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_„ 7370 SW DURHAM ROAD �-��'
April 9, 2003Y
(CITY OF TIGARD
OREGON
Firestor,Co.
9384 SW Tigard Street
Tigard, OR 97223
RE: DISH NETWORK, FIRE SPRINKLER SYSTEM
Project Information
Building Permit: 13UP2003-00118 Construction Type: NA
Tenant Name: Dish Network Occupancy Type- B
Address: 7370 Durham Road Occupant Load: NA
Area: NA Stories: NA
The plan review was performed under the State of Oregon Structural Specialty Code(OSSC)
1998 edition, and the"Tualatin Valley fire& Rescue Ordinance 99-01 (TVFR99-01) 1999
edition. The submitted ply ns are approved subject to the following.
I. A supple of spare sprinklers(never less than 6) shall he maintained on the premises
so that any sprinklers that have operated or been damaged in any way can be
promptly replaced. These sprinklers shall correspond to the types and temperature
ratings of the sprinklers in the property. Standard 9-1, section 2-2.7.1 OSSC
2. A special sprinkler wrench shall he proviL' I and kept in the cabinet along with the
spare sprinklers to b: used in the removal and installation of sprinklers. Standard 9-1,
section 2-2.7.2 OSSC
3. A minimum of 18 inches shall be maintained between top of storage and ceiling
sprinkler deflectors. The distance shall be increased to 36 inches for large drop
sprinkler heads. Standard 9-1, section 4-4.1,6 and 4-4.3.2 OSSC
4. Sidewall sprinkler deflectors shall he located not more than 6 inches or less than 4
inches from walls and ceilings. Standard 9-1, section 4-4.2.3.3 OSSC
5. Clearances shall be provided around all piping extending through walls, flow-
platforms and foundations. Minimum elearanee for pipe sizes 1 ;nch through .t 112
inches shall be not less than 1 inch. Minimum clearance for pipes 4 inches and larger
shall he 2 inches. Standard 9-1, section 4-5.4.. .4
'13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD(503)684-2772
6. Monito►ing, Section 904.3.1 OSSC All valves controlling the water supply for
automatic sprinkler s .,tems and all water flow monitoring devices shall be
electrically monitored where the number of sprinHers arc,
• Twenty or more in group 1, Divisions 1.1 and 1.2 Occupancies.
• One hundred or more in all other occupancies.
7. An approved audible sprinkler flow alarm shall be provided on the exterior of the
building in an approved location. An approved audible sprinkler flow alarm to alert
the occupants shall be provided in the interior of the building in a normally occupied
location. 904.3.2 OSSC
Approved Plans: 1 set of approved plans, bearing the City of Tigard approval stamp, shall
he maintained on the jobsite. The plans shall be available to the Building Division inspectors
throughout all phases of construction. 106.4.2 OSSC
When submitting revised drawings or additional inl6rmation, please attach a copy of the
enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of
"Tigard in tracking and processing the documents.
XBlalo.Z
Senior Plans 1?xaminer
' CITY C�F TIGARD --BUILDING PERMIT
PERMIT#: BUP2003-001 18
DEVELOPMENT SERVICES DATE ISSUED: 4/18/03
-- 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2SI 13AB-01100
SITE ADDRESS: 07370 SW DURHAM RD BLDG G
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I-P
LOT: _ JURISDICTION: TIG
REISSUE: FLOOR AREAS _ FXTERIOR WALL CONSTRUCTION
"LASS OF WORK: FPS FIRST: sf N:` !S: E: W:
-rYPE OF USE: COM SECOND: sf PRO.IFCT OPFNINGS?
TYPE= OF CONST: UNK sf N: S E: W:
OCCUPANCY GRP: E; TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf ArEA SEP. RATED:
STOR: HT: ft GARAGE sf OCOU SEP. RATED:
BSMT?: MEZZ?: REQ_D SETBACKS _ REQUIRED _
FLOOR LOAD: psf LEFT:u ft RGHT: ft _ FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORP: PARKING:
VALUE: $ 2,130.00
Remarks: Adding 16 heads.
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: 620-6140
Reg #: LIC 63846
_ FEES REQUIRED_INSPECTIONS
Description Date Amount Sprinkler Rough-In
[BUILD]Permit Fee 3/13/03 $72.10 Sprinkler Final
ITAX) 8%State Tax 3/13/03 $577
IFI.S1 FIS Nn Rv 3/13/03 $2c3 84
Total $106.71
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 accordanne 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 niles 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 By: (ZIA — -
Pe nn ittee
Signature:
Call 639-4175 by 7 p.m. for an inspection the next business day
3PI-3-'?�0 nup- HAri izox r
w Ruilding Permit Application
City O rl��lfft�
ED,,leeivePermitAddress: 13125 SW Hall Blvd.Tigard.OR '7221 appl.no.: Expire date:
Cit y of Tigard ,
Phone: (503) 639-4171 Date issued: By• ' ) Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ _ 1&2 family:simple Complex:
1
►
U I &2 family dwelling or accessory id(CommerciaUindustrial U Multi-family U New construction U Demolition
%dA Jdiaon/alteration/-^placement 5 Tcnant improvement ¢A Dire sprinkler/alarm U Other: 1
/ o
w
iJob address: 17acrrzUs7 25Z, Bldg.no.: Suite no.: —
I ctt: Black: Subdivision: Tax map/tax lot/account no.: _
Pro lect name: U -J DQ
Description and location of work cm premises/special conditions:A.!�N I Lii4LLas C �rt 1Q�1
INFORMATION,OWNER FOR SPECIIAL
Name: L (Floodplain,septic capacity,solar,
Mailing address: .2 5 ) ;� 1&2 badly dwelling:
City; r State: 7.IP:. Valuation of work........................................ $ _
Phone: Fax: . ? E-mail: No.of bedrooms/haths.................................
Owner's representative: _ Total number of floors.................................
Phone: Fax: E-mail: New dwelling area(sq. ft.) ........................
Garage/carport area(sq.ft.)
Name: CU Covered porch area(sq.ft.) .........................
Mailing address: c339A n ,D Deck area(sq. ft.)........................................
City: pZ Sta ZIP: Other structure area(sq, ft.).........................
Phone:, •C) 61 qpFax: I i E-mail: — CommercialAndwtrial/multi-family:
<.�
Valuation of work........................................ -
Effmammijklml
Existing bldg.area(sq.ft.) ..........................
Business name: tTUF> cu
Address: n 0. r — New bldg.area(sq.ft.)................................ _
City: t State: ZIP. 2 Number of stories........................................ _
Type of construction.................................... _
Phone�c�,�)6 , Li Fax: E-mail: —
CCB no.: {�, Occupancy group(s): Existing: -
-- — New:
Citytnetro lie.no.: - i Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: ,2 ei provisions of ORS 701 and may be required to be licensed in the
Addmss: Q O ; e jurisdiction where work is being performed.If the applicant is
City: , _ State: Z P:(L7zz!J exempt from licensing,the following reason applies:
Contact person: Plan no.: — ---- --
Phone:1 3 -L I Fax:L --rli t.
Name: Contac.,..rson: Fees due upon application ........................... S_1Qb.J7 I
..ddress: _ Date received:
City: _ State: ZIP: _ Amount received ......................................... $
Phone: I E-mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Not all juriKktims xcerN credit cw&.place can jurisdiction for mcwr inf xmation
attached checklist.All provisions of laws and ordinances governing this 'a visa U MasterCard
work will be complied wi hhethe specified herein or not. CrediI cttd number:
s�
Expires
Authorized signature: - ?���t+� � � Nems of cardholder u thnwn on ctedn card — s
Print name: LS.i.---_—�—� -- Cardholder tilluture
Notice:This per snit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 MWfCOM)
Fire Protection Permit Check List
A.) _ FJ Alteration ❑ Repair
tiir
_❑_New _ ❑ Addition _ .
B,) Modification to sprinkler heads only: �
Describe work to 1. 1-10 heads: No plan review required.
be done: I 2. 11+ heads: Flan review required.
Number of sprinkler heads: -i __
Additional description of work:
T OvfSys Complete A, B or C_as
A. Sprinkler Wet_❑ _ _ D — ---
Stand_pipes_ -------
Additional Hazard_Group_
Information Density
K. Factor _,_--
Srp inkler Project Valuation:
B. Type I - Hood Fire Suppression Sstem
Hood Prt Valuation $
o ec
C,.)_ Flre Alarm _ --
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire A;arm Project Valuation:
Project Valuation Subtotal -, B
Permit fee based on valuation see chart): $ - -10
--_ — 8% State Surcharge: $ ]
FLS Plan_Review 40% of Permit: $
—� -- TOTAL: S ._ (blo.'t
1Ads1sVnims\FPSchedd1st.doc 06/07/01
DEPARTMENT OF LAND USE 6 TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH NRST, HIL.LSBORO,OR 97124
COUN'! i INSPECTION REOUESTS: 503/640-3561/633-4415
OREGON XXXXXXXXX-- 640-34'/Cl
Page 1 of 1
Date UJ/lb/`J
'i'lme 14 : Z8
1'etnilt iy).,, Curllmerciai Eiectric_al Perm:. _ Permit # UbO65093
vetnlik. btatuz.; A&PHUVEL1 Applied 03/14/9`)
b.ktu , Adrlre,.: s /J /0 SW Ut1EtHAM RD 'L'1 I S 0 Ued 0J/14/'J'i
l'c:rtult '1'1t.1u, DA.L7.RON IN(-' 4 C'iRt Ul'1'S Completed
Peimit. Du:jc':t . '1'cJ Expire Uhl/1U/q`.n
1'r (.,:)f?(-t '1'itIe DA1'1'HUN IN(-' 4 t'11t( Ul'1'S Project. # P0046b3 /
k'rc;�ei�t Ue:;rr. x E:kuS1UN
1'�trc:c l Nutnuer 1.��1. .t1 - Land Use Distrir.t.
Vaivatl.on tl
Legal Deco .
