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11745 SW PACIFIC HIGHWAY-3 • • . . , : : Y • : • . 76 • • Y '�'A-11 C,E� -e�. . . II � �� 5 OCT - 2002 . 006 F, • •. . . . • • •• • • • 7 A • • • •a III •• • • • • 70P }{ { 11.10• 17.10' J r.16' Miss* J E3 NICNI1h'1( R A 1^..y DWI I;YII• nYl 91W haat `� i fit. issiso, I. I ruLlr al tr r.1.L11 rr I Lu LJ L .r 111L11 11 [- 11 I,lu/CLtr ra7l� ( e PUOY a 01 P C000l I Cocoa Lkl L.1•:vN: �- 1CnNli-YAI Lf+IN•I YAi ICON(lY At ` I tCONcYIA ,;UII i•r I tDLiC1 _ f ( I FJ Cr' rt .-, d eo• v.m I yr ..tr vm 614. I1P ev A•o- ec• v— [.�� [- M A rJ U�l L PULL- c� � I 40 140RN '51 Of. FLFLI 1a rrr I � � 1 I ANN u N c i K1Tog, I 1: 1 _ _ _ 1 - I - - - - - — - - - . _ - - I- 0 ( ANtL i C I i -3-3. .r t 1 1.m Ip r � 1 - N ' I 1101/ 1:1111 111 ,LLI Il LUCI f lOC r rush Ilii ow Il LD1 I r101r ILlM IYC. DY/If L0. YP 1 fP ............. Lo.r ui Vigo. cur wrl I I �..OVVIIV►fTVa t K 4Wf"OLSr ��s�y a 4e�If ; • o Nlbll I�AL'70YA71! 1. 11'A7icYA'I^. �� l lel UU�• j �oQ, �I/I'`r—>. � �+`•-�' � Iv•re.•1 ltn "'-� r�-'.^_— '_— �....� ��-. _ F S f I 1 j..—_ � I •IP 7J . 1 1 LlYlil01 1N�[A(If LILIT101 — I �A7l JIA C1 ' CITY OF TIGARD Approved.............. .......... ..1 AcAit. a.tTE JOB No - 741-02 Conditionally roved............................ � YAPP •.•,•••••� I � _--- SCALE flAR'hAl' - ., 1 �- For only the as described in: 1n ' PERMIT NO._2a aryl . " See Letter to: Follow.........................................( ): N0 sso200 ua Attach lats ru,u , v. DIAWIIlO . 01014100LA I'M Lt. 1 • Date. Aj rttaml imo onab Rs Ila a[•w11 Dom • � 1 Ill = 004411011. INV= ower ansa Will xls'' TiGA1D.OR 1 -- -- ____�.- _ _ ___..------��___.�� __�_.___. _ �.� -• --- --- 0.81 POW PNWIa Comm sr>n _ NOTICE: IF THE PRINT ORIYPEONANY � I l � ltltlt 111-TIllt1t2 OLI) IMAGE IS NOT AS CLEAR AS THIS NOTICEr 2 I I IS DUE TO THE A - - -1 - - ----- _ QUALITY OF THE _-- -_-_- No.III ill�ll1llIIIIIIIIIIIII. II I I IIIllllllillllllllllll_llTl-l_ll.l-IlI!. _�I ii�Il�_l'll_ll-ll-ll�llll_l. 1111I,II111_1111-1-1--I-I-II -I1-I-I-I1-1-1-111111--1-1-1-1111I► L3�ORICINAL DOCUMENT 6—llll-1lFl8 1IIIIIIIilll1___1 llIllLIllu EOZ 61 Ll 91 91 —��I1,-.�-�:•,-�1:��.-��...� —' TI ��tli3w # 1111 1111 I I 1 i WMHJIH DTAT Vd rIS gVLTT / CITY OF TIGARD IP ERMIT PERR MITTDING#: BUP2000- 000-00214 DEVELOPMENT SERVICES DACE ISSUED: 07/28/2000 13125 SW Hall Blvd..Tipard. OR 97223 (503) 639-4171 PARCEL: 1S136CD-01000 SITE ADDRESS: 11745 SW PACIFIC HWY SUBDIVISION: ZONING: C G BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS_ EXTERIOR_WALL CONSTRUCTION CLASS OF WORK: ALT — FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 3N sf N: S: E: W: OCCUPANCY GRP: U2 TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OC:CU SEP. RATED: BSMT?: MEZZ?: _ REQD SETBACKSREQUIRED _ FLOOR LOAD: psf LEFT: — ft RGHT: `ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM . HNDICP i.CC: BEDIi.MIS: BATHS: IMP SURFACE: PRO CORR: PARKING VALUE: $ 4,350.00 Remarks: Rt place existing 70 sq ft cabinet sign with new 50 sq ft sign Owner: Contractor: MONOGHAN FARMS SECURITY SIGN INC 14120 EAST EVrANS AVE 436 SE 12TH AVI_ AURORA, CO 80014 PORTLAND, OR 97214 Phone: Phone: 2.32-4172 Reg #: Lis 00122809 FEES REQUIRED Type By Dale Amount Receipt�— Final Inspection PRMT PLN 07/28/2000 $77.75 0004053 5PCT PLN 07/28/2000 $6.22 0004053 PL.CK PLN 07/28/200C $50.54 0004053 Total $134.51 This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if worts is suspended tar more than 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center -Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987. Pennitee — Signature: Issued By: ----------- Call 639-4175 by 7 p.m for an inspection the next business day ck* 5 �•�,/tfi Cl 1 11 OF I IGARD Com nlcrcial Building Permit Application Recd Plan Chehe K T 13123 :Vkl HALL BLVD, New Construction and Additions Date Recd 5 ;r- T'IGARD, OR 97223 Date to P.E. (503) 639-4171 Date to J T 1 ,/ Print or Type Permit* OaD C � Incomplete or illegible applications will not be accepted Related SWRCosa 7ksp -;CAO Wd_Ul111liil�* Name of Development/Project Job e v Existing Builrfinr• New Building p Address Street Address suite 1174 SAN Pk.Nei(- VV , _ Building Bldg* City/State Zip Data V (Z, Existing Use of Building or Property: Name fL1 Property 6/`DP06A" Owrer Mailing Address Suite Proposr,d Use of Building or Prooerty. ZO X1.15A&V ' City/State Zip Phone No. Of Stories: Occupant Name Sq. Ft. Of Project: EL Izm ( 6L Name Occupancy Classes) Contractor � 1'f` Prior to permit Mailing Address Suite Types)of Construction issuance,a copy of all licenses are requi,ed if City/State zip Phone Will this project have a Fire Suppression System? -� expired in C.O.T. Yes p No database v(2 r• U(e r� Z 14173 2.4 l 7Z Americans with Disabilities Act(AL„) Oregon Const.Con' Board Lic* Exp.D-atee d Valuation X 25% = $ Participation Complete Accessibility Form Name Project $ Architect Valuation Mailing Address Suite _ Plans Required See Matrix for number of sets to submit City/State Zip Phone on back Engineer Name I hereby acknowledge;hat I have read this application,that the information At_ given is correct,that I am the owner or authorized agent of the owner,and that plans submitted are in compliance wi'`:Oregon State Laws Melling Address Sw,e 0, Siynatwe of OwneNAgent Date _ City'State Zip Phone — ^ Y3 _ .., Contact Person Name Phone Indicate type of work New O Addition O Demolition O �.J��- !�� '1 Z t417L Accessory Structure O Foundation Only O Alteration v Repair O other o FOR OFFICE USE ONLY oescription of work: Map/TL* /1 Land Use t. f Yt_I�rr �1K 1��1 1 r1/c i x/4(3 111�T �� I c„tV 1P ))/ C 0 -01 - — Notes w__L__IJJ�.�v✓ --- - _ Perks: Estimatnd*R Employees TIF If the above figure is not supplied at the time of application,the city will calculate the fee based upon the number of parkin c spaces_ Note: Site Work Permit Application must precede or accompany Buildir Permit Application i ldststformstcomnew doc 5/10199 Jul 17 00 01 : 27p Security Signs 503-230- 1961 P. 3 1 00284 07/13/03 H7509 HOMELIFE HOMELTFE FURNITUn, #4669 5550 PRAIRIE STONE PKWY 11745 SW. PACIFIC HWY SUITE 400 TIGARD. OR ROFFMAN ESTATES, :L 60192 07/13/00 NET 30 DAYS GTNA FERRARI 07/13/00 LODI ADAM RONTSLAWSKI OREGON A. SNIP EIION STOC1 NO 100124 T' IOIRLIIR IU0 ILLUN LTAS Y/ 1 14' FUINITM 100-ILLUN PIN 1 NOUNT LITTERS. B. SNIP rW STOCI Y04 00143 1' 80111,111 RAW 10d LTIS Y/ t 12" FORNITORR IOVILLU1 PIN 1 MOUNT LETTERS. C. SUPPLY 5'x10' PtL01i WAR? t 3950 occ 395U . 0 1110YAL, PATCI. AND PAINT I. INSTILLATION V P1111T 1 ACQUISITION t G. SORirRT ; CITYOF TI GAR D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT #: BLJP2002-00394 13125 SW Hall Blvd., Tivard, OR 97223 X503) 639-4171 DATE ISSUED: 10/07/2002 PARCEL: 1 S136CD-01000 ZONING: C-G JURISDICTION: TIG SITE ADDRESS: 11745 SW PACIFIC HWY SUBDIVISION: BLOCK: LOT: CLASS OF WORK: ALT TYPE OF USE: CUM TYPE OF CONSTR: 5N OCCUPANCY) GRP M OCCUPANCY LOAD: 502 TENANT NAME: REMARKS: Ci[: 14- -1rN1�1If Ns Iwe C T,�� Owner: SMART & F 11VAl_ 600 CITADEL CR COMMERCE, CA 90040 Phone: 323-869-7591 425-881-1985 Contractor: R131 CONS iRUCTION INC 1807 132ND AVS= NE#2 13FI_I_EVUF, WA 98005 Phone: 25-881-1995 Ren #: LIC 69789 This Certificate issued 02/12/2003 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use undar which the referenced permit was sued.(, BUILDING INSPECT R BUILDING OFFICIA POST IN CONSPICUOUS PLACE CITY OF T I C AR p __--_..BUILDING PERMIT _ PERMIT #: BUP2002-00437 DEVELOPMENT SERVICES DATE IS`Ii)ED- 10/25/02 13125 SW Hall Blvd., Tigard, OR 5'223 (503) 639-4171 PARCEL: 1S136CD-01000 SITE ADDRESS: 11745 SW PACIFIC HVIY SUBDIVISION: ZONING: C-G BLOCK: LOT: —� JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: SECOND: s` __PROJECT OPENINGS? TYPE OF CONST: sf N• S: E: W. I OCCUPANCY GRP: TOTAL AREA: U O(1 sf r OOF rr":ST. FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AR,1:A SEP. RATED: GARAGE: sf O�.CU SEP. RATED: STOR: HT: ft REQUIRED BSMT?: MEZZ?: _ REOD SETBACKS---__ -_ - -- FLOOR LOAD: psf LEFT: e ft RIGHT: it FIR SPKL: SMGK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRNi : HNDICP ACC: BEDRMS: 1S: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 9,600.00 II Remarks: Mod kation of 49 fire sprinkler heads. Owner: Contractor: SMART & FINAL FIRE SYSTEMS WEST INC 600 CITADEL DR 600 SE MARITIME AVE#300 COMMERCE, CA 90040 V! lr:OUVER, JVA 98661 Phone: 323-869-7591 360-693-9906 Phone: 360-693-9906 Reg #: LIC 49732 FEES _ _ REQUIRED INSPECTIONS _Sprinkler inspection _ _ 1 Description Date Amount p P Sprinkler inspection (1t I I.U] permit Fee 10/7/02 $139.30 Sprinkler Final "F'AX] 89i6 State Tax 10/7/02 $11.14 Final Inspection FI-S] FI-S Pin Rv 10/7/02 $55.72 Total $206.16 This pet reit 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 copy of these rules or direct questions to OUNC by calling (503) 246-6699 or 1-800-332-2344. Issued g•,• -- .. Permittee 3ignz:ture: ]_ ==' ------ Call 639-4175 by 7 p.m. for an inspection the next 1 r� Z/ 0 a_ Building Peri�nit Application City Of ri'Igdrd Datereceived: // �'�' Permitno.: V// Address: 13125 SW Hall Blvd,Tigard,OR 9722.1 Project/appl.no.: Expire date: City of Tigard g - Phone: (503) 639-4171 Uate issued: Receipt no.: Fax: (503) 598-1960 Case riileno.: Payment type: Land use approval: I&2 family:simple Complex: TIVE OF PERNHT U I & 2 family dwelli•ig or accessory pCommercial/indusinal U Multi-family C]N,-,w construction U Demolition Add ition/al tcration/repl.tcement Tenant improvement ja 1�ire sprinklet(,alffm U Other: -_ r INPOANIAtION Job address: no.: Suite no.: Lot: I Block: Subdivision: �- Tax map/tax lot/account no.: Project name: C y l I � Dereription and location of work on premisestspecial conditions: AVV . F-t T-c g t , P t-Lx-g- l- SPe- c-3 --T . 1 Name`p.' - 1 ��J�i-�.dL_L� - , Mailing address: I &2 family dwelling: City' Lir State:., 1Y1 I ZIP:elgiOS _ Valuation of wo-k........................................ S-- PhoneAz-5 y Fax: -.mail: No.of bedrooms!baths................................. - Owner's representative. Total number of fk�,rs................................. Phone: Fax: E-mail: New dwelling area(iiq.ft.) .......................... 11 W 611 WON Uaragelc:trport Pica(sq.ft.) _ - Name: F ll�G �„t Sih►>IS �► Covered porch area(sq.ft.) ......................... ---- Mailingaddress: r Q- Deck area(sq.ft.)........................................ ---- -- City: Ou State:! ZIP:e` ,b J Other structure arca(sal. ft.)......... ............... --- - Phone3&(>t'r << [ l Fax: E-mail: Commercial/industrinUmulti-family: il Kiwi diwo Wil! Vpluation of work............ ........................... 3----- Business name: tg Lr S ; j�7`-r 5 wA"1 i Existing bldg. area(sq. ft.) .......................... Address: -- New bldg.area(sq. ft) ................................ ---------- -- -- . City: State: ZIP: Number of stories ...................................... : Type of constitution.................................... Phone: FaxE-mail: —--- -- CCB no.:q '1 Occupancy group(s): Existing: New: _ City/metro lie.no.: Notice:All contractors and subcontractors are required to be t licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work i:being performed.If the applicant is : ZIP: exempt from licensing,the following reason applies: City: State Contact person: Plan no.: - -- -- Phone: I a F-mail --- — Name: Contact person: Fees due upon applit:ation ...........I............... $ Address: --- -- Date received: -----_---__-_-� ._--_- City: __ State: ZIP: Amount received .............................. .. . ..... S-.- Pllore: Fax. E-mail: Please refer to fee scl edu!e. _ I hereby certify I have read and examined this application and the Na.;i junui,uons accept credit cards,pie is call junsdicuon for more intrxmatiwi!— attached checklist. All provisions of laws and ordinances governing this U'Asa ❑AasierCard work w;ll he complied with,whether specified herein or not. Cted.t card number _ __ .___1 / _ r:pires Authorized signatufG-,..Lls� Date: 1,,'4 L Name of s,nIT.lder u shown on ctedii card Print name �iY�. ��- 5��A�- ,'r.5c ---_- -- ---- s- --- %:dholder signature Amount Notice:This permit application expires ife permit is not obtained within ISO days after it ha-been accep^d as complete, 440-4613(&WCOM) CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP 'f; Received _—_ u Date Requested_— �_I'1- AM__ PM_ BUP Location _ ,�J --G'-� _ Suite __ MEC -_._-- Contact Person ___ - 4 ':— Ph( 9731 7172- yQ3 / PLM Contractor __ Phi( ))/r� ' SWR — BUILDING - ienar /Owner -_ -�r`�� ELC Footing E L.C Foundation Access: F',g Drain ELR Crawl Drain r;lab Inspection Notes: SIT Post&Beam __-- Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - - - Insulation Drywall Nailing -- -- _------- Firewall -Firewall Fire Sprinkler -- --_-_-.-- Fire Alarm Susp'd Ceiling - Roof Oth :---- - -- _ L_PAR7 . FAILPLUM91NG _ - Post&Beam -- Under Slab Rough-In Water Service --- - - Sanitary Sewer Rain Drains - - Catch Basin/Manhole Storm Drain - -� Shower Pan Other. - -- - Final --- -PASS PART 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 G1 Reinspection fee of$___ rec,uired before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE - [� Pleasr call for reinspection RE: —. _ Unable to Insi.ect-no acce-,s ire Supply Line ADA _119 '7= te Approach/Sidewalk r Inspector Other:_ / Final DO NOT REMOVE thiiii Inspection record from the job site. PASS FART FAIL ITAN REVIEW OVERVIEW FOR S,QVICE ALTERATION RD & ADDITION @ 11745 SW PAC 'This project involves changing, out the existing 6t)OA CT enclosure to an 800A terminal can and installing (2) new CT enclosures to accommodate the existing 600A service (for Cash & C trry), and a new 200A service for a newly created vacant tenant space (see copy of site drawing).i PGEe details of the service upgrade have been successfully worked of he addition ofa CT enclosure for the new 200A service will allow remote meter grouping to satisfy PGE's requirements. This arrangement also allows the grouping of service disconnects in the same room (see floor plan attached). There will be five service disconnects for the Cash & Carry project (previously permitted separately), and the new disconnect for the vacant tenant space. Load Summat;, for the building is as follows: CASH & CARRY Panel"RP" 0.9 KVA Panel""Sl" 77.3 Panel"PI" o i Panel"112" 37.8 Bailer 12.5 (est.) Panel"IIVA("' 140.0este SUB-TOTAL 129.8 KVA connecter+ load @480V 3-phase (517A) VACANT TENANT SPACE Vacant I cnant Panel=`'rl I I ',9 KVA esti SUB-TOTAL 132.9 KV A connected load(d�480V 3-phase (160A i TOTAL BLDG SERVICE TOTAL r, ' H.\ \ onnected load (a) 480V 3-phase (67"A', Respectfully subml ed, CITY OF T113ARD Approved......7f.r........ ... . ..:..... . . ...................I ,^ CondIllonally Approved ..........................................i ) work as desaribeo In: PERMIT NO. Royal.Stearns see letter to:Follow . ........................................... .( I #46IG-S Attach................................................ Job Address: 11 `�- �� N 75- � r a Q � LL� � � v 0 Jt .