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CITYOF TIGARD _CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES DATE
#: BUP2000-00438
13125 SW Fall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1
PARCPARCEL: 2SIS113 000
13AD-01800
ZONING: I-L
JURISDICTION: TIG
SITE ADDRESS: 16798 SW 72ND AVE B-14
SUBDIVISION: OREGON BUSINESS PARK 1
BLOCK: LOT:011
CLASS OF WORK: AL1'
TYPE OF USE: COM
TYPE OF CONSTR: 3N
OCCUPANCY GRP: B
OCCUPANCY LOAD: 44
TENANT NAME:
REMARKS: Tenant Improvement 5000s f.
Owner:
PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY#300-WMI
PORTLAND, OR 97224
Phone:
Contrautur:
Fl L GREEN
15350 SW SEQUOIA BLVD
STE 300
TI : W4917721 4
Reg #: LIC 41328
This Certificate issued 04/111/200 1 grants occupancy of the above referenced building or
portion thereof and confirms that the building has been inspected for compliance with the
State of 9reglon Spec ialt ...Codes for the grut10, acrupaf�cy, and use under which the
rett:-^� d permit wa �ed.
/ 1
~ \
BUIL ING INSPECTOR BUILDING OtFOCIAL
POST IN CONSPICUOUS PLACE
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Lioe: 639-Ati 16 Business Line: 639-4171Q
E U �' U
_-_ Date Requested_____ AM PM .--.— BLD
Location �t� ��;��, ,( _ ME _ _
i c�" /-/' Suite
Contact Person Ph c
Contractor Ph SWR
UILDIN Teoant/Owner ELC
Re 'ring Wall _--- ----• ---------- ELR
Footing Access:
Foundation FPS
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 A!arm
Susp'd Ceiling „�____ _J-__• _—
Roof
Misr:
rn
PART FAIL.
PL BING
Post& Beam ------ �' T` — ------- -
Under SlabL
VIC
Top Out ---- — --
Water Service
Sanitary Sewer -- - -- / — -
Rain Drains G
Final ----- — ---- ----- -- --
P T FAIL ~t:J 0c)17" r
fECHANICa
Rough In
Gas Line ---- ----
S ake Dampers
A PART FAIL
E . , RICAL ---------— - — ——.—.__— — — --..
Service
Rough In ----�-
UG/Slab —_— — -- — _
Low Voltage
Fire Alarm __-- —_-- _• —_ _
Final
PASS PART FAIL
SITE
Backfill/Grading -- ----— — -- _—_.__--_
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Nall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE: —,_ [ ]Unable to inspect- no access
ADA
Approach/Sidewrlk /
Other D�!e l LO I Inspector s ~� _—Ext
Final
PASS PART FAIL Do NOT REMOVE this inspection rev.-rO ?rorn.i the job site.
CITY OF TIGARD BUILDING INSPECTION DIVIVON MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ---__- — --
Bur
— _ Date Requested AM t 2 �� AM_ P,,"Vi __— BLD
Location_ / ^_1 Suite 13 MEC ---
Contact Person ?h _ PLM
Contractor CIA-,,-1 S P I I cG�d "7/�� _ SWR - - -- -
BUILD-1Nd Tenant/OwnerELC Ob[)
Retaining Wall EL.R _ _-
lFooting Access:
Foundation C �� PS -.____-----_
L ��e ..n z.v
Fig Drain L' S N
Crawl Drain Inspection N es.,, - ----- --
SlabSIT
Post& Beam -_
Fxt Sheath/Shear
Int Shea!h/Shear -Y — -
Framing - - -- ----- -- -- - --
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - _-- -
Fire Alarm �-- � - ----J--_ ----
Susp'd Ceiling ---- =: - -• -._-_--- _ __-
Roof
Misc: ------ --- --_ - --�=�-� -- - - _ _ ----
Final -------------._ ) _> .\) -
(21
PASS PART FAIL. - - - --- - - - - - = - ----- -- --
PLUMBING
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
fdaugh In
UG/Slab �G - - ------ -
Low Voltage,5
�.ire Alarm
S FART t 'FAIL
Backfill/Grading -- - - - - - --
Sanitary Sewer
Storm Drain [ J Reinspection fee of y-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for roirspectior, RE: iI ]Unab!e to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Date _ _ Inspector / r�-v --�'"Ext
Other ----
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY CJ F T I G AR D ELECTRICAL PERMIT
PERMIT#: ELC2000-00625
DEVELOPMENT SERVICES DATE ISSUED: 11/7/00
ooillill 13125 SW Hall Blvd., Tigard, OR 9722.3 (503) 639-4171 PARCEL: 2S113AD-01300
SITE ADDRESS: 16798 3W 72ND AVE B-14
SUBDIVISION: ZONING: I-L
BLOCK: LOT • 011 JURISDICTION: TIG
Proiect Description: Tenant Improvement
_—_RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 5003F: 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 BRANCH CIRCUITS ADD'L INSPECTIONS___
0 200 amp: 2 W/SERVICE OR FEEDER: 20 PER INSPECTION:
I 201 - 400 amp: 1st WIO SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN RE_VIF_W SECTION �_-
1000+ amp/volt: >=4 RES UNITS: i i> 600 VOLT NOMINAL:
Reconnect only: ,_____. SVC/FDR>= 2.25 AMPS CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300-WMI 10948 SE VALLEY VIEW TERRACE
PORTLAND, OR 97224 CLACKAMAS, OR 97015-000
Phone: Phone: 503-698-3417
Reg #: LIC 51539
SUP 2053S
ELE 3-2430
FEES _ Required Inspections _
Type By Date Amount Receipt Elect'I Service
PRMT CTR 1117/00 $293.60 2720000000( Elect'I Final
5PCT CTR 11/7/00 $23.48 2.720000000(
Total $317.08
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 adoptee! by the Oregon Utility Notification Center Those
rules are set forth'-. CAR 952-001-0010 through OAR 952-001.0080 You may obtain copies,i these rules ordirect questions to OUNC at(503)
246-1987
PERMITTEE'S SIGNATURE / /.� _ ISSUED BY:
/ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: — --. +—. DATE:—
CONTRACTOR
ATE:CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ ____ DATE:_
LICENSE NO: ---- — - —
Call 639-4175 by 7:00prn for an Inspection the next business day
FROM JANET To: CITY OF TIGARD DATE: 1 1/2/00 TIME: 8:46:22 PM PAGE 1 OF 1
IV/IW/YUUU 15:25 FAX 5035847257 City of Tigard Q002
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r4t�er !rt-e-rr Debttnoivod: Perroltno-: 2 p-
M7 of Projealappl.no- - Hxphedsae:
Ctryr f7i�crd Adld=r 13127 SW Hall Blvd,Tigald, (0=3 2000 Datslltusd: __ �>ly
Phone: (503)639-4171
Fay: (503)599-1960 COM UNITY DEVEIOf'ME Cue file W.-
Land use approval- _
d 1 &2 Cmndy dwttlflng or weegrosy U Corrdumial ❑Mniti-ftmaily (3 Team imprummeut
LJ New oomlhuction U Adlditi Nreptacement O CMrr. —_ U Patzial
1111311111IM11 mm Milo,
Job addreae; n 81da•rw,; 14Sow no.: Tax m iRA loUeccount no.:
_Lol Block; SuEdlriabn: _ �
pro em eta namc: `-- _---- -
-�—--- _ , DmaW� and location of wuv*o. miss: -
Bldtmsmt!d11e cJ c 1cttRmJ xlioa: -
Job no:
glWOetl name:
J,QHA jN S E N .E LF.C11I3 7.0 ---- a"'�'• •. row oo.
