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�l CITY OF TIGARD BUILDING INSPECTION DIVISION I',
MST
24-Hour InspFction Line: 639-4175 Business Line: 639-4171
Date Requested 2�l AM_ PM __ gLD
Location 2- ��� _ Suite _ MEG
Contact Person C�`� >G�Ct'l� Ph %�Q - Gj6 PLM
Contractor Ph SWR
ILDI Tenant/Owner ELCRtlt�
ing Wall ELR
Footing Access: �+ � Z FPS
Foundation --.
Ftg Dr,-,n SGN
Crawl Drain Inspection Notes: —
Slab - SIT _
Post 13 Beam �` �� �-
Ext Sheath/Shear V � 1
Int Sheath/Shear
Framing _-
Insulation G --�
Drywall Nailing li � U� I 1
Firewall j2, �/: (__ /'��� q 3 -
Fire Sprinkler , ��1L --
Fire Alarm � g01-1 _ G G t� N%
Susp'd Ceiling l --
Roof
Misc -- - �-
Fin�' ---- -
�VA_SV PART FAIL — --- -TTUMBING
Post&, Beam
Lk
Under Slabs
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
ELECTRICAL ----_-.– _ _ _—_-----.___-- —_--
Service - -----___-- _"-
Rough In
LL UG/Slab _-- - - -- -- -
rt Low Voltage
un Fire Alarm
Final
PASS PART FAIL __ ---- -- -
SITE
,
Backfill/Grading ----" -
Sanitary Sewer
-� Storm Drain I Reinspection fee of$-_ -required before next inspectior. Pay at City Hall, 13125 SW Hal:Blvd
Catch Basin
Fire Supply Line f 1 Please call for reinspection RE:_ T _ ( � Unable to inspect- no access
ADA CG vu
� J�
Approach/Sidewalk pate Z l I Inspector �'' `�` Ext"�-- c,
Other _
- � 1
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD BUILDING PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : BUF198-0043
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 01/30/98
PARCEL: 2S105DB-00400
SITE ADDRESS. . . : 13452 SW 154TH AVE
SUBDIVISION. . . . : ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION:URB
----------------------------------------------------------------------------------------
REISSUE: FLOOR AREAc;------------ EXTERIOR WALL CONSTRUCTION—
CLASS OF WORK. - FIRST. . . . : 0 sf N: S. E: W:
TYPE OF USE. . . :COM SECOND. . . : o s f PROTECT OPENINGS?----------------
TYPE OF CONST. :5N . . . : 0 sf N: S: E: W:
OCCUPANCY GRP. :U2 TOTAL-------: 0 sf ROOF CONST: FIRE RET? :
OCCUPANCY LOAD: 0 BASEMENT. : 0 sf AREA SEP. RATED:
STOR. : 0 HT- 0 ft GARAGE'. . . : 0 sf OCCU SEP. RATED:
BSMT?: MEZZ" : REOD SETBACKS- REQU I RED-
FLOOR LOAD. . . . : 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOIJ, DET. . :
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDJCP ACC:
BEDRMS: 0 BATHS: 0 IMF, SURFACE: 0 PRO CORR: PIARKINR: 0
VALUE. $ : 1211279
Remarks : Construct new 3.5 mg tank
Owner-: FEES ----------------
CITY OF TIGARD type amount by date recpt
13125 SW HALL BLVD PRMT $ 3213. 00 B 01/30/98 MANUAL REC
TIGARD OR 97223 5FICT $ 160. 65 B 01/30/98 MANUAL REC
PLCK $ 2088. 45 B 01/30/98 MANUAL FEC
Phone #. 639-4171
Contr-actor: -----------------------------
WARD HENSHAW CONSTRUCTION CO I
PO BOX 950
CANBY OR 970137
Phone #: 266-1986 11 5462. 10 TOTAL
Reg it. . : 062762 ------- RE QU I RED INSPECTIONS
This permit i! issued subject to the regulations contained in the Reinfor,ced coner-
Tigard Municipal Code, State of Ore. Specialty Codes and all other Py-estr-essed cone
applicable laws. All work will be done in accordance with Str-uctut,al obser
approved plans. This permit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oreqon law requires you to follow the
rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952-01-NIO through OAR 952-00I01987.