•r � � o lja = s Z lb LO ►� iC 4A CL d• - N N 00 r--- - A vrA ¢ R t` $ . ��(� L� N I J Z o t- VILU u B Z - z kA H t. 4 in / p r4 W � OC:T-04-2002 0(:.38 F RLJN:(L)I I tHPI 1 U-Je,.301+1+,�Ll -- POA10110 GM10rM EkCOfe CanpenY MEMORANDUM 10I04/02 TO: CONTACT, PAULA ELLIS WNW EI FCTRICAL SPEC — PHONF 503.844A788 _ CUSIOML14 NAMECASH b CARRY UNITED GROCERS ADURLSS 11745 SW HWY 99, TIGARD FROM: PGF: FNGR MILO STARTi 603.570 4414 - _. SUBJECT: 3-PHASE SECOr1DARY LINE-LINE FAULT CURRENT(RMS TRANSFQRMER_DATA XFMR Impedance(%) _1.4 % RADIAL NETWORK TRANSFORMER SIZE: 600 KVA XFMR 7 No Secor -1ary VOLTAGE(L to L):�— 480y WYE - VAULT-„�A T ','gLQole --> P01e SECONLIAF�Y; s4e*yd�jy*m LENOTH; 0 Fust WIRE SIZE Number Runs)of: 350 QX Secondary WIRE Resistance A: 0,0600 Ohmo/1000' II Seconda VIRE Re+4ctanca X' 0.0330 Ohms/1000' __ 1 VAULT_ tor_Polel_> PANEL SECONDARY (or Svc DrQDJ Service Wire LENGTH: _ 270 Foot WIRE SIZE Number of Service RUNS: 3 Run(s)of: 1350 Q Service MARE Resistance R. _0 0600 Ohms/100r1' Service WIRE: Reactnnu) X 0 0330 Ohms/1000_ FAULT CURRENT: 19,029 An ps (or 9ii0R1'CIRCUIT CURRANT) RMS Symmetrical (or INTERRUPIIN(3 CURRENT) Basest on a panel size of- 900 Amps I fo P.ri't'* Pegs:"Ctr!M"and choose"Print s-Phage Data" I!TLAn tri Wa,+If kMWW@ n (:OnYlROd b E.cel W Amen".mnibwi.WE r CnnKfty Iris-Im 3 CA 5 K �A�� / ��vIc. At:7,FR4 'Tlon4 2ooM L411 o ur .......... Y.I tT.) !J 1c.vi CT -_--- I � / N E UJ 2 rj0,4 EX IS'r CT ° mvP 1 l\1 E W ;znoA ru icD mow. I I ✓C,At,F, �2 CITY OF TIGAR.D - PLUMBING PERMIT _ DEVELOPMENT SERVICES PERMIT#: PLM2002-00392 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/17/02 PARCEL: 1 S136CD-01000 SITE ADDRESS: 11745 SW PACIFIC HWY ZONING: SUBDIVISION: BLOCK: LOT: --__—�_---_. JURISDICTION: CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE 'TOME SPACE .,. TYPE OF USE: COI`A WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES _ LAUNDRY TFAYS: SF RAIN DRAINS: — SINKS: 2 m� URINALS: 1 GREASE TRAPS: LAVATORIES: 4 OTHER FIXTURES: TUB/SHOWERS: SEWEr LINE: ft WATER CLOSETS: 3 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of all new fixtures for new grocery store. --- FEES Owner: Description Date Amount SMART & FINAL I I'LUMt3I Permit Fee 10/17/02 — $315.40 600 CITADEL DR I PLUMB] Permit Fee 10/17/02 $0.00 COMMERCE. CA 90040 11'LMPLN I flan Review 10/17/02 $78.85 I'LMPLNI flan Review 10/17/02 $0.00 Phone 1: 323-869-759I ITAX]W,.,State Tax 10/17/02 $25.23 [TAX] 8%.State Tax 10/17/02 $0.00 Contractor._ � -- Total $419.48 THREE RIVERS PLUM3ING INC; 142.5 ALABAMA ST STE F LONGVIEW, OR 98632 REQUIRED IN3wEC'I0NS Underfloor/Underslab Phone 1: 360-425-5171 Top-out Insp Reg#: LIC 148667 Final Inspection !'LM 37-526PB 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 riot started within 180 days of issuance, or if work is sus peiided for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Issued By: >cr c Permittee Signature: Cali (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building; Fixtures Plumbing Permit Application Date received:& 7 G 0- _ Permit no.hyma.ec, ; City Of j igarttl Sewer permit no.;s&)iji A_eVa8 Building permit no.: AJdress: 13125 SW halt Blvd,Tigard,OR 9722 City of Tigard Phone: (503) 6394171` 4 Project/appl.no.: Expire date: .fooi._Iz5, �1 tNa> _ Fax: (503) 595-1960 t�kP 9�oR-00 l &Tri Date issued: By: Receipt no.: Case file no.: Payment type: Land use approval: -- TYPE OF PERMIT, �\ U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvemr;nt. U New construction U Add ition/alteration/ieplacement U Food service U Other: II SITE INFOW�IATION1 Description Qty. Fee(ea.) Total Job address: LJ PA C~ Neh 1-and 2-family d"ellings only: Bldg. no.: Suite no.:_ (in(ludo 11111 ft.for each utility connection) Tax map/tax lot/account no.: SFR(1)hails Lot: Block: Subdivision: SFR(2)bath Project name. n�l <;G At-{�t� - SFR(3)bath i Each additional bath/ktchen City/county: %,f4;8f4 ZIP: �_ l Description and location of work on premises: J Siteutilities: Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain Footingdrain(no. lin.fl.) PLUMBING ONTRACUOR Manufactured home utilities r Business name i 1/�;',Sr./�'+ ;l- Manholes Address: Rain drain connector City: 4.0 ZIP: 9 13 , 3 Sanitary sewer(no.lin. 11.) Phone: , Fax: y E mail: Storm sewer(no.lin. R.) _ Water service(no. lin. fl. CCB no Plumb.bus.reg.no: Fixture or item: City/metro lic.no: Absorption valve Contractor's representative signature: Back flout preventer Print name: Date: D ' Backwater valve __ Basins/lavatory. Clothes was,e� r Name: Di,hwasher Address: Drinking lountain(s) City: State ?IP: Ejectors/sump Phone: J Expansion tank 1 Fixture/sewer cap floordrains/floo. sinks/hub Name(print): ��ty� Y 1Nf11, r3aroage disposal Mailing address: 1.06 -tllose bibb C —1-- StateZIP: makeritr c Phone: I Fax: I h.-mail: Interceptor/grease trap Owner nstallatioii/residential maintenance only- The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain commercta employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)( G� Z i� • " _ Otsncl's Si•nature: Date: I Sump KPI Tu.)s/shower/shower pan_ Urinal Name: _ _ _ _ V'7tercloset Address: _ �_ W ter heater ___" _ City: — _ State: ZIP: Other: Phone: Fax: E.-mail: _ Total Minimum fee.... ....... E NM all jensdictions acceq credit cards,plestr call junrdtcuon for mm infomt•tlon. Notice: This permit application r R 0 7 F Plan tevtca(at�= /o) � U Visa U Mastercard expires if a permit is not obtained State surcharge(8%).... E 0, Credit card t,umber —• --lwithin 130 days after it has Mien _ acceded xc complete. TOTAL........................ E . Name of cardholder u shown on ere it card tafres p _ S 1101616IQtx1C0�t Cardholder signature Amount CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00283 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/8,'02 PARCEL: 1 S185CD-01000 SITE ADDRESS; 11745 SW PACIFIC H'vvY SUBDIVISION: ZONING: BLOCK: LOT: _ JURISDIC TION: TENANT NAME: CASH & CARRY USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: TYPE OF USE: COM 140. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: 5 EDU sewer increase. All previous plumbing fixtures were capped at this location. Previous EDU billing ratn was 4 EDU's, this permit adds 72 value units, minus the 64 value units to be credited ftoju ltu demo, differance is 8 value units. Owner: — _.— FEES SMART & FINAL Description Data Amount 600 CITADEL DR COMMLRCE, CA 90040 jSV,*USAJ Swr(`onncct 10/8102 $1,150 (ii) Total $1,150.00 phone: III-M9-7591 Contractor: Phone: Reg #: Required Inspections__ _.__ This Appli ant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the, accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer' perm Iss d by: -- — Pf rmittee Signature: .1 Call (503) 639-4175 by 7:00 P.M.for an ,nspecticn needed the next business play Accumulative Sewer Tally Tenant Name: Cash& Garry - This SWRA 2002-00283 _ Site Address: 11745 SV" Pacific This PLM# 2002-00392 Fixture Value Previous Previous Credits Capped =ixture Feature New New # value capped off vaiue added added total total count off#S count tt value #s values Baptise /Foy t -4 _ 0 0 0 - 0 G - Bath- Tub/Shower 4 00 0 - 0 0 Jacuzzi/W h,.lpooi 4_ -0- - —0----- 0 0 0 Lar Wash - Each Stall 6 U 0 0 0 0 -Drive through- 16 0 0 0 0 - 0 Cuspidor/Water Aspirator 1 -0 ---0--- 0 0 0 - Dishwasher-Commercial 4 0 0 - 0 0 0_- -Dorrastic 2 0 U - 0 0 0 - Drinking Fountain - 1 0 0 0 0 0 Eye Wash 1 0 0 _ - - -- 2 ''• Floor Drain/Sink - 2 inch 2 0 p 4 2_ --- --- -- 3 inch 5 _ 0 0 6 30 6 30 - _ 4 inch 6 0 - 0 - 0 - 0 0 Car Wash Drr 6 0 0 -- 0--- 0 0 Garbage Disposal - -Domest,c(to 3/4 HP) 16 U 0 -� 0 0 G Commercial (to 5 HP) 3,2 _-_ 0 0 0 0 0 - Industrial (over 5 HP) 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 Durrip station 16 - 0 0 0 0 0 Shower-Gang (Per head) 1 - _ 0------- 0 - - 0--- --- 0 0-- - -- -Stall 2 0 0 - --- - p _0 --0 Sink-Bar/Lavatory2 _0 0 d -- Bradley -. 5 ---..o --- -0 -- - 0 --0 _ Commercial 3 _ ro --- 0 -- 0 0 - 0 _ Service 3 _ 0- 2 - 6-- 2 6-- Swimming Pool Filter -1 0 0 0 0 Washer-Clothes - 6 - 0 0 ----0 0 Water Extractor - ---.-6 -- - 0 _ 0 0 0 -_ Water Closet-Toilet 6 0 e- 3 18 3 _ 18 Urinal 6 0 -- 0 1 --66 - Previous EDU Count 0 0 C�iroed EDU Credit 4 TOTALS f 0 (` 0 U 18 72 18 64 8 Current Fixture Value 8 divided by 16 0.5 Current EDU 1 LDtI $2,300.00 Previous Fixture Value 0 divided b', i6i= --.0.0 -Previous EDU Change 8 divided by 16 = _ 0.5 over (under) $ ',150-00 Enter EDU Change Here 0.5 __ HISTORY Notes:Per Amanda,4 EDU's PI_M# - EDU# SVR# PLM# EDU# SWR# `--- EDU# SWR# PL N1# •�, - ( Name: Date:- j�ismqu ature o person that calculated this tally sheet and date perfrorred CITY (317 TIGARD T�� ELECTRICAL E - RESTRICTECTED D ENEERR GY DEVELOPME14T SERVICES PERMIT#: ELR2002-00277 13125 SW Hr,il Blvd.,Tigard. OR 97223 (503) 639-4171 DATE ISSUED: 12/4/02 PARCEL: 1 S 136CD-01000 SITE ADDRESS: 11745 SW PACIF IC HVVY SUBDIVISION: ZONING: G G BLOCK: LOT: JURISDICTION: TIG Proiect Description: Low voltage system for sound systemA.RESIDENTIAL B.COMMERCIAL_ AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OU rDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE. SIGNAL: INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS_ 1 Owner: _ Contractor: SMART & FINAL MUZAKLLC 600 CITADEL DR 12402 NE MARX (70mMERCE, CA 90040 PORTLAND, OR 97230 Phone: 32:3-869-7591 Phone: 254-7400 Reg#: I IC 142760 I I. 26-105 ( I 1 \11 1 00006434 —� Required Inspections F F E S Re- ------ - -__-g -- ---1 Descriptia i Date-_-� Amount Low Voltage Inspection I [ELPRM �� 1.1-R Permit 1214102_ $75 00 E!ect'I Final "' [TAX State Tar 12/4/02 $6.00 Total $81.00 L� 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 Utility Notification Center Tho,e rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direcyque tions to OUNC at (503) e46-6699, Permittee Signature,, Issued by f -L t_ l._ - �� I _ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, cr rent. OWNER'S SIGNATURE _ _—___ DATE: CONTRACTOR INSTALLATION ONLY ------- SIGNATURE __-___SIGNATURE OF SUPR. El EC'N 1 L41 1- ._ DATE: __ LICENSE NO: _-_ ----- - -- ---- ---- - Call 639.4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application [Date rrcccivecl: Permit no. ) Cllty Of TigardProjccUappl.no.: Expire date: try ),r1 Address: 13125 SW Hall Blvd.Tigaid,OR 97223 Phone: (503) 639-4171 boteissucd: ny:Lj.� Receipt no.: — — Fax: (503) 598-1960 Case file no.: Paymenttype: Land use approval: _ U I &2 family dwelling or accessory &C. olnmercial/industrial U Multi-family U Tenant improvement U New construction LI A(l(iitit)n/alterati,)n/replpcemcnt J Other: U Partial Job address: /-7 Ll 5 Sh./, / r., wX Bldg.no Suite no.: ITax map/tax lot/account no.: Lot: I Block Subdivision: Project name: C95/ f Lq/Zg Description and location of work on premises: sONti J SE'S r/e�L 1 lstimated date of comp coon/insf>ecfiun: __. A-ON-1141ACIOR APPLICATION ) Job no: Business(lame: N N Z� �y - — t)escriplina Qh. (eaJ lot:d no.tnsp Address: /r 'l e Z N,r_ 1 r� S r Ne"rrsidcnrial-single or ronlli-ramify per _ dwelling mill.Includes anactwifgarage. City: pere-f v e) SlatC:p/L LIP: '1 7 Z 0 Se"Icehncluded: Phone: o j_2 N--7yoo Fax: C-mail: 1(x)0 sq.fl.of lesF 4 CCB no.: / y Z �pQ Elec.hus.lic.no: L p S Bach additional.300 sqft.or portion thereof b Limited energ),residential 2 City/metrolic,no.: I =, x'11 Limiec<lenergy,non•residenlial 2 y-0 Z I ach mmnufact ured home or modular dwelling Sig"Purt!MAtioMsing electricia (required) I h Service and/or feeder 2 Sup.elect.r:dnne(print): Ct { V`-r(_ ., ?/Z Lri- Services or feeders-Installation, PROrERTY 1 alferation or relocation: 200 imps c r less 2 Name(print): 201 amps to 400 amps 2 Marling address: -�^— -�— 401 amps to 600 amps 2 601 amps to 1000 amps_ 2 City: Slate: 'LIP:^ Over IWK)amps or volts 2 Phone: ax: Ci-mail: Reconnect only 1 (honer installation:The installation. :-being made on property I our Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Ins(allotion,alteration,orrelocation: ORS 447,455,479,670,701. 200 amps or less 2 201 annps to 41M)amps 2 Owner's SIn71lUIC: Date: 4PIlo6(Mlamps _ 2 Branch cirtuits-new,alteration, or extension per panel: Name: A. Fee for branch ciredilr with purchase of Address: service or feeder fee,each branch circuit 2 City: H Fee for branch circuits without purchase - — - of service or feeder fee,first branch circuit: 2 I'Itnrtc: I ,t� i, mail' Each additional branch circuit: ' IK I IM Mr. U Service over 225 amps-nnumrrn;.l U Ilealth can:tacilny Each pump or irrigation circle _ 2 U Service over 320 amps-rating of 1&2 U Hazardom,location Each sign orouthne lig[it fig ?' family dwellings UBu!!dingover IC,WOsquarefeet four or Signal circuit(s)(it alimited energy panel. U System over 6(x)votes nominal more residential units in one structure aileration,or extension' 2 U Building over three stories U Feeders.400 amps or more •Desch tion: 1 k Ll U Occupant load over 99 persons U Manufactured structures or RV park Each additional Insper tion oser the allowable In any of the above: U Egress/lightingplan U Other _ per inspection Submit—sets or plans with any of the above. Investigation fee _ The above are not applicable tr,temporary construction service. Other Not nil jurisdictions accept credit cards,please call jurisdiction fa mote information Notice:This permit application Pertr;t fee.................. ..$ U visa U Mastercard expires it'a permit is not obtained Plan review(at _ %) $ c'redu card number. _ �._ within 180 days afle it has been State surcharge(8%)....$ - -- —�'-� Norm of colder a,shown on credit card Esrdres-- accepted as coinplett. TOTAL. ......................$ c C) _ S Cardholder signature Amount 440415(6M COM) - ELECTRICAL PERMIT- CITY OF T I G A R D ' RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2002-00290 13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 DATE ISSUED: 12/10/02 PARCEL: 1 S 136CD-01000 SITE ADDRESS: 11745 SW PACIFIC HWY SUBDIVISION: ZONING: C G BLOCK: LOT: JURISDICTION: TIG Proiect Desnription: 2 Low voltage systems. Data cnd Refrig. controls A.RESIDENTIAL B.COMMERCIAL AUDIO & STEP.EO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: hIVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: REFER CONT X ��—� — ----- TOTAL.#OF SYSTEMS:, 2_ — Owner: Contractor: SMART & FINAL NW ELECTR CAL. SPECIALTIES 600 CITADEL DR 2110 NW ALOCLEK DR COMMERCE, CA 90040 SUITE 609 HILLSBORO, OR 97124 Phone: 123-869-7591 Phone: 503-844-4788 Reg #: 1 1.E 24-4500 1 I 12;328 _ SUP 46225 FEES ~- —_ Required Inspections _ ------- — — - -1 Description Date Amount Low Voltage Inspection Low Voltage Inspection �ELPIt�t l I I.Iz I'cn;ut 12/1 n,'92 $150.00 Elect'I Final [TAX) 3 SLatr l ay 12110/C2 $12.00 Total $162.00 i his Permit is issued subject to the regulLtions contained in the Tigard Muniap3l Code, State of OR Specialty Ccdes 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. ATT ENTION 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 or direct questions to OUNC at (503) 246-6699 / Issued byO �/l !}�; Permittee Signature d'Y2 2,U11'& ('-A't �Y'--_,— _ OWNER INSTALLATION ONLY — ` The installation is being made on property I own which is not intended for sale, lease., car rent. OWNER'S SIGNATURE: _ -----__--- ---. DATE:______ __. CONTRACTOR INSTALLATION ONLY SIGNATURE Or SUPR. ELEC'Nc_!1 _' DATE:__ LICENSE N O: 4/,A '-) ------- —----— --— -- - Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 12/09/2002 01j:40 5038449529 ll!' PAGE 02 Electrical Permit Application .. RECEIVED L`atcrcccrvcd 1'^rmnno. A k City of 1 �galyd Project/appl.no.: Expiredate: City ofrigard Address; 13125 SW Hall Blvd,Tigard,OR 97223 DateIs,ued: By t Receipt no.; Phonc: (503) 639.4171 DEC U 9 2002 Fax; (503) 598-1960 Case file no., Payment type: Land use approval- — CITY C)F fl}ARD n 1 &2 family dwelling or accessory I(Commerci"Vindustrial D Multi-family f Tenant improvement U New ccstruction U Addiuon/allcrntion/rerlacemcnt D Other: O partial / t Job eddrrss /� � K3 11T, m I wits no., Tax map/tax lot/account no.: Lot: Block Subdivim : —� T pro ret name: - _ Description and location of work on premises Estlmated date of completion/ins c ,n: CON ' 1 I1. Job no: —5 �r,0 Ccs NI a% Y`— Iksctiptinn Qty. (!a) Total no.insp Husincss name Nw t• o, �,nnni alties f r N!w rowitrmtial single or madtl- omiiy per Address; 211 0 NW A l oc 1�t'�f Ir... Qom_ dwelling unit.Ino ludta altachedparage. city: State'. ZIP• Scni«included; Phone: 844 . 4788_1 Fax 9 522 E-mail: 1000 sq.ft.or Iexa CCB no.: 121328 Elec has. 1. no: 3 4 5 0 C Each additional 100 sq.ft or portion thereof _ • Umitcd energy,residentinl 2 City/metro tic.no.: 00004899 _ 1-imitcd energy,non•residenual Each mnnufnemred home or modular dwelling, SI natu n s rvt ng c can 12quirc!t Dotc Slrvicc and/or feeder 2 Srrvice$or feeders-installation. Sup,elect.name(printt f,.1 I n: n+c n° t alleralionorrelocation: t 'iil t7, '100 amps or less 2 Na�(printyNowfiN 201 nnipx to 400 snips 2 Mailing address: 401 nmpe to 600 ams 2 601 nmpe to 1000 erops 2 Statel?Q 7.IP; Ovcr 1000 amps or volts 2 Phone: Fax: I E-mail: Reconnectonly 1 Owner installation:The insta:ltlitivn is being made on property I own Temporary ltrtaltUservices or feeders alrtnnon,oreelocaltun: which is not intended for sale,lease,rent,or rxchangc according to 200 smpn jr less 2 ORS 447,455,479,670,701. '201 amps to 400 nmpi 2 Owner's si nature; Date: _ d01 to 600 amps — 2 Branch circuits•new,alteration, or @%tension pct panel: Name: /VA _ _ a_ A. fee for branch ci•cuits with purchase of Address: smtct it feeder fp.,each branch circuit 2 City: _ _~Y state.. zip! n. Fee forhraich circus,;without purchase of service or feeder fee,forst hranch circuit: 2 Phnnr: Fix li rnril Eachaddidona.bramhcircuil: �t Mist.