t'M-+.niihM" a
Addroelr�c4 A S F A I.T.F +rte as n..1b A
CUy; CLACK M A ti 9raee
7015
Fuel" _ r 1000 .ti er 1..�
-.2 4�rz_.1r ---
CCH Hlx but liL.no: -j_; raga�lda»i loo w ri o: -- a.nor — —
Ui %metro lis,na: 9��— t.Indaarna�y.nelameYl 2
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ut r uni„
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wlnah i!nod interuled toe tale,lease.rWK tx exchaty to orwMv..
ORS 447,453,479,6`10,701, 30D map a bov 2
Ownwes al shut:: Isms 401 to GM
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Name: w wtinAstre pn Rse��Y
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senior at 60do,1M mob bts"dzmk
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o Rsr�6MpPgas O oma _ rtr
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a93. c
Nm.0 IKlra1momarcod errL/Wrtsl MUirl.M>tee Nonce:lids pnrmil spplimdion P+emnl!lC................,. .S
q vlu O Ie rlclQad eapina If a pemtlt Is unl olfaimd Plan review(et ___ %) S y? (�
CJLdII e.a srvc _-- --1 ..L wlthln Ito dm"saw It L11 bass Buie surcharge(8%).. .t cX 7' rJ
lar m M �m loospv�f u oaenOlets. TMAL ............. .......: 7
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TYOF T I G�"E R� BUILDING PERMIT
in \ PERMiT#: BUP2000-00449
DEVELOPMENT SERVICES DATE ISSUED: 11/1/00
,_.Xk 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S113AD-01800
SITE ADDRESS: 16798 SW 72ND AVE B-14
SUBDIVISION: ZONING: I L
BLOCK: LOT: 011 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION _
CLASS OF WORK: FPS v� 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: 0.00 sf ROOF CONST: F'PE RET?
OCCUPANCY LOAD: BASEMf N i: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: 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: $ 1,210.00
Remarks: Modification of 8 sprinkler heads.
L_
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300-WMI 9384 SW TIGARD ST
PORTLAND, OR 97224 TIGARD, OR 97223
Phone: Phone: 620-614e
Reg #: LIC 00063846
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough-In
PRMT CTR 11/1/00 $62.50 27200000000 Sprinkler Final
5PC,T CTR 11/1/00 $5 00 27200000000
Total $67.50
This permit is issued subject to the regulat;ons contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987.
Pe rm it ee I C:�
Signature: _
Issues By:
Call 030.4175 by 7 p.m.for an Inspection the next business day
Building Permit Application
Date received: i iOO Permit no.:LPA
City of 'Tigard
Project/appl.no.: Expire date:
City gfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: 1&2 family:Simple Complex:
U I lac 2 family dwelling or accessory O Commercial/industrial U Multi-family U New construction O Demolition
U Addition/alteration/replacement U Tenant improvement J Dire sprinkloi/Marm U Other:
{ SITE INFORMATION
Job address pie Bldg.no.: Suite no.:
Lot: Block: Subdivision: _ Tax map/tax lot/account no.: _
Project name:
Description and location(�l work nn premises/special conditions:
FOR t
(Fl60
Mailing address: G' o v�, w, , • „•V,1 1 &2 family dwelling:
City:7�0�>\C' Statc: ZIP: et? Valuation of work........................................ $ __-,--
Phone:a +, I - U jFax: E-mail: No.of bedrooms/baths.................................
Owner's representative: _ Total number of floors.................................
Phone: Fax: E-mail: New dwelling area(sq. ft.) .........................
Garage/carport area(sq. ft.)......................... _
Name: -r 40 ( ) Covered porch area(sq.ft.) ........................
Mailing address:r 4, 1.tu \' C'O j Deck area(sq. ft.) ........................................
City: (- Stet . ZIP: 1 Other structure area(sq. ft.)......................... _-- —_
Phone: Fax: E-mail: CommercloVindustrial/multi-family:
Valuation of work........................................ $
Business name: �_—ire Existing bldg.area(sq.ft.) .......................... _
��
�— New bldg.area(sq. L.)................................
Address: by �, �,) �G C� ti C
City: r Q C tote:C ZIP: )")1� �, Number of stories........................................ _
Phone: -` u Fax:. ,E-mail:
Type of construction....................................
k� — Occupancy group(s): Existing:
CCB no.: to b —�_, 1�9—_ New:
City/metro tic.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: �t��r; ,� ��, laC�n��s"� provisions of ORS 701 and may be required to he licensed in the
Address: G 4, Q�, 7y �4 .jurisdiction where work is being performed. If the applicant is
City: L-1!'\ tate: Z►p; exempt from licensing,the follnwing reason applies:
LLT
Contact person: Plan no.: — — -
Phone: 4- --
Nome: c'tm►act person: _ Fees due upon application ........................... $ _—
Address: _ Date received:
City: State: ZIP: Amount received ........... ............................. $
Phone__ max: — E-moil: Please refer to fee schedule,
herehy certify I have read and examined this application and the Not all jurisdictions accept creat Lards,please call jurisdiction for more inrormnaon
attached checklist. All previsions of laws and ordinances governing this Uviso O MasterCard
work will he
complied„with,whether specified herein or n1.�t� � Credit card number:
Authorized signature: 1
ature: r J Date:_ d Name or cardholder ass own on credit card
__ S
Print name: _---Cardhoidet Rignature AmounFI —
Notice:
—
Notice:This permit application expires''a permit is not obtained within 190 days oder it has been accepted as complete. 4101611(NDa/f 7Mi
Fire Protection Permit Check List
,�, ❑ New ❑Addition 11 Alteration Repair
Modification to sprinkler heads only:
Describe work to 1. 1-10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads:_ _
Additional description of work:
Type of System Complete A or B as applicable):-
A.)
