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15350 SW PACIFIC HIGHWAY-1 4 U` LF. "l-c-, r-'f_G� � r1JG' UP,f•✓) B „'.49 L,F. K G MEC44 11CAL 3511.) br-. L isc, Foo" 10`5 P.F. I� e70Fa45E h5 C.T. ("� c11 pct r.!-1. " ,t P,F. E C:LEW4 LIN E10. :4�•1 E,-F- I�; C.04F--CFE 4CC F!"1. _,"4, ET, �• J e'ToF R'1. �� C L lE�.4F'� �"1. •.G'1 SF. �..^ A.OILF_✓ e1i,'. 1:1-1. ; I Cv1-r FOC" V-4 Y. -' i 1 I 1 .W:KaFF cmICE D E:'1."1 D � E/.�J D )_rt."" r_ LXL.`" G Cr.A""C CT�ICE G F�tJ" "� < u � (I O 1 _ - .F+.4LL ALL I BTS LI // _ � � � /• � � < i -- -- i / / �- dig Hal: Lki )t ExIW D EXAM b61 / EXAM A 77 j EXAM A kALL I X I I.i+ I� EXAM ti - Ey.aM U ,,,cmc / E-1,4:1 A W8 — — —;_=- ? I I ! I rpt U JQ1 r 71 01 Vi 13TCW,4CLE K" c=:=E E I EXA" E ?-.Roc C441= / �•+aEDt:IfVG F --- r�- nz �( 1 Ji — / RECEPTION REG:9TFATICN 1511.LING / epECIA.IBT t' r•- ---ai � , OREGON I)tilC.�� ; I HEALTH 5 U E N C E S WALL -� uNrvmtsrry ul4lTlhL' I 1 1 F E-:•."t F rX M F C1LC`RET1 --- ------ _ - -- t 1 �{ ♦ -/ - ATIpI�..E 1 I I I I I I I I I 1 L, y' { �� 1 I ! I I L-------- ------ I 1 _ ' I ------- I 1------------' ' --------- __.��--_ I --------- I — __J L_ .-J 1_._ .J L_ _I � L_ ._� 1 � 1 —J L— _J —_ 1 1 1 1 I L. �\ FLOOR FLAN A2 ---------------- - 1 A.,, 1// ep ,_1. NOTICE: IF THE PRINT OR TYPE ON ANYTItIII � 1111111 Illltl ! 1111111 111 ) 111 III1II �r 11 Ill (fiIT r�r� ! 11 1111Ill ' I ! II111 Illl ! 1 ► '~Il ! ! ll 111 ! II 1111111 11 ! 111 III Ili III III 11 ! 111 ' lllllll II1 ( II 1111111 111 ( il ! 1 ! 1111 II I II I I IMAGE IS NOT AS CLEAR AS THIS NOTICE I Z 3 I I _ _� _ -______ 1 _ 11 y IT IS DUE TO THE QUALITY OF THE --- -- ----- - - 12 1111E111111111I-IIIIIIgI! IIII II111 ----9Z__._.�SI{-:�; _ fi7___11. 1111111Z1ti11.11Y1i.11illl I-IIIIIII IIIILII-II -I--I8-IIT I-!-III-II-LI-ITIIII II9II TIIII IT911111 i11_-- 6-- IIII� IfiI1111111IlllT 0!Z F No.36 ORIGINAL DUCUtiENT Z LZllEZ E�l-�l.w•_.I.�°Z.-w�•'...�, _r,l _�1N13��w I! n `•r;. llllllllllli 1111I1.111� 11.11.. !�I�IIIII�II� I ! 1 1 i I � w 0 to E n H �a n H G7 C4 E fC AkAw l y� 1��U SW PACIFIC HIGHWAY CITY OF TIGARD DEVELOPMENT SERVICES MUMM 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 CERTIFICATE OF OCCUPANCY PEPMIT 0. . . . . . . : BUP95- 05)) , DATE ISSUED: 06/,::!3/97 ITE ADDRESS. . . s15350 SW PAC FTC HWY PARCEL: 2S110DB-01300 JJUD I V I S I ON. . . . : ZONINGxC—G A_OCK. . . . . . . . . . t LOT. . . . . . . . . . . . . t JURISDICTION: FIG -LASS OF WOR11,. :NEW VPF OF U1.3E. . . .CON ePF_ OF CONSTRi!jN 1(:CLW-'ANCY GRP. B-, OCGOPANCY LOAD: 10C KNANT NAME. . . uOHSU MEDICAL CLINIC 'omdrkst A new 13, 815 sq. ft. medical clin ;c. IlAX -FRANKLIN -10ASW LINCOLN 6T PORTLAND CR 97201 Phone C,ontractort R it 1A CONSTRUCTION 1530 SW TAYI.OR PORTLAND OR 97,?O!�, Phone #: 228-7177 F?evl #. . 2 000383 Tt i I s C e rt i F i c ai;0 9 r 0 n t occupancy a f t h e z-A b cl v s., rP f e r e n c e d b u i I d i pont + hpreof and confit-me that the building has been inspected for cump I i A.n(- P w; { r, the State of Ot- gon s)per- `,odes for the urou occupsm y, and usp i.tricie which t t i et-�-renced pet was Issued. I,1111G IW55PECTOP 81OFFICIAL V,OST It' CONSPICUOtis PLACE C'� • Comitruction Inspectiort &Related Tests arlson Testing, Inc. / Geotechnical Consulting P.O Box 23814 Special Inspection \ Tigard, Oregon 97281 Phone(503)684-3460 FINAL SUMMARY REPORT FQX (503)684 0954 May 21, 1996 _ I - � #96-4008 City of Tigard