You many obtain a copy of these rules or direct questions to OONC ----------
by calling (503)246-1987.
Permittee Siqnatut-e: Issued By:
4....+++.+- +....++++++++f+........................ .....+++.++..........++
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
........................4.......I .................................. ...........
CITY OF TIGARD Commercial Building Permit Rec'd By
13125 SW BALL BLVD. New Construction and AdditioDale Recd I
TIGARD, OR 9722 , Date to P.E. )/h
3
Date to D T
(503) 639-4171Peit# U
Print or Type \ '\�� rmR
Related SW #
Incomplete or illegible applications will not be accepted Called
Name��`��v'lopmenuP�oiecctt o, 'TExisting Building EJ Building I
Job
1l��S \f Y c t
Address 'Street Address suite Buildirg
Data
aidg# c;yisla'te Zip — Existing Use of Building or Property:
Name
Property
Proposed Use of Building or Property:
Owner Mailing Address suite �TJc, A
\3N-.a-5 $W hkl\1\
No. Of Stories.-
City/state
tones:City/state Zip Phone
I(Y.�.r.� P) 6AJ PSq. Ft. Of Project: t- 'A
OCCUpant Name 1
N r 1 Occupancy Class(es)
Name
Contractor Type(s)of Construction V1
Prior to penult Mailing Address _ Suite I�1
issuance,a copy Will this project have a Fire Suppression System?
of all licenses
are required if City/Stale -Lip Phone — Yes N
expired in C.O.T Americans with Disabilities Act(ADA) ^
database Valuation X 25% = $ Participation A
Oregon Const.Cont.Board Lic.# Exp,Date Complete Accessibility Form
Project S —-- _
-- Name `— Valuation i ZI I/21 �
Architect —�—
Mailing Address suite Plans Required: See Matrix for number of sets to submit
on back
City.Stale Zip Phone - —
I hereby acknowledge that I have read this application,that the information
Engineer Ni given is correct,that I am the owner or authorized agent of the owner, and
����a`�)�,_V,,,�4� Ah S�n1(1k •y that plans submitted are in compliance with Oregon State Laws.
Mailing Address Sults Signature of Owner/Agent Date
it ;Lt G,-; So\ kl" t�x�
Ci I t@le Zip Phone Contact Person Name Phone
Cif
n Indicate type or work: Nsit Q Addition O Demolition o FOR OFFICE USE ONLY
Accessory Strurture O Foundation Only O Alteration O
>- .,air O Other O MaplTL#, Land Use:
1,— --- 1(- r-7
J Descrlptlor c1ork: --.
Notes:
TIF
Perks: Esti Td#of Employees/� - - ---
Note: Site Work Permit Application must preeeds or accompany Building
Permit Application
I\COMNEw DOC (DST) 8197
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
DISTRIBUTION TO PLANS OUT TO DST
�--- EXAMINERS (Note a.)
TYPE: OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE
SITE I 1 -- -- 3 (j,o,u) -- --
B (New or Add) 1 1 -- -- 3 O,o,w)
F (New or Add or Ait.) 3 3 -- -- 3 O,o,f)
M (New or Add. or Alt) 1 1 -- -- 20,o) - --
B & M (New or Add) 1 1 -- -- 3 O,o,w) -- --
P (New, Add. or Alt) 2 -- 2 __ __ 20,o)
B & M & P (New or Add.) 2 1 1 -- 3 O,o,w) 2(j,o) --
E (New, Add, or Alt) 2 -- -- 2 __ __ 20,o)
B & M & P & E (New, Add) 3 1 1 l 3 O,o,w) 2(j,o) 20,o)
B or B & M (Alt) i 1 -- - 2 (j.o) _
B & M &.P(Alt) 3 1 2 -- 20,o) 20,o) _
B & M & P & E (Alt) 3 1 1 1 2 (j,o) 2 (j,o) 20,o)
LQ-T15- KLY-
a. Before returning to DST. Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o = Office M, = MEC
updates and adds actions. f Fire P = ALM
u= USA E = ELC
b. Shaded areas df:signate ALT submittals only. w= Wash. County F = FPS
c. HIS is a new permit category set aside for fire sprinkl- rs and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
72 72 Exception. contirue to forward a copy of approved fire sprinkler and fire alarm plans with
calculations.
