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13535 SW 72ND AVENUE STE 200 I I I { 13535 SW 72 No AVENUE #200 CITYOF T I G A R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2003-00171 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/23/2C33PARCEL: 2S101DC-00200 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 13535 SW 72ND AVS:200 SUBDIVISION: 72ND AVE OFFICE BU'LDING BLOCK: LOT: CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 3N OCCUPANCY GRP: B OCCUPANCY LOAD: 2 TENANT NAME: QTA REMARKS: TI Owner: PACIFIC NW PROPERTIES LTD PTNSHP 9665 SW ALLEN BLVD STE 115 BEAVERTON, OR 97005 Phone: 503-698-2971 Contractor: NORTHWEST CONTRACTORS INC PO BOX 25305 PORTLAND, OR 97298-0305 Phone: 503-698-2971 Reg#: LIC 89425 This Certificate issued 7/15/2003 grants occupancy of the above refererced building or portion thereof and confirms that the,building has been inspected for compliance with the State of Oregon Specialty C.Aides for the 'group, occupancy, and �we under Wo1qthe referenced permit wa .I BUILDING INSPE OR BUILDING O CI.NL POST IN CONSPICUOUS PLACE CITY ®F T I G A R D - BUILDING PERMIT PERMIT#: BUP2003-00171 DEVELOPMENT SERVICES DATE ISSUED: 4/23/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S101DC-00200 SITE ADDRESS: 13535 SW 72ND AVE 200 SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C-P BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS _ _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 3N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 Sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 2 BASEMENT: sf AREA SEP. RATED- STOR: HT: ft GA'AGE: sf OCCLi SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: !ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 28,000.00 Remarks: TI Owner: Contractor: PACIFIC NW PROPERTIES LTD PTNSHP NORTHWEST CONTRACTORS INC 9665 SW ALLEN BLVD STE 115 PO BOX 25305 BEAVERTON. OR 97005 PORTLAND, OR 97298-0305 Phone: Phone: 503-698-2971 Reg #: LIC 89425 FEES _ REQUIRED INSPECTIONS _ Description Date Amount Mechanical Permit Require IItIILDI Permit Fee 4/11/03 $305.80 Electrical Permit Required Sprinkler Permit Required I'AXj 59/0 State Tax 4/11/03 $24.46 Framing Insp IIUPPI.N1 Pin Rv 4/11/03 $198.77 Gyp Board Insp FI S1 Fl S Pin Rv 4/11/03 $122.32 Susp Ceiling Insp Total $651.35 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with vpproved plans. This permit will expire if work is not started within 180 days of issuance, or if work is; suspended for more 'han 180 days. ATTENTIONS Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332.2344. Issued F; Permittee Signature: _ Call 639-4175 by 7 p.m. for an inspection the next business day FOR' s "` -Building Permit Application Rccci�ed Building Date/By. Permit No.: U P fl�� Planning Approval Other City of Tigard Date/By: _ Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-59$-1960 C Post-Review Land Ilse Date/By! Case No. Internet: www.ci.tigard.vr.us Contact auris.: see Page z for 24-hour Inspection Request: 503-639.4175 Name/Method: Supplemental Information _ TYPE OF WORK _ _ — REQUIRED DATA: []New construction emolition 1&2 FAMILY DWELLING �'Addition/alte:ration/re lacement ❑Other: - CATEG RY OF CONSTRUCTION_ Note: Permit fees*are based on the total value of the work performed. Indicate [�1 &2-Family dwellin ommercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor. orerhead and profit for the work indicated on this application. Accessory Building Multi-Fad Master Builder Other: Valuation........................................................ S __ JOB SITE INFORMATION and LOCATION No.of bedrooms:__ No.of baths: Job site address: - -: 1,w 72,id 4vo, Total number of floors.................................... New dwelling area(sq.ft.).............................. Suite#: _ Garage/carport area(sq.ft.)............................ Project Name: Covered porch area(sq.fl.)