S 13125 SW Hall Blvd. T.ic and OR 97223 Re: OHSU Meidcal Cen er G W 'A9t�t--�-Sir-;iaettE--R,o�d-Gentlemen: This is to certify that the items listed below are in accordance with Section 306 of the State Building Code. We have perform. .d random/periodic special inspection at the contractor's request of the fol:-owing items per our inspection reports onJ.y: Soils Compaction Reinforced Concrete Structural Steel -Shop & Field Bolting .All inspections and tests were performed and reported according to the requirements of Section 306 and, to the best of our knowledge, the work was in conformance with the approved plans and specif4.catyons, approv3d change orders and applicable workmanship provisions of the State Building Code and Standards, as well as the structural engineer's deHign changes and approvals . Our reports pertain to the material tested/ inspected only. Information contained heriin is not to be reproduced, except in full, without prior authoririt '.in from this office. If there are any further_ questions regarding this matter, please do not hesitate to contact this office. Respectfu.l1v submitte CP RLSON� ESTING, NC. Douglas W. Leach President llo cc: Drax-Franklin Ll Ankrom Moisan Associated Architects R & H Construction KPFF DRAX-FRANKLIN LLQ' 330 Southwest Lincoln Street Portland,Oregon 97201 503••226-6500 * 503-226-65119(fax) " July 11. 1997 I C' Ms. Jill Aldrich Development Services Supervisor City of Tigard 13125 SW Ilall Blvd Tigard. Oh 97223 Re: Land Use Case # SDR95-0023 (OHSU Medical Clinic) 4"SA,4W Pacific Highway Dear Jill- Thank you for your letter dated .lune 26, 1997 regarding the above referenced projeci I spoke to Will D'Andrea regarding the outstanding issues in this letter. Will called me hack and confirmed th„t all the items mentioned had been completed. He verified this with the engineering department as we'& Will told me he would male the necessary changes in the computer to bring this issue to a close. We look forward to receiving the Certificate of Occupancy at your earliesrt convenience. Thanks again for all your cooperation on this project. We hope to work w-iO you again soon. SincerelN. Matt Baker Member C ,n11 Jnr^ ��f'Li1 Ci 292• t9-1D i ►, els, (I A ntt— CITY OF TIGARD ELECTRICAL PERMIT — COMMUNITY DEVELOPMENT ' -PARTMENT RESTRICTED ENERGY 13125 SW Hall Blvd.Tigard,Oregon 47223• -w (503)639-4171 PEPM I T #: ELR96-0165 DATE ISSUED: 05/21/96 �,QC.I 'ti k)1 PARCEL: 2S 1 10DN--00401 S 1 1"E (AUDI?I `�`_i. . . s 15350 SW td T SUBDIVISION. . . . : Z ON I 14G:C—G BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . Project Description : DATA AND COMMUNICACION LOW VOLTAGE a. RLSIDENTIAL--------- B. COMMERCIAL---------------- ------------------------- AUDIO & STEREO. . . : AUDIO & STERE.O. . s INTERCOM & PAGING. . : BURGLAR ALARM. . . . s BOILER. . . . . . . . . . : LANDSCAPE/IRRIOAT. . : GPRAGE OPENER. . . . s CLOCK. . . . . . . . . . . s MEDICAL. . . . . . . . . . . . . HVAC. . . . . . . . . . . . . DATA/TELE COMM. . :X NURSE CALLS. . . . . . . . : VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE: OTHER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : INSTRUMENTATION. : OTHER. . : TOTAL # OF SYSTEMS: 1 Uwner. _________.____._---_..__..__.__..__.__. ___ .________._____—_—___ FEES DRAX—FRANKLIN type amoLint by date recpt 330 SW LINCOLN ST PRMT $ 40. 00 JMH 05/21/96 96-279671 5PCT t 2. 