J
h vnatrtc Doc
F CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 PERMIT #. . . . . . . : PL_M98-0&:'7
DATE ISSUED: 05/15/98
PARCEL- 2SJ05DB-00400
SITE ADDRESS. . . : 1.,--)452 SW 11541-H AVE
SUBDIVISION. . . . : ZONING: R-7
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . JURISDICTION: URB
__-----------------------------------------------------------------------------------
CLASS OF WORK. . :NEW 13ARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE,. . . . :COM WASHING MACH. . . . . . : 0 BACKPLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :U2 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . .. . . . . . . I
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES--------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . : 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 3
TUB/SHOWERS. . . : 0 SEWER L...1 NE (ft ) . . . : 0
WATER CLOSETS. - 0 WATER LINE (ft ) . . . - 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . 30
Remarks : Water iines and storm sewer piping oi-ttside of operations building And
tanl< perimeter- considered pLtblic; Maintenance Department is handling them.
Owner: FEES ----------------
CITY OF TIGARD type arnot-trit by date recpt
13,125 SW HALL BLVD PRMT $ 66. 00 (iEO 05/15/98 913-30579'.3
TIGARD OR 97223 5PCT $ -3. 30 GE 05/15/98 98-305799
Phone #.-
Contractor-----------------------------------
MEYERS 9. SONS PLUMBING
6024 SW JEAN ROAD
LAKE OSWEGO OR 97035 -------
Phone #: 684-6602 $ 69. 30 TOTAL
Reg #. . : 40389
REnUIRED INSPECTIONS
This 'permit is issued subject to the regulations contained in the Rain Drain Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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, o, if wor4 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 95-2-000I-0010 through OAR 952-0001-M. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246-1167.
Iss1_ied By i r ---- Permittee SignatLlre :
-+.+++ +++++++4++++++..... ........................................................
Call 639-4175 by 7-00 p. m. for An inspection needed the next bi.tsiness (Jay
+++.......... ......................4•+f•++++++++++++++++...................... -+++++
CITY OF TIGARD Plumbing Application Recd By
13125 SW HALL BLVD. Commercial and ResidentialDate Recd 1
TiGADate to P E.
�D' 014 97223 Date to DST
(SQ:;) 639-4171 Permit* PLIV1% �Z7
Print or Type Related SWR#
Incomplete or illegible applications will not be accepted Called I-770-lb
Job Narre�Of Deveegpmennvpr e�dS��„� �M� On back indicate Work Performed by fixture.
N t _\
,r.Jv �,��. FIXTURES (Individual) QTY PRICE AMT
Address Street Address Suit Sink 9.00
Lavatory 9.00
Bldg# City/State Zip
Tub or Tub/Shower Comb. 9.00
~' Jame — 1 1 U� Shower Only -- 9.00
_ Water Closet 9.00
Owner Marling Address 1,r\ V� Suite Dishwasher — 9.00
r,� �5 w C`►.a
CTStat Phone
Garbage Disposal 9.00
Q�
Washing Machine 9.00----------
Name Floor r i 9.00
3" 9.00 <
Occupant Marling Address Suite II 4"
9.00
City/State ZIP �Fhone Water Heater O conversion—Cl-lice kind 9.00
Laundry Room Tray 9.00
Name L JJ Urinal 9.00
k rAI kye Other Fixtures(Specify) o O ( 9.00 Q
Contractor Mailing Address Suite 9.00
Prior to permit City/State Zip Phone 9.00
issuance,a cony 90
of all licenses are Oregon Const.Cont Hoard Lic 0 Exp.Date 9 00
required if Sewer- 1st 100" 30.00
database
expired in COT Plumbing Lic.# Date Sewer-each add'tional 100'
database 25.00
Name Water Service-1 st 100' 30.00
Architect I Water Service-each additional 200- 25.00
or Mailing Address Suite ` Storm&Rain Urain-1st 100' 'JU 30 00
Storm 3 Rain Drain-each additional 100'
Engineer City/State Zip Phone Mobde Home Space 25 00
Commercial Back Flow Prevention Device or Antler 1 2560—(
Oescnbe work New U Addition O Alteration O Repair O Pollution Device 10
to be done: Residential O Non residential O Residential Backflow Prevention Device' 15.00
Additional description of work t,W Any Trap or Wane Not Connected to a Fixture 9.00
Catch Basin 900
Insp.of Existing Plumbing 40.00
_ per/hr
Existing use of --- Specially Requested Inspections 40.00
building or property _ P er/hr
Rain Drain.single family dwelling 30.00
Proposed use of --- _ —__
LL. building or property Grease Traps 900
I-- QU/kNTITY TOTAL
ll— I hereby acknowledge that I have read this application,that the information Isometric or riser diagram is required rf Ouanity Total is >9
given is correct,that I am the owner or authorized agent of the owner,and "�IIBTOTAL
} that plans submitted are in compliance with Oregon Slate Laws,
I Signature of Owner/Agent Date
5%SURCHARGE -.�
�
' 30
Contact Person Name Phone
F
-- N REVIEW 25%OF SUBTOTAL
V Requvtd only if rnture qty total is>9
W
TOTAL �.