pplicable :A. S np nkiar.--- WE# ❑ D ry L11 _—
Stand_ pipes
Additional Hazard Group —
Information Density
Decsign Ares
K f=actor
Sprinkler Project Valuation: $
B. Fire Alarm —
Submittal shall Battery Calculations Yes ❑ ,_
include: individual Component Yes ❑
Cut Sheets _
Fire Alarm Project Valuation: 1 $
Project Valuatlon Subtotal A & 13): $
Permit fee based on valuation (see chart): $ _
- 8% State Surcharge: $
FLS Plan Review 40% of Permit: $
TOTAL: $
i Adst9\form9\FP3checkllst.da: 10/04/00
CITY OF TIGARD MECHANICAL PERMIT
PERMIT#: MEC2000 00442
DEVELOPMENT SERVICES
DATE ISSUED: 11/9/00
13125 SW Hall Bled.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S113AD-01800
SITE ADDRESS: 16798 SW 72ND AVE B-14
ZONING: I-L
SUBDIVISION:
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: OTR. FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS WIO APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS— HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG—�--� 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNIT''
FIRE ')AMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLQ DRYERS:
FURN < 100K BTU: AIR HANDLING_UNITS OTHER UNITS: 2
FURN >=100K BTU: <= 10000 Cf m: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of 2 ovens and associated gas piping.
Owner: ___ FEES
PACIFIC REALTY ASSOCIATES Type By —Date Amount Receipt
15350 SW SEQUOIA PKWY #300-WMI PRMT CTR 11/9/00 $72.50 272.000000C
PORI LAND, OR 97224 5PCT CTR I1/9/()0 $5.80 272000000C
Total $78.30
Phone:
Contractor: ---
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND, OR 97292 REQUIRED INSPECTIONS
Gas Line Insp
Phone:236-4152 Final Inspection
Reg #:LIC 172
PI-M 26-83PB
ThiE permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore
Specialty Codes and all other applicable laws. All work wall be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 torough OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calli g 503.Y246-9 .
/
Issue,Hy'
Permittee Signature:
�--
Cal: 1,503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Cate received: //-&-O U Permit no.:f/fr' _
City of Tigard Project/appl.no.: Expite date:
City ofTiga.rd Address: 13125 SAN Hall Blvd,Tigard,OR 97223 Cate issued: By: Pt no.:
Phone: (503) 639-4171 -
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
TYPE OF PEAMU
❑ I &2 family dwelling or accesson �Commercial/induslnal l]Multi-family Tenant improvement
D New construction ,1d A(Idiliuil/altertlhm/trpla.en cnt D Other:
1i S11,11INFORMATION.
Job address: 6P '_� Indicate equipment rluantities in buxe-,below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical material e.(uipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$ .5c2a
Lot: Block: Subdivision: *See checklist for important appli;ation information and
Project name: �Q/�� " ,jurisdiction's fee schedule 1br resia:niial pennit f'm,.
City/county: ZIP: _97 aM
Description and location of work on premises: :L'-A,#S?AGL 1
PE: 7!0 a OV e N 5-ll
Total
Est.date of completion/inspection: �' ��' Description qty. Res.only Res.unly
Tenant improvement or change of use:
Is existing spare heated or conditioned?)kYes ❑No Air handling unit ___ CFM
Air conditioning( p nn regwreO
Is existing space insulated? Yes 11 No Alteration of existin 1T1TAZsysiem
oiler compressors
Business name: q, State boiler permit no.:
HP Tons B'ru/H
Address: 5 "z Fire/smoke dampersiduct smoke detectors
City: J j� � StatcrZ ZIP: �' " cat pump(sue p an require )
BTUAI
Phone:d 5-- Fax: _O` ' E-mail: Hata rep ace urnac urner
CCB no.: Q 7 a Including ductwork/vent liner O Yes Q
No
Hata rep ac re ovateocatceaters-suspen eed
,
City/metro lic.no.: I cl wall,or floor mounted
Name( leuseprint): L fs Lld Vent fora t ance other that.furnace
e eta on:
Absorption units
Name: `� C hAI� �- �,�, GW�,i Chillers-
Address:
hillers_Address: Compressors III
Environmental ex ust an rent at on:
City: State: ZIP: Appliancevent
Phone: Fax: E-mail: Vryerexhiust -�
s, ypcreTITTTs li-Me-�7i lZmat
hood fire suppression system
Name: Tl,t Exhaust fan with single duct(bath fans) _
Mailing address: a" '; a" c: r+ t <),,v -x auntsystem s art from heatin,,or C
Fuel P P ng adistribution(up to outlets)CityLIP: ytateT /
__111'0 NG
Phone.: I I - L,%OdFax E-mail: Fuel pipingeach additional over 4 o nets
Process piping(schema",r"U11-7
Name: Number of outlets
--___— t er lRed appliance or eq—quTp`m(nti
Address: Decorative fire r�,lace
City: M State: '1.;P• nsert-t
Phone: Fax: E-mail: xx stov• et stove _
Other
Applicant's signature: _ Date: t r
Name (prinO:
9e27
Not all Jutisdicdons accept credit cards,pleas call Judsdictlon for more information. Permit fee.....................$ 7
L]Visa ❑Maatcr('ard Notice:This permit application ;Minimum fee................$
Credit cord mrmlxr
L__J expires if a permit is not obtained Plan review(at _ %) $
r.spitrs within 180 days after it has been State surcharge(8%)....$ _ .6, - 0
Name o1 cmdhohlrr as a own on cm—dit card accepted as complete. q
s TOTAL ...................... -� ..