0W0,1 IN:D!•'t:C'1'1c.IN - ']'iGAHL) Construction
Appilc•ant Name t_'Hh.Lb'1'ENbUN LLL:CTHIC Classitication
AN):,1icant Adk"i : 111 SW COLUMBIA, SUl'VE; 480 Occupancy
PORTLAND OH 9'/ZUI--b88b Validated by 1'Ei
ApI .Lit--ant Phone : 'd41-4t_ 1Z lt:�,pector Area
i- ee de-;cription Unit::; E'ee/I.Init Ext tee Data
i t bt'atich W/Uut Feeder [ Entei: # 1 1 Jt) UC1 ib . UU
A,1,li . 1',l aIiCh W/Ulli.. Feeder ( Enter # 1 J U(1 15 , 00
:DkAt,t.utal t.lect.rical Fees : bU , UU
,tate :aUrC•ha- tge ut b'1. 2 , b0
'I t-.aI E,lectrlcal E'ee- : 5L . 50
� kh E'ees Required *** *+r* E'er Collect(�d & Credits *+ �
M.!t.ho(I Clieck # Et��ceipt:. Nv . Date Paymertt
Ch 4:'405 03/14/9ts `_ Z . `,U
l'e� u : 5L . Sll
A,A luctmk-tits : uu i'otai Credits : UCI
ictal 'Jotal t'aymerits : .,2 . au
L',.:+lclnce Due : 00
NOTICE This permit becomes null and void It the work or construction for which It Is Issued is not commenced within 180 days Once construction has started.
the permit becomes null and void If construction is interrupted for a period of 180 days I certify that the information presented by the applicant and
his agent or agents In support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Wpartmenl's reliance
upon false and misleading information may Invalidate this permit. All provisions of applicable laws and ordinances gove,ning the construction and use
of this building or structure will be complied with whether or not specified on the plans or noted on the plans correction sheets I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for inspection%at various times during the process of constructfon and the building
Inspection staff verifying compllance with the various codes. Use or occupan,v of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval Is given by the Building Official. I further acknowledge that a lien may be placed on the title of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all inspection requirements.
APPUCANT'S SIONATUIIE
s
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section APPLICATION
155 North First Avenue. #350-12
Hillsboro, Oregon 97124
Information. (503) 640-3470 Fax: (503) 693-4412 ,-
permit
Number _ ! �- __ DataPLEASE PRINT
Please complete all 4. Complete Fee Schedule below
Number of Inspections per permit allowed
1. Location of installation Service included: Items Cost(ea.) Sum
Addtess. 7370 SW DURHAM ROAD
Building A. Residential - per unit
City PORTLAND Suite o. __. 1000 sq.fl.or less $110.00 _. __— 4
Tenant Name DIATRON, INC. Each additional 500 sq.ft $25.00
--
(it commercial) _ - or portion thereof $2),.00
-
!_imiled Energy — 1
Map No. —Tax Lot --- Each Manuf'd Home r Modular $68.00 — - 2
Dwelling Service of Feeder --
Thomas Map Book: Page:---- Section: _---
Directions - ----- B. Services cr Feeders
jjj_r tti'I:1 CF. C:nNTACT AT CF JnN WLM11l K _______ _ Installation,eltere ions or relocation 2
200 amm,or 1p iT $60.On
x Residential 201 amps to 400 amps $e0 Cl(, - 2
Commercial 40•1 amps to 600 amps $120.00 _— 2
6f11 amps to 1000 amps -- $180.00 --- 2
2a. Contractor installation only: Over 1000 amps or volts $340.00 — 2
Reconnect only $50.00 -- l
Electrical Contractor � ON I-LE'TRIC, INC. y
Address111S W Co UMMBII SUITEi$�
City _ PORTLAND State O_ ZIP_ LZ-91-5UE' G. Temporary Services or Feeders
Installation,alteration or relocation - 2
Data 7�;5 Job Number t-h�An --- 20o amps or less R70 10
Property Owner 201 amps to 400 amps - $75.00 — 2
Contractor's Lice tS1 No. - C 401 amps to 600 amps $100,00 2
Contractor's BoardRe . No 0045b -- Over 600 amps to 1000 volts see'B'above
_- r
D. Branch Circuits
Signature of Supr.
License No._a:Lj%._ Phone No. / 1-/R 1 - Now,alteration or extension per panel
a) The fee for branch circuits with
purchase of service or feeder fee.
2b, For owner installations: Each branch circuit -- $5.00 -
b) The fee for branch circuits without
rinli5wner s ame Pone o purchase of service or feeder fee.
First branch circuit 1 $35.00 35.0U ,— 2
A3dress Each add'nl branch circuit_3— $5 00 -Lc;—ML—
--- E. Miscellaneous (Service or Feeder not included)
l�* --- - tate Ip Each pump or Irrigation circle $40.00
The installation is being made on property I own Each sign or outline lighting $40.00
Signal circuit(s)or a limited
which is not intended for sale, lease or rent. energy panel,alteration 2
or extension $40.00 ------
Owners signature --------- ---- ------ _
F. Each additional inspection over the allowable
in any of the above
Per inspection $3500 _
3. Plan Review section If required) Per hour ---- $55 00 - --
Please check appropriate hem and entcrfso In section 5B.
In Plant $55.00 -- ---
4 or more residential units in one sti ucture 5. Fees
_Service and feeder, B00 amps or more 50.00
_SA. Enter total of above fees $
System over 600 volts nominal -
596 Surcharge (.05 X total fees) $ 2.5n
__Classified area or structure containing special Subtotal $ 53-.Ln —
occupancy as described in N.E C. Chapter 5 B. Enter 25% of line A for
Plan Review if required (Section 3) $ 52.50
Submit 2 sets of plans with application where any of the Subtotal $
above apply Not required for temporary constructlor n Trust Account
services. 52.50
Balance Due $ _.-----
M For inspections call This permit becomes null and void N the work sutborl,+d by the permit it not commenced
640-3561 or 693-4415 cusp days from date d iasany lime
of such permit m N the work authorized f Is
suspended or abandoned at any lime after work is commenced la•period d 1.0 days.
2:4-hour recorder, one working day in advance of need
Electrical permits are non-refundable and nonitanelershle. St94
DEPARTMENT OF LAND USE h TRANSPORTATION
WASHING7 014 (4ND CEVELOPMFNT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
C01 INSPECTION BEQUESTS: 503/640-3561/693-4415
IV
ORS_CA'ON XY.XXXXXXK--> b40-347 ,
Page 1 cut 1
Date 01/10/91)
'1'imP 11 : 48
hermit- '1. ype Commercial t~lcc tt: i' a1 Perini t Permit # Ob06f6:14
Pcrrnit ,�+.:atu:, APPROVED Applir d ; 01/10/91)
./J /0 :.,W iA-11ZHAM PL` '1',i. Issued til/10/95
Pf:-firlit 'fit- Le UA11'HON INC LV Completed
Permit Descr , ,_l08 b0y--4b82 1'o Expire 01/0y/91,
Pr c, 7r(.•t `Pi t I te DAlTRON INC 4 c; 1.;1CUl't . Project. # P1)U46b;3'7
1•+rc:'t. L)eue:r
P,Kt.c•eJ Number Z1:.1'.1'1. -- Land Ilse District
Vet 11-rat aorl u
Le(Jal. 0o'-;(.r .
VWrI(�Y tM3PECTION - TIGAKU t'c�n:';tr-uctiorr U'I'H
Applicant Name (:HkIi•1 ENI)UN LLtC:'1141t: C;lassi t i c:at.ion 900
At.•{.r1ic ant Arldr '. 11 5W CoLUME-1A, SULTE 480 Uccup,ancy
PuR'11,AN0 OH 9'/Z01 Validated by PH
Al pi.,caril Phone : 141-4812 lnslier- tor Area
Fee 0e F,cription Urlit3 E'ee/Unit Ext te? Dat:a
1.an1i t sed bnr31.'c>y/Alter . /Extension 1 40 . UU 40 , oil
)ui;t.ot:HJ. b'leCtr reel. } r?es ; 4U , UU
::,tate of L , U11
.Intal EIe•71,:r irel. !''::t?s
rrlr bees kequ-.red kk } kkk !-('es (-'oll.ec;t.ed 6 Credits kAk
Metho(.i C.rie k N Receipt, No , Date Pi-.iyrttt'rit
'-'I•. 4L406 01/1(1/95 41 . 00
'YO iA,, '1'Hly DATE 42 . 00
F'ee 4z . U V
Ad iwstment . W) 'i'-taI Cr(-:?dits : uU
7't,i a1 1•ee 4Z . :)(I 1ot..al Payru?nts : 42 . (II)
,ala ice Due : ),)
NOTICE: This permit becomes null and void It the work or construction for which It Is Issued Is tint commenced within 180 days. Once construction has started,
the pennit becomes null and void if construction Is Interrupted for a period of 180 days. I certify that the information presented by the r,ppllcant and
his agent or agents In support of this permit It true rind correct to the hest of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permit All provisions of applicable laws and ordinances governing the construction and use
of this building ou structure will be compiled with whether or not specified on the pians or noted on the pians correction sheets. I ar.hnowledge that
the granting of a permit sloes not grant authority to access private property or to use easements. I Further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of Lonstruclion and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the budding or structure permitted prior to approval by the
Bullding Department Is sorely at the risk of the applicant and such use or occ upen.;y Is revocable until all inspection requirements are satisfied and
approval is given by the Bulldinq Official. I further acknowledge that a lien may be placed on the title of the property upon which the permit is Issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements
APPLICAN'T'S SIONATUAE
WASHINGTON COUNTY
Department of Land Use & Transportation ELECTRICAL PERMIT
��--. Electrical Inspection Section APPLICATION
155 North First Avenue, #350-12
Hillsboro, Oregon 97124
Information: (503) 640.3470 Fax: (503) 693`441:! permit
Number ___ Date _
. rq I4. Complete Fee Schedule bpermlt
ow
Number of Inspections per allowed
1. Location of installation Service included: - Items Cast(ea.) Sum
Address_ 7370 SW DUIWAM Rr.+D — _ -
Building A. Residential -per unit
City PORTLAND Suite o.
1c-o sq.It,or less —_ $110.00 _— a
Tenant Name DAITRON, INC. is ac-)3ddiuenal 500 sq.n
(if commercial) or portion thereof _-- $2500 — ------
Limited Energy --- $?`00 --_ 1
Map No, Tax I.ot -- Each Manurd Home or Modular
Dwelling Service or Feeder $68.00 ----
Thomas Map Book: Page: Section:—__
Dir cN�r, � t t-nomIn-pATN �rir�t't�itR Services or Feeders
_ Installation,alterations or relocation
200 amps or less ---- $60.00 _— 2
Commercial Xh Residential❑ 201 amps to 400 amps $6o 00 2
401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
2a. Contractor installation only: —
Over 1000 amps or volts _ $340.00 — 2
Electrical ContractorCHRISTEN SON ELECTRIC, IN(:_. Reconnect only $5000 — 2
Address 111_ r.n1.1lMK rg,51rrE 480
C. Temporary Services or Feeders
City_ Y1lIi'rr nNn _._— State-Cliff_ ZIP 97201 P Y
Date_ ]bj9.5__ Job Number - 509-4532 Installation,alteration or relocation
200 amps or less $5000 __.—_-- 2
Property Owner ---- 201 amps to 400 amps _—_ $7500 — 2
Contractor's License No, 2fi-34a ----- 401 amps to 600 amps $1oo.00 ---- 2
Conti actors Board Reg. No. OU4 58 - Over 600 amps to 1000 volts see'B'above
Signature of Supr. Elec `%.; ,11s. 1 I R. D. Branch Circuits
License No. 87 Phone No. 241-4812 Now,altoretion or extension per panel
a) The fee for branch circuits with
purchase of service or/seder lee.