...................... .. Cross street/Directions to job site: Deck area(sq. ft.).. ...................................... .. Other structure area(sq.ft.)............................ REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: Lot#: _ - --- Tax map/parcel#: v— Note: Perot fees*are based on the total value of the work performed Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit fur the work indicated on this application. Ga,Eir�Y,,.gG1_ – r $_� 000- Valuation........................................................ Existing building area(sq.ft. New building area(sq.ft.),.......... Number of stories. ......... 2^^ PROPER Y OWNER —� TENANT Type of construction....................................... -_- Name: /'r4'CIIA(c! /YN/ lo�p��tr,e 7/�c 5 Occupancy group(s): Existing: New: —�. --- Address: City/State/Zip: . oR. Q�oe� Phone: fp 2�r•3Sd� Fax: NOTICE: Al)contractors and subcontractors are required to be APPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the _13uz,iness Name: 645ye jurisdiction where work is being performed. If the applicant is exempt Contact Name: 4P&6g: /a'//(-V1tW;./ from licensing,the following reason applies: Addrt m: ----- Cit /State/Zig — —- - --- Phone: Fax: --- BUILDING PERMIT FEES' E-mail: _ Please refer to fee schedule. CONTRACTOR/ __ --- Business Name: Fees due upon application__.......................... S Address: city/state/zip: _ - Amount received..... ....................................... g - --- Phone: Fax: —_ Date received: CCB Lic. -- Authoriz. _ Nallce: 'rhl•permit application expires if a permit Is not obtained within Sign _ _ Date: IAO days after It has been accepted as complete. •fec methodology sct by Trl-('ounty Building Industry Service Bosird. (Please print name) I,-) I 7ri- i:\l)sts\Permit hbrms\BldgPetmitApp.doc 01/03 W6" 7 1 77y y� At<, Commercial Plan Submittal Requirement Matrix City of Tigard F TYPE OF SUBMITTAL # of Plans (Includes New Additions or Alterations) Required at Submittal Site Work 4 ' (must include location of all accessible parking) Plumbing - Site Utilities 2 Building 1* Fire Protection System 3** • Mechanical 2 Plumbing - Building Fixtures t •'2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Cgntractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plats bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "T.' technicians, i\dstsvorms\COM-matrix.dor 9/24101 CITY OF TIGAPD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (50639-4171 MST _ BuP 3 Received ' —Data Requested AM _.-__PM — BLIP Location Suite. O MEC Contact Person _ Lam^_— Ph( ) 7162 6.S 3 PLM _ Contra.tnr -fP'h _ SWR UIL Tenant/Owner / ^ ) ELC Footing ELC Foundation Access: Fig Drain ELR Crawl Drain --- Slab Inspection Notes: SIT — Post&Beam Shear Anchors --— --- Ext Sh3ath/Shear Int Sheath/Shear r, -- — --T Framing Insulation Drywall Nailing ------- L) U �� ____\� ( N(�. ✓telOc. t Firewall Fire Sprinkles ----- — - ---- —. _ Fire Alarm Susp'd Ceiling --- - ---- — - - --- ---- ------ Roof A PART FAIL ---- --- --— _ _-- - VLVMBING_ Post&Bea n __ -- Under Slab Rough-In Water Service Sanitary Sewer — Rain Drains Catch Basin/Manhole Storm Drain -_-- Shower Pan Other: —— - --- Final PASS PART FAIL --- - MECHANICAL Post& Beam--- - - Rough-In Gas Lino Smoke Dampers Final PASS PART FAIL - - ELECTRICAL _ _ ---------- Service Rough-In UG/Slab Low Voltage --- -------------- ---._�— .--------- —__—_-- -----..-.--------- Fire Alarm Final Reinspection fee of$ _ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE:___ — Unable to inspect-no access Fire Supply Line ADA , 3� Approach/Sidewalk Date .-- --_ Inspector �'"� _-_ Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGA,RD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST / _ BLIP _ Received __— Date Requested �1 S AM _ PM .. BLIP Location ._ ? r� Suite c;l'cd C) MEC _ Contact Person -- Q Ph( ��3 .? �� 5�3 ( /6 -a Contractor _ _ Ph( ) SWR _— BUILDING_ Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: - SIT Post& Beam Shear Anchors _ Ext Sheath/Shear Int Sheath/Shear Framing Insulation _ Drywall Nailing ---- ----_--.