�� cardholdet silnature Amour 4404617(GO OM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE:
Description: Price Total
'O-TAL VALUATI.ON: FEE: Table 1A Mechanical Code C+tY (Ea) Amt
0 to$5,000.00 Minimum fee$72.50 1) Furnace to 100,000 BTU
01.00 to$10,000.00 $72.50 for the first 55,000.00 and including ducts 8 vents a.o0
$1.52 for each additional$100.00 or Z) Furnace 100,000 BTU+
fraction thereof,to and including includingducts&vents 17.40
$10,000 00. 3) Floor Furnace
,001.00 to$2-5,000.00 $148.50 for the first$10,000.00 and including vent 14.00
$1.54 for each additional$100.00 or 4) Suspended treater,wall heater
fraction thereof,to and including
$25,000.00. or floor mounted hector
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and _
5) Vent not included in appliance permit 6.60
$1.45 for each additional$100.00 or 5 Repair units
fraction thereof,to and Including 12.15 -,
$50000.0 _
he first$50,000.00 and Checi;all that apply:
$742.00 for tBoiler I seat Air
$50,001.00 and up For items 7-11,see or Pump Cond
$1.20 for each additional$100.00 or
fraction thereof. footnotes below. comp* -- ---
7)0W absorb unit 14.00
to 100K BTU --
ASSUMED VALUATIONS PER APPLIANCE: 6)3-15 HP;absorb alue Total unit 100k to 500k BTUDesai tion: Ea Amount t
HP;absorb955 mil 8TU3
Furnace to 100,000 TU,Including _ 0 HP;absorbducts&vents 1,170 52.20
Fumace>100,000 BTU including 5 mil BTU __ducts&vents P:absorb 87.20
Floor furnace includin vent 955 5 mil BTU -
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM 10.00
floor mounted heater 445 17.20
Vent not included in applicance 13)Air handling unit 10,000 CFM+
Emit 805
Re air units 14)Non-portable evaporate cooler 10.00
<3 hp;absorb.unit, 955
to 100k BTU 15)Vent fan cono a si
connected tngle duct 6.80
3-15 hp;absorb.unit, 1,700 -
101 k to 500k BTU 16)Ventilation system not Included in 10.00
15-30 hp;absorb.unit,501k to 1 2,310 appliance rmit
e - -
mll.BTU _ �17)Hood served by mechanical exhaust 1000
30.5 hp;absorb.unit, 3,400
1-1.15 mil.BTU 18)Domestic incinerators 17.40
>50 hp;absorb.unit, 5,725
>1.75 mil.BTU656 - - - 19)Commercial or industrial type Incinerator 68.95
Alr handlin unit to 10,000 Cfm 1 170 -
Alr handlin unit>10,000 cfm 658 20)Other units,Including wood stoves _ 1000
Non- op_rtable evalorate cooler 446 Vent fan connected to a sin ngIs duct _ 21)Gas piping one to four outlets 5A0
Ventsystem not included in 656
appliance permit 22)More than 4-per outlet(each) 1.00 _
Hood served by mechanical exhaust - 6580
Domestic incinerator _ ---_-- Minimum Permit Fee$72.50 SUBTOTAL:
1 $
Commercial or Industrial Incinerator 4 590
Other unit,Including wood stoves, 658 _ 8•%.State Surcharge S -
Inserts etc. ---- 360 $
Gas�1�1.4 outlets 25•/.Plan Review Fee(of subtotal)
Each additional outlet _ 63 Required for ALL commercial permits only
TOTAL RESIDENTIAL PERMIT FEE: $
TnTAL C0MN�ERCIAL
VALUATIO r C
- 91teLluR1010M.and t:
1 Inspections lutside of normal business hours(minimum charge-two hours)
$72 50 per nour
2 Inspections for which no lee Is specifically Indicated (minimum charge-half hour)
$72.50 per hour
3 Additional plan review required by changes,additions or revisions to plans(minimum
charge-one-half hour)$72 50 per hour
*state Contractor Boller CertIncatlon requlre0 for units>200k BTU.
"Residential AIC requires site plan showing placement of unit.
1:\dsts\formslmech-fees.doc 10/11/00
CITY OF �'I C A,R D BUILDING PERMIT
PERMIT#: BUP2000-00438
DEVELOPMENT SERVICES DATE ISSUED: 10/30/00
13125 SW Hail Blvd.. Ti4ard. OR 97223 (503) 639-4171 PARCEL: 2S113AD-01800
SITE ADDRESS: 16798 SW 72ND AVE B-14
SUBDIVISION: ZONING: I-L
BLOCK: LOT: 011 JURISDICTION: 1IG
REISSUE: _ FLOOR AREAS _ EXTERIOR WALL. CONSTRUCTION
CLASS OF WORK: 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: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 44 BASEMENT: sf AREA SEP. RATED:
STOR: I-IT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: _ PEQD SETBACKS _ REQUIRED __
FLOOR LOAD: psf LEFT ft RGHT: ft _^FIR SPKL: Y SMOK DET
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VAGUE: $ 20,000.00
Remarks: Tenant Improvement 5000s.f.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L GREEN
15350 SW SEQUOIA PKWY #300-WMI 15350 SW SEQUOIA BLVC
PORII.AND, OR 972.24 STE 300 qq77��
Phone: Tl one �74 7714
Reg#: LIC 41328
FEES--- REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
PRMT CTR 10/26/00 $235.30 27200000000 Electrical Permit Required
Sprinkler Permit Required
PLCK CTR 10/26/00 $152.95 27200000000 Framing Insp
5PCT CTR 10/26/00 $18.82 27200000000 Gyp Board Insp
FIRE CTR 10/26/00 $94.12 27200000000 Susp Ceiing Insp
_ Final Inspection
Total $501.19
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and ail(;!;I r applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not si.:,r`.eu within 180 days of issuance, or if work is suspended for more than 180 days. ATTENT)JN. Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center, Those rules are set forth in OAF
952-001 0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246-1987.
Pe rm itee
Slgnature�- l 'I,. ` �. t�'t g "_� — —•
Issaed By: Ci -- _�--
Call 639-4175 by 7 p.m. for an Inspirclion the next busirivss day
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabiNies unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may ba deemed disproportionate to
the overall alteration when the cost exceeds tw,mty-five per-cent(25%).
VALUATION of all renovation, alteration or modification being done
excluding painting, wallpapering. [11$ ����'�Ave
multiply* 25% Barrier removal requirement. — .25
BUDGET FOR BARRIER REMOVAL [21 $
In choosing which accessible elements to provide under this section, priority shall be given to those
eiements that will provide the greatest access. Elements shall be provided in the following order:
(a, Parking $ ---
(b) An accessible entrance: $
(c) An accessible route to the altered area: $ Lg
7- q � 4. Oo
(d) At leas. )ne accessible restroom for $ _-
each sex or a single unisex restroom:
(e) Accessible telephones. $
(f) Accessible drinking fountains: and $ —
(6��t rbvr.... �.�.,►�/5,,,,-lac +-�'►�.„1l
(g) When possible, additional access,uie
elements such as storage ane,, alarms: $—
TOTAL: Shall equal line 2_of Value, Computation $ S 2Z�
CL
4%ts\ihmWiccess doc
CITYOF TIGARD _ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: P /31/00
0-00403
DOTE ISSUED: 10/31 0
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL: 2S 113AD-01800
SITE ADDRESS: 16798 SW 72ND AVE B-14
ZONING: I L
SUBDIVISION:
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH. BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB/SHOWERS: SEWER, LINE: ft
WATER CLOSETS: WATER LIIIE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing fixtures added for commercial TI —
_ FLES
Owner: _ — Type By Date Amount Receipt
PACIFIC REALTY ASSOCIATES PRMT CTR 10/31/00 $116.20 27200000000
15350 SW SEQUOIA PKWY#300-WMI 5PCT C1 R 10131/00 $9.30 27200000000
PORTLAND, OR 97224 --
Total $125.50
Phone 1:
Contractor: —
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND, OR 97202 REQUIRED INSPECTIONS
,'dough-in Insp
Phone 1: 236-4152 Underfloor/Underslab
Rog#: LIC 172 Top-out Insp
PLM 26-83PB Final Inspection
This permit is issued subject to the regulations contained in the 1 , Municipal Code, State of OR.