2b. For owner installations:
Each branch circuit $5.00
_--_ b) The fee for branch circuits without
nnl�wner s Flame __---PonneeNo — purchase of service or feeder lee.
first branch circuit $35.00 _ 2
Each add'nl branch circuit $5.00 _ 2
E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle_--_ $40.00 __ 2
The installation is being made on property I own Each sign or outline lighting $4000 2
which is not intended for sale, lease or ;ent. Signal circuit(s)or a limited
energy panel,alteration 40.00
Owner's Signature —_—__—_ --_--- ---------- or extension $40.00 _ 2
F. Each additional inspection over the allowable
in any of the above
Per insoer:tion $35.00
3. Plan Review section (if required) Per hour $55 00 -
Plea a check appropriate Item and enter fee in section 5B. In Plant $55.00
4 or more residential units in one structure S• Fees
_Service and feeder, 800 amps or more 40.00
_System over 600 volts nominal A. Enter total of above tees $ —��-
__Classified area or structure containing special 5°6 Surcharge (.Q5 X total fees) $ 42.-UkT -
occupancy as described in N.E.C. Chapter 5 Subtotal -
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $ ----4 00
above apply. Not required for temporary construction Subtotal $
services. [_1 Trust Acco;lnt -
Balance Due $ . 42.00
For inspections call This permit becomes null and void N the work authorized b-,the permit I.not commsnc✓
640-3561 or 693-4415 within ISO days from date of issuanre of such permit or N the work authorized Is
suspended or abandoned at any time offer work is oommancad for a period of ISO day&
24 hour recorder, one working day in advance of need Eledrical Permits are nonrefundable and nontransferable. 8194
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST, HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON
.4
NOTICE.: This permit becomes null and void If the work or construct'-in for which It Is Issued Is not commenced within 180 days. Once construction has started,
the permit becomes null and void If construction Is Interrupted for a period of 180 osyn. I certify that the Information presented by the applicant and
his agent or agents In support of this permit Is true and torrent to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permit All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will be complied with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge!hat
the granting of a permit does not grant authority to access p ate property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at •%rlouf times during the process of construction and the building
Inspection staff verifying compliance with'he various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department In solely at the risk et the applicant and such use or occupancy Is revocabio until all Inspection requirements are satisfied and
approval Is given by the Building Official. I further acknowledge that a lien mqy be placed on the title of the property upon which the permit is issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements.
7
OVI1CANr'S SIGNATURE(',
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section APPLICATION
155 North First Avenue, #350-12
Hillsboro, Oregon 97124
Information: 503 1540-3470 Fax: 503 693.4412
PfOfE'Cti F'P.rlTllt
PLEASE PRINT - Number Date1 -6 -55
Please coMplOte through
1. Lr✓cation7o�f install tin 4. Complete Fee Schedule below
Address�/L,___ 1[� _ Number of inspections per pArmlt allowed
uilding Service included: Items Cost(ea.) Sum
Cit Suite No.—�
Tenant Name n tr. L-5oi_, I A. Residential-per unit
(if commercial) — a ' v _--- 1000 sq,ft.or less $1 10.00 4
Each additional 500 sq ft
Tax Lot --- Map No. ------- or portion thereof _...— $25.00
Limited Energy -- $25.00 1
Thomas Map Book: Page:_-- Section:_ Each Manufd Home or Modular
Directions —-_ Dwelling Service or Feeder $68.00 _ — 2
B. Services or Feeders
Commercial [� Residential�_ Installation,alterations or relocation
200 amps or less -- $60.00 -- 2
201 amps to 400 amps $80.00 _ 2
2a. Contractor install tion, only: 401 amps to 600 amps $120.00 _ 2
Electrical Cortractor 601 amps to 1000 amps $160.00 2
AddressI Over 1000 amps or volts _— $340.00 __ 2
Date-_,I _w, ab Number _� Reconnect only $50.00 2
Property Owner — C. Temporary Services or Feeders
Contractor's License No. L4 A
Installation,alteration or relocation
Contractor's Board Reg. No, 200 amps or leas $50.00 2
raaAk r/L 201 amps to 400 amps $75.00
Signature of Supr. Elec'n _ — 401 amps to 600 amps __ $100.00 _
License NoBi_ Phone No t.�>�je�+ Ogg 1 Over 600 amps to 1000 volts see W above
2b. For owner instal lions: D. Branch Circuits
New,alteration or extension per panel
Fr—int ner's Name Phone No a) The fee for branch circuits with
purchase of service or feeder lee.
Each branch circuit -- $5.00
b) The fee for branch circuits without
its ty- lat- a - p--- — purchase of service or feed r fee. C
First branch circuit $35.00 2
The installation is being made on property, 1 own Each add'nl branch circult $5.00 —'2
which is nci intended for sale, lease or rent. E. Miscellaneous (Service or Feeder not included
Each pump or irrigation circle $40.00 2
Owner's Signature ------ Each sign or outline lighting $40.00 _ 2
Signal circuit(s)or a limited
3. Plan Review section (if required) energy panel,alteration
�
Please check appropriate hem and enter fee In section 58 or extension $40 QO --
_ 1 & 2 family dwellings over 320 amps s/c meter F. Each r-1ditional inspection over the allowable
4 or more residential units in one structure in any of ne above
Per inspection $3500 -
_ Service over 225 amps; feeder 400 amps or more Per hour $55 00
— System over 600 volts nominal In Plant $51100
— Building over 3 stories in height 5. Fees
Building over 10,000 sq. ft.
Occupant load over 99 persons A. Enter total of above fees $
_ Manufactured Structures Park or Recreational 5% Surcharge (05 X total fees) $ _��bc
Vehicle Park; new, addition or alteration Subtotal $ -
_ Classified area or structure containing special B. Enter 250 of iine A for
occupancy as described in N.E.C. Chapter I Plan Review if required (Section 3) $ —
.Subtotal $ —.—
Submit 2 sets of plans with application where any of the Lass Buik Label Fee —T��
above apply. Not required for temporary construction Balance nue $ •r 22
services.
For Inspections call This pe•mit becomes null and void 0 the work authorized by the permit Is not commenced
wlthir ta0 days from date of lsauance of such permit or M the work authorized is
640-3561 or 693-4415
suspended or abandoned at anytime after work is commerreed fora period of 160 daye.
24-hour recorder,one working day in advance of need Electrical permlis are non-refundatris and non-transferable
5193
CERTIFICATE OF'
CITY OF T I GARD OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT Pr,
Rivi I T #, . . . . . , t 13UP94-0 J
13125 SW Hall Blvd. Tigard,Oregort 97223s8199 (503;M-4171 DATE ISGUFD: 02/06/95
(TE ADDRCSS. . . : 0'1.;-,,Q) 1- DURI iAll Pi 6-- PARCEL.: 2SI13ALA-01400
IBDI V I cj I ON. . . . Z ON I NG. I P
.OQK. . . . . . . . . . LOT. . . . . . . . . . . . . ..
-ASS OF WORE. :AL1
llt- OF USE. . . uCOM
�.CUPFINCY GRP. 98i!
CUPONCY LOAD.- 10
-NANT NAMr. . . :DAITRON
ROmar+N : Dickitron– teriant expiRnsion
Own Pr
15115 SW (jEQ(JOIA PKWY SUIIE 200
11GARD Or? 97224
Phone #: 62*--6300
A. J. WEBER CONSTRUCTION 1140.
1506 SW PAL X31INL- s,r
PORTLAND OR f)7219
Ph 0 01
ppg #. . : 65238
Occupancy of the above referenced building ir, hereby given, and rk-rtifies
the compliance with the State Of Oregon Gpet--talty Codes for the group,
d pet
occlApeAticLl
"ll &l1d QSe llfiet- which the reference;—it was issued.
L) 1.1)
NG INSPECTOR JIL NG OFFICIAL
PPT:�l 11\1 CONSPICUOUS P1..ACL
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone) 639-4175 Business Phone: 639- 71 /
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in F;replace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FIN
Post/Beam Mech. Sar. Sewer Gas LineId
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation Me
Llnderflr. Insul. Shear Wail Gyp. Bd. -Elect.
���� time: AM PM
Date Requested:__ ._.
Address: 17J Z _�( � �f�. ►')'i (y\,�, �f� q
_ 7� 7 Permit
Builder .- --
THE FOLLOWING CORRECTIONS ARE REQUIRFD:
--—
V Date: /_3
Inspector- __ —•
_APPROVED DISAPPROVED __APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT
13125 SW Hall Blvd.Tigard, Oregon 97223.6199 (503)630.1171 PERM 11' #. „ . . . . . : BLJP94
DATE ISSUED: 12/30/94
G39--w 1 71 QC-('
PARCEL. J S 1 1�,AB-N 1400
ADDRESS. . . : '47:i7►Il SW DURHE1-1,1 I
SUBDIVISION. . . . . ZONING: I-r
BLOCK. . . . . . . . . . . L01". . . . . . . . . . . . . .
