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CITY OF TIGARD ENER
ELECTRICAL ENERT -
RESTRICTED GY
DEVELOPMENT SERVICES PERMIT#: ELR2003-00131
13125 SW Hall Bivd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/12/03
PARCEL: 2S102BD-02600
SITE ADDRESS: 12963 SW PACIFIC HWY
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C-G
BLOCK: LOT: 037 JURISDICTION: TIG
Proiect Description: Installation of protective signaling.
A.RESIDENTIAL _ B.COMMERCIAL_
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR AI-ARM: BOILER: LANDSCAPElIRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CAL-LS:
VACUUM SYS rEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: KVAC: PROTECTIVE SIGNAL: k"
INSTRUMENTATION: OTHER:
TOTAL# OF SYSTEMS: I
Owner Contractor:
KIM, ROBERT + HAE LIM SONITROL PACIFIC
1360 SW WOODWARD WAY 8220 N. INTERSTATE AVE.
PORTLAND,OR 97225 PORTLAND, OR 97217
Phone: Phone: 223-5922
Reg#: LIC 53535
ELF 26-370t I I
^_ FEES Required Inspections
--—
Description Date Amount Low Voltage Inspection
ILl'I'Ith1 t] FI'R Permit 5/12/03 $75.00 Elect'I Final
ITA X 1 9 State'I'ax 5/12/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This 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 throuc
Issued by , l't'Ic ' 4 `. Permittee Signature---,,-
OWNER
ignature�OWNER INSTALLATION ONLY
ne installation is being made on property I own which is not intended for sale, lease, of rent.
OV NFR'S SIGNATURE: --- --- _ -- -- DATE: v_
CONTRACTOR INSTALLATION ONLY _—
SIGNA'rURE OF StJPR. ELEC'N — '• i/GTS.' DATE:-
LICENSE NO: --
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
MAY-09-03 01 :36 PM 50NITR01.—PORTLAND 9737773 P. 02
Electrical Permit Application
Data eecelved: 4 Permit no:r_44= /1
City of Tigard Project/oppl.no: Explredate:
riNof'IiXnrd Addrtss: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By Rccsiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Gso file no: Payment type:
Land us(; approval:
V
t
O;Newconstraction
mily dwelling or accessory •1u Commercial/indtislrial O Multi-family O Tenant improvement
O U Addition/aI fetal i(tn/rep)acOment U Other ❑Partial
,
Job l rw Ql C K yv)(C Rlrly, III,
Tax map/tax lot/eccount no.
Lnl! Block: I Subdivision: U
Project name: Nseription and location of work on premises:-1 4� *•
Estimated date of completion/inspection:
Job no'._i.1L -,-�— —_�-- Fac Ma,t
�� Uescn pion Qty. feu.) Total , In
Business name. r--v] hewrmidrntlal-r"Irormuld ramll)per
Address: Jv tt __k.k dNelllnltunlr.Includes enaihrdearage.
C1t—y �� `.t State Includcd.
LlF': 'l Serdc•
t^hune: Fax: '1'1 Email:
1000 sq.h.or less 4
each additional 00 s ft,of ortian thereof
PR
B nopo
1- Elec. bus tic,no: l invited soar ,rosldenUll 1
�r'm—ec.n0.' _ ___ urrdtedaner Y non nitdentfol 2
Joh manufactured home or modular dwellin0
Service and/or feeder 2
Slgnalure of surervising electrician(required ba1e S 3 -$4"Iceir or retillers— nstalleUon,
Sup.elect name(pain)' r r. [c'cr I.Itxase no: attention or relocation:
200 em s or less 2
701 am a to 400 amps 2
401 amps to 600 amps _ 2
Mailing address: 601 am s to 1000 amps 2
rtfy: Stale: 7.11': Over 1000 ampa nr volts
Fax: E-mail: Reconma nl 1-
Phone: Temporary urviesto or feeder- -
owner installation:'t'he Installation is being made on property I own yill„llanon,olleraloft,orfeloratlon:
which is not intended for sale, lease,rent,or exchange according to 2W amps or less 2
ORS 447,455,479,670,701. sol am r m 400 un s 1
Owners si nature. Date: 401 to 600 sm s 1
Branch circelts•nerr,a(terallon,
or attestation per panel;
Name: A. fee for branch circuits with purchase of
_Address: _ service or feeder fee,each brach circuit _2
---- State: LIP: B. Pee for branch 6renits without purohate
Ctty of service or feeder fee,first bran:h circuit 1
Phone: Fax: Email: achadditionalbranchcircuh.