00 JMH 05/81/96 96--279671 PORTLAND OR 97201 Phone #: 226-6500 Contrac+ r s A T & T CONSTRUCTION $ 42. 00 TOTAL 26995 NW OL.SON ROAD ------- REQUIRED INSPECTIONS ------ GASTON OR 97119 Ceiling Cover Elect' l Set-vice Phone #s 662-4669 Wall Cover Elect' 1 Final Reg #., . : 50045 This permit is issued sub)ect to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t ee Si gnat i.tr-c, applicable laws, All work will be done in accordance with Approved plans. This permit will eNpire if work is not started within 180 days of issuance, or if work is suspended for Bore than 180 days. r.ted By .____---OWNER INSTALLAT I ON The installation is being made on prnperty 1 own which is -lot intended for ale, lease, or rent. OWNER' S SIGNATURES _ �__....__ DATE: /�j.. i__.---�__--._. �ljyy]�ACTOR INSTALLATION S I GNAT URL 1F - Als DATE: -- — LICENSE NO: Cal 1 for, inspection -- 639-417` 1 Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 13 12 5 SW Hall Blvd. r Tigard,OR 97223 I'LKMI I ��'� Phone(503)639-4171 -- - — FAX(503)684-7297 DATE ISSUED 05 24q 0 TDD No. (503)684-2772 --- —�--- CITY OF TIGARD Inspection (503)639-4175 ISSUED BY PLEASE_ COMPLETE ALL .SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK � �c ►'Ff'c` >�w � Address RESIDFNI IAL—Restricted Energy Fee. , 5,40.0.0 —c3�� V(< (FOR ALL SYSTEMS) ON State Zip S.befk Type of Work Involved: PERMITS ARL SON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK IS NOT STARTED'VITHIN 180 DAYS OF ISSUANCE OR IF WORK i5 SUSPENDED FOR El Audio and Stereo Systems 180 DAYS. ❑ Burglar Alarm a 2. CONTRACTOR APPLICATION [J Garage Door Opener* ❑ Heating,Ventilation and Air Conditioning System* Contractor t t _Type _ ❑ Vacuum Systems' Address ❑ Other-_ Date_ MA%( .Z I , 19�� COMMERCIAL—Fee for each system . . . . . . . . . 5fig.00 (SEE OAR 918-260-260) Property Owner 12,A1C_ - t4 LL.L, ;heck jyVv of Work Involved: Contractor's Board Reg. No. 30, )C l� Audio ord Stereo Systems \ El Controls Phone# Sty ) Z�2 "- 19'�Q ❑ Clock Syst ems 3. OWNER APPLICATION Data Telecommunication Installations ❑ Fire Alarm Installation ❑ HVAC Print Owner's Name Phone No ❑ instrumentation Address — ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* City State Zip ❑ Medical This permit is Issued under OAR 918.120.370.This applicant agrees to make only ❑ Nurse Calls restricted energy Installations MXI volt amps nr least under this permit and to do the ❑ Outdoor Landscape Lighting' following: 1. Only use electrical licensed persons fu do installations where required.(Certain ❑ P OfeCtive Signaling residential and other transactions are exempt from licensing.These have ❑ Other asterisksm.All others need licensing). 2. Call for an inspection when all of the Installations under this permit are ready far inspection at 503-639.4175. ❑ C5N e- Number of Systems 3. Purchase separate permits for all installatinns that are not ready for inspection when the inspector is out to inspect under this permit. 'No licenses are required. licenses are required for all other Installations. 