IZLISSSUE: FLOOR AREAS----- E:iTERlUFt WALL CONS
CI-ObS OF WORK. :AL.T FIRST. . . . : 1025 sf N: S. E: W:
TYPE OF USE. . . :COM SECOND. . . : af° �',R:,I'ECT
TYPE: OF CON,ra'r.. :3N THIRD. . . . : s f N: S: Ei: W:
UCCUE FANCY GRP. :B,2 TO TAL---- ---: 102-15 s f ROOF CONST:J E=IRE
OCCUPANCY LOAD.- J.0 BASEMENT. : S f AREA SEP. RAVED:
6 OR. . 1 HT. : 18 ft GARAGE. . . : Sf OCCU SCP. RATED:
Bblyl 1 '.' .N IYIEL Z:' :N READ SE T BACKS------
FLOOR LOAD. . . . : 125 p s f LEFT: ft RGHT : ft F I R SSKI_:`r' :iMOK i)E-C.•. :N
DWELLING UNITS: FRN"C: ft REAR: fIV FIR ALRM:N HNDICP ACC:Y
BLORMS: DATH6: 11YP SURFACE: PRO CORK:N PIA RK I I\IG:
VE4LUE. f s 1500+0
Remav-ks: Daitron-- tenant expansion
Uwrter _. __._______._ FEE13 ------.-_______
PAC I'RUST typE 'Amount: lay d� tt+ re<::pt
15115 SW SEQUOIA PKWY SUITE_ 200 PRMT $ 110. 50 JF 12/30/94
PL CK $ . 1. 8 3 JF -
I IGARD OR 97224 F=I RE: 1, 44. ::'01 JF 1.;::/.::,0,/94 -
-'hone #; 624-6300 5PCT $ 5. 53 JF 12/30/94 -
N. J. WL-BER C:ONS"TRUC f 1GN INC.
1506 SW POLST I NE 51'
PUll'LANU UH 9i'219
F�jI i o n e 0: $ 2,32. OC T OTkL
Reg #. „ E.56-:__38
----- -- REDU I RED INSPECTIONS -___-..._
This pereit is issued subject to the regulations rontained in the F r,aminy Insp �
Tigard Municipai Code, State of Ore. Specialty Codes and all other I n s .i l at i on 1 n 5 p
applicable laws. All work will be don? in accordance with OyP lAoai-d Insp __ .,. _....__.__.._.____.._. ......._.._
approved plans. This pereit will expire if work is not started Susp Ceilnq Insp .......
within 186 days of issuance, or if work is suspended for Bore Fina 1 Inspection
tnan 18N days. �._ _._. --___--
,
1y is...ied By
L Call fot, J,nspecticln - 639-4175
i
_ y 1
Commercial Building Permit application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobslte Address: 7 �a �Uje� i
Tenant: SultP # Office Jse Only
'
Valuation: # i
/�� � Plandc/Rec
Petmd #'k
Owner: Pad ficRealty Associates , L.P. (PacTr s ) MapRTL#
Address: 15115 S.W. Sequoia Pkwy. , Suite 200
Approvats.Required
Portland, OR 97224-7199o
Planninq,_
Phone: (503) 624-6300 _ Engineering
Other
Contractor:
i .a : . �
Address: 4-� 1
L, Type of const: 3�
Phone:
✓� _ Occupancy class:
3��'
Contractors5prinklered? `es i No
License #�� � 2
(attach copy of current Oregon iic:ense) Sq. ft. of project:_ e '
Story (1st, 2nd, etc.)
Architect/Engineer: John H. Romi sh Proposed use:
Address: 2216 S.E. 24th Avenue — Previous use:
Portland, OR 97214 Note: Plumbing & mechanical plans
must be submitted at time of
Phone: (503) 236-6306 building permit application.
COMMENTS:
r
L f A--
�F�:ant Signature 9 Phcnd number
Received by: C pate Received:_ ;-CL
Permit S Account Description Amount Amt. Pd. Bal. Due
qBldg. Permit (BUILD)
_L_!u/ I
_ Plumb. Permit (PLUMB)
Mech. Permit (MECH) _
State Tax (TAX) o
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldq: _
Mech:
Sewer Connection (SWUSA)
Sewer Inspection WINSP)
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDS DC) —
Residential TIF (TIF-R)
Mass Transit TIF (T'F-MT)
Commercial (TIF•C)
Industrial TIF (TIF-1)
institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERFRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS:
ELECTRICAL PERMIT-
CITY OF T I G A R D
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2000-00043
131,'5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 02128/2000
fSITE ADDRESS: 07370 SW DURHAM RD BLDG G PARCEL: 2S113AB-01400
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I-P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Difln Telecommunication Installation
A.RESIDENTIAL _ B.COMMERCIAL
AUDIO& STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
-- —^ --INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS: 1 J
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ALLEN/FALK INC
15350 SW SEQUOIA PKWY #300-WMI 9020 SW GEMINI
PORTLAND, OR 97224 BEAVERTON, OR 97008
Phone: Phone: 646-0533
Reg#; LIC 47236
SUP 781JLE OR ` �:I G I
'N A
ELE 34258CLE
_ FEES Required Inspections
Type _ By Date _ Amount Receipt Low Voltage Inspection
PRMT KJP ^ 02/28/2000 $60.00 00-321867 Elect'I Final
5PCT KJP 02/28/200C $4.80 00-321867
Total $64.80
This Permit is issued subject to the regulations contained in the Tigard Municipal Core, 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 a.spended for more than 180 days. ATTENTION Oregon law
requires you to follow rules adopted by the Oregon Utii,ty Notification Center. Those rules are set forth in OAR
952-00 1-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-1987. l
Issued by Permittee 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: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N 7(_ �y. DATE:
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF,TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION RP.:'d by
13125 SW WILL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR IYPF
V - 503-639-4171 X304 Permit#._4:LP XQOV –Ccxt3
F - 503-598-1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:_
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
EL�\p_ Restricted Energy Fee....................................... $60.00
— (FOR ALL.SYSTEMS)
,JOB Street Address Ste#
ADDRESSmow ur �i Check Type of Work Involved
71 _
C; /Slate ip ony a� Ph ❑ Audio and Stereo Systems
— 1Nar '�_
�';�� I �� ❑ Burglar Alarm
❑
OWNER Mailing Address Garage Door Opener'
1S3S") S
Ci�y/State Phone# ❑ Heating,Ventilation and Air Conditioning System'
Name �� ,, , ❑ Vacuum Systems'
A�1�.n / l 4^1 I�� L1L_ ❑ Other --- --- --�.
CONTRACTOR Mailing Address
gQaD !,vv TYPE OF WORK INVOLVED -COMMERCIAL ONLY Y_
iPnor to Issuance a 'ity/Stale Zip Phone# Fee for each systr:m.............................................. $60.00
opy of all licensesJbQC %/P q pp y( -(Fjg (SEE OAR 918-�RrJ 250)
arei required if Oregon Contr B d i # Exp,Date
expired in C O T t-{�� �, pZ f Z�1 Check Type of Work involved
data base) Electrical C ntr Lic # r Exp ate
n o�rj �LrG _ pfJ ❑ Audio and Stereo Systems
C O T or Metro Lic # Exp Lr'ate
J S �QO - ❑ Boller Controls
Owner's Name
__�� — ❑ Clock Systems
OWNER - Mailing Address
APPLICANT City/State ne Data'Telecommunication Installation
�Zip Pho # ❑- Fire Alarm Installation
This permit is Issued under CAE 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 J
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 503-639-4175; �❑ 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
Assume responsibility for calling for a final inspection when all of the �1
correctionL_
s are completed _I Other
Permits are nontransferable and non rcf;rndable and expire if work Is not
started within 180 days of issuance or if work is suspended fnr 180 days Number of Systems
The person signing for this permit must be the applica,'or a person No licenses are required Licenses are required for all other installations
authorized to bind the apolipant
— -�sc — 3 it FEES:
Signature IN �
TER FEES $ DD
W SURCHARGE(.05 X TOTAL ABOVE) $_ u 8G
Authority if other than ApplicantTOTAt. $ to 4,80__—
\dsts\forms\resele dor:3/98
CITY OF TIGARD MECHANICAL.
COMMUNITY DEVELOPMENT DEPARTMENT P'ERM 1 1
13126 SW Hall Blvd.Tigard,Oregon 97223o6199 (503)539.4171 PERMIT #. " . � . : MEC95—OCA 1
DATE ISSUED: 01/21/91�
PARCEL: 2S113AB---01,W
'SITE ADDRESS—DRESS— : 12.17370 SW DURHAM RI,
61_11-ADIViSION. . . . : ZONING: I—P
LALOCK. . .. . . . . . . . . LCJ 1•. . . . . . . . . . . . . .
CJ_A'5S3 OF WORT;. . SALT FLOOR FIJ14N. . . . EVAP COOLr:..RS%
I'YPE OF USE. . . . :00M UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP. . : VENTS WIO ADPL: VENT SYSTEMS.
"OURIES. . . . . . . . : I BOILERS/COMPRESSC)R�) HOODS. . . . . . . :
FULA- 0-3 HP. . . . : 1. DOMES. INCIN:
: /b"b/ 3-15 HF'. . . . : CC)MI1L. IIICIN:
MAX INPUT: 8TU 15--30 1 IP. . . . -. REPAIR UNITS;
FIRE` DAMPERS?. . : 30--50 HP. . . . WOODSTOVES. . :
GAS I*DRESSURE. . . t rjo+ IAP. . . . CLO DRYERS. . :
N(J. OF UNIT" AIR HANDLING UNJ 'I"S OTHER UNITS. :
iIJRN ( 100K BTU: 1 10000 C-fin . GAS OU TL.ETS. - I
A
i-iiHN ) = ,00h4, BTU: 1CV100 fm :
Daitron-- tenant expansion
qnerl: I------.,-.-- FEES
)C`T RUST t y Vj e a m 0'.1 n t by date r-ecpt.
,1 15 SW ";E0,UOIA PKWY SUITE 2,00 PRMT $ 25. 00 JF 01121195 —
PLCK $ 6. 25 JF 01/21/95 --
: UARD
: UARD OR 972c�4 T $ 1. 213 ,IF 01/121/1)15
,,fie -14- 624-63001
_1MATE. CrjNTROL HIG & A-C
NW 26TH AVE
1HIL-14ND OR 97210
,iane #- R2,3-4392, $ 32. 50 TOTAL
q .0. 62 1.96
--------- REQUIRED INSPECTIONS
is Derpit is issued sub,m1 to the regulations contaired in the Gas L-ine Inso
Igard Municipal code, State of Ore. Specialty Codes and ail other Nect-ianical In-,p
applicable laws. All work wall be done 0 accordance with Final Ins;pest ion
approved plans. This pervit will expire if work is not started
within 188 days of issuance, or if work is suspended for core
than IR, days.
11)""littee Signati-ii-e:
I
,.i,ied by -
Lail for-, inspect ion 639--"1175
City of Tigard MECHANICAL PERMIT Planck/Rec. # — ��
13125 sw Hall Blvd. APPLICATION errrlit # ' l s- u `1
Tigard, OR 972.23
(503) 639-4171
Table 3A Mechanical Code QTY PRICE AMT
.lob • -7-270 564., !k/eH1t%r1 Rf,. 1) Permit Fee -0- -0- 10.00
Address a• — -
-----^ rm;ftp[) 77;,1-3 2) Supplemental Permit — 300
« •,--, ----Fumace to T00.006 BTU —
Plk-72C u 5,7, 1) incl.ducts&vents 6.00
MWV ••• urnace 100,000 BTU +-�-
Owner 1'5-115- -r w Ser"t914 F 2) incl duc',&vents 7.50
or -urnance --
�q 774V 3) incl. vent 6.00
�•^••«^m ..` - Suspended eater,wall fioater
p/V 4) or floor mounted heater - 6.00 -
-921;-m=- en no incl. in
Occupant J370 5) appliance permit 3.00
�- epair of hPatuig, re r q --
7'/(�yQ�el) r7R- 6) cooling,absorption unit 6.00 -
Booiler or comp, pump,air cond-,
C G sss/�Jai Cs�i?7�j�1��171(C 7) to 3 HP absorp unit to 100K BTU i 6.00
M.I.V - iic or comp,heat pump,air conk.