-- ------ ----._-, Firewall Fire Sprinkler - - - Fire Alarm Susp'd Ceiling — Roof Other: -- i_.- .`---- ------ — Final P _ RT FAIL --- - -� uM Post& Beam -- — - ---- -�- -- / — ,r Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Brain -- --- --- -- -- Shower Pan A_SS PART FAIL ---- - - - - Mwft ICAL Post& Beam Rough-In Gas Line Smoke Dampers 5� Final -�� PASS PART FAIL ELECTRICAL ------------ Service Rough-In UG/Slab - -- -- __—_------.---________--_-.-- Low Voltage Fire Alarm ---------- ------------__ Final Reinspection lee of$_- --__- Pa inspection.before next required re ins at Ci Hall, 13125 SW Hall Blvd. PASS PART_ FAIL (- g p y City SITE——__ _ Please call tar reinspection Unable to:,ispect-no access Fire Supply Line ADA Approach/Sidewalk Date ---_T.� G Inspector _S./'�------- ---------- t Other. Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIOARD 24-Flour BUILDING Inspection Line: (503)639-4175 MST _— INSPECTION DIVISION Business Line: (503)639-4171 — Received Date Requested_—_ " if — AM_. ___ PM— BUP — —_ Location ___ !4 ;�L� 7Z�-'i — Suite MEC —00 Contact Person Ph PLM Contractor _ — Ph ( _) _ -- SWR BUILDING_ Tenant/Owner _ —"_____ —.__ ELC _- Footing Foundation ELC Access: Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT _-- — Post&Beam Shear Anchors —"-"----- - -- -- Ext Sheath/Shear Int Sheath/Shear Framing _ _— — ---- ----- —------- -- Insulation Drywall Nailing - — —_------ - --- Firewall Fire Sprinkler ------ — -- — -- — Fire Alarm Susp'd Ceiling Roof Other: --- -- - — Final -------------.. PASS PART FAIL PLUMBING Post Beam Under Slab -. ---- -- --- --- Rough-In Water Service - ------------ __—_. Sanitary Sewer Rain Drains _— Catch Basin/Manhole Storm Drain -------- — ---- -. ------ - Shower Pan Other: Final PAS APART FAIL -- — ISM"""-��- — --- ------ Post eam gas ine Smoke Dampers PART FAIL - -- - - --- ---- ------ -_ —_ RICAL Service Rough-In UG/Slab Low Voltage —_------__- Fire Alarm Final lPART FAIL Reinspection fee of$ _-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd PASSSITE — Please call for reinspection RE:_ _ _—___`_ __ Unable to inspect-no access Fire Supply Line ADAData _ C� Approach/Sidewalk __ ; Inspector _ rr Other. Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2003-00417 DEVELOPMENT SERVICES DATE ISSUED: 7/9/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S101DC-00200 SITE ADDRESS: 13535 SW 72ND AVE 200 SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C-P BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 3N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ'l: REQD SETBACKS _REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR. ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,286.00 Remarks: Relocate(9)fire sprinkler heads for new tenant.Owner: Contractor: Contractor: PACIFIC NW PROPERTIES LTD PTNSHP AFP SYSTEMS INC 9665 SW ALLEN BLVD STE 115 19435 SW 129TH BEAVERTON, OR 97005 TUALATIN, OR 97062 Phone: Phone: FAX-692-1186 Reg #: VFJM92-907800a 334q345 FEES LIC REQI�I& INSPECTIONS Description Date Amount Sprinkler Rough-In IBUILD I Permit Hee 7/9/03 $62.50 � Sprinkler Final TAX] 8'% titatc Tax 7/9/03 $5.00 Total $67.50 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if worts is suspended for more than 180 days. ATTENTION: Oregon law requires you to folirm, the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503)248=86x9 or 1-800-332-2344. Issued ByN ✓l,�G�.