4. Assume responsihilily for assuring that all corrections required by the inspector are done,and 5. Assume respomihility for calling for a final inspection when all of the 5. FEES cnrr!!,ms are completed. The person signing for this permit must he the applicant or a person a. Enter Fees $ authorized to hind the applicant. - 17"� �� bm f b. 5% Surcharge(.05 x total above) $ Signature TOTAL $ 4;1, Q�L ll�iRAIt- Authority if other than applicant l(,CX(,( f .N I t5zl FNLRGAP.CHf' C1� ` L ELECTICAL PERMIT CITY OF TRESTRICTED ENERGY COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR96-0160 13126 SW'Hell Blvd.Tlgerd,Orsgo:i 97223.8190 (503)639-4171 DATE ISSUED: 05/15/96 1 11��, PARCEL: 2SIlODB-00401 .SITE Al)DIlESS. . . : i:�..;,.J� W �}{�� SUAD:i V I S I ON. . . . : ZONING:C—G 'LOCK. . . . . . . . . . LOT. . . . . . . . . . . . . . Project Description: Installing Iandscape irrigation control A. RESIDENTIAL----______ B. COMMERCIAL---------------- AUDIO & STERE.O. . . : AL:9IO & STEREO. , : INTERCOM & PAGING. . BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . : x GARAGEOPENER. . . . : CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . : HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . : NURSE CALLS. . . . . . . . . VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE: OTHER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : INSTRUMENTATION. : OTHER. . : . . TOTAL # OF SYSTEMS: 1 Owner: _____._____________---- ------_.---------._____._._.__-_____—__—_ FEES ---_ DRAX—I:"RANKLIN type -tmoLlnt by date recpt 3:.30 SW LINCOLN STPRMT $ 40, 00 P 05/15/96 96--279427 5PCT $ 2. 00 B 05/15/96 96--279427 PORTLAND OR 97201 Phone #: 226-6500 Contractor: GO7 ITRACTOR NOT ON FILE $ 42. 00 TOTAL ------- REUUIRED INSPECTIONS Elect' 1 Ser-vice Phone #: El t' l Final Rey #. . This permit is issued subject to the regulations contained in the j Tigard Municipal Code, State of Ore. Specialty Codes and all other et m i t e e S i gnat Lire appllcabie laws. All work will be done in accordance with approved plans, This permit will expire if work is not started qq within 180 days of issuance, or if work is suspended for more -Arti'L.6 �........... .C1��2'{, 1--� than 180 days, I s s ued By _ R INGTALLATION ONLY----_—__._.__.___.__..-•-_-----___.__..._ The installation is being made on property 1 own which is not intended for- m a I e, ormale, lease, or rent. OWNER' S SIGNATURE: DATE: �INSTALLATION iGNA'TURE OF' SUPR. ELEC' N: CtitlCcti lC'f'^ DATE: I I C .::NSE NO: Call for inspection — 639-4175 Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 13125 SW Hall Blvd. Tigard,OR 97223 PERMIT#. � 'L(( Phone(503)639-4171 FAX(503) 684-7297 DATE ISSUED_ TDD No. (503)684-2772 -- CITY OF TIOARD Ins[ection (503)639-4175 ISSUED BY ; ,�_Lr PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK VA"F/L A<to Address RESIDENTIAL—Restricted Energy Fee . . . . . . . . . $40 t2t) -('te,A �►2 cq x 2 (EOR ALL. SYSTEMS) City State Zip (Check TXpe of Work Involved: PERMITS ARE NONTRANSFERABLE AND NON•REFUNDAftl:AND EXPIRE IF WORK ❑ Audio and Stereo Systems is NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR y 180 DAYS. ❑ Burglar Alarm El Garage Door Opener' 2. CONTRACTOR APPLICATION ❑ Heating Ventilation and Air Conditioning System* S/f SSGc IIvL & g y Contractor____ ___ _ Type—' ❑ Vacuum Systems' �0 13 S `S -T VILA 1W O� ❑ Other Address — - - -- Date__ t /g r_� 6 _ COMMERCIAL—Fee For each system . . . . . . . $4,0.04 (SFc OAR 918-260-260) Property Owner e:,1.f 5 V -- -- Check Type of Work Involved: Contractor's Board Reg. No. �;-G S-0 Z-" Ad 0 5_L_Ia. L Audio and Stereo Systems ❑ builer Controls Phone# ❑ Clock Systems 3. OWNER APPLt%-ATIUJN ❑ Data Telecommunication Installations LJ Fire Alarm Installation ❑ HVAC Print Owner's Name Phone No ❑ Instrumentation Address ❑ In•rcom and Paging Systems /Landscape Irrigation Control' City State Zip ❑ Medical This permit Is issued under(_)AR 918-320.370.This applicant agrees to make only ❑ Nurse Calls restricted energy installations(10)volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting" following: El Protective Signalingg, 1. Only use electrical licensed persons to do installations where required.