Contractor F3,1 ti-u/. 2- 8) 3.15 HP absorp unit to 500K BTU 11.00
Boiler or comp,boat pump,air con .
�Gy2r•G,�u,� G,Q. QJJ/�' 9) 15-30 HP absorp unit .5-1 mil BTU 15.00
3= M - BoilWr or comp,heat pump,air con .
�1/A�? 10) 30.50 HP absorp unit 1-1.75 mil BTU 22.50
TTiere y acknowleage that I have readT is app icaTwn-iat�ie--- Boiler or compheat pump,air condr --
inform3tion given is correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 rril BTU 31.50
of We owner, that plans submitted are in compliance with Statetr nit ingc�f unit to--
laws,that I am registered witli the Construction Contractor's Bcard, 12) 10,000 CFM 4.50
that the number pi-.on is correct. (If exempt fron State registration, -7iir an i�---- --
please give mason below.) 13) 10.000 CTM 4 7.50
Non porta a --
14) evaporate cooler 4.50
-Vent tan connected -�
15) to a single duct 3.00
anti-Fab-on system not
16) included in appliance permit 4.50
sv-3�ZG�a {5Hood served y -- _
17) mechanical exhaust 4.50
l new — a ui� a tera nrepauZCommercial or industrial
to be done residential O non residential 18) typo incinerator 30.00
-Ezis$ng use of --w000dstove,w-ale---
buikling or property 19) heater, solar,clothes dryers,etc. 4.50
I'r(pwsed use of 20) Gas piping one to four outlets 2.00
kAJing or propeity ---
'yne of tual-oil O natural gas�( 21) More than 4-per outlet LPG Q electric O -- - -
NOTICE
Mir.imum Fee$25.00 SUBTOTAL �_5•<<
PEnMITS BECOME VOID IF WORK OR CONSTRUCTI-W - -'
AUTFIORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR -
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED ------ -- ---
TOTAL T ,
Special Conditions - - -- -- --- -- -
-_ _-- - Date issued by
CITYOF T I GA R D CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: BUP200?-00097
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 2/27/03
PARCEL: 2S113A3-01400
ZONING: I-P
JURISDICTION: TIG
SITE ADDRESS: 07376 SW DURHAM RD BLDG G
SUBDIVISION: FANNO CREEK ACRE TRACTS
BLOCK: LOT:
CLASS OF WORK: ALT
TYPE OF USE: COM
TYPE OF CONSTR: 5N
OCCUPANCY GRP: B
OCCUPANCY LOAD: 40
TENANT NAME: DISH NETWORK SERVICES
REMARKS: TI Expand finished space and ADA upgrade
Owner:
PACIFIC RFALTY ASSOCIATES
15350 SW SEQUOIA PKWY#300-WMI
PORTLAND, OR 97224
Picone: 624-7717
Contractor:
H L GREEN
15350 SW SEQUOIA BLVD
STE 300
TI 6:OR6P?2M 7
200-95S( (RANDY)
Reg #: FIC-881 14I)MfIGI 11 )
This Certificate issued 5/I5/j13 grants occupancy of the above referenced
building or portion thereof-and confirms that the building has been inspected for
compliaes"V with the $t . e o regon Specialty dfor,the group, occupancy,
and us,6 t�hder whit t e r enced permit w
13UILDING INSPECTOR BUILD N I L -
POST IN CONSPICUOUS PLACE
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST —
INSPECTIdN DIVISION Business Line: (503)639-4171
3
BUP
Received _ __ __.___ Date Requested--S �S AM-- PM CFUP)2_4DU3' OC4 C1_)_
Location ._" __� �U_—__.(� Suite
_
Contact Person _---_ �" �_.— Ph(—) PLM� b � � -- -
Contractor — __— __._____ _-_.�._... __ Ph(--) _ SWR
-BUILDINGi� Tenant/Owner --------_- — ' v� �� ELC _-- ---
ELC
Foundation Access:
Fto Drain ELR -
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam -----_-_- — ---
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear
Framing _— --- ----- ---- - ------ -- _ _
Insulation
Drywall Nailing ----- - ---- ----- ---
Firewall
Fire Sprinkler ---- - ---- - ....____- - --- ----- - --.----
Fire Alarm
Susp'd Ceiling -- -- - ----- ----- --- ----
Roof
`h ART FAIL - __ --- --- -------- - --- -
---
PLUMBING
Post
_
Post&Beam
Under Slab - - - - --- --- - -- --
Rough-In
Water Service ---- --- - -- - -- - ----
Sanitary Sewer
Rain Drains ---- - - - --- -- -- - -
Catch Basin/Manhole
Storrs Drain --- -- -- _ ----- ----- --
Shower Pan
Other. - --- ----- _____Final
---PASS-
------ - -
PASS_ PART FAIL ---- ------ - __ .�_____-- ---- - - - ------_ __------
MECHANICAL
Post&Beam
Rough in - -- - -- - - --- -- ---- -----
Gas Line
Smoke Dampers - --- ---- ------- ----
Final
_PASS PART FAIL — -- -- -------- --
-ELECTRICAL
-- ------------
service
Rough-In
UG/Slab
Low Voltage _.._---- -- -
Fire Alarm
Final Reinspection fee of$--_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd,
PASS PART FAIL
Please call for reinspection REE Unable to inspect-no access
Fire Supply Line
ADA r
Approach/Sidewalk Inspsctoi _ �� -_ Ext --
Other:
rmal DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY Or- TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION! DIVISION Business Line: (503)639-4171 MST
BUP
Received Date Requested __. AM___� PM—_ BLIP
Location _____�. __71'2—._` 12-� --Suite__ — _ MEC —
Contact Person Ph PLM
Contractor ____ Ph(—) ____� __.�_ SWR 2
BUILDING Tenant/Owner _ �__ — �._ __._—.— ELC —
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT _ __—
Post& Beam
Shear Anchors
Fxt Sheath/Shear
Int Sheath/Shear
Flaming _ -- - --- -- - ------
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
PASS PART--,FAIL,-,-
MECHANICAL
Post& beam
Rough-In - --- --
Gas Line - - --- - __------
Smcke Dampers ------------ -___ -_—
Final
PAS —DIRT FAILLPIT --- - -
GrTR) ---
. ervice
Rough-In
UG/Slab - --- --- - - -------__
Low Voltage — - - - --- - --
Fi Alarm
FAIL
rm
Reinspection fee of$ —_—require(]before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
l PAS
SITF Please call for reinspection,RF Unable to inspect-no access
Fire Supply Line 1
ADA
Approach/Sidewalk Date ___.�%l - Inspectof /_ �"' _ Ext
Other: _
inal DO NOT REMOVE this Inspection record from the jdb site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 _
BUP
Rsce�;ed _ &5J x- ��,Date Requested—_G�'3�.____._-. AM--____.__ PM.�_—_ SUP
Location __._ w _� >It--) 1?t-"-INA-41 ---Suite 9*6-7MEC
Contact Person Ph (.�3) ;2_a(P 7L5_-z- PLM 3 174_73
Contractor __ ___ Ph( ) — _—__ JR
BUILDINGS Tenant/Owner ��_�` AJ S — 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 wailing -----------. _ -- -- -.._ -- ---
Firewall
Fire Sprinkler - - ,�-.----_-_._----_-__--
ICiro Alarm
.uap'd Ceiling - ---- - ----
Roof
Other: - -
-------------------------
Final
PASS PART FAIL—
Post&Beam
Under Slab ----- -_-.- - ------
Rough-In
Water Service _-
Sanitary Sewer
Rain Drains - - - —
Catch Basin/Manhole
Storm Drain -- -- -- - -----
Shower Pan
Other: --- ----
n )
Asla I/ PART FAIL ----- - - - _ - - --
MECHANICAL
Post&Beam - T - --- ---- ---
Rough-In - - -- - - ----- --
Gas Line
Smokc Dampers - - -- -
Final
PASS PART FAIL - -- -_----- --__-- - ---__-_- -_ _�-
ELECTRICAL
Service
Rough-In --- ------- ------ ---- -
UG/Slab
Low Voltage
Fire Alarm
Final -- - ------- f-------------
Final
PASS PART FAIL Reinspection fee of x_ required before next inspection. Pay at City F ill, 13125 SW Hall Blvd.
SITE _ -� Please call tot reinspection HE l Unab ,to inspect-no access
Fire Supply Line
ADA ` r `' ) 6
Approach/Sidewalk Date__.____ Inspector t.% _ Ext
Other:
Final /DO NOT REMOVE this Inspection record from the job site,
PASS PART FAIL
i4RD --BUILDING PERMIT
CITY OF TIG
PERMIT#: BUP2003-00097
DEVELOPMENT SERVICES DATE ISSUED: 2/27;03
13125 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 2S113AB-01400
SITE ADDRESS: 07370 SW DURHAM RD BLDG G
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I-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: 5N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 40 BASEMENT: sf AREA SEI,. RATED:
STOR 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: _ REQD SETBACKS REQUIRED —Y
FLOOR LOAD: psf LEFT: ft RGHT: Jft FIR SPKL: SMOK DET:
DWELLING UNITS: FRN r: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 49,000.00
Remarks: TI Expand finished space and ADA upgrade
Owner: Contractor:
PACIFIC REA'_TY ASSOCIATES H L GREEN
15350 SW SEQUOIA PKWY #300-WMI 15350 SW SEQUOIA BLVD
PORTLAND, OR 97224 STE 300
TIGARD, OR 97224
Phone:
Phone: 624-7717
Reg #: LIC 41328
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
113UiLUJ Permit Frc 2/27/03 $463.30 Electrical Permit Required
1 AX 8°/%Stair l ae 2/27/03 $37.06 Plumbing Permit Required
I � J Framing Insp
IBUPPLNI Phi I: 2/27/03 $301.15 Gyp Board Insp
IFLSJ FLS I'In Its 2/27'03 $185.32 Susp Ceiing Insp
Total $986.83 Final Inspection
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 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.-001-0100 You may obtain a ropy of these rules or direct questions to OUNC by
calling (503) 246-6699 or 1-800-332-2344
/✓
) L
Issued By: k1 , [ CP 1 _
Pennittee '
signature: _---
Call 639-4175 by 7 p.m. for an inspection the next business day
CITY OF T I G A R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00073
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/4/03
SITE ADDRESS: 07370 SW DURHAM RD BLDG G PARCEL: 2S113AB-01400
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I-P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: CUM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLUOR DRAINS: 2 TRAPS:
STORIIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSi:TS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Capping (2) shower stalls and installing (2) 2" floor drains in their place, a,'Jing (2)wate, closets.