(Service or t,.tder not Inclndcdl: J Srrvocaovri is amps-cnrRmrrciul f]1•len11114;nrefMLilit) flchpumporitngetioncirete _ 2 U Service over 320 amps-rannR of 1 R2 U Naurdous lonatlon Eact,61n or ouili—lighting 2 fardlydwcllings r]Building over I0jW square feet fouror Signal c:rcuit(s)err it hmiied energy panel, �t C]Syvtemovcr600volwnominal mom residential units in one structure nileration,orexl:neinn• cX 2 ❑Ruilding over three stones U Pecdcrs.400 amps or mote *Description: U Occupant load omen 99 petwns f]Manufactur"I s,ructumi or RV park Each additional Impectlon mer the allowable in any of the attovt: O Eg rest/lighting plan Q Other — per ins ectinn Submit_eety of plata with any of them bove. Invemliation kc _ L�te above are not applicable to ternpontry cnnstraetion ttexrice. Other NM all jurisdictions scmTt eredit cads,please call judrEiclian far mors infnnnatinn. N'.tice'.This permit application Permit fee.....................$ — 0 visa Cl MasterCard eximims If a perrnit is not obtained Plan review(at ,_„_ %) $ Ill Cradat cod somber. �._ wilt,In 180 days ager it has been State surcharge(8%) ....$ accepted as complete. TOTAL, .s Neale u s an t cord -- CstdbWder dgnanus Arount� eart.th i 1,aUOn'�M) CITY OF TIG/ARD 24-Hour BUILDING Inspection Ling:: 1503)639-4175 MST - INSPECTION DIVISION Business Line: (503) 639-4171 BLIP - - --- Received _._.-___:--____ Date Requested___-� ` oZ 3- AM--- PM BUP - Location l i -7 Suite---- -- --- MEC - Contact Person _ �'� __� Ph(. ` no 2_2_�.9 c' PLM __ Contractor —_ -__ __ — Ph SWR _----- BUILDINGTenant/Owner ��oK-ti --. ELC - - Footing - _- E. C Foundation PSS: ELR Fig Drain Crawl Drain '— SIT Slab Inspection Notes — Post&Beam Shear Anchors Ext Sheath/Shear - T i Int Shea'h/Shear Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler ` =- Fire Alarm Susp'd Ceiling Roof Other. Final PASS PART FAIL PLUM_BI_NVI _- - - Post&Beam Under Slab Rough-In Water Service -'-�- - - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pen Other Final PASS PART FAIL MECHANICA c_ Post&Bearn Rough-In Gas Line Smoke Dampers Final _ PASS PART FAIL ELECT RICAL _ __-- Servica Roug)-In - -— UG/!flab Low Voltage -- - - --- - - -- Fira Alarm Reinspection fee of$ _ nrquired before next inspection. Pay at City Hall 13125 SV/Hall Blvd. A ) PART FAIL 1 SITE J F] Please cell for reinspection RE:_—___ __ L! Unable to inspect-no access Fire Supply!_ine —_ Approach/Sidewalk Date -�J,L. 1 Inspector _ __ Ext__— ADA Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL RMIT- CITY OF TIGARD _ ELECTRICALRESTRICTED ENERGY RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2002-00301 13125 SW Hall Blvd., Tigard. OR 97223 (50.3! 639-4171 DATE ISSUED: 12/15/02 PARCEL: 1 S136CD 01000 SITE ADDRESS: 1174.5 SW PACIFIC HWY SUBDIVISION: ZONING: C-G BLOCK: LOT: JURISDICTION: TIG Proiect Description: Installation of burglar and fire alarm. A.RESIDENTIAL B.COMMERCIAL_ AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: H!AC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: BURGLAR X TOTAL #OF SYSTEMS___:-' Owner: ^v Contractor: SMART" & FINAL SECURITY PROFESSIONALS LLC 600 CITADEL DR 13023 NE 99 STE 7PMB198 COMMERCE, CH 90040 VANCOUVER, WA 98686 Phone: 323-7369-7591 Phone: 360-574-5329 Reg#: LIC 133914 IiLI'. 37-832( I I' St'P 3395LEA -- FFES Required Insrections Amount Low Voltage Inspection Description Date Low Voltage Inspe.,tion (ELI-I0/11'1 ElLR Permit 12/19/02 $150.00 Elect'I Final (TAX( `3" State Tax 12119/02 $12.00 Total $162.00 This Permit is issued subject to the regulations contained in the Tigard Municipai Code, State of OR Specialty Ccdes 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 issL-once, or if work is suspended for more than 180 days ATTENTION Oregc n law requires you to foliow rules adopted by the Oregon Utility Notification Center Those piles 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 b j �;. /c, Permittr . Signature OWNER INSTALLA T ION ONLY-- The NLY _The installation is being made on property I own which is not intende 1 for sale, lease, or rent. OWNER'S S!''lATURE: - DATE:.—_ CONTRACTOR INSTALLATION ONLY _- SIGNATURE OF 3UPR. ELEC'N c' _ DATE: LICENSE N O: ` L ` -.) I /_A --- ---- ---------- --- -- - ----- _ Call 639-4175 by 7.00 P.M. for an inspection needed the next business day FROM : SECURITYPROFESSIONALS PHONE NO. : 360 571 8715 Dec. 16 2002 01:59PM P2 1:/1812002 12:49 FAX 8036981900 rITY OF TIGARD 12002 4 • r Electrical Per. P "ca r L,, Datonweivea: Pcrnut nn. 4 a Tigard l City of , igard ��-t� � �\.P��N• t M)Wt/appl,n0.. - Expire dale.: Addicss: 19125 SW I"Tall 81vd. r:iry ur'1 i trd kp l Date issued' Uy: - IiecClpt n;.. Phone.: (503) 639-4171 Fax: f503) 596-1960 ��p�N case flien�•• Payrnenttype: 14ind use approval: r.f D 1 8 2 fainily dwelling or accessary )ACo inerclal/industrial 0 Multi fat 0 Tenant improvernent 0 New cunbtruWon U Addittrnt/alteration/repincctnrnt U 0111r-r: 0 Partial jolt SJ'1*17.IN111101ATION 1w ]tib addreas: If l T q `J f _ 'az a T--re.r 131d� n� o tiuitc nu.- TUt LM tax loUacoauat p0.: Lan: Block: Subdlvloi—�— � � - -- -- Pmjeet name: �'t>` IrG�t a.A.- Tle_�cripUon and location of work on premises: /T- J CT ^d Fstirriated date of corn letion/inspection: JQi,t10t F'rr Malt 13usine"nam�e: <_ 77 K. _•y (L Dtrscripriem Qtv. (ea) Yo .Imp �1 IY61Y t4 1 LDW)e m nnrlli fRM1ty per t Addrrsb:��Q 13 U -�) � J tG dwilftbnil.lnu imusartar.Iteoi H-W<_ r,( vState:&)0_1 ZIp: - , (o >nwke :Lode& Phr,w 6,6 -47 5_�21 Frtrttl l' 1 :} 1000 srR or S CCR nu: ( r. / ^ ee.bits.lie.a 37' ✓1 t�ad'hnonal 500 sq.ft.or portion th t tdmiteda►ctg� •esidentf•.i 2 City/metro lic.no.: a'� l �' Wnited nergy,non-reaidentIST 1 E nutwtacnned Mind er modular dv 3i rmttiKe 6l� n elwtrlehn requ teal Due j G• cn 7- Service-1,or lease 2 Sup.cert pe m(pncty GI;r G� lie/tuenot�3`J'S� jA altCrstl�onernitrcatton:allufnn, 200 amps of lead — 2 Name(print): 201 amps to 400atului — _- 2 Nf,dli addtrsts: --- — _. — 40l amps to nW amp'._ .— 2 _ 60l amps t- City: I State: Im Over 1000 artuss or volts _ Phone: - - hax: E-mail: anectooiy Own"hmiallatiatr.Tito installation Is be+.dr imde on property I own etapanrY 5trviCm or fenders- whiCh 0 not intended fur!•file, Tease,r,.nt,ur exchange according to fttttallutwp.ahefptlon,nr trhKaflnn; 2�Xt nn,a or las 2 ORS 447,455,C'9. 701. I - .O.ami s w 400 antpi UW:th''S sl L1ttIr0' Darr+• _ 401 to i6M atups Om Brant It tit vii4w•at 19,atteitalion, or extemsion prr parr: Ntuae: 0 n_ r't'e for branch Ciratdts with purchasr.,f Address: w4ce of feedo,fer.tact,hrancli cit,At _ 1 Cj St-ate" --y-- - p or branchcucultawlthoutpurohrse of servto or ferAw fee,first brahe i eimlit: - PIIODC: ebaddtno4albtaneheamtie Mlle.( 'crvtce or ieedertW r-�-tud ): C7Setviaruva?1�anipxRutunenlal ❑}taalthdtretyclllly Each um erirricannn• rcle _ 2_ 6aeh al n a outlfpc Ittrtin _ O BtavlM pvet-120 antpynting of M2, ❑Ftsxmttoualxaeon �_� - — famllydwellinEa Cf9uildingovcr10,000squarefretfotoor 4tRualt:ilcuit(a)uralitrutadr gVpanel, USyttrtnover6mV✓Irswilillutl motrre-Wentialuniminone sWnua alterption,orextenaon• 2 - C3 sunding over Cime dories M Reedws,400 ampf or more •�pcti tion. __ - --_- __- U Ck:upMt load over no nwvtoik. U Mnnufartured advents or RV perk Incl,rdditiorrt nrvpmetltn over t rr nuowable in any off the above; U Eetaulligtaingplan G Ot ear: __ _ PerinsppCiion - _ -. F _.L- .l Subtait--_ wta of pts.s with arty of ttx above. Imestigacontu ��_ he allow and not applicable to 11mix-:• N:onumctiou eetsice, tither — Permit fee......... ...........$ Net an)ttt W done acmr tm&::.'.Se r1r7m call Mulfrtlre W t vmt hdormatlb• Notice:This permit application plan r1CViaW(at %) Via J Muttrc tM expires if*pttmit is not nhtained � !inch a $95 ,,..S -,T- w(lhin 180 days after it has bt;n � ( ) _ •� accepted SS nrnnrlC(C. TOTAL. ......... .............S oma drr M tb.•+ur+nn r.nrit CNd S `. -� `� f l Idu•4615(StONr'�M1 �'/mac Fe-as��k,G�4 c, ✓ y n CITY Q►�� T I G A R D --- ELECTRICAL PERMIT — PERMIT#: E' "2002-00501 ;_"A DEVELOPMENT SERVICES DATE ISSUED: 9/24/02 13125 SW Hall Blvd., Tiqard. OR 97?23 (503) 639-4171 PARCEL: 1 S136CD-01000 SITE ADDRESS 11i45 SW PACIFIC HWY SUBDIVISION: ZONi?(G: C-G BLOCK: LOT : JURISDICTION: TIG Proiect Description: Install 1 200arrio service and 13 branch circuits. RESIDENTIAL UNIT TEM_ P SRVCIFEEDERS MISCELLANr_OUS j •1000 SF OR LESS: 0 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 400 arrip. SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 awn: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps - '000 volts: MINOR LABEL (10): SERVICE/FEEDER "4 v BRANCH ClkC!!ITS__ ADD'L INSPECTIO_14S 0 200 amp: 1 W/SFRVICE OR FEEDER: 13 PER INSPECTION: 201 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ _ PLAN REVIEW SECTION 1000+ainulvolt: >=4 RES UNITS: �^ > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >= 225 AMPS__ CLASS AREA/SPEC OCC____ Owner- Contractor: SMART & FINAL NW ELECTRICAL SPECIALTIES (300 CITADEL DR 2110 NW ALOCLEK. DR. COMMERCE, CA 90040 SUITE 609 Hll.l_SBO,�O, OR 97':A Phone: 323-869-7591 Phone: 503-844-4786 Reg #: ELE 24-450C LIC 121328 SUP 46225 -EES Required Inspections Type By Date Amount Receipt Elect'I Seiviut. PRMT CTR 9/24/02 $153.•3:3 2720020000( Rough F Elertl Final ,PCT CTR 9124/02 x12.27 2720020000( Total $165.60 This Permit is issued subject to the r9gulations 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 wori, is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adop'ed by the Oregon Utility NoVication Center Those rules are set forth in OAR 952-001-0010 through OAR 952.001-0080 You may obtain copies of these rules ord rest qLe,'ions to 01 INC a;r703) 246-6699 or 1-800-332-2344 Permit Signature: lT \ Issued By: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, i.:dse, or,rent. OWNER'S SIGNATURE: ____ — DATE: _ CONTRACTOR INSTALLATION GNI Y SIGNAI URE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day 09/20/2002 10:5F 5038449529 11MIS.G PAGE 02 Electrical Permit Application rDatereceived-� p 2 Pcfmlt no. � -QrJ��l City of Tigard �� "� Projcctlappl,no,: axpircditc; Cir)�l Tigard Address: 13125 SW Hall Blvd�TlgltFd Z7R 97223 Date issued, 113y-4 I Receiptno.: _ Phone; (503) 639-4171 Fax; (503) 598.1960 i Case file no.. Payment type: Land use approval- 7N )M y dwelling or accessory Otommercial/i in• nal ❑Multi-family O Tenant improvement ction ❑Addition/altcraLun/rcplaccmcnt 7 Othcr. ❑Pilftinl $ "_ YQ, Bldg.no.. Suitcno.; Tax map/twx loUaccount no,: — Lot-, Blcxk: Subdivision _ Project nam_Z`p,rl of N��A �Dcsctiption and location of work on premises: Estimated oAt.c ')f com lc ttan'ins�pcc(to' t Job pot fcc Max _ _a y------- ---- i1_�:riplion 71- -T04,,qJ(t Tulal no.inaBusiness nitme; Newrmidend2l single o;mule famllyrer Address: 7.110 N% ,A1oclek DrCity: State; P' 4844. 4788 844 . 52 qPhone: Fac Email: Pesch additionr portion rhorwr CCB no.: 1 21 3 2 8 Elec.hos lie.nn: 3 4 .4 5 0 C Limited energy,reaidcndsl City/metro Hc,ro.- Q Q 4 _ _�_— Limited encr6y,non•residentinl 2 —ivEach mnmdnrtureJ home or modular dwelling patr_ Scrvicc andlor feeder Siginatu n s_ F7 nee roan(required)^_ _ Llccnacno Services or cede–inslallalionr Sup.elecr.,name iprimk Q Awl aIlcrsttion or relocation: WWWWMA1 200 amps or less 2 �A 201 amps to 400 amps 2 Name(print); i ft li siiYa _pAti NKLAS _.�rX, 401 amps to(nn amps ------ _ 2 Iv(tliling address; I Zo ' Lv 601 ams to 1000 am a City: -AyIlk State:CO• 21P. rs-(X. I Over 1000 amps or v 1!1 n Phone: Fax: I E-mail, Reconneclonly Owttcr insudli.tion:The installation is being made on property I own Tetnpenryservicesorfeeders which is not intended for sale,Icasc,rent,or exchange according to inrtallatrorr,nit ntinn,orrelecation: 200 amps of less _ 2 ORS 447,455,479,670,701. 201 amps to 444 amps _ 2 Owncf's %i niturc, Dalt; 4^1 to 600 amps_ 2 _— Prals,h NR dire-aPN,aitCMllen, or exicnslor per panel: Name: _ __ A. Fax for branch circuits wilt,purchase of 2 Address: — service or feeder fee,each h.,ulch circuit �o�05 City- of Sete: ZIP' B Fee for hunch circuits v�ithout purchase of scrvicc or feeder fee,Flrit hranc),cin un 2 Phone! fax: E•rtajl Eocheddidorslbranchcircuit hilae,(Service orfeeder r,ot incfuZd)i C1 Servi^e over 225 amps-commercial ❑Health•care fedliry Each pump or irrigation circle 2 2 ZI Service over 320 amporning of I AL 7 Hazardous location Each sign or outline lighten _J _ Earthly Mvellings O Building over 1o,00o square feet four or Signal circuit(s)or a limited cncrgy panel, -3 System over 6W volts nominal more tesidential units in one structure alteration,or extension' 0^utidingoverthree stnmes 0 Feeders,400 amps or more +Description: — O 0CLOriant load over 99 persons 0 Mant}factured structures or RV park FAch additieaal Impection user the itnoNahle in any of the above. 0 EgrevOighiingplan 0 othee __-_— Perlimpeclion Sublalt—"is of plans with any or the six,ve. Investigation fee _ nw above are not applicable to ferrtlrorary construction service. Other Permit fcc........... .........$ Not all jurss rdar accept credit cm*.clear.coil)urisdictwn for mote iah IM110on. Notice:This permit application �— 13visa ❑MasterCard cstpires if a permit is not obtained Plan review(at + elf,) $ -- cradii card,wrmhri: ._ _ within 1 SO days aR:r it has been Stme surcharge(R%)....$ aptrw accepted as complete TOTAL ....... ...............$ --�"irtre of wdbddrr.s sne.m nn credit c S Cardholder rignatare Amami UnJRIS f6rt1dCOM) v I T 1 OF T I G/"1 R D — ELECTRICAL PERMIT` PERMIT #: E:C2002-00357 DEVELOPMENT SERVICES DATE ISSUED: 8/1/02 13125 SUV Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S136C:1-01000 SITE. ADDRESS: 11745 SW PACIFIC HWY SUBDIVISION: ZONING: C-G BLOCK: LOT : JURISDICTION: TIG Proiect Description: Derno phase: D^rno existing elect. to prepare for new project. --- --- --I RESIDENTIAL UNIT _ TEMP SRVC/FEEUrRS _ MISCELLANEOUS _ 1001 SF OR LESS: 0 - 200 amn: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 an p: SIGN/L'UT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER _ _ BRANCH CIRCUITS _——_—_ __— _ADD'L INSPECTIONS__ 0 200 amp: W/SERVICE ^R FEEDER: 0 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FUR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 20 IN PLAN r: 601 - 1000 amp: PLAN REVIEW SECTION _ 1000+ amp/volt: _ >=4 RES UNITS: > 600 'JOLT NOMINAL: Reconnect onlySVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: SMART & FINAL NEW TECH ELECTRIC 600 CITADEL 6950 NE CAMPUS ST COMMERCE, CA 90040 HILLSBORO, OR 97124 Phone: not available Phone: Reg#: I0-6443t8*0 SUP 2113s ELE 26-418c. -- FEES _J R, --.d Inspections ^ Type By Date Amuunt Receipt Rough-in �5PCT CTR 8/1/02 --$14.39 2720020000( �lect'I Final PRMT CTR 9/1/02. $179.85 2720020000( Total $194.24 This Permit is issued subject to the regulations contained in the Tigp d Municipal Code Siate of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans Th.: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 OC80 You may obtain copies of these rules ordirect questions to OUIJC at(503) 246-6699 or 1-600-332.2344 Permit Signature- Issued By: JJ OWNER INSTALLATION ONLY —_ The installation is being made on property I own which riot intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE:— CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: ___ � ____—___�—_—.__._ _..— DATE:— LICENSE ATE:t_ICENSE N O: -- ----- _-- ------- - -------— ------- ----- -- -- Call 639-4175 by 7:OOpri for an inspection the next business day ata�ta� 07/26/02 THi7 14:35 FA.1 503 848 3131 NEW TECH ELE" lel ttn I Electrical Perinit1kyllification •— ---s ` --.t— Datereceived:,' I ) 2 perrMt no.:F_w- 00� 'G` City of Zllglru I F4oject/appl no.: l3xpiredato: - (•i•ynf'igr,rd Address: 13125 SW[jail M*d,Tlgari,OR 97229 D4to1saued:—__ BY:��', R iptnr,. Phone (303)6394171 Fax: (503)398-1960 Case file no.: - Payment type: Lznd use approval: ILI V111113 i> 1 Rc 2 family dwelling or accessory XComiru:rcinl/ittdust:ial U Multi-family l 1 1 cuhnl Imptovctnrnt Q New wrimuctiou U Additi(o/elteraiiutvteniatxmettr U Oilier:_ — — J partial 1 � Job�_� Ca e-i ��,, E;I'tg I; , _ Suite no.: Tax tnap/tax lodare cunt uo., Lot: Block: 5ulidivision _=�� --- �. DMdr don and location of work an pT-nilie6: I }intimated dr'^.of completinttiu►sperdQA_- � ca rt�y e #er n CtN r 11711.7,31yu1 1 [AM Jk Fm Klatt Job no: t7O�U -- IMsat_liar Lqy. (a�) lotal no.Ito I Ntilinessname: New Tech E_1_ectT-1C � „tit eb,x,wtur,�ayP_ AddtrAc C 9 5 0_N E C;z!n1u s W it y _ dwell6tg rmk rntlMn attAc'tr-d prce- City: f 111.15hn;U StatrUR 42; 97124 %M V;4 kK+1'r-+ 1000sy ft nrless 1'Iiodt03-648-1900 Fte)164T-31-31_ +Finall: FxhatWiuonalSoown.nrpnttionownicr CCB nn.: 16 8 - PJec.lrtr:.lie.no: 26-4180 u„�t�lnwtgy`reid�na.l _ C Pnt'ttro 11c,no.: _ urulimr.ar non•residentiel 2 Oxy -- '��Zy �Z F/ch manufactured borne ormtvlulrtdwelling _ a Cnl _;avior a, Vor leader sl _n[=n v cg ri clan npq�jirrd) nate Set�icr�ntlrYden-Irtatallatian, - — rJed tMrtr(phot):r' N �Z Lhsnseao' �Z -� altaauttgor telocatlM: I"ROMITV OWNER 2NO stn"or less c"^ _Name(print): �ha�';- rl G r:�- 401&2=as boo ampi _ z MW Lu j address: 1i^� 0 j, ' - - `C--0i�n , pt it,I(M at a StatP.:��L�: 9Oo-7 o�ltt00t1nnplorwfltr -- --- - - � 1 Phone. Fax. �F'Mail. utAUgdon is bring -Tet�orar7. rYke+orteeder.