lac.(Senlee or feeder not Inc u e ):
Faeh Dump or UTMation circle 1
O Service over 125 amps-con tserri:il ❑ Healthcutfacility Each si n or outline I+ linin 2
U Service over 320 amps reiing of I A2 ❑ Ilasardou rincadon 9i h cit or ou)or a limited enerjY panel, '
family dwellings 1 r3ulldmgover l0,000equmefeetfuuror a
O System over 600 vola norrunal more residential units in one struetute alteration,or extenslor• 1
0 nuilding over three stories t]Feeden,400 amps or micro r(7tu�cr�i tion:� —
❑Ckcupant load over 99 persona Q Manufactured swctutes or RV pati ch addlllonal YuprrIon over the allowable—�am )many of rhe abort.
C]Egremlighlintipla, ❑Other -- — per inspection
%bilitlt_sets or plana with any orthe above. Inrelu aeon fee
no above are eat appllcable to temporarycondructlan service. 011ier _
-- --- Permit fee -...................S
tid ui Twiznoru aixpr aa.at cards.ptaaaa Call jurtadisslat for mon law""eo. Notice,This permit apFliceNnn Plan rat few(at — %) $ -
sa 0 Mu rcard U N la ezpfrcs if a permit is not obtained State surcharge(8Q6) .•••S -L2' ►--.�'UC
cpdh aatd rnrm!er .) r / 0 4 t. s s within 180 days after It has been t
4 .x'17"{' xp 1es accepted as complete TOTAL ....................... S
"04615(aVtllMM)
Amount
r I�ilgnstun
MAY-09-03 01 :39 P1 SONITROL-PORTLAND 973777
Elcctr;Cal permit Fees: Limited Energy Fees:
- TYPE OF WORK INVOLVED RESIDENTIAL ONLY
Complete Fee Schedule Below: Reetrfcied Enorgy Fee...................................................... $7S.00
Number of Ins ecilons er enTilt allowed (FOR ALL SYSTEMS)
Service Included, Items Cost Total Check Type of Work Involved:
M
Realdentlal-per unit -
1000 6q It cr 1060; $145.13 4 Audio and Stereo Systems
Eacn additional 500$q.fL Or v $33 40 1
portion thereof Burglar Alarm
Limited Energy S75.00
Farb Manurd Name or MCAUlar Garage Door Opener'
I�well(n0 SAn-Ir.e Of�eA(1Hr ___-- __
$90.90 2
Services or Feeders Heating, Ventilation and Air Condltionlrig Sy6tem'
Installation,alteration,or relocation 2 i ►"''�
200 amp6 or less _ _ $60,00 _ L_..I VOCULm Syster,Ia'
201 amps to 400 amps; $106.35 _ 1
4C1 amps to 600 amps _ St6o,60 2
5240.60 .• 2 n all
60t amps to 1000 amps �
Over 1000 amps or-its 5454.69 _ 2
Reconnect unly S66,e.' �- 2
Temporary Servloes or Feeders TYPE OF WORK INVOLVED •COMMERCIAL ONLY
Inewit4tion,a!teratlon,or relocation 2 rat for each Aystern......................................................... 575. 0
200 4MV6 or 1454 (SLE OAR 919.260-260)
201 amps to 400 amps S 1100 00 100 ?
401 amps to 600 erhps _ __�_ 5199 15 __ 2 Check Type of Work Involved:
Over 600 amps to 1000 v0115,
see"b"abovo L� Audio and Stereo Systems
Rrrnch Clrrulls
New sutra(on or extension per panel Boiler Controls
a)ThA fee for branch circuits •
w/111 purchase o/servlet or Q Clock Systems
hider loo.