Specialty Codes and all other applicable laws All work will be done in accordance with approved plans.
1-his permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are sr1 forth in OAR 952-00C1-0010 through OAR 9520001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
/ Parmittee Si nature: -
issued By: g
Call (503)639-x175 by 7:00 P.111 for an inspection needed the next b:isiness day
Plumbing Permit Application
rDatercce!iived:/.7 2/• Oil Permitno.:�L City Of Tigardermit no.: Building pern.it no.:
r 1dress: 13125 SW Hall Blvd,Tigard,OR 97223 --
C'iryofTig°rd Phine: (503) 639-4171 PtojccUappl.no.: Expiredate:
Fa): (503) 598-1960 fate issued: By: Receipt no.:
Land use approval: ^_ case rile no.: Payment type:
U 1 &2 family dwelling or accessory '�j Commercialhndustrial L1 Multi•family Tenant improvement
❑New construction Additirn/alteratiorJreplacement 0 Food service ❑Other: _
I
Job address: (�� -
�'- - �7a . Description Qt . Fee(ea.) l'otal
Bldg.no.:
--'-1� `' --`-- Neil 1•a�tdI-family dwellings only:
/ I Sutte no.:
(includes 100 ft.for each utility connec(ion)
Tax map/tax lot/account no.: SFR(1)bath
Lot: Block: Subdivision: SFR(2)bath
Project name: aniq - _s SFR(3)tiath
City/county: Z2 6A- ZIP: LA Each additional batlr/kitchen
Description and location of work on premises:_ Slteutilities:
Catch hasin/area drain _
Est.date of completion/inspection' i r- --- Drywells/leach line%trench drain -
Footing drain(no. lin. ft.)
Manufactured home.utilities
Business Warne: p :��y�,�/A(.�, , („ �, Manholes
Address: f"- -`-
3 L I l S E Rain drain connector
C.ily: Pop-a' I_A,,a State: ZIP:9 7�.r� Sanitary sewer(no.lin. ft.) _ ----
Phone:a,3(,-4 1 g;:j Fax: A 7F-1- 7 E-mail: Storer sewer(no.lin.ft.) -_
CCB no.: O I j 9, Plumb.hus.reg.no: of 6&3 Pe Water service(no.lin.ft.)
City/metro lie.no.: / 9 Q ( Fixture or iters:
Contractor's representative signature: !' Absorption valve
Print name: ( h;utc: Back flow pre%enter --
Backwater valve _
Basins/lavatory
Name 1. I .,:/ /_ C C i_.40 r -'j Clothes washer -- - --- -
Address: Dishwasher
City: State; ZIP: Drinking fountain(s) --
Ejectors/sump
Phone: Fax: E-mail: Expansion tank _
Fixture/sewer cap
Name(print): PAG TR h ST- Floor drains/floor sinkr/hub_--
Mailingaddress: r•'"" e- Garbage disposal
Hose bibb
City: ' i7 Stater-Os ZIP:e 7 ini, Ice maker — -- - - ---
Phone:6 cl,- - Fax: E-mail: Interceptor/grease trap - —
Owner installation/residential maintenance only: The actual installation Primer(s) _
will he made by me or the maintenance and repair made by my regular Rcwl•drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) _
Owner's signature: Date: Surra
Tubs/shower/shower pan
Urinal
Name: ----.--_—__-- —___--- Water closet'-- -- ---
Address: Water heater -
City: State. Z.II': Other: - ---- ----
Phone: Fax: r E-mail: _ J--` Total
Not all ludkdcliom accept credit cords please call}urirliclion for m xe Inframneon Millinlum fee................$
Notice: "is permit application
O Visa LlMasterCard expires if a permit is not obtained Plan review(al __ Ir)
credit card number: _-- State sol charge(876)....
apiece -- within IRO days eller art has been
— Name or c +01 t"8 own omit coir -- accepted ns complete. TOTAL .......................$ /:2.5,_S-z)
S
_ ._ Cardholder dgnuure Amoum — 140,4616(WWOM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-1a illy dwellings only:
FIXTURES individual) :::T: TT
Be AMOUNT (includes ail plumbing fixtures In PRICE TOTAL
the dwelling and",he first100 ft. QTY (ea) AMOUNT
Sink 16.60 /lp,ro for each utilit cy onnectionj Lavatory 16.60 1„ a [Three
ne(1)bath _ $249.20
16.60 wo 2 bath_ _ $350.00
Tub or TublShower Comb. 3 bath $399.00
Shower Only- - - 16.60 _— -
Water Closet — 16.60 - SUBTOTA
sL _
Urinal 16.60 _ 8%S7ATESURCHARGEf_
—'- 16.60 PLAN REVIEW 25%OF SUBTOTAL
Di
shwasher _TOTAL -
Gaibage Disposal 16.60
Laundry Tray 16.60
Washing Machine 16.Ef
Floor Drain/Floor Sink 2'• 16'- 3 L� PLEASE COMPLETE:
3"
4" - 1F 60 -
__ Quantit b Work Performed
Water Heater O conversion O1i a kind 1610 Fixture Type: New Moved Replaced Removed/
Gas piping requires a separate mechanical /(,, (o Q —� Ca ed
ermit. - 46.40 Sink - -
MFG Home New Water Service Lavatr,�y —
MFG Home New San/Storni Sewer Tub or 1,01/Shower
Hose Bibs 16.60 Combinaliol.
