Inspection 03/19/98 / / 04/09/98 PASS BRP 04/22/98 J+H
F.LPC725 Low Voltage Inspection / / / / 04/24/98 no access.
fiA71, BRP 04/29/98 J+H
ELRC799 Elect'l Final 03/19/98 / / 04/09/98 PAS PRP 04/22/96 J+H
ELRC800 Case finaled / / / / 04/30/98 1)4/30/98 JT
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT -
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 RESTRICTED ENERGY
PEPMIT #: ELR98-0082
DATE ISSUED: 03/19/98
PARCEL: 2S 1 1.3AB-01201
SITE ADDRESS. . . : 16c'80 SW UPPER NOONES FERRY RD
SUBDIVISION. . . . :F ANNO CREEK ACRE 'TRACTS ZONING: I-L_.
BLOCK. . . . . . , . . . . LOT. . . . . .. . . . . . . . . JIJRISDICEN: TIG
Project Description : Add protective signaling to an existing commercial tenant
occpy.
-------------------------------------------------------------------------------------------
1. RES I DENT I Al_-- --__ --- B. COMMS RC'.IA1-------------------------------------- ------
AUDIO
.---.--------------.---_-------__---- ----..AUDIO R STEREO. . . : AUDIO & STEREO. . : INTERCOM R. PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE. OPENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL.. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . . NURSE CALLS. . . . . . . . .
VACUUM SYSTEM. . . . : F 1 PF: ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL-. . : X
INSTRUMENTATION. : OTHER. . : .
TOTAL # OF SYSTEMS: 1
Owner: -- ------- - -- --__.___---__.__---_-.----_-__-___._______.- FEES -----------------
FL_IR type amol_int by date r^ecpt
16280 SW UPPER BOONES FERRY PRMT $ 40. 00 GEO 03./19/98 98-:304268
TIGARD OR 972c14 5PCT $ 2. 00 GEO 03/19/98 98--30426B
Phone #:
ContTactor••: ---------__._______.___.____________________..__._.__--•-_---_--___---_____
HONEYWELL INC: $ 42. 00 TOTAL
15495 SW SEQUOIA
STE 100 - ----- RE(�L.11 RED INSPECTIONS
PORTI_.AND OR 97224 Low Voltage Insp
Phone #: 968-3333 Elect' 1 Final
Reg #. . : 000578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes ;.nd all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 189
days of issuance, or if work is suspended for more than 139 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Ltility Notification Center. Those rules are set forth in OAR 952-991-0919 through OAR 952-991-8969. You may obtain copies of
these rules or direct question Ao OW A (583)246-1987.
I s s I-re d b- P e r,In i.t t e e S i g rr a t 1_r r-
-.-OWNER
-._OWNER INSTALLATION ONLY-_-.---.__...._
The installation is being made on property I own which is riot intended for-
sale,
orsale, lease, or rent.
0 W N E R' 5 S I G N A T U R E: _ —�. DATE
-_-------------•------- - --rON 1 RACTOR
INSTALLATION
NSTALLATION
SIGNATURE' OF SUPR. ELEC' N: ✓?���— _ DATE:
LICENSE N O:
+++++++4 4+++++++++•f•+++++.4-++4•++4-++++++++++++++++++++++++++++++++-F+++4+++++++++4-+++
Call 639-4175 by 7:00 F. M. for, an inspection needed the Tre>+t bi-isiness day
+++++++++++++++++.i.+++++++++.++++++++++ +-++++++ �_++++J•++++++++++++++++++++++++f-+++++
- n
s
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Pec'd by: 4
13125 SW HALL BLVD Date Recd .? 1
TIGARD OR 9722.3 PRINT OR TYPE
V- 503-639-4171 X304 Permit#: `�,��� �a�s•,
F - 503-684-729;' INCOMPLETE OR ILLEGIBLE APPLICATIONS Cut;t.Call'd:
WILL I40T BE ACCEPTED
Name of Development Pro)ect TYPE OF YORK INVOLVED -RESIDENTIAL
Restricted Energy Fee................................~.. $40.00
(FOR ALL SYSTEMS)
JOB Street AddresiV Ste#
Check Type of Work Involved
ADDRESS
Dty/Slbte Zip Ph ne# L Audio and Stereo Systems
t111, 1. • � X73/
Name 1 ❑ Burglar Aiarm
OWNER Mailing Address ❑ Garage Door Opener-
City/State Zip Phone# ❑ Heating,Ventilation and Air Conditioning System'
Name Vacuum Systems'
❑ Other _A —
CONTRACTOR Mailing Addres r
l6qq6 `j� N!�'o TYPE OF WORK INVOLVED-COMMERCIAL
(Prior to issuance a 'jity/sfsteZip
hone# Fee for each system.............................................. $40.00
copy of all licenses i jeo (SEE OAR 918-2bU-260)
are required If Oregon Con .Brd Lic.# Exp.Date
expired Ir C.O.T. Q J I Check Type of Work involved.