- 1 IwnPs_10�lution:Tit ��—_ R made an I7TbPe�h'I owe ��hl��•orrdnn►i°a 200.wlrf oc 1•is _ _ -- Post-IN Fait Note 7871 Date N o �-` i uyr to 4?amps M - a 7425-/ pages iL� 41 i to FA(1 sme a V, Bntecfi cittta`ty o r,rkerMiely Co./Dnp, ormtandmper pst ei t c <"'� t 7 L C �� A. Pne fat btennc t'nu+lts with pure`109e of Phone N Phorlg M 2 pfp ti 8 1 1 t'>0 "�or feeder lee,each bleu)h circ)+. _ axNSD�y !9�q --- — R bntrcedKuirswldrnn,purrhitncJ1fir- --J Fax N o/s�rapeatleedutee,fincthtaruhr,rcuit: ► '1r'4. 2 F=L adii.iarw bmneh c.1-ui: �1\��' Mlac.dSar�ertar�rrnat;•,clnlnrlh Fur pu Orirrigaucn CAN It 3 DStnmvM io175th'"mnr r .ri"I 13) J,o 'tealttefsrililY ----- -- ---of 1 LI - F�thsign otoutlitmlleb,ing S<:rvia m••-'170 amps rYtnp, .47 QFlnratdouclncetit n Si nal ritrult(a)M r lirr.li;d rnrray Oanrl rnrttilydwellings ❑Bnitiing over 10,1(11)aquarr feV toUI III 1 USy2'Crttovrr600volb.ro,tmati ),citeimornoRlunitsti.ow"IT"Alre alVutiOn,oretttmion" h 8vilcling wmi llnt+awrtea O Feedcna,400 unp a-Innte •[)eti<xi 'eo: ^' c 1 t1C4tpant Inad m ri 99 mrVirt L)MLturwriLrw un;ctu,T_%m VV park I'Aeb IL&Amultsal laaMaeUno eret the a11MMb AN M'*"k abotre: l..grrst/ltrtuing�lttn (7Odmr —_-._._.— _ perimpection —�--f— I Su6tnit _.aetio[ptunallY�>roti�ta6o►e Investisadanfx - - -- -- -- -. 1 111e above ar a not applidible to tcmpt/htry cotm67etloo Kttltx• '� — —_— -- Pe _ _ _ _ rmit fu.................. .. A all je laart;Ms rxq+trnUt c.ds,p4ra,<an i;+stadlm for nm i�^rsoua°. Notice:Tots p'+mil xpplic:ttiee plan review(Al (]viae q Mutrst AM eKµinw if a pemtit is not obtuned _ _1__ within l9n day.01er it hes been Stetr sumhuge cfam card aumbtr — uea ! acceptul au rnmp:eta TOTAL .......................$ �:L�t-s•_- - Na,te N rtuttasuWa'�vWn ei e+rlit tarsi s 'ri1Lrit 11C'CC]lti L 1 H513 �•� —(Si�aldo t()pw+ra `� � ARMODt-—J rla(1.{41S(t3g0/('OM) Hein vif'^e Salem Office Bend Office P.O. Box 23814 1060 Hudson Ave.,NE P.O. Box 7918 Tigard,O•egw 97281 Salem,OR 97301 Bend,OR 97708 Carlson Testing, Inc. Phone(503)584-3460 Phone(503)589.1252 Phono(541)330.91,-,5 FAX(503)684.0954 FAX(503)589-1309 FAX(54 i)330-916", Specini Inspection FIN,,AL SUMMARY LETTER January 2, 2003 T0202011 City of Tigard 13125 SW Hall Blvd , Tigard, OR 97223-8199 Attn: Building Department Re: Cash & Carry 11745 SW Pacific Hwy - Tigard, OR Permit No : BUP2002-1.`0479 Dear Sir or Madam I his is to certify that in accordance with Section 1701 of the Uniform Building Code and Ghapter 24.20, Title 24, we have performed special inspection of the following item(s) per our inspection m-ports only. Structur=I Steel — Shop, Includes Venflcation of welder Certifications,Material Certifications and We'd Procedures Ail inspections and tests were performed and reported according to the requirements of i rolect Uocu-nents and, to the best of our knowledge, the work was in conformance with the approved plans and specifications, approved change orders and applicable workmanship provisions of the State Building Code and Standards, as well as the structural engineer's design changes, approvals and verbal instructions Our reports p-main to the ma'Arial tested/inspected or ly Information contained herein is .iot to he reproduced, except in full, with gut prior authorization from this office If there are any further ques ions regarding this matter, please do not hesitate to contact this office. Resp fully subm,,ted, CA ON TESTING, INC. es F. Hietpas ality Assurance Manager ,/1FH/Is cc: NW Awning & Sign, Inc. RBI Construction, Inc Tarlos & Associates P MORDIREPORTSTINI-TRV0202011 (11,02;07 THT! 11:32 FAX 503 684 0954 CARLSON TESTING (p;uu;: Main Office Salem Office Vend Office P.O.Box 23914 4060 Hudson Ave.,NE PO.Box 191H Tigard,Orr.gon 97281 Salem,OR 97301 Bend,OR 97708 Carlson Testing, Inc. Phony(503)694-3460 Phone(503)589.125? Phone(Ml)33G-9155 FAX(503)684.09$4 FAX(503)589.1309 FAX(5411 330.9153 Special Inspection FINAL SUMMARY LET-TE! January 2, 2003 70202011 City of Tigard 13125 SW Hall Blvd., Tigard, OR 972.23-8199 FILE COPY Attn, Building Department Re Cash & Carry 11745 SW Pn�.ific I Iwy - Tigard, OR Permit No.. BUP2002-00479 r)e6r Sir or Mariam This is to certify that in accordance with Section 1701 of the Uniform Building Code and Chapter 24.20. f file 2.4, we have performed special Inspection of the following iiem(s) per our inspection reports only Structural Steel — Shop, Includes Ve;ification of wr!ldnr Certifications,Material C^rtlfiantions and Weld Procedures All inspec_'ions and tests were performed and reported according to the requirements of Project Documents and, to the beet of our knowledge, the work was in conformance with the approved plans and specifications, approved change orders and applicable workmanship provisions of the State Building Code and Standards, as well as the structural engineer's design changes, approvals and verbal in,.;tructions Our reports pertain to the material tested/inspected only Information contained herein i;: not to be reproduced, except in full, without prior authorization from this office. If there are any further questions regarding this matter, please do not hesitate to contact this office. fie-, tkilly submitted, CA ON 1-ES I ING, INC. i a es F, t lietpas ality Assurance Manager 1JF H/Is 1 cc NW Awning & Sign, Inc. RE31 Construction, Inc. Tarlos &Associates F.�WQPDkRF.FORTS\FINLYR%T0.0e(l11 I Main Office Salem Office Bend Office P.O. Box 23814 4060 Hudson Ave.,NE P.O.Bax 7918 Tigard,Oregon 97281 Salem,OR 97301 Bond,OR 97708 Phone(503)684.3460 Phone(503)589.1252 Phone(541)330.9155 Carlson �estingg Inc• FAX(503)684.0954 FAX(503)589-1309 FAX(541)330-9163 Special Inspection FINAL SUMMAR`! LETTER January 16, 2003 T0202011 **AMENDED** City of Tigard 13125 SW Hall Blvd., Tigard, OR 97223-8199 FILE COPY Attn. Building Department. Re: Cash & Carry 11745 SW Pacific Hwy —Tigard, OR Permit No. BUP2002-00479 Dear Sir or Madam This is to certify that in accordance with Section 1701 of the Ur,ifo-m Building Code reports hapter 4.20 Title 24, we have performed specie. nly : inspection of the following ite n(s) p rinspection Installation of Epoxy Anchors of Welder Certifications Material Certifications and Weld Procedures Structural Steel — Shop & Field, Includes Verification All inspections and tests were performed id reported according to the requirements of Project Documents and, to the best of our knowledge, the work was in conformance with the approved plans and specifications, approved ch Inge orders and applicable workmanship provisions vals aoather to te in BstBuildingns ode and Standards, as well as the structural engineer's design changes, app Our reports pertain +.o the material tested itnspected only. Information contained herein is Tint to be reproduced, except in full, without prior authorization from this office It there are .my further questions regarding this matter.. please do riot hesitate to contact this office Respe full submitted, CARL TESIING. INC J0 s . Hietpas e;1 f Assurance Manager (` JFI /)'s cc: NW Awning & Sign, Inc RBI Construction, Inc. Tarlos & Associates P\W0RD\REP0RT9VINLMT02020'1 CITY OF TIGARD 24-Hour BUILDING Inspectio-, Line: (503) 639-4175 MST — INSPECTION DIVISION Business Line: (503)639-417'. euP e2o4 72 Received Date Requested AM PM _ But, LOCLflon _Suite MEC — t �L�` Contact Person .._ - _. -�. �C/ - Ph( ) -�--�-- PLM - Contractor Ph SWR BUILDING —� TenanVOwner _-. _-_ _-_ ELC - Footing ELC Foundation Ftg Drain Access: `` / y ` ��'�� ELR Crawl Drain --- - Slab Inspection Notes: %� 3 SIT Post&Beam - ----- Shear Anchors 5Z G �^ GJ Ext Sheath/Shoar - Int Sheath/Shear Framing - _ --- Insulation - Drywall Nailing --- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Root Othe,r: 'ASS ` PART FAIL --- Post&Beam Under Slab -- — Rough-In _ Water Service -- Sanitary Sewer _ Rain Drains Catch Basin/Manhole Storm Drain - -- - Shower Pan I _ — Other: -- Final --- -- _ -- -__ -- PASS PART FAIL _M_ECHANICA_L_ ----- Post& Beam Rough-In -------- - — -- — Gas Line Smoke Dampers Final PASS PART FAIL Service Rough-In -- — UG/Slab Low Voltage -- -- - - -- Fire Alarm Final I Reinspection fee,'s_ required before next inspection. Pay at City Hall, 1317.6 SW Hall Blvd. PASS PART FAIL SITE — u Please call for reinspection RE:—_ ❑ Unable to inspect-•no access Fire Supply Line ---- ADA pate Inspector Z Ext -- Approach/Sidewrflk Other Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF I IGARD 24-Hour BUILDING Inspection Line. (503)639-4175 MET - — INSPECTION DIVISION Business Line: (503) 639-4171 // e,UP - Received - Date Requested AM --_ - PM BUP Location .___- _.___��r? ------_.._---Suite MEC Contact Pe- ,n �— -- Ph(- ) � .-_7 L_n 0- PLM J — Contractor -_—_ - Ph(- ) SWR BUILDING —! Tenant/Owner (.. �� -.1 � ELC G) Footing ELC Foundation Access: —_ - Ftg Drain ESR - Crawl Drain Slab Inspection Notes SIT Pos'R Bearn -- - -- Shear Anchors Ext Sheath/Shear �. Int Sheath/Shear Framing Insulation Drywall Nailing - - - Firewall Fira Sprinkler - -- Fire Alarm 3usp'd Ceiling c-�/ .' Roof —--- � - + -�— r{� - Other: '--- Final PASS PART FAIL.. � �-- -�--- - PLUMBIN_G_ _^ — ------_-___ POSt&Btiam Under Slab Rough-In Water Service - -- -- - --- ----� Sanitary Sewer Rain Drains - �— Catch Basin/Manhole Storm Drain Snower Pan Other: Final 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 SS PART FAit. Reinspection fee of 5� required before next inspection. Pay at City Hall, 13125 SW Hail Blvd. -- �� Please call for reinspection RE:_�___.. -. _ __ Unable to inspect-no access Fire Supply Line ADA �q -� P "'� Approach/Sidewalk Date ins ectm Ext -_--. Other: Final DO NOT RFNIOVF this Inslpectlo:� re!-oi'd frc m the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Ir.spection Line: (503) 639-4175 MST INSPECTION DIVISION Cusiness Line: (L173)639-4171 BLIP ReceivedDate Requested - — AM.. PM BLIP A-- Location Suite ME Contact Person - - Ph Contractor - - --- -- Ph SWR -- BUILDING Tenant/Owner _� .- -_ ELC - —_-- Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain ---- Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheaih/Shear - --- Int Sheath/Shear Framing - - - - Insulation Drywall Nailing - - - Firewall Fire Sprinkler - — - - Fire Alarm Susp'd Ceiling ---: - — --- Roof Other: Final PASS--PART---FAIL PLUMBING Post&Beam Under Slab ---- - --- Rough-In Water Service - --- -- -- Sanitary Sewpi Rain Drains -- Catch Basin/Manhole Storm Drain - - — — — Shower Pan _ Other: Final (-MECHANICAL,-,'_ -- ---- _. Post&Mm Rough-In -------- -- - - - -- ---- ------ — - - -- — Gds Line Smoke Dampers -- - �_� __ _--- -- - - ------------- ASS ART FAIL ----- - -- ---- --- -- -- — -- Service Rough-In -- UG/Slab Low Voltage --- Fire Alarm Final I Reinspection fee of$- required before next inspschon. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ �. Please call for reinspection RE:> >__ _ Unable to inspect• no access Fire SuADA pply Line Approach/Sidewalk Dates .�� I '� InSPOOOr Ext --_�— — Other: Final DO NOT REMOVF th:e Inspection record from the job site. PASS PART FAIL CITY OF TiGARD 24-11our BUDDING Inspection Line: (503)6394175 MST INSPECTION DIVIL-!ON Bu!;iness Line: (503)639-4171 - BUIP Received - ___. _Date 9equested__— / AM---- _----__-. PM _!' _ BLIP Location Suite _ MEC _ Contact Person Ph(� G) - S�� PLM Z6 Yl7_ Contractor _ Ph( /7 ) _ SWR _ � o .3 Cl L BUILDING Tenant/OWne• _ ��C�.l+�t ?� ELC Footing t =oundation ELC ACC`,'SS' Ftg Drain ELR Crawl Drain �. Slab Inspection Notes: SIT Post&Beam Shear Anchors - -- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall - '1 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. -- -- S PART FAIL _ HANICAt` Post& Beam Rough-In Gas Line Smoke Dampers Final PASS PART FALL_ — ELECTRICAL— Service LECTRICAL Service Rough-In - - UG/Slab Low Voltage Fire Alarm Final Ll Ro-Inspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ Blease call for reinspection RE: . E] Unable to inspect-no access Fire Supply Line ADA Dale _ T C� ---- Inlrpedor_ Ext --- Approach/Sidewalk Other: Final + DO NOT REMOVE this Inspection record from the job site. PASS PART_ FAIL J �►RD _--- BUILDING PERMIT CITY OF TIC PERMIT#: E11P2002-00418 DEVELOPMENT SERVICES DATE ISSUED: 10/17/02 LEW 13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 PARCEL.: 1S136CD-01()UU SITE ADDREaS: 11745 SW PACIFIC HWY SUBDIVISION: ZONING: C-G _ BLOCK: LOT_ _��_ ____ JURISDICTION: TIG _ REISSUE: FLOOR ARE_A_S __EX_T_ERIOR WALL CONSTRUCTION — CLASS OF WORK: FPS FI.3ST` sf N S: E: W:�� TYPE OF USE: COM SECOI:n- sf PROJECT OPENINGS? _ TYPE OF CONST: sf N: _ S: E: W: OCCUPANCY GRP: M TOTAL ARIA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: -;f AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _ RECID_S_ETBACKS _ __ REQUIRED _ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: - MOK DET: DWELLING UNITS: FRNT• ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO C:On..: PARKING: VALUE: $ 2,000.00 Remarks: Fire alarm installation for tenant irnproverrnent. Owner: Contractor: SMART & FINAL SECURITY PROFESS IONf\LS 600 CITADEL DR 13023 NE HIWAY 99 STE 7 COMMERCE, CA 90040 VANCOUVER. WA 98686 Phone: 323-869-7591 360-574-5329 F none: 360-574-5329 Reg #: LIC 133914 FEES _ REQUIRED INSPECTIONS _ Descrirtion Date Amounti� Fire Alurm Insp 1131.111,D] Permit Fee 9/24/02 $62.50 Final Inspection TAX] 8%State Tax 9/24/02 $5.00 FLS] FLS Phi Rv 9/24/02 $25.00 Total $92.50 This permit is issuer] subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable la,v 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 copy of these rules or direct questions to OUNC by calling (503) 246-5699 or 1-800-332-2.344. Issued By: Permittee / Signature: Call 639-4175 by 7 p.m. for an inspection the next business day SEE 35M1V1 ROLA, # 20 FOR OV--ERSI ED DOCUMENT D9412GID74 :1G Control/Communicators Specifications Control FeaturesM,,.dµ • Eight programmable areas,each with perimeter/interior partitioning. Regular,master, associate,or shared option by area • Real-time clock and test timer • Up to 1000-event log,Including time,date and event with area,point and user number • Battery c'rarr•'ng circuit;AC pourer,voltage anu grounc fault supervision �:• i • Automatic inset circuit protectors • On-board CFU watchdog warning buzzer and r '`M0/1111111,010 diagnostic LF-'Ds • Lightning and EMI protection User Interface • Power limited external circuits • Supervises up to 8 command centers(up to 32 Communicator non-supervised command centers can be used) • Built-in digital communicator with phone line • Custom command center text monitor(loop or ground start) D74120:4 custom frinctions • Multiple telephone numbers,primary and duplicate 0 D9411 20: 16 custom functions paths with main and alternate destinations • Full function command menu Including custom • All reports within each 4 route groups are functions programmable • D74120:99 Users • Optional dual phone line switcher monitors 2 phone • D94120: 249 Users Ilnss • Each user has authority by area and 16-character • Aulomatir'est and status reports name • Time windows for arming and open/close repert • 14 custom authority levels control user's authority suppression to change,add,delete passcodes or access control • Programmable answering machine work-around r- tokens/cards,disarm,bypass points,Initiate system remote programming on shared phone line tests,and more • Adjustable brightness/loudness for command Programmable Outputs center display/sounder • 2-amp alarm power @ 12 VDC • D7412G: 1 parallel printer • 1.4-amp aux power @ 12 VDC D9412G:3 parallel printers • 4 alarm output patterns Access Control • Automatic bell test • Pro'lrammable bell shut-off timer • Dkens/c 2 access control doors and 396 07412G:67 programmable outputs 94120: ards • D9412G:8 8 access control doors and 996 • D9412G: 131 programmable outputs tokens/cards System Response • Custom door strika.point shunt and b:to disarming response by area • D7412G 75 points.8 on-board,up to 67 oq-board • Logging options for:Access granted,No Entry, • D8412G:246 points,8 on-board,up to 238 off- Request to Exit and Request to Enter board • 14-panel wide access levels with both manual and • 31 custrnn point indexes,including fire supervisory scheduled control • Selectable point response time • Fire alarm verification • Fire Inspector's local test • Watch mode • Scheduled events(Skeds)arm,disarm,bypass and unbypass points,control relays,control authority levels,control door access and more �'• ` '� 0 ►I(.