� Pe mt It tee Signature: Call 639-4175 by 7 p.m. for an inspection the next business day - Fire Protection System FOR OFFICE USE ONLY , Building Permit Application Received Build, ng Date/By: / Pernut City of Tigard Planning Approval Other Date/13y: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Dete/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Revicw land Use Date/B Case No, Internet: www.ci.tigard.or.us Contact Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: '71�'/ Su Icmental Information _ TYPE OF WORT: REQUIRED DATA: ❑ New constructionDemolition 1 &2 FAMILY DWELLING Addition/alteration/replacement ❑ Other: —" CATEGORY OF CONSTRUCTION Note: Permit fees'are based on the total value of the work performed. Indicate &2-Family dwelling VA Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. Accessory Building Multi-Family ❑ Master Builder _ ❑Other: _ valuation........................................................ S JOB SITE INFORMATION and LOCATION No.ofbedrooms: No.of baths: —_ Job site address: 3 3 5 -7.1 ��[, , Total number of floors..................................... New dwelling area(sq.ft.).............................. Suite#: Bldg./Apt.#: Garage/carport area(sq.ft.)............... ............ ®_ Project Name: CIT A Covered porch area(sq.ft.)............................. Cross street/Directions to job site: Deck area(sq.ft.)............................................ -- Otherstructure area(sq. R.)............................ REQU 4• 1 DATA: COMMERCIAL-USE CHECKLIST Subdivision: Lot#: -� Tax ma / areal #: Note: Permit fees'are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, tt--''•• overhead and profit for the work indicated on this application. Cdi� ct(-) Valuation......................................................... Sj,% -- -- i Existing building area(sq.ft.)......................... 000 --- - ---- — _– New building area(sq. ft.)............................... Number of stories............................................ _T--- FROPERTY OWNER TL NANT Type of construction....................................... Natne: Occupancy group(s): Existing: .7 —_� New: Address: UJ _ City/State/Zip: O� Phone: �Sb-�50V Fax: NOTICE: All contractors and subcontractors are rept fired to be APPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board urder provisions of OILS 701 and may be required to be licensed in the Business Name: _ Sym, tjurisdictit.n where work is being performed. If the applicant is exempt Contact Name:-91,,�� _ T,— from licensing,the following reason applies: Address: l ad h-, S. 3__ I A3 I 1A _— ------ ---- Cit /State/Zip: -1- Phonee° c 1 H Fax: b91.-11$b_ ---- BUILDING PERMIT FEES* E-mail: & 31 M _ 5_51C__QY , — Please refer to fee schedule. _ CONTRACTOR —Bi _—� ----- - ___—..----- Business Name: IP�– :;N r;D.--,S .� � Fees due upon application.............................. q 9 � C', Address: 1 �t3 _ Zq _— Amount received............................................. Cit /State/Zi Pbone: -92 `1 Fax: 02-11 16 Date received:_ CCB Lic. # -- Authorised 1 80Notice: a is permit been accepted expires c mif a permit Is not olnafncl++Itbin Signature: Dale._ L9�� 180 days aper It has been accepted as complete. lw. w E "Fee methodology set by Tri-County Building Industry Set%Ice hoard. ( ease print name) i.\Dgts\Penrit Fortns\BldgPermitApp.doc 01/03 Fire Protection Permit Check List Describe work to be done: A.) ❑ New B.) Modification to sprinkler heads only: ❑ Addition EA 1-10 heads: No plan review required. �2 Alteration ❑ 11+ heads: flan review required. ❑ Repair Number of sprinkler heads: 9 _ Additional description of work: A6-c� 9 kv-\ Type if System Complete A, B, C or D as applicable): A. Commercial S rinkler Wet Uh- _ D ry ❑ _ Additional Stand Oes Information: Hazard Group L $ Density .IC DesiOn Area 1500 K. Factor Sprinkler Project Valuation: $ Ia. I - Hood Fire Suppression System — Hood Project Valuation: $ C.