data base). Electrical Contr.Lic.# Exp.Date
e L& ❑ Audio and Stereo Systems
C.O.T.or Ree 1 Ir S Fxp.Date
/? Boiler Controls
Owner's Name
Clock Systems
OWNER - Mailing Address
APPLICANT Data Telecommunication Installation
City/State Zip Phona# ❑
Fire Alarm Installation
This permit is Issued under OAE 9.18-320-370.This applicant agrees to
make only restricted energy Installations(100 volt amps or less)under this 01 HVAC
permit and to do the following:
Instrumentation
1. Only use electrical licensed persons to do Installations where required.
Certain residential and other transactions are exempt from licensing Intercom and Paging Systems
These have asterisks('). All others need licensing;
❑
2. Call for Inspections when Installation under this permit are ready for Landscape Irrigation Control*
inspection at 603-639.417b; Medical
3 Purchase separate permits for all installations that are not ready for an Nurse Calls
inspection when the inspector is out to inspect under this permit;
4 Assume responsibility for assuring chat all corrections required by the Outdoor Landscape Lighting*
inspector are done,and;
Protective Signaling
5 Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Other
Permits are non-transferable and non-refundable and expire if work is not
started within 180 days of issuance or If work is suspended for 180 days. �-_ Number of Systems
The person signing for this permit must be the applicant or a person No licenses are required Licenses are required for elf other installations
authorized to bind the applicant
__ FEES:
SI nat ENTER FEES = G G
5%SURCHARGE(05 X TOTAL ABOVE) Ili p D
Authority if other than Applicant TOTAL
I iresele doc 12/9e —
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 639-4171
Date Requested: p c' ✓ _� P.M. - — MST:
I1!O
Locatioi .CA UYLgAA�eBUR
Tenant. Suite: Bldg: NEC:
Contractor: �_ Phone: �t� — 5,56) PLM:
Owner: _ , Phone: ELC:_
r1, 11) C.(,(,�� /�, 0! Cj U ELR:
—� ctm t, �t'!�'t�.C.C. t SIT:
BUILDING _-'B On't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Pij"stllicam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFl/Slab Rough-in Ceiling Water Line
Slab Framing Top Out (las Line Rough-In UG Sprinkler
Foundation Insulation Sewer Ilood/Duct Reconnect Vault
Bsmt Damp Drywall Storrs. Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I feat Pump Low Volt
Approved Approved Approved Approved
Appr/Sdwlk of Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL.
Ae , ---
---- - -- V
C0.5 ez, NOT I55(4EL YET; F�
_
e a�fZCG 1'-�-i a� `�U Pr C Ky
0 Call for rein -tio C] inspection fee of s_ req red before next inspection O Unable to inspect
Inspector•, _ Date: __ Page _of
� � U
7
CASE HISTORY pop CASE NO.: BUP97-0466
Page No. 1
PACTPUST
162,'0 SW UPPER BOONES FERRY RD
05/13/98
Rao/ S^hd/ End/ Action Notes
Diop By Update Upd
Action Descrir U.on Date By
Sant Dane Done
Code ----'---"------
RECD (,,go 10/08/97 DST
B1JPC005 Application received / / / / 10/09/97 PASS GEO 101/09/97 DST
BUPC008 Permit created / / / / 10/UB/97 PASS GEO 10/08/97 DST
BUYCO10 Check for prcl. restrict. / / / / 10/08/97
/ / 10/00/97 PASS RY 10/08/97 DST
BUPCO24 Plane Apprcrved by CPE / / PASS GEO 10/08/97 DST
BUPCO26 Approved Plane routed to D3Ts / / / / 10/0 /97 PASS GEO 10/09/97 DST
BUPC100 (F) Inoue permit / / / / 10/0 86/97 PASS TLP 11/06/97 J•H
/ / / / 10/30/97
BUPC740 Framing Inep / / / / 10/30/97 PASS TLP 11/06/97 J-14B,M^760 Gyp Boara Insp / / / / 03/12/98 PASS TLP 04/08/98 J•H
BUPC802 Final Inspection 04/13/98 JT
/ / / / 04/13/98
BUPC960 case Finaled
■
CITY OF TIGARD BUILDING PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . ..