FEES
Owner:
--' Description Date Amount
PACIFIC REALTY ASSOCIATES —
15350 SW SEQUOIA PKWY #300-WMI il'Ll INIl3J Ncruut Fee 3/4103 $72.50
PORTLAND, OR 37224 I IAN 18%,,State Tax 3/4/03 $5.30
Total $78.30
Phone
Contractor:
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND,OR 97202 REQUIRED !NSPEC7IONS
P lone : 236-4152 Rough-in Insp
Top-out Insp
Reg#: LiC 172 Final Inspection
pl_M 26-831113
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 Oregon
Issued By: y :{� (L j c _ Permittee Signature:
c`� �
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
Building Fixtures
Plumbing Permit Application Received M��Date/By: dPermit No.: YG �% J %'
Planning Approval Sewer ��e���0�7 7
City of :Tigard Date/B �- Permit No.: L
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.: —
Phone: 503-639-4171 Fax: 503-598-1960 Dost-Review Land Use
Date/B _ _ Case No,:
Internet: www.ci.tigard.or.us Contact J see Page 2 for
24-hour Inspection Request: 503-639.4175 Namc/Methou __ /�• supplemental I:Jorn,atlon.
_ TYPE OF WORK FEF*SCHEDULE forspecial Information use checklist
F] New construction —_ Demolition
Description Qty. Fre{ea.) Total
Addition/aIteration/replacement Other: New t-& or cacti
dwellings
includes 100 ft.for each ulllfty connection)
CATEGORY OF CONSTRUCTION SPR 1)bath 249.20
1 & 2-Family dwelling N Commercial/Industrial SFR(2)bath 350.00
[Accessory Building _ Multi-multiSFR 3 bath _ 399.00
❑ Mas_ter Builder _ Other: Fach additional bath/kitchen 45.00
JOB SITE INFORMATION and LOCATION Firesprinkler-sq. ft.: Pae 2
Job site address: �'^ i�uR l4 �1 R D,
Site Utilt fes
-- ,, Catch basin/area drain 16.60
ite#: BId ./,A ----
Drywell/leach line/trench drain -__ 16.60
Prosect Name: T Footingdrain no.linear ftpPa,c 2
Cross street/Directions to job site: Manufactured home utilities 110.00
C��[l��F,Q dse,,�ES f ✓��l Manholes 16.60
Rain drain connector 16.60
Sanitary sewer no.linear fi.) Page 2
/��� � ���O T� Lot#: Storm sewer(no. linear ft.) Pae 2
SubdiVlSlOn: Water service(no. linear ft) _ Page 2
Tax map/parcel #: _ Fixture or Item
DESCRIPTION OF WORK Absorption valve 16.60
��i,, p�-su.+� Z-U.�C. Backflow preventer _ Page 2
f� r''� Backwater valve 16.60
Clothes washer 16.60
-- ---- - Dishwasher 16.60
Drinkin fountain_ 16.60 _
PROPERTY OWNER _ F M TENAN7_ _ Ejcctors/sump 16.60 1
ame: i�t i ��' _
Expansion tank 16.60
Address: /$-3�i� CLt�t2 ty Fixture/sewer cap 16.60
City/State/Zip: o,t. ie.�..Q t _f�7 Flocs drain/floor sink/hub _ 16.60 J
Garbage disposal 16.60
Phone: 62# - (e : O v Fax: k ]1 S SJ Hose bib 16.60
APPLICANTCONTACT PEP 'ON Ice maker _ 16.60 _
Name: Interce tor/ rease trap 16.60
Address: !Medical as-value: S Pae 2 -J
__ -- -- Primer 16.60 --jl
Cit /State/Zi
_ Y p• _-- _ Roof drain(commercial) 16.60
Phone: Fax: Sinkfbasin/lavator 16.60
1,rnai1: Tub/shower/shower pan 1660 _
CONTRACTOR - Urinal 16.60
Water closet Z 16.60 �' r
Business Name: D1;A&L U,2eAAX-:Yt. -PL134- _ Water heater
Address: I i c i _ Other:
Cit /State/Zi : PP�-�p -1r7�DZ Other:
Phone: 03--L epi s Fax:s p3 236 1 3
Plumbing Permit total
Subtotal S
CCB LIC. #: 0172- Plumb. Lie.#: 2,6 f 3 Minimum Permit Fee$72.50 $
Authorized Residential Backflow Minimum Fee$36.25 7,�
Signature: _ _(' _-Dafe:.ice- --03 _ Plait Review(250,16 of Permit
State Surcharge 8%of Permit Fee S
(Please print narne) TOTAL PERMIT FEIN: S J�
,,otice: 'rhls permit application expires If a permit Is not nhtalncd wi+kin All tew commercial buildings require 2 sets of plans with homctrlc or
I RO days after It has born accepted as complete. rlsrr diagram for plan review.
*Fre methodology set M TH4 ou-t} Building.Industry Service hoard.
I\I)sts\Permit Forms\Plnd'em App doe 01103
Plumbint Permit Appliegtion - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppsession Systems: '
Site Utilities Qty. Fee(ea) Total Square Footage: Permit fee: —�
Footing drain- I" mo' 5>wt 0 to 2,000 $115.00 _
2
Footing drain-each additional 100' 46.40 001 to 3 600 $160.00
3,601 l0 7,200 $220.00
Sewer- I st 100' 55,00 7,201 and greater $309.00
Sewer-each additional 100' 46.40
Water Service-Ist IM' 55.00 Medical Gas S 5ten15:
Water Service-each additional 100' 46.40 Valuation: I Permit Fes:
Storm&Rain Drain- Ist 100' 55.00 $1.00 to$5,000.00 1 Minimum fee 572.50
Storni&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000,00 and$1.52 for each
additional$100.00 or fraction thereof,to and
Fixture or Item Qty. Fee(ea) Total including$10,000.00.
Commercial Huck flow Prevention lhvice 4040 $10,00!.00 to$25,000.00 $148.50 for the first$10,000.00 and$1 54 for
each additional$100.00 or fraction thereof,to
Residential Backflow Prevention Device
minimum erniit fee$36.25 _ 27.35 and it !uding$25,000.00.
Ram Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1 45 for
-- each additions,$100.00 or fraction thereof,to
Inspection of existing plumbing or and including$50,000.00.
specially requested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.29 for
Subtotal: each additional$100.00 or fraction thereuf.
Fixture Work:
Are you capping,moving or replacing existing tixtures" If
",yes",please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sencer fees*.
Quantity V (Fliture Work Performed i onunents regarding fixture work:
Fixture Type: rReplalce —�
_ New MovedCap d
lrylonIBath -Tub/Shower-Jacuzzi/Whirl oolCar Wash -Hach Stall ---
_ -Drive Thru _
Cas idor/Water Aspirator — —
Dishwasher -Commercial _ ------ ---
-Domestic
Drinking FountainEye Wash --- -------- ------ -
Floor Drain/sink 2"
3" --
Car Wash Drain ---- *Note: If the fixture work under Ibis permit results in an
(larhage -Domestic
Disposal -commercial increase of sciver F.Dlls,a sewer permit will he issuctl and
Industrial fees assessed for the sewer increase must be paid before the
Ice Mach./Refrig.Drains plumbin}; permit can he issued.
Oil Separator (Jas Station
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink -Bar/Lavatory -
-Bradley —_
-C'omrnercial
-Service
Swimming Pool Filter
Washer-Clothes
Water Extractor
Water Closet-'toilet
Urinal -.-
Other
i tDststPermit Fumu\PlmPermitAppPg2.doc 01/03
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2003-00077
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/4/03
SITE ADDRESS; 07370 SW DURHAM RD BLDG G PARCEL: 2S113AB-01400
SUBDIVISION: I ANNO Uk FK A( RL TIRA(-1 S ZONING: 1-1'
BLOCK: LOT: JURISDICTION: "fi(i
TENANT NAME: DISH NETWORK
USA NO: FIXTURE UNITS: 12
CLASS OF WORK: NEW DWELLING UNITS:
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: .8 EDU increase. Previous fixture values were 245, this adds 12 values for a new total of 257.
Owner:
_ FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY#300-V1%MI
PORI LAND, OR 97224 (SWUSAI Swr Conncct 3/4/03 $1,840.00
)SWUSA]Swr Connect 3/4/03 $0.00
Phone: -
Total $1,840.00
Contractor:
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180
days from ttie date issued. The total amount paid will be forfeited if the permit expires. The Agency does net guarantee
the accura(y of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in alf directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm
Issued by: , _- - Q'_Ec t"„yr ��, Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needt'd the next business day
Accumulative Sewer Tally
Tenant Nafne: Dish Network This SWRA2003-00077
lite Address 7370 SW Durham Rd This PLM# 2003-00073
1 ixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
_ count off#s count # value #s values
Baptise /Font 4 G 0 0 0 0
Bath- Tub/Shower 4 0 0 0 0 - 0
-Jacuzzi/Whirlpool 4 0 0 _ 0 _ 0 0
Car Wash- Each Stall 6 0 0 0 0 0-
-Drive through 16 - 0 0 0 - 0 0 `
CuspidorfWater Aspirator 1 0 _ 0 U 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 2 4 2 4 -
3 inch 5 _ 0 0 0 0 0
_ -4 inch � 60 0 0 0 0
Car Wash Drr 6 0 — 0 0 0 0
_Garbage Disposal _Y. --
_ -Domestic(to 314 HP) 16 0 0 0 0 0
Commercial (to 5 HP) 32 ^_ U 0 0 0 0
Industrial(over.511P' 48 0 _ 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 _ 0 0 0
Oil Sep(Gas Station) -6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower-_Gang (per head) 1 0 -- _0 —0 0 0
Stall 2 0 2 4 0 -2 -4 —_
Sink-Bar/Lavatory _ 2 _ 0 _ 0 _0 0 U
Bradley 5 0 _0 0 0 0
Commercial 3 0 0 0 0 _ 0
Service 3 ----0 _ 0 _`- 0 — 0 0 —
Swimming Pool Filter_ 1 0 U �- 0 0 0
Washer- Clothes 6 0 __0_ 0 0 0----
W ater Extractor 6 0 0 -----0--- 0_ 0
Water Closet-Toilet 6 _ 0 _ 0 2 '2 2 _12
Urinal 6 0 0 _ - 0 0 0
Previous EDU Count 15.3 244.8 I 244.8
Capped EDU Credit 0
TOTALS 0 244.8 2 4 4 16 2 256.8
Current Fixture Value 256.8 divided by 16= 16.1 Current EDU 1 EDU _ $2,300.00
Previous Fixture Value 244.8_ divided by 16= 15.3 Previous EDU
Change_ 12divided by 16 = �0.8 over (under) $ 1,840.00
Ent_er EDU Change Here 0.8
I4ISTORY
`dotes — PLM# 2.001-00625 _ _ED'J# 15.3 SWR# 2001 00312
PLM# Per acct. 15 EDI I's FDU# _ SWR#
P M#.- —
EDU# �I/5W R#
I I Date: 7
Signature Of P14sar that calculated this tally sheet and date perfrorned is required
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT#: ELC2003-00119
DEVELOPMENT SERVICES DATE ISSUED: 3/11/03
13125 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 2S113AB-01400
SITE ADDRESS: 07370 SW DURHAM RD BLDG G ZONING: I-P
SUBDIVISION: FANNO CREEK ACRE TRACTS
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install 10 branch circuits for TI.