�If�tll(' Security Professionals 13023 NE Highway 99 Suite 7 PUB' 198 Nfancouver, WA 98686 Specifications Listings and Approvals • Undorwnters Laboratories apeClflnatlo� D411 D412 C.SrM Circuil Conflquratlon Class B,2-wire Class A or Class B,4- NYC-MEA wire Rated Input Voltage 10.5 to 31.0 VDC 12 V Operating Current 0.014 A 0.02.1_q.A _ Ordering Information 24 V Operating Current 0.025 A 0.038 A _ Oupul Current 3 A 3 A/circuit Wiring Two 012 to 818 AWG(2.34 mm to 1.22 Model Description mmj each screw terminal _ Number Temperature Ranga 32'F to 120°F(0"C to 49"C)@ 85%RH D411In le Circuit Glsss 13 Synchronlzellon Module For Indoor use only____ 0412 Duel Circuit Class A Synchronization Module Back box 41 1l,e In.square by 2 I In deep 05015 24V,Hom Sync Strobe,15Cd _ Regulrements -- - -- _-- D503S 24V,Hom Sync SUobe�15/75 Cd D505S 24V,Hom _Y_r q Strobe,110 Cd Dimensions Q508S 24V Hom SyncStrobe 30 Cd D509S 24VLHom Sync Strobe,75 Cd . D',11 12V.Hum Sync Strobe,15 Cd _D411 p4. D512S 12V,Hom Srtnc Strobe,15/75 Cd Dentli IT In.13.6 cm) 11/ in. 3.8 cm Db13S 12V Hom Sync Strobe 30 Cd Width 4 he In.(11.0 cm l 5.0 In.112.7 cm D5'8 24V Mini Hom Sync Strobe 75 Cd H.I ht 4 he in. 1. crn 5.0 In.02. qTt D559S 24V Mini Hom S Strobe, 15/75 Cd __DF90:T 12V Mlnl Hom gyne Strobe 15 Gd 0561S 24V Mini Hom Sync SUobe,1S Cd �D5823 12V Mini Hom Sync Strobel 5175 Cd D579S 24V,Hom Sync Strobe,15 Cd Cellina Wht D580S 24V.Hom Sync Strobe,30_Cd Celling hi D 81 4V Hom Sync Strobe.15 Cd Calling WM D582S_ 24V,Hom Sync Strobe,100 Co Calling Whl Synchronization Module Audible Strobes\ U �I -- Q -_ FACP 5I I� l I f Strobe CircLlit Audible Circuit Typical 0411 Installation: Audible Signal an! Strobes Operate Independently 1a0 noon V� CERTIFICATE NO.A8137 Cv 1999 Radlonles,a division of Det,,clion Systema,Inc 34903C 08/99Htc Radianies"0 The Radlonics logo is a registered trademark of Redlonics. D411, D412 Specrrtions PO Box 80012,Salinas, CA 93912-0012 USA L845 Page 2 of 2 All rights reserved. Customer Service (80n) 538-5807 D12561 D1257 Fire Command Center, Fire Annunciator Specifications Features • Compatible with the D9124, D9412G, D9412, D9112, r>>r>r�tcirttn ' Yilrrti, D7412G, D7412 and D7212y„ M • Attractive low profile fire annunciators • D1256 provides system uontrol with easy to use function keys 1 • D1267 can be remotely installed in public access areas • Built-in multi-tone sounder �t�f14 • Easy to read vacuum fluorescent display9111 Y' • Displays complete system status In English format n-- • Programmable custom text for each point • • Local system test display • Molded red ABS plastic construction Description Vi, Command Center and Fire Annunciator Radlonics' D1256 Fire Command Center and D1257 Fire Application Alarm Annunciator are four-wire serial devices used with the The D1256 can be mounted in secure areas for use as both a Radionics' D9124 Addressable 24 VDC Fire Alarm Control/ system controller and annunciator Communicator and the D9124, D9412G, D9412, D9112, L7412G, D7412 and D7212 Control/Communicators. One The D1257. Remote Fire Annunciator is typically Installed in X1256 is included with the D9124 panel, which can be building entrances and areas with unrestricted access Near accessed through the slide door on the front of the enclosure. exterior doors in hotel or business lobbies are ideal localions Both annunciators jrovide English text displays of system This allows a responding agency, or person.evacuating the building to quickly Identify the type and location of the emergency events with highly visible blue vacuum fluorescent displays. A from outside the building without being in danger. built-in sounder alerts building personnel to system alarms and troubles and guides responding agencies to the Both devices have a built-In sounder that allows them to be annunciator location. installed in locations not in general view Audible tunes alert Both units are molded In durable red plastic and have low personnel to fire system events and assist fire fighters In profile enclosures. The wording "Fire Alarm Annunciator" is locating the annunciator. clearly printed on the faceplate of the D1257. This allows Installation Inspectors, service technicians and responding fire agencies to identify the annunciator. The D1256 and 01257 system annunciators connect to the fire control/communicate, !'trough standard four-wire cable The D1256 Fire Command Center is a full-functr-)n system Shielded cable may sometimes be required where excessive controller and annunciator. Four special one-touch function EMI is a problem. keys provide user-friendly control over the system.The function keys allow the user to silence the audible alarm output,silence The field whiny connects to a four-wire harness supplied with the trouble sounder, reset the annunciator display and reset the unit. This harness plugs into a four-pin ;onnector on the system defectors. Four additional navigational keys allow circuit board through the back of the D1256 or D1257 Each access to other programmed system functions. unit has three mounting holes in the base that allow secure. The D1257 Fire Alarm "enunciator provides remote correct positioning during Installation. annunciation capabilities withoui system control. Similar in Do not install the D1256 or D1257 in direct sunlight This appearance to a D1256 Fire Command Center,yet the D1257 damages the module caniponents and makes the display Fire Alarm Annunciator lacks function keys This makes system less visiblo. control functions Inaccessible to unauthorized persons. Thus, install, !ost and maintain these uevices according to their the D1257 can be placed in locatiosis where the public may Installation Guides, NFP N.72, Local Codes and the Authority have access to it.Two navigational keys allow the user to step Having Jurisdiction. Failure to follow these procedures may forward or backward through a list Y system events result In failure of the devices to operate properly.Radionics Is not responsible for devices+.het are improperiv installed.tested and maintained. sr rddlonics L Operational Data Listings and Approvals The D12!.6 and D11257 operate through the Seridl Device UL Listed Interface cuss of the control/communicators The D1256 and CSFM Listed D1257 r -give serial data and power through a four-wire cable. FM Approved Both devices continually show the statue of the fire alarm • system. Changes in the nore^a panel cold+tion such as alarm Ordering Information or trouble events are displayed In alptanumeric English text _____ - and the appropriate (sounder response tono emitted. 11,110delHUmb4.r De"ption Resetting the display and wounder can only be avomplished at the D1256 Fire Command C:-neer by authorized p6rsons. D1256 Fire Command Center Specifications D1257 Rumots Fire Alarm Annunciator �----.�-,• --r---�-- 0540 Brass Faceplate )+ ,r. ) - .�L — D54C Stainless Steal Faceplate Operating Vottaps Nominal 12 VDC -- ----- (suppW by controilcommunicalor) D55 Desk Stand OImniting CUrreM 104 mA min 20r,mA mar D58 Conduit Backbox ` Wiring Four conduclo a supply:Sarlal data, X12 VDG and panel common Specifications Display 16-character vacuum fluorescent The contractor shall furnish and install, where indicated on 'Opp+raling Tompwstuie +32•F to 1227(0'C to•50•C) the plans,Radionics D1256 Fire Command Center and D1257 Remote Fire Alarm Annunciator. Each device shall have a 16 Non-condensing Relative5%to tl54.at 88'F(3o•c) character vacuum fluorescent display and show all fire system HurnIdny events. Alarms shall be prioritized ahead of other system Ossa Dimensions(l x W K[t) 8.3 In.x4.5 In.0.8 In. events and displayed In sequence. The D1257 shall have no l�' (21 cm x 11.4 cm x 2 cm) on board system control function keys. Wire Information A built-in sounder shall Indicate events with distinct tones for fire alarm and system trouble. The D1256 and D1257 shall wrr�i connect to the fire control/communicator through a four-wire cable. 12 VDC _ t2 VDC(Red) _ The D1256 and 1257 shall be constructed of high Impact red Data Out Date.In(veflow) plastic.The D1257 shall have the text"Fire Alarm Annunciator" -- — clearly printed in bold letters to the right of the event display. Dsta-71n Dale-Out(Green) The D9124,with the 09112LTB,D9112B1 and D7212B1,have Com, I Common(Buck) a 500 event non-volatile event memory log. The D9124 with — the D91t1LTB-EX or D9412GLTB, 9000/7000 Series panels have a 1000 event non-volatile memory log.All system events are displayed on system annunciators, printed locally or retrieved from off prsmises via the Remote Account Manager (RAM)software package. i q0 i0070 CERTIFICATE NO AStlr 2002 Radionics, a division of:election Systems, inc. 75-06926-000-D 2/0? PO Box 80012,Salinas,CA 93912-0012 USA Speclflcatlons D1256, D1257 Customer Service: (800) 538-5807 L643 Page 2 of 2 Specifications Li-tings and approvals • Underwriters laboratories • CSFM Operating Vo!iage 7.15 VDC(supplied by ZONEX Module) _Operating Current 2.E mAper Addressing Module_ Ordering Information Alarm response time Approximately 1 second Dimensions(N x W x D) 4.75 in.x 3 18751n.x.8751n. 12anx8cmx2,211 Model Description D462 Addressable Manual Station 0463 Double-Action Cover D464 Deep Backbox D465 Glass Replacement Rod D466 Backbox, Red 0482 Manuel Station ----� Bin p18 AWG (1.22 mm)Wire Data Expansion Loop t t � dMld(lUi YIn O _ Tle WIFl�• �—+ tdrnnil _ On•5oard O \ Slide Switches �J POPIT Module(PIN:37519) 33K 0 5W Resistor ISO 9002 CERPFICATENO A513i Z 2001 Radionics, a division of Detection Systems. Inc 75-06562-000 E — 8101 PO Box 80012, Salinas,CA 93912-0012 USA Specifications D462 Customer Service: (800) 538-5807 L1130 Page 2 of 2 D500 Series Synchronized Horn/Strobes Specifications Features • 12/24 VDC,CeWng-Mount Synchronized Horn/Strobes • Coat-effective two wire design „N • Selectable continuous tone or temporal'Code 3)sound `� pattern synchronization • Three field-selectable sound levels • Strobe an audible synchronization using the D411 or D412 Synchronization Modules • Class A or Class B clrcult compatible • Low average cuiTent draw • Zero Innish current • Combined hom/strobes allow horn silencing while strobe continues • UL Listed for Indoor use with a temperature range if+32'F to+120'F(0°C to 49°C)and a maximum humidity of 85% 0579S Synchronized tiorn'Strobe Description Application Radlonirs'D500 Series of Synchronized Horn/Strobes are two- R,,dionics'500 Series of Synchronized Hom/Strobes are two- wlrn calling mounted notification appliances.Depending en the wire ADAINFPA ceiling mounted compliant devices listed for jumper setting, the hom/strobe In these synchronized horn/ Indoor use. They provide a means to alert both visually and strobes provide either a continuous horn or a temporal Code 3 hearing Impaired persons of alarm conditions. pattern. Installed In a system using the 0411 Single Circuit Synchronization Module or the D412 Dual Circuit These horntstrobe notification appliances allow horn silencing Synchronization Module,these notification appliances provide while maintaining the strobe.This allows emergency personnel synchronized Code 3 Horn. to communicate while maintaining the visual alarm cundition,a The rlrouit module that rnntrols synchronlzatlon must be b"b" requirement In some jurisdictions. the first device to provide synchronization. This series allows a choice of sound levels and strobe Intensity. The D500 Series Horn/Strobes combine the continuous horn Installation or a temporal Code 3 pattern with a random strobe when connected directly to a fire Alarm Control Panel(FRCP)or a A universal mounting plate I:.Included with these notification synchronized strobe when con-ter:tea through a synchronization appliances that allows Installation on single or double gang module, backboxes and 4 In. square backboxes, among others. No These notification appliances use either filtered DC or unfiltered additional trimplate is required to flush-mount. Adjustable screw full wave rectified Input voltage.All inputs are polarized. holes simplify mounting and leveling. This flexible design cuts Installation time and simplifies retrofits. Two-wire circuitry reduces the number of circuits connected to These notification appliances are for use on rircuits with the FACP resulting In lower material and labor costs tot continuously applied voltage. installation.The use of existing two-wire circuits reduces costs for upgrading an existing building to meet ADA requirements. CAUTION:The strobe may not flash on these horn/strobes are All the combined horn/strobe devices In this series have sound connected to coded or Interrupted circuits In which the applied ovals,selectable In the field by jumper,of 90 clH.95 dB or 99 voltage is cycled on and oft. dB,measured at 10 ft.(3 m). DOvice connection is through INIOUT wiring terminals that Strobe Intensity for the calling mounted devices Is available In accept two .vires,#12 to#18 AWG (2.3 to 1.2 mm), at each 15 cd,75 cd and 100 cd. Strobes meet ADA requirements of screw terminal. one flash per second from 20-31 V(24 VnC)or 1?V to 15.8 V Install, test and maintain these devices according to their (12 VDC).All strobes have a Xe►on flash tube protected by a Installation guides, NFPA 72, Local Code: and the Authority Lexan®lens.The 15/75 candela sh obes were UL-tested for 75 Haviny Jurisdiction. Failure to follnw these procedures may cd on axle.They are listed at 15 rd under UL 1971 and meet result in failure of the devices to operate property.Radionlcs is 75-cd intensity on axis for AGA guidelines. not.esponsiblo for any device 11-at Is improperly Installed,tested or maintained. A m,.,- l 1 -it the radionics F3°`(t, `'roor, Specifications dBA Ratings for 12VDC arrl 24 VDC Horn/Strobes Average Current Draw with Low dBA Setting(90 dBA) kk eev�rborant dPA Nottage I 03709 J OS718 D57J9 D5748 DS728 Anechoic JBA Tone Volurrw CT 10 R.(3.1 m) ®10 ft.(3 1 m) 16 VUG 66 mA 103 mA 135 mA 218 mA 271 mA per UL 484 High g1 gg 24 VDC 64 mA 77 mA 98 mA 149 mA 177 mA Continuous 33 VDC 58 mA 67 mA 84 mA 117 mA 148 mA Hom Medium 88 95 Voltage DS758 D5788 Low 83 90 8 VDC 238 mA 348 mA High 87 99 12 VDC 156 mA 194 mA (,ode 31M.9 dium Ham 84 95 17 5 VDC 132 mA 162 niA - ow 79 90 Voltage 04798 D5808 Dula 05828 Average Current Dr aw whit High dBA Setting(99 dBA) 16 VDC 112 mA 160 mA 332 mA 382 mA Vultage 08708 D5718 D5738 D574S 05728 24 VDC b2 mA 113 mA 219 mA 252 mA 18 VDC 104 mA 124 mA 152 mA 240 mA 291 mA 33 VDC - 69 mA 95 mA 164 rnA 207 mA 24 VDC 87 mA 102 mA 120 mA 177 mA 202 mA Listings awl Approvals 33 VDC g0 mA 100 mA 118 mA 152 mA 183 mA . UL VoBage D5758 D9768 • CSFM 8 VDC 303 mA 408 mA • NYC-MEA 12 VDC 223 mA 256 mA • FM 175VDC 214 mA 25`1 MA Ordering Information Voltage 05791111 Dun D8818 05828 Model Number Description 10 VC 130 mA 178 n-A 357 rvA 404 mA D400' Backbox 24 VDC 106 mA 135 mA 248 mA 271 mA D411 Class B,2-wire Synchrunizatlon Module 33VDC 67 mA 131 mA 200 mA 245 mA D412 Class A,4-wire Synchronization Module Average Current Draw with Medium dBA Setting(95 dBA) n570S 24 NDC, 15 cd Horn/Strobe,Wall,Red VoMage Db708 D8718 D5738 D5748 D5728 L)571S 11 VDC, 15/75 cd Horn/Strube,Wall,Red 16 VDC 89 mA 108 mA 140 mA 224 mA 278 mA U5725 24 VDC, 110 cd Horn/Strobe,Wall,Red 24 VDC 72 mA 83 mA 105 mA 156 mA 183 mA D573S 24 VDC,30 cd Horn/Strobe,Wall,Red 33 VDC 67 mA 77 mA 92 mA 130 mA 158 mA f D514S 24 VDC,75 cd Horn/Strobe,Wall,Red VoMage DS7814 D8788 D575S 12 VDC, 15 cd Horn/Strobe,Wall,Red 3 8 VDC 251 mA 54 mA D57 SS 12 VDC, 15175 cd Hom/Strobe,Wall,Red 12 VDC 171 mA 217 mA DK79S 24 VDC, 15 cd Horn/Strube,Ceiling,White I 1/.5 VDC 147 mA 182 mA D560S 24 VDC,30 cd Horn/Strobe,Ceiling,White VoMape DffM DOM D88/8 D5828 -- D581S 24 VDC,75 cd Hom/Strobe,Ceiling,White 18 VDC 116 mA 164 mA 339 mA 389 mA — D582S 24 VDC, 100 cd Horn/Strobe,Ceiling,White 24 VDC 91 mA 120 mA 226 mA 258 mA -- — 3 VVDC 79 nil! 103 mA 179 mA 217 rTA 'No CSFM r€;2n01 Redlon!cs,a division of Detection Systems, In,. 