. . . . . . . : BUP97--0466
13125 SV'Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 10/08/97
PARCEL: 25113AB-01201
SITE ADDRESS. . . : I61280 SW UPPER BOONES FERRY RD
SUBDIVISION. . . . : FANNO CREEK ACRE TRACTS ZONING: I-L
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION:TIG
REISSUE: FLOOR AREAS----- EXTERIOR WALL CONSTRUCTION--
CLASS OF WORK. :ALT FIRST. . . . : 0 sf N: S: E: W:
TYPE OF USE. . . :COM SECOND. . . : 0 -,f PROTECT' OPENINGS )--------------
TYPE OF CONST. :5N . . . . 0 sf N: S: E: W:
OCCUPANCY GRP. :B TOTAL-----: 0 5f ROOF CONST: FIRE RF-T? :
OCCUPANCY LOAD' 0 BASEMENT. : 0 sf AREA SEP. RATED:
STOR. : 0 HT: 0 ft GARAGE_.. . . : 4) sf OCCU SEP. RATED:
BSMT?: MEZZ" : REOD SETBACKS--------------
FLOOR LOAD. . . . - C71 p5f LEFT: 0 f RGHT: 0 ft FI R 9PKL: S11OK DET. . :
DWELLING UNITS: o FRNT: 0 fc, REAR: 0 ft FIR ALRM: HNDICP ACC:
BEDRMS. 0 BA-IHS- 0 IMF, S(ARFACE: 0 PRO CORR: PARKING: 0
VALUE. $ : 28333
RemLz.k--ks : Interior alteration for new tenant occpy. No increase in occupant load
- ADA is OK.
Owner-: FEES ---------------
PAC7RUST type arnot.int by date recpt
15115 SW SEPUDIA PARKWAY PRMT $ 188. 50 GEO 10/08/97 97-29990."
SUITE 200 5PCT $ 9. 43 GEO 10/08/97 97-299902
TIGARD OR 972EH-4 FILCK $ 122. 53 GEO 10/08/97 97-29990E'
Phone #: FIRE $ 75. 80 GEO 10/08/97 9729990,-_�'
Contractor—
H GREEN
15350 SW SEOLJOIA BLVD
STE 300
TIGARD OR 97224
Phone #: 624-7717 $ 396. 26 TOTAL.
Reg #. . : 000413 REOUIRED INSPECTIONS
This pernit is issued subject to the regulations contained in the Framing Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Gyp Board Insp
applicable law,;. Ail 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 Oregon Utility Notification Center. Those
rules are set forth in OAR 952-00I-010 through OAR 952-80111987.
You many obtain a copy of these rules or direct questions to OW,
by calling (503)2461987.
Permittee Signatur Ued By
.... ++++++++++++++++++++++•..++++ .... ... ... ++4•...........
Call 639-4175 by 7:00 p. m. for- an inspection needed the next business day
++4.....................................4+++++4..............I...................
MEMBAH
Commercial Building Permit Application
City of Tigard I yO
13125 SW Hall Blvd. i
TigL,rd, OR 97223
(503) 639-4171
/� rd
Jobsite Address:
oHles Use Onl
Tenant: _ Suite#
.� PlancklRec #
Valuation: _ _ !_ Permit P- C)
#
Owner: Pacific. Fealty Associates, L.P. (PacTrust) Map & TL#_ --
Address: 15350 S.W. Sequoia Pkwy, Suite 300 _ Approvals Regv%ed
Portland, OR 97224 Planning
Phone: 503/624-6300 — Enginu3-ring
Other _
Gontractcr. H.L. Green Company
�'ddr-ess: 15350 S.W. Sequoia Pkwy, Suite 300
Type of const:
Portland, OR 97224-7199
— Occupancy class:
503/624-7717 r
Phone: —— Sprinklered? Yes ) No
Contractor's License # 41328 — project:
(attach copy of current Oregon license) Sq. ft. of P ro 1
Contact name & phone: Chris Green, 503/624-7717 Story (1st, 2nd, etc.)