'Minimum permit fee is$25-5%surcharge,except Residential t!fow
Prevention Device,which is$15*5%surcharge
d%rstpimepp doc 5%9'
PLEASE COMPLETc.
Fixture Type Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
_ 4"
Water Heater_ -
Laundry Room Tray -
-
Urinal
Other Fixtures (Specify)
i
COMMENTS REGARDING ABOVE:
f
f�
J
J
J
1 WSIMPIMapp doc SM7
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 6394175 Business Line: 639-4171 —
(� I� �/�, BUP
' _Date Requested ;'- -1 �? A^A ""QPM BLD
Locationl�� 5 Z ��,(� 1 t I i(i-- _ Suite MEC
Contact Person 'I�LtkpL � �Qy`� �kft Ph �q ���? -- PLM -
Contractor Fh SWR
BUILDING Tenant/Owner _ f � �. ELC y `
Retaining Wall ELR
Footing
Foundation ACC2SS: FPS _
Ftg Drain
Crawl Drain Inspection Notes: 1 ' SGN `—
Slab SIT
Post$Beam -
Ext Sheath/Shear
Int Sheath/Shear -
Framing -- ------ --- --- ---
Insulation -'
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm -
Susp'd Ceiling -----_--_--� __ - _�
Roof
Misc: -- — — —-- ---- -
-------------
Final ------_._..
T FAIL - -- --
LUMBING
Pos -
Under Slab
Top Out -------
Water
-----Water Service
Sanitary Sewe• - -------------- -— ---iLiiLLDrains
cPAW PART FAIL
CHANICAL
Post& Beam
Rough
--
Rough In
Gas Line - - ---
Smoke Dampers
Final -
PASS PART FAIL
ELECTRICAL -- ---
Service
LL Rough In ------ --___--- ---
CeUG/Slab - - ------- - - ------- ---- ----- ------ - --
v) Low Voltage
> Fire Alarm
Final ----------.__._ -� ------ -----
PASS PART FAIL
L 81TE
W Backfill/Grading - — --- - -- - ---
-' Sanitary Sewer
Storm Drain I J Relmzzection fc,r:of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Please call for mins ection RF
Fire Supply Line ( 1 / P __.- ( ]Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date ___ Inspector _ Extz
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 / siness Line: 639-4171
BUP
Date Requested - AM PM . BLD y
Location 0 S�' c-'ite MEC
Contact Person Ph 1W-5 L4Z /ALM _
Contractor SWR _
BUILDING Tenant/Owner _ ELC4�
Retaining Wall ELR
Footing Access:
n / �
Foundation ylY' FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: ,
Slab _ ' — IT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear `
Framinq _ 57 • ` Z 7(O C
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: 2 — —
Final
PASS PART FAIL -- _
PLUMBING
Post& Beam -
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FML
MECHANICAL
Post& Ream --
Rough In
Gas Line - --
Smoke Dampers
Final - — --- — — -----
P T FAIL.
)ELECTRICAL -
Service
Rough In - ----- -------__--- -- -
UG/Slab
Low Voltage ------- - --- ------ --------- --
Fir m
r S ART FAIL
sm
J
.r Backfill/Grading - ---- -- --- -
Sanitary Sewer
w 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:_,_ [ ]Unable to inspect no access
ADA ,,
Approach/Sidewalk Date d" InspectorExt
-f'Z��`
Other --- _ __.