417800 5101 PO Box 80012,Salinas,CA 93912-0012 USA Specifications Synchronized Horn/Strobes Customer Service:(800)538-5807 L1009 Page 2 of 2 O � ��',�� _ BUILDING PERMIT TY DEVEL13PMENT SERVICES DATE ISSUIED: 111/12/02 00479 13125 3W Hall Blvd., Tigard, OR 97223 (!)031639-4171 SITE ADDRESS: 11740 SW PACIFIC HW'( PARCEL: 1S136CD-01000 SUBDIVISION: ZONING: C-G BLOCK: LOT: _ JURISDICTION: TIG REISSUE: _ FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: ACS FIRST: sf N S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 2N sf N: S_ E: W: ' OCCUPANCY GRP: M TOTAL AREA: n Oo sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: ,f AREA SEP. RATED: STOR: H7' ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: f`. RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP AGC: BEDFMS: BATHS: IMP SURFACE: PRC CORR: PARKING: VALUE: $ 23,200.00 Remarks: Awnings. Owner: Contractor: -_-_- -- —`_- —_-- SMART & FINAL NORTHWEST AWNING + SIGN CU 600 CITADEL DR 4812 N. INTERSTATE AVE. COMMERCE, CA 90040 PORTLAND, OR 97217 Phone: 323-869-7591 Phone: 503.493-9111 Reg#: LIC 00025643 FEES! REQUIRED INSPECTIONS_ Description Date Amount Bolts in concrete final repos 1131 iPPLNJ Pln Rv 10/29/02 $177.91 Structural welding final rept I I S] FLS Pin Rv 10/29/02 $109.48 Final Inspection BUILD] Permit Fee 11/12/02 $213.70 I' AXI R°l,5tate'I•ax 11/12/02 $?1.90 Total $582.99 This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTL NTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth to OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-669P or 1-80r.-332-2344. � J 9 t'9 mi it to a `f Signature: i Call 639 17 by 7 p.m.for an Inspection the next business day I q/0z'. Permit Application [latereceived: i dPermit no.: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Projecl/appl.no.: Expire date: City ojTigard Phone: (503) 639-4171 Date issued: By:JK I Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: I&2 family:Simple Complex: OF U 1 &2 family dwelling or accessory ,klCommercialhndustnai J Mulu lanilly U New construction U Demolition I 1 U Addition/aheration/replacement [J Tenant improvement U Fire sprinkler/alarm U Other: -rte JOB SVIT e ► Job artdress: t 11 q5 liki QA _ _ Bldg.no.: Suite no.: Lot: I Block Subdivision: Tax map/tax lot/accoun no.: 1$(1(41C D ICD R 2eL419(o Project name: _ "-- Description and location of work on premises/special conditions:..• Name: YVvi7 t3 _ Mailing address: 1 N I-W LVA N, Arlt 1 &2 family dwelling: City:py fCCT2 N Stale:CQ I'LIP: a 00 I U Valuation of work........................................ $ � Phone: I:tx: E-mail: No.of bedrooms/baths................................. _. Owner's representative: Totid number of floors................................. a Fax: E-mail: New dwelling Brea(sq. ft.) .................... ..... _ Garage/carport area(sq.ft.)......................... _ Name: C Ih�,i-1 + C A lE rz W Covered porch area(sq.ft.) ...............•....... . _ Mailing address: Q i -jr) L IUf[ t V k i Deck area(sq.ft.) ............................•........... _ State: p 71P: Other structure area(sq.ft.)......................... City: (tn�r xtMeY�C�- CO I Phone:3 q'-( FaK F-mail:l Commercial/industrial/multi-family: t Valuation of work........................................ $ 2o0.Q9 Existing bldg.area(sq.ft.) .............•........•... _ Business name:[A*'-1 Wit'_,i hw r-1 '"Cs New bldg.area(sq.ft.) Address:y13:2 N I *vSiA'Tk. bV E Number cif stories •.. .......................•........ .... City: erd Tue rJ) _ State: W_ ZIP: G-7 217 Type of construction........I.......• _ Phone: 111 Fax: uh3. s-A E-mail: Occupancy group(,,) Existing: _ CCB no.: ZS Io 41 3 New: _ Notice:All contractors and subcontractors are required to be licensed with the Or,-gon Construction Contractors Board under Name: .r a_ SSpG provisions of ORS 701 and may be required to be licensed in the Address: p' 1 T �I E1t_ fJ M i jurisdiction where work is being performed.If the applicant is exempt from licensing,the following reason applies: City: L fe-d t rpt State. CA ZIP: c ,� Contact person: L.r,U l L I Plan no.: — "ii� : 1 . 1 E-mail: — Nam 1 Contact person:_0209 13 I Fees due ulxm application ........................... $ Address:l _7j2 10 Fi. vc Date received: City: �tA (� P2 tN State: Lia ZIP: u(r'T Amount received ............ ........................... $•--- -- Phonr:��Z l'1� '0 Fax: ��• E-mail: _ Please refer to fee schedule. I herebv certify I have read and examined this application and the Not all jurisdictions accept rredit card%•please call jurisdiction for more information. attach:d checklist. All provisions of laws and ordinances governing this U visa U MasterCard work will be complied with,whether s cified herein or not. Credit card number —___.-�_____—_ 1 — — — expires Authorized signature:r Irv. a� -C r Date: 0.'1 a Name or corJtwlder a tho.n on credit card — Print name: )l�1Z t ►_�t _ ti Is(W, SPil U'J Cardholtfer uRiuure s Amount Notice:•this permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44(1,�13 tWcuMi Commercial Plan Submittal Requirement Matrix City of Tigard TYPE OF SUBMITTAL # of Plans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 2 Building 1* Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of:a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" techniciE,ns. hdsts\forms\COM•matrlx.doc 9,24/01 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 SUP C. Received --- Date Requ ted_ lam, AM-- PM _ BUP — --- _—. Location — -.--- Suite MEC -- Contact Person ��`� _. Ph( _) –� �— PLM ,ce:: Contractor __ �1 �=6 h( —) SWRLl BUILDING Tenant/Owner _ ELC — Footing v ELC - Foundation Access: Ftg Drain ELR --_.---__-- Crawl Drain SIT ---- Slab Inspection Notes: ---- -- Post&Beam - - ------- - ---- —---- Shear Anchors Ext Sheath/Shear -- — _ int Sheath/Shear Framing —___-- --------------"-----..._ -------------- Insulation Drywall Nailing ----- - ------- -- -------- --------- Firewall Fire Sprinkler --1 ----� i�G iC - -- - ------ -----___-. - -....-- - v Fire Alarm Susp'd Celliny -- -- -----_----------------- Roof ---- ------ - -- - Other. -- Final PASS PART FAIL_ PLUMBING -- - - -- -- r P,js;& Beam Under Slab Rough-In Water Service - — ---"--"------_T Sanitary Sewer -- Rain Drains --—-- — -- - --- ---- Catch Basin/Manhole Storm Drain ------ --- Shower Pan Other: ----- Final -_—__-- PASS PART FAIL - MECHANICA_L_ - Post&Beam Rough-In -- - ------- -- — --- Gas Line —_ -- — -- Smoke DampersFinal PASS PASS PART_ FAIL_ -- - ELECTRICAL — - ---_—_-- ---- -- Service Hough-In — UG/Slab Low Voltage __ ------- - - --- -------` Fire Alarm Reinspection fee of$ ___required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PAS PART FAIL. Please call for reinspection HE: _- - - [_] Unable to Inspect-no access Fire Supply Line ADA oma. --- Approach/Sidewalk Other: _ -- Final r DO NOT REMOVE this inspection record hoM the fob site- PASS PART PAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 SUP Received —_—Dale Requested_ L ,1?2�. AM PM OUP Location — ---F�-�– --�'___ Suite MEC Contact Person —_ —__— Ph( ) PLM Contractor 1 _ P11( SWR BUILDING Tenant/Owner _ .� ,= �' SLI U14 ELC Footing V V ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam - Shear Anchors ---- Ext Sheath/Shear Int SheFah/Shear Framing Insulation Drywall Nailing - - - -- -- - Firewallr - Fire Sprinkler -- Fire Alarm Susp'd G�;,Iing - ----- ---__-- ---- --- - Roof Other: --- - --- --- ---- -- - -- -- Final -------PASS PART FAIL ---- ---------- -- -------.-_.---------- --- ---- PLUMBING -- rost&Beam Under Slab ---- - - Rougn-In Wate, Service Sanitary Sewer Rain Drains --- ------ --- --- - - --- ---- -- Catch Basin/Manhole Storm Drain ____.-___.T------------- -- --_-_-�_ --__-- Shower Pan Other: ------ ----.. __ ------------------...-..-_ ---- Final PASS PART FAIL MECHANICAL _ Post&Beam Rough-In - - - -- - - --- __- - ----- - --- - Gas Line Smoke Dampers - ---- - -- ------ ------ -- ----- -- - -- Final PASS PART _FAIL - ---- ---- ----- --------- ------ - ---- -- -- ELECTRICAL Service ---- --- ------_. __- - -------- --.-...------- Rough-!n UG/Slab - -- ---i---- - Low Voltage moire Alarm II-��------ ------^ -- _- SAS PART FAIL u Reinspeclion fee of$.-__- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Sn Please hall for reinspection RE: _-.—___ Unable to inspect-no accec:o Firo Supply Line ADA Approach/Sidewalk Date Inspector A:11ln�ee' Ext--_- Other: _ Final - DO NOT REMOVE this Inspection record from the jab site. PASS PART FAIL October 21, 2002 City of Tigard CITY OF TIGARD' Sherman S Casper OREGON 13125 Hall Blvd. Tigard, OR. 97223 7 Smart & Final Stopes inc Att: Fernando Gallarzo 600 Citadel Dr City of Commerce, CA. 90040 Mr Gallarzo It is my understanding that the Smart & Final Store inc will be providing a traffic study to be used in the calculation of the traffic impact fee for the project at 11745 Pacific Hwy in Tigard, OR. The traffic impact fee is normally collected at the issuance of the building permit. In order to continue with the proiect we will need to defer this fee until occupancy. To accomplish this deferral please complete the enclosed form and return it to me at your earliest convenience. If I can be of assistance pl :ase call o� e-mail me. r Sherman Casper Permits Coordinator sherman ci.tigard.or.us cc file Brian Rager 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD(503)684-2772 ----- ---- ------ — 10/64/2002 16:34 5038449529 NWSt_ PAGE n Electrical Peanut Appji q tion .`' V LM [laiPrcc •; c� r:1, _ _ - Pelmitno.: -- — t`.7f71�Ylq�111!• City Of Tigard � Project/appl,no Sxpirc date: J �•f•ir,„� Address: 13125 SW['gall Blvd,Tii;4)(PP. 972-31007 Date issued: fay: Recciprno.: Phone: (503) 639.417) 1 Fax; (303) 598-1960 i '. Case file no.: Payment type: Land use approval;. ADDT'L INSPECTION ELC20010050I ❑ 1 lRr 2 family(Iwelling or accessory XMommereial/industrial Q Multi-family Cl Tcnant improvement • New constm.tion U Addition/alteration/rcplacemetu ❑Other: ❑Partial .1misi'll UNUORMATION .7 MI Job address: 1.1745 Pa c-i f i C Hwy - Bldg.no. Suite no.; Tax maQ/tax lot/nca,ount no Lot; Block: Subdivision: Project name; Cash & Car>r Descdpt�oil and location of work on remises; 04 Estimated date of rompletiurt/inspectiOrl, aslassam" am I Job not 10 2 5 4 _ 1'eQ Max f3usinesa ntutte: iota F i e _ _ Description �� (tx Total no.ins is v r r r-ix:z1� t&ci�.Lti tit Very msidential•glaslror multi-fandiy per Address: 211 NW Ale i Dr SLe dweltineunit.includecetbclredaarage. City: State: ZIP: Service Included! Phone: 8 4 . 4 7 Fax$4 4 .9 5 2 E-mail: loon aq it.or leas + CCB no.: 1 21 3 2 8 TElec.bus,)Ic.no; Toch ed ever y 500 ii c tot.or portion thereof _ � .4 5 0 C Limited energy,residcntinl 2 Cit /melrolic.no.tLimiiedener y,non-residenuol 2 10/q O finch manuf ctured brnnc or modular dwelling Signanr n s Service andlnr feeder 2 ServiceRorfeedenndation, Su .elect.itame(print) Lice.,sono, n- alteration or relocation s 290 amps or lege 2 Name(print): on f_i i r' 201 ATMLO to 4(10 amps - -- 401 Amps to 600 ample 2 Mailing address 601 am <tn 1000 Amps 2 City; _ Statc;' UP! over 1000 amps or volts 2 _ Phone: Fax: I E-mail: Reconnect only 1 Owner installation;The Installation is being made on property I own Temporary servicer or feeders- which is not intended for sale,lease,rent,or exchange according to allaticn,alreratlon,orrelocation: 200 ORS 447,455,479,670,701. 201 Amps nr _ 2 400 201 Amps to 400 amps Owners signature. Date- 401 to 600 nm R2 Branch circuits-new,-trration, or extcnslon per panel: Narnc: n a __- — _ A. Feo forbranch circuiix with purchaseof Ratites-: _ -tervlce or feeder fee,each bench circuit 2 Citi: V $ ZI1' B. Pee for branch circuits without purchase -- -- — of service or feeder fee,tint brunch arcuir. 2 Phone: j ax In-Mail: itch additional ne bricircuit, M Ise.(Service or feeder not Included): *Serviceover ips-commincial OHealth-cnrefacility Fachpump ofirtigtntioncircle 2 V Service ove, amps-ratings oi1&2 U Hazardous location 5ach si n nr ouliirte Iighting. 2 funilydwellinga 13Building over 10,000 squmo feel four or Signnl circuit(-)or a limited cnarpy panel, d System over 600 vola nominal more residential units in one structure Alteration,orextension•, --1 2 O Building o�erthree stories ❑Pcoders,400amps ormm orkscli bon• O Occupant load over 99 persons ❑Manufactured atructures or RV pnrk Each Additional Inapt-tion over the a�ble In any of$I*above: O Epmimilhdngplan O Other Psly terin- eetion '�_ v _ Submit_sets of plan+-with any of tate above. Investigatlo_o fee -_ Ile above are not appiieAble to lemporary coustruction service. Other Nai all jurixiietione accept credit earns,please call,liundicrion fa mac information. Notice:Thls permit application Permit fee..... ............... U Visa O MasterCard expires If a parmit is not obtained Plan review(at _ 9h) $ Credit cud number: _ �_ L.__ within Igo days after it has been State surcharge(8%) ....S accepted as complete TOTAL ...... ...............$6T-50 Now of cardWiller Ra shown on eredit cord _ `� C a t slptatutn 5 -- 440-4615(6MICOM) CITY OF T'GA R® _ MECHANICAL PERMIT DEVELOPNIENT SERVICES PERMIT#: 9/ 00367 DATE ISSUED: 9/17/0217/02 Rpm 13125 SW Hall Blvd., Tigard, OR 97223 (50:3) 6394171 PARCEL: 1S136CD-01000 SITE ADDRESS: 11745 SW PACIFIC HWY SUBDIVISION: ZONING: C G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN EVAP COOLERS: 5 TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M VENTS WIO APPL: VENT SYSTEMS: STORIES: _ I OILERS/COMPRESSORS HOODS: _ _FUEL TYPES_ — 0 3 HP: DOMES. INCIN: 3 15 HP: 5 COPIMl . INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 70 + HP: CLO DRYERS: FURN < 100K BTU: _ AIR HANDLING ITS S — OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: _ EAS OUTLETS: > 10000 cfm: Remarks: new refrigeration Owner: - ------- FEES ---- _-- l Mechanical Permit Application �^ Date received: t7 PetinaW.Floop- -DO 31.,il City of Tigard Project/appl.no.: Expire data: ) 0tv of Tigard Address: 13125 SW hall Blvd,'Tigard,OR 97223 Phone: (503) 639-4171 rate ivsued_ By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: r, Land use approval: !/ Z -00 0 Z is Building permit no.: U 1 &2 family dwelling or acccrsory iWCommercial/industrial U Multi-family U Tenant imprr vement Ll New construction U Addition/alteration/replacement U Other: Job address: 7 Ctsce` lyzZov Indicate equipment quantities in boxes below.Indi +tc•1,—ollar Bldg.no.: Suite no.: value of all mechanical materials,cqumaicni,labor :-h ad. Tax map/tax IoUaccount no.: - pmftt.Value s�� Lot: Block: I Subdivision: _ 'See checklist for important application information and Project name: C jurisdiction's fee schedule for residential permit fee. City/county: 'ZIP: Dc rpti and Ioc lof�ryron pre i " I ee(e■.) I old Est.date of completion/inspection: ,Z S~ _ on • Res.only Res.� Tenant improvement or change of use: '�/ TAiImg unit CFM _ Is existing space heated or conditioned?dyes U No Air conditioning(site plan r utroiT) _ is existing space insulated?Ld'Ycs U No terauon of existing FTVAC system ilex/compressors -- Business name: State Moiler permit no.: Lqfi tip Tons BTU/H Address: �s 6;/, Fltelmtoke�atnpers/duct smoke detectors -- (&( State: ZiP: eat pump(site plan required) _- Phone: ,Z j f-Q73 'Fax: 6 mail: nsta rep ace Furnacefliumer _ _ Including ductworlavent liner 3 Yes O No CCB no.: ns rep c reocate heaters - sugren City/metro lie.no.: -_-_ wall,or flair mounted Name(please print): C tL Vent for a !intra o than furnace e iteration. Absorption units ItTt:/H Name: , l'hillcrs lIP Address: <oolpnwsors m ron■rent■ ex ost and ven ■ on: City: I _ _ Stale:_ ZIF - Appliance %cnl Phone: (•es Fax: E-mail: Myer exhaust Iloo&.Type /If/res. itc /harmat hors i fife suppression system Name: _ _ Exhaust fan with single duct(bath fans) _ Mailing address: _ Exhaust sZ.;-m a� from or AC City:_ Y Slate: ZiP: PIRR and (up to 4 outlets) --. - Type: LP(i NG Oil Phone: Fax: E-mail: -� uc piping each additional over 4 outlets Procasis piping 00-matte required) Name: Number of outlets _ -- Mher 11diQ i iK eqn pTiseM: Address: rkcorative fireplace City: _ State: =1P: Insert, type -- -^- ` oet tove'honc: E-mail: Other:s - Applicnnt's sign urc: Daws CW61tt Name(print): all / -- - N•N ell pnisdictkms accept eredit raids.please call jumadicaon for mate information. Notice This tit erir it fes .....................s U vise U Mssretc:wd rapplication Minimum fee................ $ Cmdit card number f - expires if a permit is aftl obtained Minimum review(at __ %) S raptres within 180 days after it has been State surcharge(A%) S Name of cardholder as shown,M credit card accepted as complete. c'arAoi(kr mitnetwe — Amount 440.4617(6WC0M) aaa�aaaaa�tr _BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2002-00394 DEVELOPMENT SERVICES GATE ISSUED: 10/7/02 13125 SW Hall Blvd., Tigard, OR 97223 (5011 639-4171 PARCEL: 1S136CD-01000 SITE ADDRESS: 11745 SW PACIFIC HWY SUBDIVISION: ZONING: C-G BLOCK: LOT: _ _ _JURISDICTION: TIG REISSUE: _ FLOOR AREAS_ _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT e FIRT:Ssf NJ S: E: _ _ W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? _ TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: U 00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 502 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED FLOOR LOAD: Psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 400,000.00 Remarks: Create a grocery store Owner: Contractor: SMART& FINAL RBI CONSTRUCTION INC 600 CITADEL DR 1807 132ND AVE NE #2 COMMERCE, CA 90040 BELLEVUE, WA 98005 Phone: 323-869-7591 425-881-1985 Phone: 425-881-1985 Reg #: LIC 69789 FEES W REQUIRED INSPECTIONS Description Date Amount `Mechanical Permit Require Gyp Board Insp 11LSI FLS Pln Rv 9/10/02 $762,72 Electrical Permit Required Susp Ceiing Insp Sprinkler Permit Required Final Inspection iFI.SJ I LS 11111 KV 9/10102 $0.00 Fire Alarm Permit Requirec lilt 111PLN1 Pin Rv 9/10/02 $1,239.42 Plumbing Permit Required 1I11'PPI.NI I'In Itv 9/10/02 $0.00 Framing Insp (additional fees not listed here) Framing Insp --- Insulation Insp Total $4,061.48 Firewall Insp ��-- Firewall ins rhis permit is issued subject to the regulations contained in the Tigard Municipai 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 18C days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requiies you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001.-0010 through OAR 9,-2-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-6699 or 1-800-332-2.344. Issued By: 1 PennitteP Signature: i Call 639-4175 by 7 p.m.for an inspection the next business day %.!t F SE 1 t Building Permit Application Date received: r: :r, ; City of Tigard r r crnut no.:fes✓ „� o v 3 7 7 r•r Project/appl.no.: Exp,,:date: Addi c>, 13125 SW Hall Blvd,Tigard,OR Phone: (503) 639-4171 -vti'ZL Date issued: By: Receipt no.: Fax: (503) 598-1960 y11 It 111 Case file no.: Payment type: Laird use approval:_._ G" I&2 family: Simple Complcx: J I &2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family C3New construction ❑Demolition J Addition/aiteratiun/replacement ATenant improvement -1 i pi wl i i.warm J Other: a Job address: L Bldg. no.: Suite no.: Tax ma /tax lot/account no.: _ Lot: Bloc St divisl n: P Project name: 1 -"Description location of�tiori: laremises/special conditions VIG I ��Name: �iMb?1�— Wiling addresss L3T1 ---_ - I &2 family duelling: fCity: State: C ZIP. QQ Valuation of work .................•...........•........ . — rphone.34 -79 1 f?-mail: No.of bedioums/baths.................................. ►!Lo Tetrl number of floors. Owner's representatn.' UIo d --- — .........................'.. .... Ncw dwelling arca(sq.ft.)............................ Garage/carport area(sq.ft.) N.unc. �tjn^A tl'Zp, Covered porch arca(sq.ft,) ....... ......... MuUingadtlress � � �� - ------ --- [)cckarca(sq. ft.).......................................... — - Cit State:(/� lIP: Q Other structure area(sq. ft.) ................ .. ...... --Y= - -�- — --� - Commerciallindustriallmulti-family: I'hunr - Fax' h-mail: Valuation of work ............................... ....... $ Cxi+ting bldg.area(sq.ft.)....... ......... .. Business name: JG New bldg.area(sq.ft.).................................. —_ ---- Address: W -- Number of stories.......................................... cit : W ZIP: p�,�,� — Y .._ 1]!S;tatc �-.-lfc=. Type of construction ..................................... —.— Phone Fox7 r-mail: Existing: — _ Occupancy group(s): g -JW L-- CCB n , ' New: _— City/metro lie.no.: Notice:All cont, ,rs and subcontractors arc acquired to be i licensed with the Oregon Construction Contractors Board under Name: S 3� 7. provisions of ORS 701 and may be acquired to be licensed in the - -- jurisdiction where work is being performed.If the applicant is Address: ( Z 1 exempt from liccn,ing,the following reason applies: City: -- Contact person: kv11 ACKUP. Plan no.: - ------- Phonr Name: b Contact person: Fees due upon application.............................$ Address: - - bate received, State. _ Phone: _ �Fax: E•ma Am .. ount received.... ..................................... .�_.—. y; 11 _ Please refer to fee schedule. I hereby certify I have read and examined this application and the Nal all jurisdiction%accept credit cards,please call Jurisdiction for more mfnnnation attached chef klist. All provisi ns of;.,vs and ordinances governing this O visa U Maarei-Card work will be complied with, hethe spec ifaed herein or not. credit earl number --- -- apkn Authorized 3ignatllfe: ---bate: �� d?' Name of cardholder as shown on credit card S Print name: _.. _ �K -- ----- �— Catdi•Tdersignuwe Amnnni-- Notice: Phis pem,ii application expires if a permit Is not obtained within 180 days after it has been accepted as complete a4aaau lrs1trv((N) \ F�� --- BUILDING PERMIT CITY OF TIGA E DEVELOPMENT SERV'^ES DATE ISSUED: 88/1/02 2 00334 13125 SW Hall Blvd..Tigard. CoR 97223 (503) 639-4171 PARCEL: 1S136CD-01000 SITE ADDRESS: 11745 SW PACIFIC HWY SUBDIVISION: ZONING: C-G BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: DENT ,1 � — FIRST: sf N: S: E: — W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5f N: S: E: W: OCCUPANCY GRP: TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY L.O,AD• BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ.?: _ REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL SMOK DET:! DWELLING UNITS: FRNT: ft REAR: ft FIR AL.RM : HNDICP ACC- BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: � vt S aOQ- 60 Remarks: Demolition of interior space for future remodel. Owner: Contractor: SMART& FINAL RBI CONSTRUCTION INC 600 CITADEL UR 1807 132ND AVE NE #2 COMMERCE, CA 90040 BELLEVUE, WA 98005 Phone: 323-869-7591 Phune: 425-881-1985 Reg #: LIC 69789 SEES REQUIRED INSPECTIONS Typo By Date Amount Receipt Final Inspection PRMT CTR 8/1/02 v $62.50 27209200000 5PCT CTR 6/1/02 $5.00 27200200000 i_ Total $67.50 This permit is issued subject to the regul�tinns contained in the Tinard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work v,ill 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 -ire set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a opy of these rules or direct quest;,-ns to OUNC by calling (503)246-6699 or 1-800-332-2344. PermItsee- - Sig "tura: Iss By: Call 639-4175 by 7 p.m. for an Inspection the next business day /\ Ruilding Permit Application i - Date received: '01i, 117;- Permit 7 Permit.10.: �y or Tigard Address: 13125 SW Hall Hlvd.Tigard,OR 97223 project/appl. no.: Expire date: t tm �7it��ud —' Phone: (503) 6394171 bate issue-d: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1&2 family: Simple ('omplex: U I Rt 2 flimily dwelling or accessory 1-f Commercial/industrial U Multi-family U New construction emullUon U Addilion/allcr ition/rcpl,,ccntcut U Tenant improvement U I irs spnnkler/alann U Other: Job address: 11-1 •-. ) t(__ i i 1 -. 1 2-L ', Bldg.no.: Suite no.: I.ot: I Block: Subdivision: ITax map/tax lot/accouni no.: �- Project name: C - Descriplion and location of work on premises/special conditions: /r 1 kLA-I_I.1 r t r.,h �•I rF�LI r. P- ' Mailingoddress: tccL C kA-f\ I &2 familt dwelling: City: CC• - State:CF LIP: C'C' t, Valu titan of ark ......... ................ ........... Phone: 7,,)t a ,c 4 ' Fax: I E-mail: No.of bedrooms/haths.................................. --- -— ---- - Owner's representative: I CVr4r\(AU(, A l L r _. U Total number of floats ,........I........................ Phone:lil-� 1 i'1 ! fns F-mail: New dwelling area(sq. fl.)............................ -- Oatrge/carpclt area(sq.fl.) Covered porch areas Name, �`^ (2�. �. � t �, t r t_ \! � lit "' p ( q. fl.) .......................... Mailin address: - rt. � Deck arca(s• . 11.).............................I........... --- g lf�r 1 1 .1 n.vt I it. -L City: �% r T~tate: t�(� ZIP: c ti,(C,t; Other strncture arca(sq. ft.).......................... - Phone: � I �-1-twill CommerciaIII adurtrlaUmulil-famll : Valuation of work ......................................... $ i i �.,�.� C Existing bldg.area(sq.ft.) Business name: New bldg.area tsq.fl.).................................. _ Address: 1'' C A, J C- i 1 L. tit L_ Number of stories City: V t_`I_Lc--v; Stater Type ofconstruction ..................................... i hone. �;� X11 1�.'.' Fax: E-mail• --- -- -- CCB no,: t- 1 Occupancy group(s): Existing: _— City/metro tic.no,: Notice:All contractors and subcontractors arc required to he lieensed with tl-e Oregon Construction Contractors Hoard under Name: j� 11.Ct� f �`.,[�C ( l_ provi cons of URS 701 and may be required to be licensed in the Address: ` C Z. r'�t 1 11 1. l,L_ r' .1 l I! t I jurisdiclrun where work is being performed.If the:applicant is City: t_J t`t Stater ZIP: 'I - exempt from licensing,the following reason a(,piies- Contact person:L t,t a,. t, Plan no.: — -- Phonc: r y,=,, 1 Fax: I F.-Mail: -- Name: Contact person: Feer.due upon application.............................$ _ Address: Da►c received: City: ZIP: Amount received........................................ .$ Phone: Fax_ E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all ptri dictions eccep credit cards,plane call lurisdiclion for more inamnation attached checklist.All provisions of laws and ordinances governing this U W" o MastetCed work will be complied with,1whether s d herein or not. Cmdit card number Authorized signature: 'A � t I�prres ate: _1 vema of ca olan hown on credit c:.i Print name: - -- Cardholder siputure Amount Notice:This permit application expires if a perril t is not ohtained within 190 days after it has been accepted as complete. 440.46111,.Ul't YJ41a CITYOF TiGARD MECHANICAL PERMIT _ DEVELOPMENT SERVICES PERMIT#: ML-C2002-00415 13125 SW Hell Blvd., Tigard, Cil, 97223 (503) 639-4171 DATE ISSUED: 9/18/02 SITE ADDRESS: 117453W PACIFIC HN/Y PARCEL: 1 S136CD-01000 SUEDIVISION: ZONING: C-G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O ADPL: VENT SYSTEMS: STORIES: _ BOK ERS/COMPRESSORS HOODS: FUEL TYPES ) - 3 HP: DOMES. INCIN: 3 15 HP: COMML. INCIN: MAX INPUT. BTU 15 - 30 HP: FIRE DAMPERS?: 30 -50 HP: REPAIR UNITS GAS PRESSURE: 50 + Hp; WOODSTOVES FURN < 100K BTU: _ AIR HANDLING UN' S CLC) DRYERS FURN >=100K BTU: <= 10000 cfrn: OTHER UNII S: > 10000 cfm: GAS OUTLET: Rem,-Arks ;remove ducts and add concentric kits anr+ ,stats. Project value: $16,000. Ow�ier: FEES SMART 8 FINAL Type By Date Amount Receipt CO ;MERG , DR CA 5PCT CTR 9/113/02 $19.27 2720020000 COMMERCE, CA 90040 PRMT CTR 9/18!02 $240.93 272002000x, ' Phone:323-869-7591 Total $260.17 Contractor: OREGON HEATING 4- A/C INC PO BOX 397 DUNDEE, OR 97115 REQUIRED INSPECTIONS Mechanical Insp Phone:538-2913 Final Inspection Reg #:LIC 125815 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuan^e, or if work is suspended for more than-- han 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 thrOUgh OAR 92-001-0080. You ma obtain copies of these rulE!S or di ect questions to OUNC by calling /,h�'319AR_g1 W } �n Issue By: � , - -{�.`(.U_ftL� Permittee Signature: Call (503) 619-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Dale received: /Q D� Permit no.:f Afe Cit of Tigard '' y � f'rojecUappl,no.: Expire date: 0tvofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: 1 U I &2 family dwelling or accessory B Commercial/industrial U Multi-family 0 Tenant improvement U New construction U Addition/allaation,rrcplar.cmcnt J I)lher:_ VALUATIONWMMEKCIAL I Job address;: e�" e, t_ Indicate equipment quantities on b(xes below. Ind�cate(he dollar Bldg.no.: I Suite no.1 value of all mechanical materials equipment,labor,overhead, "Tax map/tax lot/account no.: - profit.Value$ _Z4 -�— . Lot: _ 791ock: Subdivision: —_ *See checklist for important application information and Project name: �'n`,(� jurisdiction's fee schedule for residential hermit fee City/county: C, ;QIP: _ — 1 2 FAMILV I I D ascription an lir ion of r on premise. 1 I 1 �� / Ftr•(ca.1 I olid Est.date of completion/inspection: IMscription (A). Res.only Res,onit Tenant improvement or change of use: HVW t Is existing space heated or condili•:ncd'. id 1'es U Air handling unit N° it conditioning(site p an rcquircdr Is existing space insulated?4 Yes U No teration of existing 11VAC system 1 1 rn er cornpr,!ssors Business name: /),/G _ State boiler permit no.: � HN Tons BTU/H Address: L ZIP: r T ip-stn-o e rinmp-c-r7duct,anwk-c JeF ectors City: _ State: *� eat pump(site plan required) Phone: e `yT5 Fux: E rttail: ossa /rep acefurnac burner r CCB no.: / r /r_ Including ductwork/vent liner U Yes i]No _— nstall/replace/relocate eaters-suspenr,e , City/metro tic,no.: /y waG,or floor mounted time( lease print): Vent f,rt appliance other t an urnace 1 Itchl erallon: Akorption units___ _ BTUM Name: ( hillers_ _ HP Address: -- -- --- Co m�ressorc „�— fill City: i State: ZIP: ;nom i ronnoter(at exhaust and ventilation: _ Appliance% pit _ Phone:r tj q 6, C` •T:i\ E-mail: Ihycrexhaus( — - no-o s, 'yplTi des. itc ren/hazmat hood fire suppression system �.. Namc: _ _ —_ Exhaust fan with single duct(bath tans) Malling address: x aunt ,tem a art Irnm M.eating or AC City: --� _ Stale: _ ZIP: ue p to nig aPd distribution(up to nal ets) 1 ypr Lf'O NO __ Oil Phone: I i E-mail: Fuel rr•,n��ea'c' ar itional over 4 outlets _ rocessplpTng(seu� maticrcquirec) Numhsr of out lets Name: �� _ ter ti appTrance or�qu pment: Address: _ I)ecorativeftreplace City: C_ Slutc: III': nT srn�type-� — Phone: Fax: E-mail o s:ove/(relletstovr _-- Other: ---- --- - Applicant's signature: Date:r r f Other: Name (print): '- -._ Na all)unsduinns rcepi credit rants,pk;ase call)unsdiciionhe more inGxniailon Notice:This permit application Permit fee.....................$ L)visa v 1NastrrC'ard iMinimum fee.. $ _ expires if a permit s not obtained l'm,id cant numhr•r ..-----------.,_--- _1�— Plan review(at — 3F) $ Expurs within 190 days after it has been State surcharge(8%).... Name of cardholder as rhown on c ii c accepted as complete. TOTAL ~, ---— S .......................