Proposed use.
John H. Romish `
ArchitecUEngineer. -
Previous use. --
A.ddress. ?216 S.E. 24th Avenue
Note: Plumbing & mechanical plans
Portland, OR 97214 must be submitted at time or
— building permit application
Phone. — 503/236-66306 —
JOB DESCRIPTION
A licant Signature& Phone number
Received by Date Received:
Permit 0 Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Moch. Permit (MECH)
�
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check
Bldq:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit T1F (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _
Office TIF (T1F-O)
Water Quelity (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS) r�yv
Erosion Cntri Permit (ERPRMT)
Erosion P!anck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS:
woo IL
CASE HISTORY FOR CASE NO.: F.LP97 0255
1'a,1e NoFL
1 INC'.
IR SYSTEMS,
16280 SW UPPER b.^ONE` FERPY PD
98
Peq/ Scluii II.d% Action Notan
Uinp ev Update Upd
„ 1 on Dencription Date BY
Sens Done Done --- --- .. .. ----- ---
RECD CEO 09/04/97 GEO
ELR^_001 Application Received / / 09/04/97
0:/04/97 PASS G80 09/04/97 GEO
ELPC003 Permit Created PASS GKo 09/04/97 GHO
ELRC500 (F) Ieeue permit 09/04/97p4/09/98 P9SS BRP 04/22/9e J-H
ELRC725 bow Voltage Inspection
09/04/97 / /
09/04/97 / / 03/12/98 yer Tan Pleecher, note writs-:. an final PASS TLP 04/13 98 .TT
ELRC799 Elect,l Final building inspection, ALL the following
permits can be case finaled: bup97-0505,
bup97-0466, elr97-0255. Jeanne T.
PASS BRP 04/31/08 IMI
/ 04/09/98
ELPcaoo Case finaled
I
I
I
i
1
S
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT -
- 13125 SIN Hail Blvd., Tlgard,OR97223 (503)639.4171 RESTRICTED ENERGY
PERMIT #: EL_R97-0255
DATE ISSUED: 09/04/97
PARCEL: 2S 1 13AB-01 201
SITES ADDRESS. . . : 16280 SW UPPER BOONES FERRY RD ZONING: I--L
SUBDIVISION. . . . : JURISDICTN: TIG
BLOCK. . . . . . . . . . . L-01.. . . . . . . . . . . . .
Pr o j ect Descr•i pt i an: Add protective signaling. --------------
----------------------------
(4.
--------__-_---------------------(4. RESIDENTIAL-
B. COMMERCIAL----_.----------•----------------____..-__.______
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : I-ANDSCAAF'E/IRRIGAT. . :
GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . . . . .
HVAC. . . . . . . . . . DATA/TELE COMM. . : NURSE CALLS. . . . . .
VACUUM SYSTEM. . . . : F IRE AI_..ARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: , , HVAC. . . . . . . . . . . . : PROTECTIVE SaIGNAL. : :X
INSTRUMENTATION. : OTHER. . : '
TOTAL # OF SYSTEMS: 1
-- FEES ------------------
FL_IR SYSTEMS, INC. type amol_rnt by date recpt
t6280 SW UPPER BOONES FERRY PRMT $ 40. 00 GEO 09/04/97 97-298939
TIGARD OR 97224 5PCT $ E. 00 GE:O 09/04/97 97-:98939
Phone #: 684-3731
Contv,actor': -----------------------------------
HONEYWELL INC; $ 4 . 00 TOTAL
15495 SW SEQUOIA
-_----- RECJU I REU INSPECTIONS -
STE 100
Ceiling Cover Low Voltage Insn
PORTLAND OR 97224
Phone #: `•368-x./333 Wall. Cover Elect' 1 Final
p p g #. . : 000578
This permit is Issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within leo
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon titility Notification Center. Those rules are set forth in OAR 9 AMI-0010 through OAR 952•01-0080. You may obtain copies of
these rules or direct st/0tOUNC 15031246-1981.