Egrh Gran'h Cirtull S6 05 2
�] Data TeleGommunlcaCan Inetallati0n
b)Tho fee for hranch ci COIS
w1thout purcheae Otialvf:e ❑
or feeder tee. Fire Alemt Installation
First 0morh circuit
F.ach additlonal br*meh circuit R�— $6 65 _ MVAC
Miscellaneous �I
t$erNce u(feeder not included) Inetrvrnentafion
Each pump Or ImyaUnn clrcle Sys 40
Erarh sign of o(illine 119hting IntefCOm and Paging Systems
Signal clrrult(5)or a dmltod energy $7500
parol,a teration er e><1en61or _..�__ - `*�' Q Landsoype irrigation Control'
Minty I-Abels(10)
Each additional inapectiorl Over Medical
the allowable In any of the ab.ws $92.60
Per Inspactlon $82.50 U Nurse Calls
Per hour
In Pleni $73.79 ❑ Outdoor Landscape Lighting'
Fees. Prof'. -o Sipnal!r0
Enter total of above fees 3 -
@%Stnte cmrcharpn $ �--� 1 — --�
1 Number Of SVSfeMe
25%Plan Review Fee $
Sea'Plan Reoe'ti 6ACL:0n On • No licarw ire rear-fed �canses are required Icr as ober InelallOLJM
front of apnlKawr
Fees:
Total 19a/ance Due
Enter total of above fees
Trust AGcaunt 0 __
I` 9!L Stats Surcharge
Tota/Balance Due $ �
i.ldats�fomr�tir:•fees.doc 10/09/0x)
CITY OF T;GARS) 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
BUP ----
Received _ _- Date Requested_ -5- J �_AM_. PM-` BUP
Location __ _ -_ Suite-. __ MEC
Contact Person _ -- Ph 2 d-3 '5 PLM
Contractor—_ _ Ph(_.__ ) _-__ SWR —
BUILDING Tenant/Owner - ___ ELC
Footing ELC _---
Foundation Access:
Ftg Drain ELR
Crawl Drain -
Slab Inspe tion Noes: SIT _-
Post&Beam _
Shear Anchors -
Ext Sheath/Shear ---.-.- _.--
Int Sheath/Shear
Framing ---- ---
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler --i---- -
Fire Alarm
Susp'd Ceiling -
Root
Final
PASS PART FAIL - - ^—
PLUMBING —_-
Post&Beam
Under Slab --- -- ---
Rough-In
Water Service - ----- -- - - — ---.
Sanitary Sewer
Rain Drains ----- --' --
Catch Basin/Manhole _
Storm Drain
Shower Pan
Other: - ----- ---- ---- --- ---
Final
_PASS PART FAIL - - -
MECHANICAL___ --------- -- -- - ---- ------
Post&Beam -
Rough-In - - -- -- --- ---
Gas Line
Smoke Dampers - -- --- -
Final
PASS_PART FAIL_ `---' —
ELEGTRICAf _-
Service
Rough-In - --------
UG/ 1
_Low Voltage ) -
Fit'B A1t3rffl--"
WAna [j Reinspectlon fee of$ ___.____-- _- required before next inspection. Pay at City Hall, 13125 SW Hail Blvd.
SART_ FAIL_ _
SITE_ eas
Ple call for reinspection RE:—�--__ Unable to inspect-no access
Fire Supply Line /
ADA Dab InapAcR�r
Approach/Sidewalk
Other:.-__ _
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITYOF TIGARD ___ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: P28/02 -00337
AIL DATE ISSUED: 8/28102
13125 SW Hall Blvd., 'rigard, OR 97223 (503) 639-4171
PARCEL: 2S102130-02600
SITE ADDRESS: 12963 5W PACIFIC HWY
SUBDIVISION: NOR'H TIGARDVILLE ADDITION ZONING: C-G
_ BLOCK: LOT: 037 _ JURISDICTION: TIG
CLASS OF WORK- OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP. M FLOOR DRAINS, TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: (iU ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Excavate for new water service water meter to inside of building and install 2"double check valves.
FEES
Owner: Type By Date Amount Receipt
KIM, ROBERT + HAE LIM PRMT CTR 8/28/02 $101.40 27200200000
1360 SW WOODWARD WAY SPCT CTR 8128/02 $8.11 27200200000
PORTLAND, OR 97225
Total $109.51
Phone 1
Contractor:
APOLLO DRAIN + ROOTER SERVICE
2208 NW BIRDSDALE #8
GriESHAM UP, 97030 REQUIRED INSPECTIONS
Water Service Insp
Phone 1: 239-8801 RP/Backflow Preventer
Reg #: LIC 00049 318 Final Inspection
PLM 26-533pb
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. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling 003) 246-1987.