16.60 Shcwer Only-_- - --
Roof Drains _ _ - Water Closet --—
Drinking Fountain - 16.60 —
_ _ Urinal
Other Fixtures(Specify) 16.60 Dishwasher—
Gtr Garbage Disposal —.----
ti. Laund�aam Tray
Washing Machine
_ _ Floor UrainlSink: 2" ----
5ewer-1st 100'- - 55.00
46.40 —Heater-
, 4"
Sewer-eah additional 100' -• Water _ ---
Water Service-1st 100' 55.00 —
Other Fixtures
Water Service each addlUonal 2C0' 4640 ----
Storm&RainDrain—1 st 100 — 55.00 - S iv k -----
46.40 LV.A
Storm&Raln Draln-each additional 100 ---_ _-- -
Commercial Back Flow Prevention Device 0
Residential Backflow Prevention Device' 27.55 -
---- 60
Catch Basin 16. -- - -
Inspection of ExistingPlumbing or Specially 72 50
ermr COMMENTS REGARDING ABOVE:
Requested Ins ep ctions - -- 65.25 ------ ---- --
Rain Urain,single family dwelling - --— _-_ -
Cirease Traps
16.60
QU—AN TITY TOTAL -- — ---- �-
Isum,Irl:c,neer diagram Is required If
Ouantlt Total Is >A -
'SUBTOTAL ,� _ ----
8°/a STATE SURCHARGE 9
•'PLAN REVIEW 25°/aOF SUBTOTAL — —
Required unly II fixture tty total Is;'g
TOTAL
°Mlnin+um permll fee Is$72 50•6%,state surcharge,except Residential Backmaw
Prevent on Device,which Is$39 25*0'Y state surcharge
`*All Naw Commercial Buildings require plans with Isometric or riser diagram and
pian rc view
i,\dst:\lorms\plm fees.doc 10/10/00
Accumulative Sewer Tally
Tena-.t Name 46oIV A,�)Ti.✓ eN77--k AXIS6 S This SWR#
Address /6 7 72- ~= _ This PLM#:
Fixture Value Previous Previous Credits Capped Fixtures ixtures New total New
# Value Capped off value added# added #s tctal
Count off#s count value values
Baptistry/Font 4 —_ -- — _
Bath - Tub/Shower _ 4 — --
_ - Jacuzzi/Whirlpool 4 — _ —
C,�r Wash - Each Stall 6
- Drive Through_ 16
CuspidorfWater Aspirator_ 1 —
Dishwasher- Commercial _ 4
Domestic — 2Drinking Fountain _—
Cye Wash --
Floor Drain/sink- 2 inch 2
—_ ,inch__ 5 ---
4 inch _ 6 --
-- Car Wash Dm 6
Garbage Disposal 16
Domestic(to 3/4 HP) —.—
Commercial Ito 5 HP) 32—
Industrial (over 5 HP)— __—
Ice Machine/Refrigerator Drains 1
Oil Sep (Gas Station) 6 �-
Rec Vehicle Dump Station 16
Shower- Gang (Per Head) 1 —
�_ - Stall 2 ----
Sink -Bar/Lavatory 2 - -
_ Bradley _5
Commercial — _ 3 —
.2 -_S_ervice�`jO o L..rz !
Swimming Pool FilterWasher - Clothes _ 5 _ _ _._— -- —•
Water Extractor 6 —
Water Closet - ToHet 6
Urinal C -- Y �— --- ---- —
1 OTALS /D y3
Total fixture values /0-5 _divided by 16 EDU U 1 E.�c�'� CRF1J i7—
A
HISTORY AHISTORY
PL_M_#,1p(,,O_Q ?k EDU# 65 SVVR# PLM# e7-;- - EDU# SWR#9�-on;
PL_M#j"-6ie)19y EDU# /,7 SWR#IN,9 x_35 PLM# 94- O,p:+o EDU# SW_R# y�, - .0 35 P'_
PLM#/sem -oolFP EDU# SWR#r Ifly oo1_ PL.M# y` ei EDU# SVVR# ",
PLM# 1� o 353 EDU# (e -7 SWR# 1j - 03yy PLM# EDU# SWR#
\dsts\swrtaly doc
!�
CITY
�� �,�����® ELECTRIrAL PERMIT
PERMIT#: ELC2001-00018
DEVELOPMENT SERVICES DATE ISSUED: 01;12/2001
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S113AD-01800
SITE ADDRESS: 16798 SW 72ND AVE B-14
SUBDIVISION: ZONING: I-L
BLOCK: LOT : 011 JURISDICTION: TIG
Proiect Description: Installation of service and 10 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 BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: 10 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION _
1000+ amp/von,: >=4 RES UNITS_ > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300-WMI 10948 SE VALLEY VIEW TERRACE
PORTLAND, OR 97224 CLACKAMAS, OR 97015-000
Phone: Phone: 503-698-3417
Reg #: LIC 51539
SUP 2053S
ELE 3-243C
— —_
—FEES _ Required Inspections
Type By Date Amount Receipt
_ Elect'I Service
5PCT CTR 01/12/2001 $11.74 2720010000( Elect'I Final
PRMT CTR 01/12/2001 $146.80 2720010000(
Total $158.54
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 rf work is
suspended for more than '180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001.0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(!103)
246-1987
PERMITTEE'S SIGNATURE ISSUED BY
OWNER INSTALLATION ONLY
The installation is being made on property I own which is riot intended for sale, lease, or rent.
OWNER'S SIGNATURE: __ _—__� —. — __ DATE:_ _.
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N:
LICENSE NO: --- ----- ----- -------------- -------- -- —
Call 639-4175 by 7:00pm for an inspection the next business day
Foots. JANET To: CITY OF TIGARD DATE: 1l1 1/01 TIME: 2:18:38 PM PAGE 1 OF 1
10/10/2000 1b:20 FAX 5038847297 City C'1' Ticard 14002
Electflln"11,""_��1CBtil.O�
r��, TJfbttoetfrod: �,(L L P�mitna rLCZooV_,�o
C`' ofMewdreo)ectrl.ao-: ' R,gbtedac,
City r jTigcrd Ad4tecr:'13123 SW Hall B7.vd.r4m L O 7M3 17doc ItsoW: - BY: tpt na.
Nouc: (503)639-4171 -- y
F&r. (503)598-1960 ch"rue no�_ pyymW typo.