�Fire Alarm Submittal shall Battey Calculations__ Yes ❑ Include: Individual Component Yes ❑ Cut Shee,s — Fire Alarm Project Valuation: $ — Residential Sprinkler Stand Alone §ystem _— Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 _ 3,601 to 7,200 $292.50 _ 7,201 and greater _ $381.50 Sprinkler Project Square Footage: — Q sic .. ft. t Project Valuation SubtotalA( , B 8 C : $ _ Permit fee based on valuation (see attached char _ Permit fee based on square footage(D) (see fees above): $ State Surcharge 8% of Permit Fee: $ _FLS Plan Review 40% of_ Permit Fee: $ — TOTAL: $ Plan review requires a completed application and 3 sets of plans at submittal. Plan review fees are required at submittal. 'New" Fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i\dsts\1 nms\F-Pscheckhst doc 02128/03 CITY OF TIGARD 24-Hour BU;LDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST — —� // BUP Received ___ Date Requested Q /0 AM PM _ BUP __—�-- Location 3 S 3 S 7i� _—_suite MEC Contact Person — -- Ph( ) PLM Contractor_ Ph SWR _) S�� SWR BUILDING Tenant/Owner _ _ l ELC Footing - �� ELC Foundation Access: Ftg Drain ELR _ Crawl Drain -- -� - Slab Inspection Notes: SIT _-__-- Post 9. Beam --__— - Shear Anchors --- -- Ext Sheath/Shear Int Sheath/Shear ��- Framing - Insulation Drywall Nailing ----- -- --__._ _ —_- _--- _-- Firewall Fire Sprinkler — -- ---------- - -- -- --- Fire Alarm Susp'd Ceiling ------ — ------- Rout Other: ----- - Final - -- PASS PART FAIL PLUMBING _ Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains — ------- — — Catch Basin/Manhole Storm Drain - ----- --- ---- Shower Fan Other: —-_.- ------- -- ---_- Final PASS _PART FAIL MECHANICAL Post 8 Beam Rough-In ---- --- ----------- Cas Line Smoke Dampers Final PASS PART FAIL ---- - - --- ------ -- --_-_ ELECTRICAL Service----— - -------•----- -- -- --..----._ Rough-In UG/Slab -- -- --- -------.._ -- Low Voltage _ _----------------- Fire Alarm M&S-) PART FAIL ❑ Reinspection tee of$ _—required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 817v-- n Please call for reinZe Ation RE: Unable to inspect-no access Fire Supply Line ')A Data /Ly Inap�to�. -f �r– t,proach/Sidewalk �- - --- Ext Othor: Final PO NOT REMOVE this Inspection record ram the fob site. PASS PART FAIL \ CITY OF TIGARD ELECTRICAL PERMIT PERMIT#: ELC2003-00245 s DEVELOPMENT SERVICES DATE ISSUED: 5/1/03 13125 SW Hail Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S101DC-00200 SITE ADDRESS: 13535 SW 72ND AVE 200 ZONING: C P SUBDIVISION: 72ND AVE OFFICE BUILDING BLOCK: LOT: JURISDICTIC.A: TIG Project Description: Job#532 Install 15 branch circuits. RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: _ PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BkANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 14 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amplvolt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: PACIFIC NW PROPERTIES LTD PTNSFIP GEORGE+ SONS ELECTRIC CORP 9665 SW ALLEN BLVD STE 115 PO EOX 339 BEAVERTON, OR 97005 CLACKAMAS,OR 97015 Phone: Phone: 503-654-8634 Reg #: LIC 35600 - ---- — ELE 3-I17C FEES _ _ SUP 31855 Description +Date Amount Required Inspections [ELPRNI j ELC Permit 5,I;u3 $139.95 �— [TAX]8%State Tax 5/1/03 $11.20 Rough-in Elect'I Final Total $151.15 This Permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire i`work is not started within 180 days of issuance,or if work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adcpted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules ordirect questions to OUNC of(503) 246(6699 or 1 800-332.23 / Issued By: eo,r'. z_Zcd ,pj> Permit Signature:— / ( _ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: HATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _ __ DATE:-- LICENSE ATE:_LICENSE NO: 31Kr—� S _ _ Call 639-4175 by 7:00pm for an Inspection the next business day 04/30/2003 15:15 503-653-6986 GEORGE & SONS ELECTR PAGE 01 Electrical Permit Application �q,,,,��, Dta "Ceived:.5--1-C 3 W.:� - 3 Chy of j'fi'�'d Prolcethppl.no.: dole: ar,�iq4,„d A&lre a: 13125 3W Hall Blvd.7'lgard,OR 97223 Phone: (303) 6394171 Drlt iarued: By: Raot>ipt ao.: Fax: (303)SWI960 