$ r`ardholde+signature^ Ammnr MECHANICAL PERMIT FEES COMMERCIAL FEF_ SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Descriptio•,. Brice Total $1.00 to$5,000.00 Minimum fee$72.50 Taole 4A Mechanical Code _ my . (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Fur lace to 100,000 BTU $1.52 for each additional$100.00 or Including ducts&vents _ 14 00 fraction thereof,to and In,,Iuding 2) 7wi,aCe 100,000 BTU* $10,000.00. Includ ng ducts&vents 117 40 $10,001.00 to$25,000.00 $148.50 for the first$10,000,00 and 3) Floor Fumace '1.54 for each additional$100.00 or including vent 14.00 1 iraclion thereof,to and Including 4) Suspended heater,wall heater $25,000.00. _ or floor mounted heater 1400 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included In appliance permit $1.45 for each additional$101.00 or 6.80 fraction thereof,to and Including 6) Repair units _ $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pun,p Cond fraction thereof. footnotes below. Comp •• Minimum Pnimlt Fee$72.50 SUBTOTAL: 7)<3HP;absorb unit to 100K BTU 14.00 8Y.State Surcharge a 0)3-15 HP;absorb unit 100k to 500k BTU 25.60 25%Plan Review Fee(of subtotal) $ u 15-30 HP;absorb 35.00 Required for ALL commercial permits only ___ unit.5-1 mil ;a TOTAL COMMERCIAL PERMIT FEE: $ 10)301.7 mil absorb 52.20 unit 1-1.75 mil BTU 11)>50HP;absorb unit>1.75 mll BTU 1 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM _ 10.00 _ -i Value Total 13)Air handling unit 10,000 CFM+ Description: Qt Ea Amount 17.20 _ Fumace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace>100,000 BTU Including 1,170 15)Vent fan connected to a single duct ducts&vents 6.80 Floor fumace including vent 955 1 16)Ventilation system not Included in Suspended heater,wall heater or 955 appliance permit 10.00 _ floor mounted heater 17)Hood served by mechanical exhaust Vent not Included in appliance 445 10.0u permit -- - 18)Domestic Incinerators Repair units 805 _ 17.40 <3 hp;absorb.unit, P55 to 100k BTU 19)Commercial or Industrial type incinerator -- 69.95 _ 3-15 hp;absorb,unit, 1,700 20)Other units,Including wood Moves 10 i k to 500k BTU 10.00 15-30 hp;absorb.trait,501k to 1 2 d10 mil.BTU -_ 21)Gas piping one to four outlets 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU _ 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee 572.50 SUBTOTAL: $ >1.75 mil.BTU _ Air handling unit to 10,000 cfm 6568%--- ----- Air handlingunit>10,000 cfm 1,170 State Surcharge $ Non-portable evaporate cooler -656 _ TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 448 - Vent system not included In 656 applianceptrmlt Hood served b mechanical exhaust 656 Other 1 Inspections eecuons and Fees: Domestic incinerator 1,170 outside of normal business hours(minimum charge-two hours) $62 5o per hour. Commercial or industrial Incinerator 4,590 2 Inspections fcr which no fee is specifically indicated (minimum charge-half hour) Other unit,including wood stoves, 656 $62 50 per hour Inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas piping 1-4 outlets _ 360 charge-one-hall hour)$62 0 per hour Each additional outlet 01 - - - "State Contractor Boller Cortiflcaiion required for units>200k BTU. _T_ ''';;,sidenlial A/C requites site plan showing placement of unit. TOTAL COMMERCIAL VALUATION: All New Commercial Buildings require 2 sets of plans. t:ldstsdormsUnech-fees.doc 02/11/02 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 z BLIP Received Date Requested AM _ - PM BLIP -- -_--- -_- -_- Location _—__ J 4S_ Suite___- / ---/�-/—L�--.yy MEG Contact Person — r Ph(��z) �!_ �G�rZSCZ PLM ---- - - Contractor_ Ph( ) _____ -_-_____ _ SWR IL NG _ Tenant/Owner - _ ELC FootLad oundation ELC CCA88: Ftg Drain ELR _ Crawl Drain _ Slab Inspection Notes: SIT ^ Post&Beam - Shear Anchors —___ -- Ext Sheath/SheF r Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - -- -- Roof 14- Other: ��.. Z i - � PART FAIL P ING -_ 11 Post&Beam Under SlabRough-In Water Service1+ Sanitary Sewer Rain Drains --- Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS PARTFAIL. — 1-`'`- — MECHANICAL Post&Beam - —� -- - Rough-In Gas Line Smoke Dampers —-- — —. Final PASS PARTFAIL ELECTRICAL_ Service Rough-In UG/Slab Low Voltage Fire Alarm Final I PASS PART FAIL Reinspection fee of s required before next inspection. Pay at City Hall, 13125 SW Hall Blvd SITE Please call for reinspection RE: — —_.^_ Unable to inspect-no access Fire Supply Line a nn � ADA � "vl — 2 Approach/Sidewalk D ---- -- — IDfp•Clet _— Other: f-11al DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL) CITY D F' JI ,i'I�V;i/"'1►RD ELECTRICAL PERMIT PERMIT#: ELC2002-00426 DEVELOPMENT %3'FRVICES DATE ISSUED: 21)8/02 13125 SW Hall Blvd..Tigard, CIR 972?3 1503) 633-4171 PARCEL: 1 S136CD-01000 SITE ADDRESS: 11745 SW PACIFIC I''NY SUBDIVISION: ZONING: C-G BLOCK: LOT : JURISDICTIOW TIG Proiect Description: (1)sign lighting for new wFII sign. RES'DENTiAL UNIT _ _ TEMP SRVC/FEEDERS_ _ _ MISCELLANEOUS 1000 SF OR LESS: '— 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500Si: 201 - 400 amp. SIGN/OUT LINE LTG: 1 LIMITED ENERGY• 401 .. (dPl. amp: SIGNAL/PANEL: MANF HM/SVC/ FDR: 601+amps - 10G(' volis: MINOR LABEL (10): _ SERVICE/FEEDER; _ BRANCH CIRCUIT — ADD'L INSPECTIONS _ 0 - 200 amp: _ Nil ar_RVICE OR FEEDER: PER INSPECTION: L' 91 - 400 amp: 1 st W/O SRVC OR FUR: PER HOUR: 4111 - 600 amp: EA ADD1 BRNCH CIRC: IN PLANT: 601 - 1000 arnp: _ PLAN REVIEW SECTION 1000+ amp/volt: >=4 PES UNITS — — >600 VOLT NOMINAL: — —� _Reconnect only. SVC/FDR >= 225 AMPS. CLASS AREAISPEC OCC: _ Owner: Contractor: UNITED GROCERS SECURITY SIGNS INC 11745 SW PACIFIC HWY 436 SE 12TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: Phone: 503-232- Reg #: EL r. LS FEES Required Inspections Type By Date — Amount Receipt Rough-in PRMT CTR 8/28/02 $53.40 212OU20000( Elect'I Final 5PCT CTR 8/28102 $4 27 2720020000( – _-- Total $57.67 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 stta[t"lltn'tBQ,days of issuance,or N work is suspended for more than 180 days. ATTENTIC N Oregon law requires you to follow rules adopted by the Oregon Utility Nbtiflcation Center. Those rules are set forth In OAR 952-001-0010 through OAR 952.001-0080. You may obtain copies of.ltlese rules or direct questions l )UNC at )246.6699 or 1-800-332-2344. _ / Permit Signature: � � �� Issued By: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE _ _ �— �_- �_ DATE:__ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. FLEC'N: _ ______ __—__.___________�_ -- DATE: — LICENSE NO: — Call 639-41"'5 by 7 OOpm for an inspection the next business day IMI tile Llectrig, 1 Permit App ieation Received Electrical �nM,-��/n/ Date/B P� ,'do.• Plannin - Sip, 13 � city of "higard Test ; jorm Date/B : IV.nitNo _ 13125 SW Hall Blvd. Plan Review Otho Tigard,Oregon 97223 Date/By: Permit No.: Post-RevPhone: 503-639-4171 Fax: 503-598-1960 Date/By: Land Use Date/By: __ case No.: Internet: www.ci.tigard.or.us Contact Juris: Sec Pate 2 for 24-hour Inspection Request: 503-639-4175 Namc/Method: Sajifilementol Information. pk,y;b6A-ao4,o5- M TYPE OF WORK _ PLAN REVIEW(Please check all that apply) New construction ❑ Demolition _ Service over 225 amps- Ilcare facility commercial ElI lizardazardous location Ad_dation/alteration/replacement Other: p Service over 320 amps-rating of U Building over 10,000 square feet. CATEGORY OF CO STRUCTION I &2 family dwellings four or more residential units in 1 & 2-Family dwellin r Commercial/Industrial W ❑System over GW volts nominal unc structure ❑building over three stories ❑Feeders,400 amps or more Aeeelso $Ulldln ulti-Family ❑Occufant load over 99 persons ❑Manufactured structures or RV park Master Builder _ Other: ❑Fgrecs/lighting plan ❑other:__ _JOB SITE INFORMATION and LOCA?ION Suhnrit—_sets of plain with any of the above. —--- The above are not applicable to temporary construction service. Job site address: U 1577_k.1 ar,P 14_W�__. FEE*SCIIEDULE Suite#: _ $ld%Apia'#:— _ i_ Number orins ectbns er crmit allowed Pro'c� et Name: (,_�,(�-Tr py11`��S��J�-� nescri tion 6I Fee(en.) Total New residcnllal-singie or multi-fandly per Cross street/Directions to fob Site: dwelling unit.Includes attached garage. Service included: 1000 sq.It.or less 145.15 4 Each additional 500 sq.it.or rtion thereof 33.40 __ 1 Limited energy,residential _ 75.00 _ 2 Subdivision: I-tit#; Limited enemy,non residential 75.00 2 _Tax man/parcel M Fach manufactured home or modular dwrlling — llF.SCRIPTION OF WORK service and,'or feeder 90.90 2 Services or feeders-Inslallailou, r alteration or relocatlon: 200 amps or less _— 80.30 2 201 ams to 400 ams 106.85 _—• 2 401 ams to 600 ams �- 160.60 2 El PROPERTY OWNER— TENANT 601 amps to 1000 amps 240.60 2 —— Over 1000 ams or volts _ 454.65 2 Name: _ Reconnect only 66.85 2 Address: Temporary services or feeders-Installation, — — alteration,or relocation: Clt /State/Zl 200 amps or less _. 66.85 1 --� --p--- 100.30 2 Phone: Fax; 201 amns l�0 400 amps _ 401 to 60I amps 133.75 _ 2 APPLICANT I LJ CON'T'ACT PERSON Branch circuits-nesv,Aeration.ar Name: extension per panel: �. A.Fee for branch circuits with purchase of Address: L4tG.—_��_ service or feeder fee,each branch circuit f'fS 2 Cit /�te/Z�pG{2 1-- L. L 11.Fee for branch circuits without purchase of - service or feeder fee,first branch circuit4r �> 2 Phone: 2 1 Fax: Z3 G7 t Each additional branch circuit _ ____ r.65 2 3�-�lL----- �_ �l_ — E-mail: Se o r t S uC..t.N�6 �.� ,L isc.(Service or feeder not included) Each pump or irrigation circle 53.40 2 CONTRACTOR — ----- tiach sign or outline lighting _ 53.40 Job No: _ _ Signal circuit(s)or a limited energy ranel. Business Name: ,��. t-r^+Y �jlt �___ �lteration,orextension* 75.00 2 �� Description Address: Each additional inspection over the allowable In any of the above: City/State/Zip:_ z • �LPer inspection(Ner hour-min. I hour) 62.50 Phone: & TFax: '..'f.3 O f (0 1 Investigation fee: _ CCB Lie. #: gbh _ Lre.M t_&G► Other: Electr_ical_Permit Fees* Supervising electricitt -� Subtotal S b si ature re uirq ed; —_ — Plan Review L25"/o of Permit Fee 'S Print Namc( �CC_.�.� Lic. #: / — State Surcharge(8%of Permit Fee) TOTAL PERMIT F1,T I t z Authorized _ Notice: This permit application expires if a permit is not obtained within Signature: Date: Z 180 daps after It has been accepted as complete. B - li- -- 1! O Ia��L.f ... _ _ -Fee methadologp set by Tri-County Building Industry Service Board. (Please print name) CITY OF TIGARD 24-Hour BUILDING In..pection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP a009_02 Received _ Dale Requer?ed .,�P1�a2.._. AM PSI ___ BLIP Locrition Cr -J==��L77L_ � _ V ---Suite—_ MEG Contact Person Ph(,_) -- -__ PLM Contractor /,''f _P JCf,` � L�1-- SWR Ph ) _ _. _Y _ -- -- — - — --- BUILDING _ TenanUOwner G.;�� - /7_ _-_- reel L ELC Footing V Foundation ELC -_- Ftg Drain Access: ELF! Crawl Drain Slab Inspection Notes: SIT - Post& Beam Shear Anchors Ext Sheath/Shevr Int Sheath/Sheai Framing --- -- Insulation Drywall Nailing -- Firewall Fire Sprinkler - -------- -- Fire Alarm Susp'd Ceiling Roof Other: - - --- - - Final — PASS PART FAIL PLUMBING Post&Beam Under Slam --. Rough-In Water Service - Sanitary Sewer Rain Drains - - ---- +- - Catch Basin/Manhole Storm Drain -- — - - - - _ - -- - --- - - - Shower Pan Other: - - - =inal PASS PART FAIL MECHANICAL Post& Beam Rough-In Gas Line Smoke Dampers - Final PASS PART FAIL - -- - -- --- --- ---- -- --- -- - -- ELECTFii Service — - Rough-In UG/Slab Low Voltage FimAlarm P PART FAIL Reinspection fee of$ _._.____— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S ITtPlease call for reinspection RE: _ _ Unable to inspect-no access Fire Supply Line ! I ADAp / -�c�- Jc1 l- Approach/Sidewalk Oats ��'C„ � M � C�, Inspect r Ext Other: Final DO NOT REMOVE this Inspection record from the job sato. PASS PART FAIL __ CITY OF T I G,A R D LLECTRICAL PERMIT PERMIT#: ELC2002-00585 DEVELOPMENT SERVICES DATE ISSUED: 11/6/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S136CD 01r?Ou SITE ADDRESS: 11745 SW PACIFIC HWY SUBDIVISION: ZONING: G-G BLOCK: LOT : JURISDICTION: TIG Projet.• Description: Joh No. 10254 Tenant Improvement RESIDENTIAL UNIT_ __ TEMP SRV_CIFEEDERS_ _MISCELLANEOUS_ 1000 SF OR LESS: 0 200 amp PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp. SIGN/OUT LINE LTG: LIMITED ENERGY: 4^' - 600 am, SIGNALIPANEL: MANF FIM/SVC/FDR: 601+amps - 1000 volt.. MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'l_INSPECTIONS 0 200 amp: ? W/SERVICE OR FEEDER: �i PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: 1 EA ADO'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: 1 _ _ _ _ PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: — > 600 VOLT NOMINAL: — Reconnect only. SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: SMART 8 FINAL NW ELECTRICAL SPECIALTIES 6HO CITADFI_DR 2110 NW ALOCLEK DR COMMERCE Cri 90040 SUITE 609 HILLSBORO OR 97124 Phone: 323-869-7591 Phone: 503-844-4788 Reg #: ELE 24.450C _ FEES Description Date Amount Required Inspections [ELPRM"1] ELC Pcrmit 11/4/02 $601.70 - [ELPLCK) ELC Pin Rcv 11/4/02 $150.43 Ceiling Cover (TAX]S%State Tax 1 1,.1 ni $48.14 Wall Cover Underground Cover Total $800.27 Elect'I Service Elect'I Final 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 wcrk is not started within 180 days of issuance,ortf 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 ruses ordirect questions to OUNC at(503) 246.6699 or 1.800-3 344.. ' Issued By: l! �Lrl� rl< �/ Permit Signature: J l + ' I _ OWNER INSTALLATION ONLY The installation Is being made on property I own which is not intended for sale, lease, or rent. f ,WNFR S SIGNATURE: —_ --- DATE: DATE: _�- - -- CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: ��" �' ` _ DATA: _ 1 I C E N S E NO: _..-- -- -- 1 ,�.�.r -�l _f L L Call 639-4175 by 7:012pm for an Inspection the next business day Electrical Permit Application "Datereceived: it 02 mit n OD City of Tigard Project/appl.no.: Expire date: Ciry of Tigard Address: 13125 SW I lall Blvd,Tigard,OR 97223 Date issued: By: Receipt nt, Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: .J Land use approval: U I & 2 family dwelling or accessory XW Commercial1industrial U Multi-family XX Tenant improvement U New construction U Addition/alterntitm/replacen)ent U Other:_— U Partial .1011 SITE INFORNIA'l ION Job address: 11745 Pacific HWY no.: Suite no.: Tax map/tax lot/account no.: Lot: I Block: Subdivision: Cash & rarry Bldg Project name: Vacant T7_ Ocscriptinn and location ul'work on premisrs: alter existing servic?r [unmated date of Com)letion/ins ection: add new 200 service Ir.e . t Job no: 10254 -�_ vee Max Business name: --- Descripti,m QlY. (ea.) f•otal no.imp Newn�idenl4d single ornmlti Wnih per Address: 2110 NW Aloelek Dr Ste 6 Q�_ dwell6lgwril.Includrs xuxelred{;arttf;e. City: Stale: LIP: Servicelncludctil: aPhone: 8 4 4 . 4 7 8 8 1 Fax8 4 4. 9 5 2 I.^mall: 1000 Sy It.Il ICSS 4 1 21 3 2 8 3 4 4 5 0 C Each additional 5tx1 sy.A.or portion thereof CCB no,: Flec.bus. lic.no: • — I.imitedenergy,residenUul _ 2 �O City/metro lic.no•: _0 0 4 8 9 9 Liinited energy,nun-residential 2 10/4/02 Each manufactured home or modular dwelling Signatul I s acv ng a icmM (required) Dale Service and/of feeder _ Sup clru n:une(ptinULicense no. Services or feeders-Installation, alteration or relocation: 200 amps or less 2 80.30 160.50 2 Name(print): Monaghan Earms_Ine 201 amps to 4011 unips i 2 --- 401 amps to 61M1 amps 2 Mailing address: 14_120 E Evans Ave 601 amps to 1000 anips — 244.50 z City: Aurora State: Ca ZIP: 80014 over IUOO amps or volts - — —2 — Phone: I Fax: I E-mail: Reconnect only - -- --- I Owr,vr installation:The installation is being made on property I own Temporaryservices or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocatlon: s ORS 447,455,479,670,701. 200 amps(it less 2 201 amps to 4W snips 2 Own_r's si tialurc n a_ Ikdc .101it)6onuni s -- 2 Branch circults-new,alteration, Name: or C%lension per panel: ._ n a, _. �._ 90 A Fcc(ur hranch circuits with purchase of 6 6.6 39. Addre.,s: service or feeder fee,each branch circuit 2 `► City: I S ale: ZIP_-Y _ _ B. Fee for b anch circuits without purchase Pt nr: I a t I' mail of service tit feeder fee,first branch circuit: 2 Ench additional branch circuit 'tI Its Mbe.(Service or feeder not Included): rvice over 225 amps-conaoetaal U I lealth care facility Each pump or itrigaunn circle 2 11 service over320amps-rating of IAt2 U Haaarduuslocation Each.' naroutlinelighling 2 farnilydwellh,gs U Building over 10,000 square feet four or signal cirruit(s)or a limited energy panel, U System over 600 volts nominal mote residential units in one structure alteration,or extension* 2 J Building over three stories U Feeders,4(X)arnps or arare *Description 1 J Occupant load over 99 persons U Manufactured structures or RV park Lach additional Inspection Iter the allowable In any of the alcove: U 4ressilightingplan U Other: - -_--- - Per Inspection --�--- Submit sefs of plans with any of file above. Investigation face _ The above are not applicable to temporary construction service_ other Not all jutis actioaccept credit sands,please call jurisdiction fix mote infrnnurmn Nclice:This pemttt application Permit fee.....................$61]1 ]f) n O Visa U MasterCard expires if a permit is not obtained Plan review(at _ 'Y,) $1--51] Credit card number: — within 180 days oiler it has been Slate surcharge(8%) ....$ 48.14 Expires "fifes accepted as complete. TOTAL, . $8D(L, _7 -- Name of cart ldrr as shown on credit card _ S _ Crdholdet sipature Amount 4404615 tytxyCOM I