l �soed by Permittee Si gnat
OWNf R INSTALL_.ATION UNLY-------------- --------
The installation is being made on property I ow» which is not intended for-
-,ale,
orsale, lease, or rent. DATE:
()WNER' S SIGNATURE: _- --- -- - -
_____----------------------CONTRACTOR INSTALLATION ONLY---------------
c:;T GNATURE OF SUPR. ELEC' N: DATE: O
I CENSE NO:
++++++++++++•f-.++++-4++++++++.+++++++++++++++-+-++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 6:00 P. M. for- an inspection needee the next bi_is;iness day
+++++++++a-++++++++++++++++++++.+++1--1..++.+.+++.+.+.+++++++++++++++++•++++++++++++++++++F+
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: _
13125 SW HALL BLVD Date Recd_
TIGARD OR 97223 PRINT OR TYPE
V- 503-639-4171 X304 Permit#: IQ o�7jS
F - 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL
_ Restricted Energy Fee........................................ $40.00
P/r7 -r /)C (FOR ALL SYSTEM)
JOB Street Address Ste# Check Type of Work Involved.
ADDRESS /(, O Sri
10 ate Zip P one# Audio and Stereo Systems
217.2 j!
Name CJ Burglar Alarm
OWNER Mailing Address
El Garage Door Opener'
Heating,Ventilation and Air Conditioning System'
City/State Zip Phone#
Vacuum Systems'
Name
Other —
I
CONTRACTOR Mailing Addr. s #�Juo TYPE OF WORK INVOLVED -_CON r1AERCIAL
�c/q J Fee for each system...................... 540.00
(Prior to issuance a CAyy/* ate Zip one# y
copy of all licensesb - / c la 9�5 X300 (SEE OAR 918-260-260)
are required if Oregon ContiBrd Lic # Exp.Date
Check Type of Work Involved
expired in C.0 T
data base) Electrical Conti is # EVP ate
F� Audio and Stereo Systems
C.0 T.or Metro Lic,# Exp ate
/ �/it Boiler Controls
Owner's Name — L
L Clock Systems
OWNER - Mailing Address
F-] Data Telecommunication Installation
APPLICANT
City/slate Zip Phone# ❑
Fire Alarm Installation
phis permit is issued under OAE 918-320-370 This applicant agrees to F–] HVAC
make only restricted energy installations(100 volt amps or less)under this
permit and to do the following Instrumentation
1 Only use electrical licensed persons to do installations where required
Certain residential and other transactions are exempt from licensing Intercom and Paging Systems
These have asterisks(') All others need licensing,
Landscape Irrigation Control'
2 Call for inspections when installation under this perry it are ready for
inspection at 503-619-4175; ❑ Medical
I Purchase separate permits for all installations that are not ready for an Nurse Calls
inspection when the inspector is out to inspect under this permit,
4 Assume responsibility for assuring that all corrections required by the
Outdoor Landscape Lighting'
inspector are done,and, N Protective Signaling
Assume responsibility for calling for a final inspection when all of the E]
Other
corrections are completed
Permits are non-transferable and non-refundable and expire if work is not
started within 180 days of issuance or if work is suspended for 180 days Number of Systems
The person signing for this permit must be the applicant or a person No licenses nre required Licenses are required for all other installations
authorized to bind the applicant. --
FEES:
(N11d.L6�ef / ENTER FEES $
Signa SL 11�
� re ���/� �� ^
p --� 5"/o SURCHARGE(.05 X TOTAL.ABOVE) S �L_• C) l)
nj t t'7 tta/ 0, ,�u sty 0a.0 /.,2 Z_ TOTAL f
Authority if other than Applicant
i vesele doc 12196
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by:
13125 SW HALL BLVD Date Rec'd:_
TIGARD OR 97223 PRINT OR TYPE
V- 503-639-4171 X304 Permit
F - 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust Call'&
WILL NOT BE ACCEPTED
Name of Development Pro)ect TYPE OF WORK INVOLVED- RESIDENTIAL
Restricted Energy Fee........................................ $40.00
Flit- , /y) -/)c (FOR ALL SYSTEMS)
JOB Street Address / Ste#
ADDRESS Check Type of Work Involved.
l U;1 O SW
i)ty/grate I Zip Phbne# ❑ Audio and Stereo Systems
161
j Name ❑ Burglar Alarm
OWNER Mailing Address — ❑ Garage Door Opener'
Git;'State Zip Phone# ❑ Heating,Ve,-,tilation and Air Conditioning System'
Name / / ❑ Vacuum Systems'
L C l i 1 1 t LL ❑ Other —--
CONTRACTOR Mailing Addr s
< < fr/o n TYPE OF WORK INVOLVED -COMMERCIAL
(Prior to issuance a City/S ate Zip one# Fee for each system.............................................. $40.00
copy of all licenses e 2j 9G N 33un (SEE OAR 918-260-260)
are required if Oregon Contr.Brd Lic # Exp.Date
expired in C O T c " � Check Type of Work Involved.