Care fik tw.: t type: LwA uw approval: ____ ------ -- ❑ 1 &2 fondly dwelling or aocteuM ❑Cotm ems industrial CI Multi-family T it improvement 0 New odrtruction ❑Addition/alteratiordrepiacement 13 Other. Job s Suite no.: 00 Tax map/tax 1W ocount no.; Litt: �k_ Subdivision: t trartre: Description and location of work on premises: 'Tle `o Esdmagd date of omn a don! on: Businera name; rl1 11e T 6 7tir1 M&NOP Address_ 4 oNew reddmwliel• w - dw@Mbq ri.rcrtissaaM�l�*s Ca L _ stab: Z1P 7p S".4011 ' I Phone: Fret: &mall: IJWsq.n.orleu CCB no.: Op 1 Elec.bus.lic.no: E3adt addidorul S00 sq n;Of dW@0 - --____ � umiWd! ,nddenad 2 City! tic.tr0.' �— tedenetoy,ma-taidrntiw 2 eBacm anufwaitad horn:or modular dwellial sl' of sumviffing,,decakim —_Wired) D&W_ ' u� suvice indict feeder 2 el�tat ttaats / 5_S s°r.foaertarers=l..bIWIM., gyp• �W� 1 Liaznse n: d aharalMr r ralaerrn 200 snips or isss 2 01 Now Noy: 201 ge an" Moo.mss - 2 601"so low atop. - - 2 City: Su t -- ZIP: Over i opo asp a volts 2 Pdtamc' Fax: &hall: Ramrrw q owl t Ow"a lnsWiMion:The inaallatkm is being made on property I own T•MPWMy settle"w lsedan- which Ir not inWrided for task,ratrc,rent,or exchange according to rt.aYlea."��'rroMe.tl� ORS 447,455,479.670,701. 100 mop of km 2 201 aap.b SOU rep 2 rNww: Date: sol 10== 2 armeli to cam-aew, ZMm— or exfnidar ter pious:wvice or flydrr fee,a:h beech dttrk 2 ty. TdP: n Pee ;d) Phaaa: Fax' P.mail of service a leader r•�Mt k= l. G 2 'p Savloe evver 225 ampr-ax.rnft:W V Malrh-c�ldlry swb or Ittllsoat drde•Urvkae over 320 amps adne d 1!2 J Hass**ium iorwian .uh si`u a cedim Hot'" -42 tae mydwa tioW U HullalY s ova 10.000 square fact fou rn Siartd cltt:o I or a 11 ted�O'pSyners(waw!1011 Yalu nottdns. more n%ddentlr)unite In wr ghweltn alexadon,ruaurriam• 2BrlMaof overarec tttMlee f]rtse+na..100 atop.er more •O OwupstM load ova"peso s ❑Mrwfletuarl senr:trres or Rv peakCl IRS-s%htMalleo ❑AdeewsrlMKpbsis wkb my offt Met Investigation In _ _ tiro WIsm an aw_tzeuaMa to t envu,01006vuMan asvlee. `— na+selr�"e.►....w ,err aero p1w.wx}draem:tf race Yrerarso. Notloe:Thls Perin rppHeatfon Permit tee... ...,.... Vere r] i"/C► 1 expires if a petmft Is nos obWtted 146A review(al __ %) $ _ t a Y _9Yj within 110 days&&tit his been state surcharge(8 ) $C 0? r !� w complete TOTAL .............. ........$ l CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: Pl_M2003-00196 DATE ISSUEu: 5/16/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S 101 UC-00200 SITE ADDRESS: 13535 SW 72ND AVE 200 SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C-P _ BLOCK: LOT: JURISDICTION: TIG _ CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install (1) new sink and relocate (1) sink. _ FEES Owner: Description Date Amount PACIFIC NW PROPERTIES LP [PLUMB] Permit fee 5/16/03 $72.50 9950 SW ARCTIC DR [TAX]80/„State Tax 5/16/03 $5.80 BEAVERTON, OR 97005 Total $78.30 Phone Contractor: DP PLUMBING 904 S. CHEHALEM NEWBERG, OR 97132 REQUIRED INSPECTIONS Rough-in Insp Phone : 503-537-9492 Top-out Insp Reg#: PLM 110612 Final Inspection LIC 36-70PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregrin /�/ ' Permittee Signature: Issued By: Z2�t l' 'v�-� --� Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Accumulative Sewer Tally Tenar.;Nam. : Q'i A This SWRA 2003-00160 _ Address: 13535 SW 72nd. This PLM# 2003-00196 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added ,added total total count off#s count # value #s values Baptisecy/Font 4 0 0 0 — 0 0 Bath-Tub/Shower 4 0 0 0 _ 0 0 -Jacuzzi/Whiri pool 4 0 — 0 0 0 0 Car Wash-Each Stall 6 0 0 0 0 0 Drive through 16 0 0 y 0 0 0 Cuspidor/Water Aspirator 1 0 0 0 0 0 _ Dishwasher Commercial 4 _ 0 0 0 0 0 Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 _ 0 0 0 0 Floor Drain/Sink-2 inch 2 0 0 0 0 1 0 3 inch_ 5 0 0 0 0 0 -4 inch 6 0 0 0 0 0 _ Car Wash Drn 6 0 0 0 0 0 Garbage Disposal _ Domestic �o 3/4 HP) 16 _ 0 0 0 0 0 Commercial(to 5 HP) 32 0 0 0 _ 0 0 Industrial ;over 5 HP)_ 48 0 0 0 0 0 l,;e Mach ine/Refrigerator Drain 1 0 _ 0 _ 0 0. 