Final
PASS PART FAIL DO NOT REMOVE th;% Inspection record from the job site.
CITY OF TIGARD
�uEVELOPMENT SERVICES PPERMIT
PERMIT'T ##.. .. .. .. . . . : PUF198-0042:
13125 SW Hal!Blvd.,Tigard,OR 97223 (503)639.4171 DATE ISSUED: 01/30/98
PARCEL: 25105DP-00400
SITE ALn'-,ESS. . . : 13452 SW 154TH AVE
SUBDIVISION. . . . : ZONING:R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JUR,ISDICTION:URB
---------------------------------------------------------------------------------------
RIISSUE: FLOOR AREAS----------- EXTERIOR WALL CONSTRUCTION—
Cl_:ASS OF' WORK. :NEW FIRST. . . . : 96 sf N: S: E: W:
TYPE OF USE. . . :COM SECOND. . . : 0 sf PROTECT OPENINGS?-------------
TYF'E OF CONST. :5N . . . . 0 s f N: S: E: 14:
OCCUPANCY GRP. :B TOTAL-----,—: 96 sf ROOF CONST: FIRE RET ;1 :
OCCUPANCY LOAD: 1 BASEMENT'. : 0 sf AREA SEP. RATED:
STOR. : 1 HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED:
BSMT? : MEZ Z?: REQD SETBACKS--------- REQUIRED--------------------
FLOOR
EQUIRED--------------------
FLOOR LOAD. . . . : 0 ps f LEFT: 0 ft RGHT : 0 ft FIR SPKL:N SMOK DET. . :N
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:N HNDICP ACC:N
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR:N PARKING: 0
VALUE. $ : 534120
Remarks : Construct new operations building for new 3.5 mg tank
Owner: ----------_--___..__.____.__----_----______.._ _____ - -----._-.-- FEES
CITY OF TIGARD typ'a amol_tnt by date recpt
13125 SW HALL BLVD PRMT f 295. 00 B 01/30/98 MANUAL REC
'TIGARD OR 7223 5PCT $ 14. 75 B 01/30/98 MANUAL_ REC
PLCK $ 191. 75 B 01 /30/98 MANUAL REC
Phone #: 639-4171
Contractor: ------_--__---------___--_
WARD HENSHAW CONSTRUCTION CO I
PO BOX 950
CANBY OR 97013
Phone #: 266-1986 8 —. 501. 50 TOTAL -- ----- _—.^_-_---___--
Reg #. . . 062762
----- REQUIRED INSPECTIONS -- - ----
�f This permit is issued subject to the regulations contained in the Foot/Found Insp
r Tigard Municipal Code, State of Ore. Specialty Codes and all other Masonry Insp
applicable laws. All work will be done in accordance with Framing Insp 4_
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 188 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-MI-WO through OAR 9552-M191987.
N You many obtain a copy of these rules or direct questions to DUNG
by calling (583)246-1987.
C-0 •.
W �
J Permittee Signati.treIss1.1ed By :
r
F++4.4.++++++++++++++++++++++++++++++f+++++++++++++++++++++....++++++++++++++++•+++
Call 639-4175 by 7:00 p. m. for-• an inspection needed ttie next bi_isiness day
++++++++++++++i-+++++++++++++++++^h-F+++++++++++++++++++.0-++++++++�++++++.+++++++++
C*Y-OF TIGARD Commercial Building Permit ('A . Rec'd By gG
1312 SW HALL BLVD. Date Rec'd 1�—
New Construction and Additions
TIGARD, OR 97223 `1 a��c� Date to P.E.