data base) Electrical Contr Lic # E p.Uate
ZG I CL - Audio and Stereo Systems
C O T or Metro Lic # Exp Date
_J f S //!i ❑ Boiler Controls
Owner's Name
_4� ❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City/State y Zip Phone# ❑
Fire Alarm Installation
This permit is issued under OAE 918-320-370 This applicant agrees to
make only restricted energy installations(100 volt amps or less)under this HVAC
permit and to do the following:
❑ Instrumentation
1 Only use electrical licensed persons to do installations where required
Certain residential and other transactions are exempt from licensing ❑ Intercom and Paging Systems
These have asterisks(') All others need licensing,
2 Call for inspections when installation under this permit are ready for F-1 Landscape Irrigation Control'
inspection at 503-639.4175; I] Medical
3 Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector is out to inspect under this permit.
4 Assume responsibility for assuring that all corrections required by the Outdoor Landscape Lighting'
inspector are done,ani,
Protective Signaling
5 Assume responsibility for calling for a final inspection when all of the
corrections are completed ❑ Other
Permits are non-transferable and non-refundable and expire if work is not
started within 180(lays of issuance or if work is suspe ided for 180 days ___-- _Number of Systems
The person signing for this permit must be the applicant or a person Nc licenses are required Licenses are required for all other installations
authorized to bind the applicant _
FEES:
Signa re y ENTER FEES $_
�. rt 5%SURCHARGE(05 X TOTAL.ABOVE) $_ ) t)
0,).)rtt�Z� CZl�Otu�n rct
Authority if other than Applicant — TOTAL $ <� . t�
Vesele dor,12196 _
RECEIVED
SEP 0 4 1997
COMMUNITY DEVEIOPMEN.
10 PORTI- AND
CARMAN RD,
EXIT #291
c .7
5
1---4--A Z '
...............
^0
BLIS 114E SS
1----�-----1----� � (I a e) t� � o'''ff � f� 1 (t 7�,r _�'� 4 `,�•?, 'r'"'^'"*+� _ '
PARK I I
174 124
1fs 1721 (1I3) C/ 121 (1221 rn
(23e)
-A (2411 f 2421
E OSWEnCi
ci 1, LA E nt�imrdl
N \UW flu EXIT IF290
EEOU21A PKWY (171 (1251 cy
A
f INS
so mln=rtmn
0 7 7
fn --- I (
112251 w 4
PA..--' i r I c (233) 1�, (211) 117 14 OREGON
770 3 al. 2 a
CORPORATE (22f) f1l, ( 13)
lo"111– WW%Iff
Milt" (1271 BUSINESS
CENTER f 2311 (227'
ttjjj%� ke, 09) 10) (1061 PARK I
2 in I rmffi�
U"UUU= 16
SIN 72ND AVENUE C---- umuu I flu SW 7214D AVENUE
1w [D�J 11941
TltO A
r (21S) A
(21 e) (214) F u u
C, 11931
(YOH P-44 (106)
-0 n
cw y f147) 0
1 r I -
COINISOL IDATIV
f 2171D (let)
(221) 4
;,> r"I" N
(2 2) H � WIT
�4X00
BURL I NG 0 NOR RN —RR—
> (loll
a tel
SV174TH AVENUE OREGONnw
BUSINESS cp' t1e7t (lee lee FPACTRUST
PARK III u"fnmruall f BUSINESS
G CENTER
TO TBC I do II
NORTH
P711
tow 200* 3". 400. W.
no o amry
16280 SW Upper Boones Fry Rd
1 of 1
7-1 T11 I III 11TIT11111111 I 11111111111ti 1-11 IIT I i I i I I IIp-1-1 T'IT]TTT TI-1 1,I
LEGIBLE THAN THIS NOTATION ,
IF THIS DOCUMENT IS LESS io 1,3j
IT IS DUE TO THE QUALITY OF 41 111 1
No.36
THE ORIGINAL DOCUMENT ,
L IRI Ll ST 91 TI 1 6 9 c g loll