0 Oil Se Gas Station) 6 0 0 0 _ 0 0 Rec.Vehicle Dump station 16 0 0 _ 0 0 0 Shower-Gang(per head) 1 0 1 0 0 0 0 - Stall 2 0 0 0 0 0_— Sink- Bar/Lavato 2 0 0 0 0 0 Bradley 5 0 0 0 0 0 Commercial _ 3 0 _ 0 0 —_ 0 0 Service 3 0 0 1 3 1 3, Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes — 6 0 0 -0 0 0 ^ Water Extract( 6 0 0 0 0 0 Water Closet-Toilet 6 _ 0 0 _ 0 _ 0 0 A_ Urinal 6 U 0 0 0 0 Previous EDU Count 9 144 144 Capped EDU Credit 0 TOTALS 1 0 144 0 1 0 1 1 1 3 1 147 Current Fixture Value 147 divided by 16= 9.2 Current EDU 1 FDU :$2,300 00 Previous Fixture Value 144 divided by 16= 9.0 Previous EDU Change 3 divided by 16= 0.2 over (under) $ 460.00 Enter EDU Change Here 0.2 HISTORY /2nm `tRln�� PLM# EDU# — Y SWR# p ny PLM# - EDU# _SWR# PLM# EDU# SWR# / / t Name: s -�-`.' er en _� �Lli (� Date: �5-- Signature of person that calculated flits tally sheet and date perfromed Is required CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00160 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/16/03 SITE ADDRESS; 13535 SW 72ND AVE 200 PARCEL: 2S101DC-00200 SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C-I' BLOCK: LOT: JURISDICTION: TIC, TENANT NAME: QTA USA NO: FIXTURE UNITS: CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: C—M NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .2 EDU increase. Previous EDU=9.0 for a total of 144 fixture values. Addition of 3 fixture values, for a new total of 147 fixture values = 9.2 current EDU's. Owner: _ PACIFIC NW PROPERTIES LP FEES 9950 SW ARCTIC DR Description Date Amount BEAVERTON, OR 97005 [SWLJSA]Swr Connect 5/16/03 $460.00 [SWURA]Swr Connect 5/103/03 $0.00 Phone: Total $460.00 Contractor: Phone: Reg#: Require6 Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The pennit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located,the installer shall purchase a "Tap and Side Sewer" Perm cZslr_ ��,:c t�GZ Permittee Signature: Issued by: A4 -4. Ca, r 33)639-4175 by 7:00 P.M. for an Inspection needed the next business day Building Fixtures Plumbic Permit Application ' Received Plumbing --� '"" Date/B 'j: O% -- Permit No.:fLlp s✓� ., - City of Tigard Planning Approval Sewer Date/By: Permit No.7 'WB - OO? -tat./too 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: _ Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use _ Internet: •oww.ci.tigard.nr.us Date/By: Case No.: 24-hour'nspection Request: 503-639-4175 Contact Juris.: See Page 2 for Name/Method: _ /' Supplemental Information. /'/IS Rtlr �c'Cj- b0 1 7U 7/ - _ TYPE OF WORK ...... FEE*SCHEDULE(forspecial information use checklist New construction _ Demolition __ _Desai,tion t;�t>. Fee(ea.) Total Addition/alteration/replacement ❑(.ether: � New I-&2-family dwellings _ _CATEGORY OF CONSTRUCTION includes 100 ft.for each u IlIty connection ❑ 1_&2-Family dwellin _ Commercial/Industrial SFR t bath 249.20 SFR 2 bath _ 350.00 Accessory Build' Multi-Family SFR 3 bath 399.00 Master Builder ❑Other:_ Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION Firesprinkler-sq. fl: _ Pa c 2 Job site address: 1j��_ S,c.. � -_ Site Utilities _ Suite#: 'op Bld�./A t.#: - Citch basin/area drain 16.60 \a Project Name: f Dr cll/leach line/trench drain 16.60/,)7-A _ Footing drain no.linear fl. p�2 Cross street/DireeUons to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer(no. linear ft.) Page 2 Subdivision:_ T Lot#: Storm sewer(no. linear ft.) Pa c2 -�- Water service no. linear Tax ma / .reel #: R. Page 2 � _ --��-��- DESCRIPTION OF WORK Fixture or Item -- n �- -- Absorption valve 16.60 c("AJ !< Backflow preventer Page 2 Backwater valve 16.60 fif Clothes washer _ 16.60 rid_ f „_ y_ Dishwasher - 16.60 PROPERTY OWNER TENANT Drinkingfountain16.60 Ejectors/sump 16.60 Name: -- �---___-_- _ .