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 1-TG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps -1000 volts: — MINOR LABEL (10):
SERVICEIFEEDER BRANCH CIRCUITS ADD'L INSPECTION
0 - 200 amp: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 9 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: >=4 RES UNITS: >61:4 VOLT NOMINAL:
Reconnect only: SVC/FDR>=225 AMPS: CLASS AREAISPEC 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 20535
FEES ELE 3-2430
Description Date Amount Required Inspections
I.1.PRM-1.I ELC'Pcrmit $106.70
I AX)8%State Tax I I n; $8.54 Rough-in
_ Elect'/ Final
Total $115.24
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Or' Specialty Codes and all other appli�;able 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 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 at(503)
246-6699 or 1-800-332.2344
Issued By: j._ 'L4 (. r} 1!"l ��,� >'`ah� 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: DATE:--
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: __ DATE:–
LICENSE NO: �' 1 � _—_ - ---- ---- -- — --
Call 639.4175 by 7:00pm for an inspection the next business day
From.Charlynn J Leifsen To City of Tigard Data:3/5/2003 rime 9 58.34 AM Pape 2 of 3
Electrical Permit AppUcation
Dew raa:ived: i i Perini,no1kPV03-ova
ED
City of Tigard j t-i_���: .+ Project/appl.ne Expire dale- —
0yofTrgerd Address: 13125 SW Ilall Blvd.Tigard,OR 97223 bale issued: B W Rttceipt tw
I me: (503) 639-4171
Fax: (503)598.1960 rase foe tura: Payment type'
Land use approval:
U t f4 2 family dwellinS cr accessory I&IC•ommercial/industrial D Multi-family :J 7enant improvement
U New construction UAddition/alteration/replacement D Other: ___D Partial
Job address: 7370 SW Durham Bldg.no.: uite no.: Tax map/tax lot/account no.:
_Is
— -
Lo;: Block: Subdivision: _ __--
Project name: Dish Network _^ Description and location of work on piemiwli: Tenant improvement
Estimated date of completion/inspection:
Jobno: 8132 Mm`
Business name: Johansen Electric Inc, �'' tt•l r.W .a.l.a�
New rsYee/id-�ka�i rhrd7/er
Address: 10948 SE Va_Iley View Terr• dwe�mIr.taelrrI sattaAedasraaa.
city: Clackamas State:OR ZIP:97015 +
Phone: n po
503-699-3417 Fax:503 688-1.466 F-mail:Johanxnnelwa��eo—Loom IMan •tt ar Ins 4_
ccg no-51539 Elcc.bus.lic.no:3-243C — E,cb afrlihrnal s00 hyo 00.� n;°n thereof Limited enemy, resiCai
dstrtW _ 2
/mc Ili.n . 4896 _ L��tom! roast'. no"toridomw 2
CA
3/5/03 FA&mumlea red home m modular dweiiingi -
5ignatura of%o icing elmUiciae (required) ---- Date Service rawer.fesrinr _ 2
sap.etect.-sine(prim: Carl K. Johansen Lloeau oo: 2053S ear.(""«taraer.-•1'ra'"'e"''
altenrt.n or res.e.rto.:
200 am,,*or ler, _ ?
Name(print)' int amps w 400 stays
--------- 401 un w(M amps _ 2 —
Mailing address: _ 601 amps to loon amps ?_
('fly _ State: 7lP: Over 1fNJ0 amps m vola 2
Phone. {aX: E-mail: Rte,ahnez t only
Owner installation The installation is being made on property 1 own Titor nary aerdees or feeeera-
which is not intended for sale,lease,rent,or exchange according to I1ataNatlaa,aNerarla"'°►rrtrrratM"`
AN)amps N lens
ORS 447,455,479,670,701. . —2
z01 roil,w 400.mm, 2 _
Owner's si lure _ __ Date: 4111 to hal amps 2-
Rnera etreWr-sew,atten(ba,
or rxtelaios per pawl:
Nan:t:._J-- _ A Fur Gr branch cinvits wdh purchase of
Address: service or feeder fac,each brianeh_circuit_ - 2 -
city: _..-`-- — State: ZIP. 11. F�- fin branch circuits without purchase
of srnvice or fide fee,flnt branch circuit 1 46M 41111', 2
Phone: Fax n-mail - -- ____ — -__
E.ach additional trench circuit.
• nsfw.(srrA omreeaawnot f"r►atea):
D Service m•,r 225 stnp4rnmtWirial 'J Wailt-carr tYrilitg
U 4rvhue over 120 ampstalwp.or Id 2 U llarstdorhr Ih>Lw/im luheb rias or outtiec 11 tins _
family dwelling, U fluilding nuts 10,0110 spun feel Fina rr Sipnad circaiga)of■limited energy panel,
U Svslrrn over 600 volt..nreninal mho Rrlmbal rnih in Ian:vnCe,re allegation, or eite_neion•
if Ruiiding ovts three Min Ll I cnMn,410)stop,it mat •Oestri i°o. _—
U f)rcurym Mad over 94j pe-.hns U Maphhfa imA.oru'uaec o,kV
P+* i'eeb ad/Mloaal laapectlaa over this dawable is any adlfc aM.a
U EWw%lightinil plan U(hher -- --_ --- Por imphy-urn _-�.—
Sewmi este of plana wttM way of One above. levcs�gwan fm
flu above are i.t app"""le to tesprary cwaevd600 serrke, (ober -
--- ---- Permit fee . ........ S 106. 0
e
Nur all imdhcmm mmvpt rmdo. A,,,p)-call jhalsdicri—6w in("WiArraloo Notice: This permit applicittirnh ........... .. - —.
u Vhra J Maaerc'a"i expires if a permit is not obtained Plan review(at _ %) $ _
(`,edn cant numbs. _�-_ /. I. within I NO dnv+after it hes breen State surcharge(8%).....S !_8.54
espinaRCcerpled as complete TOTAL. _.....................5 115.24 --
-----Name of c4Wc;1�-Aviva an ce�i used .s.—
_ S
l'rtAhOlbt a1N1alM AneWa1 aMJM1hS hhtn./'thNl
CITYOF T I GA R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00121
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/18/03
PARCEL: 2S1 13AB-01400
SITE ADDRESS: 07370 SW DUI;HAM RD BLDG G
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I-P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRE:i'i_ORS HOODS:
FUEL TYPES _ 0 - 3 HP: DOMES. INCIN:
IPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 100,000 BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN >=100K BTU: 1 <= 10000 cfm: OTHER UNITS: 2
>
GAS OUTLETS:
10000 rfm:
Remarks: A(Idiiig(1)rooftop w1it I oHhcr unit Valuc 's"50 ,00
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300-WMI i,MFCII1 1'ernit Fee 3/18/03 $72.50
PORTLAND, OR 97224
1 I'AX1 K"i,State"fax 3;18103 $5.80
�MEUPI-NI Plan Rei 3/18/03 $18.13
Phone: Total $96.43
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Phone: 233-6911 Gas Line Insp
Mechanical Insp
Reg #: LIC 38868 S.D. Shut-down inspection
Final inspection
This perrnit 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
952-001-0100. You may obtain copies o' these rules or direct questions to OUNC by calling
(503)246-6699. '
t-sued By: - Permittee Signature: 6L L -----
'a
Call (503) 639-4175 by 7:00 P.M. for inspections needed t next ICsiness day
Mechanical Permit Application '
Received Mechanical
Permit No.: —06
Planning Approval Building
City of Tigard Date/BY Permit No.: 7
13125 SW Hall Blvd. Plan Review other
Tigard,Oregon 97223 Date/13y: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land Use
Date/By: _ Case No.:
Internet: www.ci.tigard.or.us contact Juris.: N See Page 2 for
24-hour Inspection Request: 503-6394175 Name/Method: Supplemental Information.
Of TYPE OF NORK COMMERCIAL FEE`'SCHEDULE-USE CHECKLIST
New construction Demolition Mechanical permit fees'are based on the total value of the work
Addition/alteratio_ n/replacement ❑Other: performed. Indicate the value(rounded to the nearest dollar)of all
_ mechanical materials,equipment,labor,overhead and profit.
CATEGORY OF CONSTRUCTION
I &2-Family dwelling Commercial/industrial value: $ �2� See Page 2 for Fee Schedule
Accessory 8uildi> Multi-Family
RESIDE TIAL F.QUIPMENTISYSTEMS FEE-SCHEDULE
Description Q Fee ea. "Total
Master Builder (Nthcr: IIeatInjWVCoolio
JOi3 SITE INFORMATION and LOCATION Furnace-add-(n air conditioning+" 14.00
Job site address: 2A.70R{�� Gas heat um _ 14.00 _
Suite#: _ d /A t#: Duct work 14.00
_ �—_— ---
Pro�ect Name: "' H dronic hot u ater system 14.00
S,WAt� ---- -- Residential boiler
Cross street/Directions to job site: for radiator or hydronic system) _ 14.00
Unit heaters(fuel,not electr.'c)
in wall,in-duct,suspended,a cam_ 14.00
Flue/vent (br any of above 10.00
Subdivision: _ Lot#:
Repair units 12.15
_ —_ Other Fuel A rllances
Tax ma / areal #:^ Water heater 10.00
_ DESCRIPTION OF WORK Gas fimlace 10.00
L „�j�f�r �►- -As p� Flue vent(water heater/ as fireplace) 10.00
Log lighter(gas) 10.00
� � �'— --- - Wood/Pellet stove 10.00
Wood fire lace/insert 10.00
Chimney/liner/flue/vent 10.00
ROPERTY OWNER TENANT Other 10.00
Nar.ie: ,a Environmental Exhaust do ventilation
— Range hood/other kitchen equipment 10.00
Address: *�, y��pyot,l �kw� Clothes dryer exhaust 10.00
Cit /state/Zi Yr.i i0 *!e _.__ Single duct exhaust
Phone:Cyay G,3 oc� I Fax: (bathrooms,toilet compartments,
APPLICANT I Lj CONTACT PERSON utility roomer 6.80 _
Name: Attic/crawls ace fans 10.00
- Other: 10.00
Address: ,-----_-__.__ Fuel PI Ing
City/State/Zip: **($5.40 for first 4,$1.00 each additional
PFaX: Furnace etc.