Tats.use Approval: - -
D 1 Ac 2 fim>ily dsvellJrt),Or actv6tory `p'Cammeaddl'iadst.stri>!1 U Multi-ftanily U Tenant ialptovcmont
13 New cmishwtita U AdditIWo1 r&dkvVmplaoemem U Odmr— -- U PRFdRl
Job a4dtets: ^ _T q L r iRMA-no.: Sm�na.: Tea qut loUtwt:auut tor.:
I.ot: Filuck: Stlbdirifloit• J --�-__.. ----_--
acdptiou Oa o_n of worst cm pomds :
FJetimztui data ad c c k'tiumfws
Job ea
_ _ nv nlltx
usmsc uanw:•T1 TLs � E L F D m g T Q,_ mac + .. Twl tta
Addr�e_l� c; . A T,T,RV TPk' T4.w ,.allot �art.r
City �,LACKAMA`' SO-,oR.Zt'.97015
p3-698341 Pax: p - X46 - toa►u�.norl�.. 4
CCB oa• 1 5 3 9 _ Filet.bus.lig.nrr _ tai .ds�to loo y k o�wuon -
UnoW mum.rmimt*of q
metty dr.nt>.:
a�a�„ _ l3aoh marnfemarwt Mme a mof W r dviTl lti� -
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is
Nsum(pA nt)' - ---- - -- --- as 1 .m aoa.m�.�
b'1t111 sdd"=• 401 r� ne rnp� T-..--- 1
-. _city: �S1Sd� T'QIP. �.. 401""Ile'o_ -.' � --- -
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Mom
Ownm EwWlhuou;T1.se1 inet Usdon is betas made Ono1 o wd T.e�.tMrP .:bdto• —
wtedS is enc intetdod for sde.Iwo.halt or exctmv wct>1+d1nR to
ORS 447,453,419.610.7(8. 200 awle'bw ---- --• a_
1 MAWS is 4000&no@ _
JrmtSrtl 1 rltttiRra: I7e�hc - e0o to . --'--'-- - - - - -i__
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r, .�d.+llrrp nena,il,yn.�ln-oat nreetrnarw xian,rerR:nc•)a.1�w«�yp:�el.-- --
C1 lyysrmtrvn 4t10.alu aacddol mr�r.t.dNanfl.i ods if Srrcaue slnSrslt o raa+.da.• 1 7
L1 IMldkm&vrdtrnesm.lrs 0 Peadea,4Muworrra _ --------.-----_--
a Ooorpra Yui cors"pn mm ❑mmehommw in cores RV peck wrier do M.W...
a 4�umopum U Starr ----- -
RebmLt.—.&1&efphm vrkb tory alibe&bore, id feimRc
il&atw.e Stn Mt aOglbtWa L4�7 ann_tr>reAnitl -Ol;.r ,-----
me al ladirdr an.yt WWII eardt plow f"hlwMtr par a I.F. .al Noll":M,Pltoxit swiratim ...
0vt.a O"a.t rcnvd ex yw tf a psmk b not obuiw4 Plan rcvlrw(st %) _ _
cleft t.td&,mer .-_(�L,.. Wahl&Ito dn"alter M bm beers state nlnsl.aw 0%). -.s
Mrr don.s
aeesgt.d o manplsne. TOTAL... ...................S -1.?r9 6_1f
WIL
/1
-, Mr MIS fMt1CDM1
D TO x 'T1 6 PEK m 1 TA/
C.2.000 -0 0(0-'2-5
. t1,
CITYOF T I GA R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00010
13125 SW Hall Blvd.; Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/16/01
SITE ADDRESS: 16798 SW 72ND AVE B-14 PARCEL: 2S1 13AD-01 800
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: i-L
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: ALI FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: 1
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES _ 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP:
FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN >=100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Tenant Improvement - B-Vent exhaust ovens and vapor vent dishwasher
Owner: FEES-----
EES, -- --
PACIFIC REALTY ASSOCIATES Type By Date Amount _ Receipt
15350 SW SEQUOIA PKWY #300-WMI PRMT CTR 1116/01 $72.50 2720010000
PORTLAND, OR 97224 5PCT CTR 1/16/01 $5 80 272001000C
Phone: _ _ Total $78.30
Contractor:
REQUIRED INSPECTIONS
Duct Inspection
Phone: Final Inspection
Reg l:
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Ore.
Specialty Codes and all other applicable laws All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001 0010 through OAR 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: A��- Permittee Signature
C311 (50i) 6394175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Date received: I L Permit tA2.9, xDr,vo/D
City of Tigard Project/appl.no.: Expire date: T
Cirvo/Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 -- ---
Phone: (503) 6394171 Date i.sued: — By: I Receipt nu.: --
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
U 1 &2 family dwelling or accessory Cofnmercial/industrial U Multi-family Ll Tcnant improvement
G New construction U Addition/alteration/replacement U tither:
Job address. 8- ) lndicatc equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
T_axmap/tax lot/account no.: profit.Value$ -(p_? �i "' -
Lot_ Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's Tee schedule for residential permit fee.
City/county: )tQf& I ZIP: 9 ---
De�sc110 ton and locati n of work on premises: •- Llte n/ _
Fer(ea.) Total
Est.date of_(.ompletion/inspection: Descrl on (Ny. Res.only Res.only
Tenant improvement or change of use: /
Is existing space heated or co dilioned?Ili Yes U No Air handling unit ---CFM^_
'Air conditioning(site plan required)
1s existing spam insulated?W Yes U No Alteration of existing H 'system -- --
11011 (iLEmILIIE� ot er compressors
BusinState boiler permit no.:
ess name:l sc t
HP 'Pons HTU/H
Address:r�' it smo a ampee uct smokeectors -
City: Stat r2_ ZIP: y yS ieat pump(site plan require ) — -
Ph( E-mail: nsta rcp acc furnac umer
Including ductwork/vent liner U Yes U No _
CCB no.: nstalTTrep acme relocatciicaters--suspended,
City/metro lie.no.: iwall,or floor mounted
Name(please tint): e- Vent for af appliance other than furnace -
Wilb]Will all gerstlon:
I11 Absorption units HTUM
Name: AUC C�\hl\1�� Chillers_..--__---- HP
Address: Com.ressorsIIP
�� - -� ar ,nv ronnicuta ex gust an vent at on:
citrCA2 State• L ZIP:9 70Appliancevent _
Phone:(� Fax E-mail; 1)r arca east _
s, ,ype /res. itc eel azma(
hood fire suppression syst.im _-
Name: ufj Exhaust fan with%Ingle_duct(bath fans)
Mailing address: <<e'1 Cts ( N<� sx lausl sstem a art iiomseat}in or AC
City U State j(p; a Pue piping andistribution(up to out et%)
L 3 Type Ll'G __— NO _ Oil
Phone: Fax: E-mail: F11c1 i in each odd itlona of vrrTout cls -
rocess piping(schematic required)
_Name: Numbcr of outlets
_fft erTC+tr�irppliance or equipment:
Address: _ _ _ Decoi alive fireplace
City: - Sate: 7.IP:------ °Tscrt-type7}--z7r7 - — - --
d ICl 910
Phone: - -_--- Fr.x: E-mail Oostovelpel Ve
— _— -
-
Applicant's signature- - — Date: _� t �•
Name (print): -- --- - — -
NDN all imixliciiau accept ardn caf0,p1 call Jurisdiction fm more Inf mailan. Permit fee...........^•••.••••$ '
U visa U Mnstetvar(I Notice:•this pennit application Minimum fee................$ �Jr.
t wdil cant nnmher expires if a permit is not obtained
Pian review(at
within I F0 days after it has been
-Namr of c---ar�ldpr uaT wn or cmm t cWl accepted as complete.