___-_ -------__--- Expansion tank 16.60 Address: Fixture/sewer cap_ 16.60 - � ---- ------------------- ------------ Cit /State/Zi . Floor drain/floor sink/ftub 16.60 _ -_- -i"- -- GarbagePhone: Fax: dis oral _ I6.60 _ "PLICANT Hose bib 16.60 CONTACT PERSON Ice maker 16.60 Name: T-_ -_ __-- lnterceptor/grease tray __ 16.60 _ Address: Medical gas-value: $ _ Page 2 -- ---- -- - Primer 16.60 -- Ci�/State/'Lip: Root drain(commercial) 16.60 - Phone: -- -__ Fax: -- asmAavato Nr .' I6,60 -- E-mail: Tub/shower/shower pan _ 16.60 CONTRACTOR Urinal _ _ _ 16.60 Business Name: I t � Water closet 16.60 �`�`f- -----id Water heater 16.60 Address: 3 4 other: - - City/State/Zi _ �)P q,-713,,> other. -- -- - Phone 7 tl4�l Fax: s-X.43L,�_ Plumbing Permit Fees* _CCBPlumb. Lic.#: 36 7! subtotal $- -- ' Minimum Permit Fec$72.50 $ Authorireo ' $ ! ` Residential Backflow Minimum Fee$36.25 cD Signature: bate: - - -17 Plan Review 25%of Permit Fee) $ State Surcharge 8%of Permit Fee) $ fr (Please print name) L _mTOTAL PERMIT FEE Notice: This permit application expires If a permit Is not obtained within All new comercial bulldings require 2 sets of plana with Isometric or ISO dais aflet It las been accepted as complete. rlser diagram to, plan review. *Fee methodology set by Fri-Counh Building Industry Service hoard. i'Dsh Vernal l arm%PIndlernulAnr doc nim? Plumbing Permit pp&ation - City of Tigard ` Page 2 -Suppitniental Information Residential Fire Sup ression S sy'terns: Fee Scitedulr: Permit Fee: Site Utilities Qty. Fee(ea) 'Iotat S uare Footage: 0 in 2,000 _ $115.00 55.00 � QOI to 3,600 $160.00 _ Footing drain-1' 100' $220.00--- -- 46.40 3(>I to 7,200 Footing drain-each additional 100' $309.00 —__--- Sewer� 55.00 _ 7,201 and eater Sewer-each additional 100' 46.40 ss.00 Medical Gas S stems: W ater service tst t(xr Permit Feed 46.a0 Vaivation: Service-each additio 1 tan (� $1.00 to$S,000.UO Minimum fce$__Z 50 55.00 St(..o&Rain Drain-l st 100' C5,OOI.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each 46.40 _ additional$100.00 or fraction thereof,to and Storm&Rain Drain-each additional HXY Total including$10,000.00. Fixture or Item Qty. Fee(ea) Commercial Back Flow Prevention Dcwce 46.40 —_ $10,001.00 to$25,000.00 $148.50 for the first$10or f, 0 and$1.54 for each additional$100.00 or fraction thereof,to and including$25,000.W. _ Residential Backflow Prevention Device 27,55 _ rminimum pemrit fee$36.25) 6525 $25,001.00 to$50,000.00 $379.50 for the fust$25,000.00 and 51.45 fnr Rain Drain,single family dwcllmg each additional 5100.00 or fraction thereof,to and including$— 50,E 00 Inspection of existing plumbing or 72.50 $50.001.1N1 and up $742.00 for the first$50,000.00 and$1 20 for s ciall is nested ins cctions- er hour each additional$100.00 0_ fraction the, Subtotal: Fixture Work: Are ypu capping,moving or replacing existing fixtures? If "yes",please indicate work performed by fixture. "ailure to accurate) re ort fixtures could`result illure Work P sewer edees* (,omments regarding fixture work: ) Replace — Fixture Type: New Moved Exlslfn� (a Ba ttsa /Font _-- — Bath -Tub/Shower ---— -- -Jacuzzi/Whirl onl ('arWash -Each Stall _--- -Drive Thru _ Cus idoWN"ter Aspire — Dishwasher -Commercial _ -Domestic --------- Drinks Fountain ---- -- E e Wash — _— Floor Drain/sink .2" 3" 4., Car wash Drain *Note: If the fixture work under this permit results in an Garbage -Domestic _ increase of sewer EDUs,a sewer permit will he issued and Disposal -Commercial fees assessed for the sewer increase must be paid before the -Industrial --- plumbing permit can be issued. Ice Mach/Refrig.theins — Oil Se arator Oas Station — Rec.Vehicle Dun Station — Shnwer -(fang - -Stall Sink -iia—T/I2"tory _ -Bra 11eY -('ommcrcial _ -Service — Swimmin Pool Filter — Washcr-Clothes — Water Extractor r _ Water Closet-Toilet —_- Urinal — Other Fixtures. — — i 09t0ernui ForrnsU'ImPcrmitAppPIt2.drx 00/0!