1 '
Issued By: � , ' j �_.�_'_--- Permittee Signature:
Call (503, 639-4175 by 7:00 P.M. for an inspection needed tkee�Et business day
I USE:
i�.umbing Permit A alic•afioll Received , , Plumbing.:r�O�d
,
Date/By: 'vis O�
Permit Nof- ?
City of Tigard Planning Approval Sewer
Test l�Ol-til Date/By Permit No.:
1.,125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No,:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Rcvicw Land Use
Date/13y: Case No.:
Internet: www.ci.tigard.or.us Contact 0 See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Method: ` _ �� l• supplemental Information.
TYPE OF WORK FEE*SCHEDULE(for special Information use checklist)
ewconstructinn _ Demolition_ Description Ql>• Fec(ea•) ental
Addition/altcration/re laccment Other — New I-&2-family dwellings
CATEGORY OF CONS UCTION Includes 100 ft.for each utlllty connection
SFR 1 bath 249 211
1 & 2- -amity dwelling Commercial/lndust'nal SFR(2)bath 350.00
Accessory Buildin► Multi-Family SFR 3 bath 399.00
Master Builder Other: _ Each additional bath/kitchen _ 45.00
_ JOB SITE INFORMATION and LOCA' ON Firesprinkler-sq. ft.: _ Pa'c'- _
Job site address: (,y / / Site Utilities _
Suite#: Bld 1. A tom.#_: Catch basin/arca drain I0.60
D ell/leach line/trench drain 16.60
Proicet Name: — Footin drain no,linear ft.)____ Page 2
Cross street/Direetins to job site: Manufactured home utilities 110.00
(XIqI N JT- ?PALi RL' 1A • Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no. linear ft.) Pae 2
Subdivi:,t(in — [of #; Stomi sewer(no,linear fl. _ Pa c 2
L--- Water service no linear fl.) Page 2 56.00
Tax ma /parcel M Fixture or Item
DESCRIPTION OF WORK Absorption valve _ WOO
MP-&J =rfle �i t'�P.yiue Backflow reventer? Pae 2 %, q0
—� — ----
�M 1,"ftiL Ili%QQ SU1101' Backwater valve 16.60
-i�tJ: AMO ihw*4.11101 Z �' 1/ DishwS herwas16.60
Dishwasher IG•Gtl
i�►S E ek I u0i Drinking fountain 1660
114-0—PEERTY OWNERTENANT 13jcctors/surnp 16.00
Nat11C: TEEN 1�IN� �i _
Expansion tank 16.60
Address: 12`3(03w
_S� I AC I_F� h-�w Fixture/seer ca I Ct CSO
City/State/Zi `t' p0►2,_— g 'L13 Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Ph011e:5j03 10117- 42, jFa',: t-loscbib 16.60
_CJAMILICANT ONTACT PERSON Ice maker 16.60
Name: F_M L S. talt•L ___ Intercc tor/ rcase trap 16.60
Address: Medical as-value: S Page 2
-- -- Primer _ 16.60
city/State/Zi __ —_
_ _Y ��'• _. Roof drain commercial 16.60
Phone: 503 9(09-Sg g3 Fax: _ Sink/basin/lavatory 16.60
L_-
E-mail: � Tub/shower/shower an 16.60 _
CONTRACTOR Urinal _ 16.60
Water closet _16.60Business Name poll c 'LfJ 4.oe'TEQ S� Water heater 16.60
Address:ZZCS NW 3190004C S `0 Other:
Citv/State/Zi stl it, _99030 Other:
---- --���— ChPlumbin Permit Fees*
Phone:*a&z71-f S o I Fax;5e3 jW ._ 5,+fk ___ Subtotal 5 o q0
CCB Lic. 1 _ Plumb. Lic_#_2tta-53310� Minimum Permit Fcc$72.50 S
Residential Backflow Mt,iimum Fee S36.25 �
Authorized ZQpZ Plan Rcvicw(::5%of Permit Fee S
Signature: _ Dater - °
State Surcharge(8%of Permit Fee 5
4 S , _ _ TOTAL PERMIT FEE S '
(Please pont name) Notice: This permit application expires if a permit Is not obtained within
I80 days after it has been accepted as complete.
All new
Commercial building require 2 sets of plans with isometric or *Fee methodology set by Tri-County Building Industry Service Board.
Hier diagramm for plan review.