(503) 639-4171 \ Date to D T
Permit'll
Print or Type Related SWR•
Incomplete or illegible applications will not be accepted Called -
Name of D}velopmen Project Existing Building 0 New Building
Job rn"M o� Se V o.yr
Address Street Address suite Building
_ 'yt i J ; l NData
B1dg'` city/Stagy Zip Existing Use of Building or Property:
Name j I Y Property �' Proposed Use of Building or Property:
Owner hiading Address Suds
�13��..5 SuJ Fiat\ p�d� • �(' � ,, �or' ,,\�;�r
City/State` Zip Phone No. Of Stories:
Sq. Ft. Of Project AA
Occupant slams
Occupancy Class(es)
Name
Contractor (I 1 J,( �� Type(s)of Construction v A 1
Prior to permit Mailing Address Suite ' 1
Issuance,a copy �; Will this project have a Fire Suppression System?
of all licenses ril &Y `'t`
Yes N
are nrquired if City/State Zip Phone
expired in C.O.T. Americans with Disabilities Act(ADA) `�
database c. l 11'1 z Valuation X 25% = S Participation N
Oregon Coinst.Cont.Board Uc.0 Exp.Date Complete Accessi ility Form
l 1,*2 1 I t - 10 j S Project —
Name Valuation
Architect — – —
Mailing Address Sui}e Pians Required: See Matrix for number of sets to submit
on back
City/State ZIP Phone
I hereby acknowledge that I have read this application,that the information
Engineer Na 0"I ' �4� a� given is correct.that I am the owner or authorized agent of the owner,and
9 !,`�� )
V" that pians submitted are in compliance with Oregon Stale Laws.
Mailing Address U1e Signature of Owner/Agent Date
ON rn c 9 w,Do
r
i / tale Zip Phone Contact Person Name Phone
&-)V")l a J o--{ J)j 9 a to
l.L
r Indicate type or work: fV Addition O Demolition O FOR OFFICE USE ONLY
> Accessory
r Stru_cture O Foundation Gnly O Alteration O
MaplTUt� Land Use:Lair O Other O —
Description vork: .,.�
r L p,�e 'T-N� NN Notes:
7V (}\ `Itihlaat t1 tv i
5 �{ TIF:
Parks: Estlm-,so t of Employees
INote: Site Werk Permit Application must precede or accompany Building
Permit Application
I:tCOMNEW.DOC (DST) 8/97
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC97-0711
13125 SW Hall Md.,7798rd,OR 97223 (503)6394171 DATE ISSUED: 10/24/97
PARCEL: 2S105DB—,00(,00
SITE ADDRESri. . . : 13230 SW 154TH
4TH AVE
SUBDIVISION. . . . :37. 5 MG MENLOR RESEVOIR ZONING: R-25
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: URB
Pt-oJect Desc.V,i pt ion: Installation or relocation of a 200 AMP or less service,
eleven (11) branch circuits and signal circuit or a limited energy panel or
extension.
------------
UNTT "3RVC/r-EEDERS-----
1000 SF OR LESS. . . . : 0 0 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
.7'
EACH ADDIL 500SF. . . : 0 —01 1400 AMP. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : I
MA,",Ir- . HM/ SVC/FDR. . : 0 C0J+aMp5--1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
-----SERVTCE/FrEDER------ ------.BRANCH CIRCUITS--- -----ADD' L INSPECTIONS— —
0 200 AMP. . . . . . .. I W/SERVICE OR FEEDER,. 1. 1 PER INSPECTION. . . . . : 0
201 400 amp. . . . . . : 0 1st W10 SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401. 600 amp. . . . . . : 0 EP ADDIL BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
GO 1 1000 amp. . . . . : 0 REVIEW SECTION
1000+ amp/volt. . . . . : 0 )=4 RES UNITS. . . . . . . . : ` GOO VOLT NOMINAL. . :
Reconnect only, . . . . 1 0 SVC/FDR >= 225 AMPS. . : CLASS AREA/SPEC OCC. -.
Owner,: - FEES
CITY OF TIGnPD type amol.knt by date t-ecpt
1311125 1o'W tIALL BLVD. PRMT t 155. 1710 GEO 10/24/97 97-3003137
TIG,nRD OR 9722'3 5r,CT $ 7. 75 C1170 10/24/97 97-300387
Phone #.
TICE ELECTRIC $ 162. 751 TOTAL.