$ IL)
---- _- Cwtilidder signature - �- --Amwnl 44)I6I7(t1000'OM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE:
TOTA_L_VALUATION: _ J Description: Price Total
$ _to$5,000.00 --_ FEE:Minimum fee$72.50 � Table 1A Mechanical Code --__ oty (Ed) Amt _
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to BTU - --
$1.52 for each additional$100.00 or including
ducts&&vants 14.00
fraction thereof,to and including 2) Furnace 100,000 BTU+
$10,000.00. includingducts&vents 1740
$10,001_.00 to$25,000.00 $148.50 for the first$10,000.00 and 31 Floor Furnace
$1.54 for each additional$100.00 or including vent _Y- _ 14 00
fraction thereof,to and including I 4) Suspended heater,wall heater
$25,000.00. or flax mounted heater 14.00___
$25,001
4.00 -
$25,001 00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional$100.00 or 6.80
fraction thereof,to and including C) Repair units
__
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
.1 fraction thereof. _footnotes below. Comp* - " -
7)<3HP;absorb unit
_
f ASSUMED VALUATIONS PER APPLIANCEto 100K BTU 14_0_0 8)3--15 HP;absorb
f - Value Total unit 100k to 5001,BTU 25.60
Description: __ - lit Ea Amount 9)15-30 HP;absorb
cumace to 100,000 BTr;,including 955 unit.5-1 mil BTU 35.00
t'ucts&vents _ 10)30-50 HP,absorb
I umace> '1001'00 BTU in�,wdiny 1,170 unit 1-1.75 mil BTU 52.20
ducts&vents _ - 11)>50HP:absorb
Fluor furnace Including vent _955 unit>1 75 mil BTU _ I 87.20
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heatar_ _ _ -_ 10.00
Vent riot Included in applicance - 445 13)Air handling writ 10,000 CFM+ -
_pennll __�--_--_ -_ _ 17.20 _
Repair units _ 805 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 955 1000
to 100k BTU -------- 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 6.80
101k!o 500k BTU - - iC'Ventilation system not Included in-
15.30 hp;ab,orb.unit,501k to 1 2,310 appliance permit _ 10.00
mil.ETU ----- 17)Hood served by mechanir:al exhaust
30-50 hp;absorb.unit, `3,400 _ _1 10.00 _
1-1.75 mil.BTU - - T8j Domestic incinerators -
>50 hp;absorb.unit, - - 6,725 - 1740
>1.75 mill.BTU --- 19)Commercial or(ndu,trial type incinerator
Air handling unit to 10,000 dm _ 656 _ - 69.95
Air handling unit>10,000 cfnl 1,170 _ -- 20)Other units,including wood stoves _
1`4011-portable eva orate cooler_ -_ 656 __ _ _ __ _ 10.00 -�
Vent fan connected to_R single duct 446 211 Gas piping one to four outlets
Vent system not Included In 656 -_ - _ 5.40 --
�ppllance Pemtlt _ _ - 22)More than 4-per outlet(each)
_Ho_od served by mechanical exhaust 656 1.00
_1,170 _
Domestic Incinerator __ -._.._..___- Minimum Permit Fee$71.50-` SUBTOTAL 5'
Commercial or Industrial Incinerator 4,590 __-
Other unit,including wood stoves, 656 --- --- 8'!.State Surcharge 5
inserts,etc. _------ _ _ --.--------- _ __ _ _--
Gaspipiing 1_4 outlets _ 360 __ _ - - 25'/.Plan Aeview F'ee(of subtotaq E
Each additional outlet _ 63 Required for AI_;-r:ommercial acrtnits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: S
VALUATION:
Qthor nc ectlon+�latLd Fse�:
1 Inspections outside of normal business hours(mintrnum charg.two hours)
$72 51 per hour
2 Inspe:tions for,vhich no fee Is specifically Indicated (minimum charge half tour)
$72 9)per hour
3 Addiflonal plan review required b)changes,additions or revisions to pians(minimurn
charge-onn half hoor)$72 SO per how
'Stag Contractor Boller Certification required for units>200k BTU.
"Reildentisl A/C requires site pian showing placement of unK.
I%fists\foriusbrnech-fees.doc 10/11/00
CITY OF TIGARD BUIL E G INSPECTION DIVISION MST
24-11-Iour Inspection Line: 639-4178 Business Line: 6394171
"UP
Date Requested ,�—�( AM PM BLD _
Location_ ty� /� Sr..J 7L.� / ✓� A—4 4t Suite MEC _
Contact Person Ph _`�� �/ 3 PLMvv,lru yo 3
Contractor Ph SWR
BUILDING � ' Tenant/OwnerELC
Retaining Wall _ ELR
Footing Access: �- -
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN _
Slab _--_. - - - - --- - SIT
Post& Beam ---
Ext Sheath/Shear
Int Sheath/Shear -- ----� --
Framing
Insulatiu.i - --- ---- --
Drywall Nailing ----- - -- - - --- -- _..
Firewall
Fire Sprinkler
Fire Alarm
4 Susp'd Ceiling - ---- --_ _- - --- -
Roof
Misc:�- ------- --- - -_ -- --
Final -----
PASS PART FAIL -
"�BTfdC -
,- a Beam `_- -- -------- --- -� ----- - ----
Under Slab
Top Out — - .. _ - --� -- - -------- --- - ---
Water Service
Sanitary Sewer --- - -- --�— - --- ---
Rain Drains
P PART FAIL
ANIGAL
Post& Beard - -- _- ---
Rough In
Gas Line ------.._ / -
Smoke Dampers
Final -- ------ ------------- --
PASS P 4RT FAIL
ELECTRICAL - — - —
Service
Rough In — —-- --
UG!Slab
Low Voltay a
Fire Alarm
Final ---� - - -i
PASS FART FAIL
SITE
Backfill/Grading ----- - ---- - --- - -
Sanitary Sewer
Storm Drain [ i Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE: __— [ J Unable to inspect- no a^cess
ADA
Approach/SidewalkL./..Oif
Other __ — Date � ,—_-- Inspector — Ext _
Final
PAS" PART FAIL DO NOT REMOVE this inspection record from the job site.