Plumbinp- Permit Application - :'its of"I igar(t
Page 2-Supplemental Information
Fee Schedule:_ Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage:_ Permit Fee:
Footing drain-1"I On' 5500 0 to 2,000 $115.00
Footing drain-each additional 100' 40.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer-I st 100' 55.00 7,201 and grealer _ _ $309.00
Sewer-each additional 100' 46.40
Water Service-Isl 100' 55.00 Medical Gas S stems:
Water Service•each additional 100' 46.40 Valuation: Permit Fee: _
Storm&Rain Drain-I st 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 46,40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each
additional$100.00 or fraction thereof,to and
Fixture or Item Qty. Fee(ea) Total including$10,000.00.
Commercial Back Flow I'Icvention Device 46,40 $10,(X)1.00 to$25.000.00 $148.50 for the first$10,000.00 and$1.54 for
Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to
minimum permit fee$36.25 27.55 and including$25,000.00. For—
each
Rain Drain,single family dwelling 65 25 $25,(X)1.00 to$50,000.00 $379.50 for the first S25,000.00 and$1.45
additional$100.00 or fraction thereof,to
Inspection of existing plumbing or and including 550,000.00.
specially requested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and S 1.20 for
Subtotal: each additional$100.00 or fraction thereof.
Fixture Work:
Are you capping, moving or replacing existing fixtures? If
"yes",please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
uonfity b Fixti re Work Performed Continents reVarding fixture work:
Flxture Type: neplace
New Moved FS1111112 Ca i ped ------ —
Bu
Bath -Tub/Shower _
-Jacuzzi/Whirl ool
Car Wash -Each Stall
-Drive Thru
('us idor/Water Aspirator
Dishwasher -Commercial _
-Domestic
Drinking Fountain
Eve Wash — -----—
Floor Drain/sink .2.,
3"
.4" -- ---
-4"
Car Wash brain *Note: If the fixture work tinder this permit results in an
Garbage -Domestic
Disposal -Commerclai increase of sewer EbUs,a sewer pernllt will be issued and
-Industrial fees assessed for the sewer increase must be paid before the.
[cc Mach/Refri .Drains _ plumbing permit can be issued.
Oil Separator Gas Station
Rec Vehicle Dump Station
Shower -(long
-Stall
Sink -Bar/Lavatory -
-Bradley
-Commercial
-Service _
Swiriminst Pool Filler
Washer-Clothes
Water CXtraelOt _
Water Closet-Toilet
Urinal
Other Fixtures
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST _------
INSPECTION DIVISION Business Line: (503)639-4171
to BUP
Received Date Requested.— c^ -- AM_4—PM -- Bul --- --_ __.
Location _--_�ZT�—�'��Z'�'c��' - —Suite_ �p p—� MEC
Contact Person Ph( _) 2PLM
Contractor __ Ph(—) SWR _
BUILDING —� Tenant/Owner — ELC —
Footing ELC
Foundation Access: _� /%,�
Ftg Drain ELR
Craw! Drain
Slab Inspection otes: SIT
Post&Beam =-
Shear Anchors
Ext Sheath/Shear ------
Int Sheath/Shear /
Framing - -- - - - ----
Insulation
Drywall Nailing - - ---- _ -- __-_-
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling ---- —--- --
Roof ZIA
Other: --- ---- -- ----- - -
Final -- ---- ---- �- —-------- - ---
PASS PART FAIL
PLUMBING -------- -
Post&Beam
Under Slab ----- ---- ----- - -—Rough-In
-
rn ary Sewer
Rain Drains -- --- -- - --
Catch Basin/Manhole _
Storm Drain ------ - -
Shower Pan
Other: a
F.—ns.
_t A PART FAIL _
HANICAL_
Post&Beam
Rough-In
Ga.;I ina
Smoke Dampuic
Final
PASS PART FAIL -
ELECTRICAL
Service -------- ----
Rough-In
UG/Slab ---- — — -
Low Voltage _ _.�—_ -- --- ----- ---- - --
Fire Alarm
Final Reinspectlon fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_PASS PART FAIL
SITE - �] Please call for reinspection RE: _ Unable to inspect-no access
Fire Supply Line
ADA (Date ' L) � Ext
Approach/Sidewalk
LL7
Other:
Final DON T REMOVE this inspection record from the job site.
PASS PART FAIL