SE BEI-MONT ST
PEOUTPED INSPECTIONS
r,OPTI—AND OR 97215 Ceiling Covet-, Undet-gr-oi.tnd Cove
Phone #: 233--OA01 Wall Cover- E:1(1(:t-' I Spt-vice
Reg #. . : 000001
This permit is issued subject to the regulations contained in the Tigard Municipal Codi, State of Oregon Specialty Codes and all other
app:icable laws. All work will be done in accordance with pproved plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for vore than IN days, ATTEN71ONi Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are sef forth in OAR 952-001W10 through OAR 952-001-1987. You oay obtain a copy
of these rules or direct questions to OX by calling 131246-1987.
LL
i'I'mittee S S t.1 c.,
INSTALLATION
The installation is being made or, pt-opc,v-ty I own which is not intended for,
4 sale, lease, or- rent.
(.3 0WNFR9S SIGNPTURF--t DATE:
TW"ALLATION ONLY---—•----------------
-7r,NnTURF nr CI—ECIN, DATE:
zill—1-1--
! .ICENSE NO:
Cal ' (",.3,9-4175 by ;':00 p. m. for an inspect i on needed the ne>(t bi-l"ines es day
++4+++4--f-1 4-+++4.......+,++4-+J ++4............I-+++i f-4
2940
Community Development ELECTRICAL PERMIT APPLIC
` 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit #
Phone (503) 639-4171 Date Issued
CITY OF TIGARD FAX (503) 684-7297 Issued by
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 3.5 MIS Men or R G rvni r Number of Inspections per permit allowed
Address 13230 SW 154th Service included: Items Cost(ea) Sum
City/State/Zip Tigard OR 97223 4s. Residential-per unit
1000 sci It or 1068 $11000
name of business) City of Tigard Each additional 500 aq It or
Name or 1
( portion thereof $25 00
rl Energy $2500
Commercial® Esc Residential❑
Eec Menurd FfOR,e or Modular 2
Dwelling Service or Feeder $6800
2a. Contractor installation only: 4h.Services or Feeders
Installation,alteration,or relocation 2
Electrical Contractor Tice Electric Co zoo amps ar Ie66
1 $6000 60.00 2
nr� n l 5nno_—
201 amps to 400 amps $8000 2
Address w 401 amps to loo amps $12000 2
City — State_,_ Zip o'7' 601 amps to lou i amps $18000 2
rn --- 2
Phone 0. 7"7"2—AAl11 Over 1000 amps or volts $34000
Contractor's License No. 26126c- RoLonned only $5000
Contractor's Board Reg. No. 166 4c.Temporary Services or Feeders
_ � �4�—_� Installation,alteration,or relocation 2
C Elec'n 2� It.i�-c.� 200 amps or less $5000 2
Signature of .,upr. —
201 amps l0 400 amps $7500 2
License No._ 211 1 S Phone No. 21'3_RR(u 401 amps to 600 amps $10000
over 600 amps to 1000 volts
2b. For owner installations: ties•b•above
4d. Branch Circuits
Print Owner's Name Now,allernbon or extension par panel
Address a)The lee for branch circuits wllh
purchsee or soi vete or feeder M. 2
City_ State Zip 00 55,00
Each branch circuit 11 E5
Phore N0. b)The fee lot branch circuits wilhoul
The installation is being made on property I own which is purchase of service or heder W. 2
First branch circus $35 00
not intended for sale, lease or rent Each additional branch circuit $500
Owner's Signature_ 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump at vngalton rarcJe $4000 2
tach sign or outline lighting $4000
Signal cimuit(s)or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel alteration or extension 1 $40 00 40.00
4 or more residential units in one structure Minor labels(10) $10000
Service and feeder 225 amps or more
4f. Each additional inspection over
System over 600 vette nominal
the allowable in any of the above
Classified area or structure containing special occupancy
�-•' tier ins prrlion
$1500
ct as described in N E C Chapter 5 per tin„r $55 no
►--
n in PIarN
$5500
r Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction servicer. 5. Fees:
—�
5s. Enter total of abovty fees $ 155.00
r NOTICE 5%Surcharge(05 X total fees) $ 7.7�,
co Subtotal $
w PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25%of line A for
J AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF
Plan Review it required(Sec 3) $
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR _
Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED ❑ Trust Account 0 $
Balance Due $ 162.75
„ e.ww vT•e
LL
11
Y
F�
J
L
W
J
RECEIVED
OCT 2 4 1997
COP.1tJltlf;�tY �,�,,,i,