Phone:
-- Gas heat pump ••
E-mail: Wall/sanded/unit heater •• __
CONTRACTOR Vater heater
Business Name: ±ircplacc •' _
Address:�Zir�g Vis.= Bs
Range
_ .•
Cit /state/Zip:_ NAA A& _a_ 9119= Clothes dryer as
Phone: „ AW-�j�/ I Faxa,?jr •9w7 other:
CCB Lie. #: ate_ _ _ Totae _
__Mechanical Permit Fees*
Authorized Subtotal: 5
Signature: Date:/*3 Minimum Permit Fee$72.50 5
Plan Review Fee 25%of Permit Fee S �/�
— uise7 --- -- State Surcharge 8%of Permit Fee
,'(Please print name) TOTAL PERMIT FEE $ r _
Notice: This permit application expires If a permit Is not obtained within •Fee methodologv set by Tri-County Building Industry Service Board.
180 days ager It has been accepted as complete. ••Site plan required for exterior A/C units.
iADsts\Pemiit Forms\MecPermitApp.doc 01103
Mechanical_Permit Aunlication - City of Tigard
Page 2 - Supplemental Information `
Commercial Fee Schedule:
Total Valuation: Permit Fee:
51.00 to$5,000.00 Minimum fee$72.50 _
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52
for each additional$100.00 or fraction
_ thereof,to and including$10,000.(x1.
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and
$1.54 for each additional$100.00 or
fraction thereof,to and including
$25,000.00.
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and
$1.45 for each additional$100.00 or
fraction thereof,to and including
$5-0-10-0-0-00.
$50,001.00 and up $742.00 for the first$50,000.00 and
$1.20 for each additional$100.00 or
fraction thereof.
Assumed Valuations Per A liance: '
Value 'total
Description: _ Q1Y (Ea) _Amount '
Furnace to 100,000 BTU,including 955
ducts&vents
Furnace>100,000 BTU including duct 1,170
&vents
Floor furnace including van► 955
Suspended heater,wall heater or floor 955
mounted heater
Vent not included in appliance permit 445 �..
Repair units 805 _
<3 hp;absorb.unit, 955
to 100k BTU
3-15 hp;absorb.unit, 1,700
101 k to 500k BTU
15-30 hp;absorb.unit,501k to I mil 2,310
B'IU -
30-50 hp,absorb.unit, 31400
1-1.75 mil.BTU _
>50 hp;absorb.unit, 5,725
>1.75 mil.RTU
Air handling unit to 10,000 cfm 656
Air handling unit>10,000 cfm 1,170
Non-portable evaporate cooler _ 656
Vent fan connerted to a single duct 1 446 _
Vent sys'•:,n not included in appliance 656
rr A _
tend served by mechanical exhaust 656
domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit,including wood stoves, 656
inserts,etc.
Gas piping 14 outlets _ 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION:
i\Dsts\Permit Forms\Mcc1'crmitAppl'g2 doc 01103
ELECTRICA'
CITE` OF TIOARD RESTRICTS PERMIT-
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2G03-00084
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 3/18/03
SITE ADDRESS: 07370 SW DURHAM RD BLDG G PARCEL: 2S113AB-01400
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I-P
BLOCK: LOT: JURISDICTION: TIG
Prolect Description: T-Stats
A.RESIDENTIAL B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE CC'".M: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#01: SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES PROTEMP ASSOCIATES INC
15350 SW SEQUOIA PKWY #300-WMI 807 NE COUCH
PORTLAND, OR 97224 PORTLAND, OR 97232
Phone: Phone: 233-6911
Reg #: ELE 26-1063CRE
LIC 38868
MET 00004556
FEES S11P 4644 hid Inspections
_Description _Dato Amount Low Voltage inspection
I::1,111W I j LI.R Pcmui 3/18/03 $75.00 Elect'I Final
I-AXI 99%State Tar 3/18/03 $6.00
Total $81.00
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 per;-iit,x1111 expire if work is
nct started within 130 days of issuance, or if work is suspended for more than 160 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those riles are set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699.
Issued by �;i; ,L ,� �C. Permittee Signature
G
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 INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ DATE:-- ^_
Lh,ENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next businesE day
FOR OFFICE USE ONLY
Electr:eal Permit Application Received l.lccnical
Date/B :f,/iC- d L _ Permit Nut`
CitCit of Tigard Planning Approval - Sign
y g Date/By: Permit No.:
13125 SW Hall 13111d. Plan Review other -
Tigard,Oregon 97223 2ate/I3y Permit NL,,:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
Date/By: Case No.:
Internet: www.ci.tigard.or.us Contact Juris.: 0 See Page 2 fur
24-hour Inspection Request: 503-639-4175 Name/Method _ Supplemental Information.
TYPE OF WORK PLAN REVIEW(Please check all that apply)
ew construction Demolition 0 Service over 225 amps- Health-cure facility
_H
commercial ❑Hazardous location
Addition/alteration/re_plaeement _Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square feel.
CATEGORY OF CONSTRUCTION I &2 family dwellings four or more residential units in
❑ l & 2-Family dwelling ommercial/Industrial ❑System over 600 volts nominal one structure
AccessoO— ry Building Multi-Famil ❑Building over three stories ❑Feeders,400 amps or more
_ Y ❑Occupant load over 99 persons ❑Manufactured structures or RV park
El Master Builder Other: _ ❑f.gressdighting plan ❑t Ither: _
7013 SITE INFORMATION and LOCATION Submit_sets of 1311111%"kh any of the above.
_ The above are not appiicaMe to temporary construction Service.
Job site address: 23 7Q._3 ,,bp W% FEE*SCHEDULE
Suite#: I Bldg./Apt.#: _ Number of Ins ections err ermit allowed
Project Name: -- Description - Qty Fee(ca.) Total
New recidenlial-single or multi-famlly per
Cross street/Directions to job site: dwelling unit Includes attached garage.
Service Included:
1000 sq 11.or less 145.15 4
Each additional 500 sq.R.or portion thereof 33.40 1
Limited energy,residential 75.00 _ 2
Subdivision: Y LOt#: _ Limited energy,non residential 75.00 ?
Tax rna / arcel #: Each manufactured home or modular dwelling
DESCRIPTION OF WORK service and/or feeder 90.90 2
Services nr feeders-Installation.
alteration or relocation:
20(1 amps or less _ _ 80.30 2
_. - - ---.----- - 201 ams to 400 ams _ 106.85 2
401 amps to 600 amps_ _ 160.60 2
PROPERTY OWNER ICITENANT 601 ams to 1000 amps 240.60 2
K d� — - --- Reconnect
nett amps or volts _ 454.65 2
Name: I Reconnect on1 66.85 2
Address: eVxm Sw sftg1JV I �AGry;� Temrorary services or feeders-Installation,
■ duration,or relocation:
City/State/Zip: T I✓I _ _ _ 200 amps or less 66.85 I
Phone: ax; 201 amps to 40P amps 100.30 2
APPLICANT CONTACT PERSON 401 to blot s 133.75
— _._ s Branch circuits-new,alteration,or
Narne: extenslan per panel:
--- - - ------ - A.Fee for branch circuits with purchase of
Address: _ service or feedei fee,each branch circuit 6.65 _ 1
City/State/Zip: B.I-ce for branch circuits without purchase of �
-- --- -- — service or feeder fee,first branch circuit 46.85 12
Phone: _ )"ax_ I::ch additional branch circuit 6.65 2-
L-mall: Mise.(Service or feeder not included)
CONTRACTOR i•.ach pump or irrigation circle 53.40 2
-- -- Each sign or outline lighting 53.40 2
Job No: Signal circuil(s)or a limited energy panel,
alteration or extension Pae 2 2
Business Name �T ..�� >sa59'Z ___,___ Description
Address: y _ -
City/State/Zip:/State/ZI Each additional Inspection over the allowable In an of the■bocr.
b 4,W V e17e�?.2 Per inspection per hour(min. I hour) 1 62.50 1 _
Phone: 1R3:k.!t Fax: 7 Investigation fee:
Other: _
CCB Lic. #: Gas R _ Lic. #I?,/0 t" Electrical Permit Fees* _
Supervising electrician ,AA Subtotals 5 --__-
signature required_ w(� Plan Review(25%of Permit Fee S
Print Nam _ Lic. #:�(�,/3 �Q�/ State Surcharge 8%of Permit Fee S
TOTAL PERMIT FEE I S
Authorized �-/ Notice: This permit application expires If a permit is not obtained within
Signature — Date:�.y/ 1 �3 180 days alter It has been accepted as complete.
_ TTT T *Fee methodology set by Tri-County Building Industry Service Board.
( use print name)
I\I)sts\Permit Forms\ElcPennitApp.doc 01/03
Electrical Permit Application - "'b.v of Tigard
Page 2 -• Supplemental Information '
LIMITED ENERGY PERMITH EES:
RESIDENTIAL,WORK ONLY: _
Feefor all systems............................................................ $75.00
Check Type of Work Involved:
Audio and Stereo Systems*
Hmglar Alarm
t iarage Door Opencr*
I leasing,Vcnn anon and An('oWition:ng System*
Vacuum Systeme*
Other
COMMERCIAL.WORK ONLY: _ F
TFee for each system.......................................................... $75.00
(SEE OAR 918-260-260)
Check Type of Work Involved:
D Audio and Stereo Systems
Boiler Controls
Clock Systems
Data Telecommunication Installation
hire Alarm Installation
HVAC
E- !nstrumentation
ElIntercom and Paging Systems
E] I andscape Irrigation Control*
CJ Medical
[—] Nurse Cah.
u Outdoor landscape Lighting*
Protective Signaling
nOther ---
Number of System
* No licenses are required. Licenses are required for all
ollier installations
i:\bsts\Permit FormsTIcPermit kppPg2.doe 01103