(Certain residential and other transactions are exempt from licensing. these have ❑ Other asterisks(').All others need licensing). — -- 2. Call for an inspection when all of the installation,under this permit are ready for Inspection at 503-639-4175. ❑ Numher of Systems 3. Purchase separate permits fo installations that are nat ieady for inspection — — when the inspector is out to im act under this permit. •No licenses are required. Licenses are required for all other instailatlins. 4. Assume responsibility for assuring that all rorrections required by the inspector are done,and 5. Assume responsibility for calling for a final inspection when all of the 5. FEES corrections are completed The person signing fu.this permit must he the applicant or a person a. Enter Fees authorized to hind the applicant. 7 - b. 5%Surcharge (.05 x total above) $ 2- Signature TOTAL $ y? Authority if other than applicant ENERGAP.CHP PLUMBING PERMIT CITY OF TIGARD DATEIISSUED: • 05/15/966-N11,�, COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223.6100 (503)639.4171 PARCEL: 2:S 1 l ODB-004Q'1 SITE ADDRESS. . . : 1`,;3`10 SWr; SUBDIVISION. . . . : 4 IF,L k'V ZONING: C-G BLOCK. . . . . . . . . . . LUI . . . . . . . . . . . . . . CLASS OF WORK. . :AL-C GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. :-0~� TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1 OCCUPANCY GRP. . :B2 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . . 0 WATER HEATERS. . . . . ; 0 CATCH BASINS. . . . . . . : 0 FIXTURES--------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . 0 SINKS. . . . . . . . . . : 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 LAVATORIES. . . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . . : 0 SEWER LINE (ft) . . . : 0 WATER CLOSETS. . : 0 WATER LINE (ft) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN ft) . . . : 0 Remarks: Installing back-flow prevention device Owner: -_.__._______.__.._._____----._-_________.----___._________._-- FEES - -----______-_- DRAX-FRANKLIN type amoi.lnt by date recpt 330 SW LINCOLN ST PRMT ! 25. 00 B 05/15/96 96-279427 5PC'T $ 1. 21t5 B 0 5/15/96 96-27942-1 PORTLAND OR 972'01 Phone #: 226-6500 Contractor: ----._____._._._______________•-__- CUNTR$-:iCTOR NOT ON FILE Phone #: $ 26. 25 TOTAL Reg #. . : ------- REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the RP/Sackflow Prev Tigard Municipal Code State of Ore. Specialty Codes and all other Final Intpect ion �- applicable laws, Ali Mork will be done in accordance with - - approved plans. This pet-sit will expire if work is not started within 19e days of issuance, or if work is suspended for More than 180 days. I-?ermi.l:tee ai nature : Vis%' Call for inspection 639-4175 I City Of Tigard PLUMBING PERMIT APPLICA rION Planck/Rec. # 13125 SW Hall Blvd. Permit # F'ci.li 7 Tigard, OR 97223 (503) 639-4171 MINIMUM $25.00 PERMI d' FEE + ST. SURCHARGE New Single Family Residences Only ❑ 1 BATH HOUSE$140.00 Jobe~�f-j C13 BATH HOUSE 527.5.00 TM HOUSE$195.00 Address arrr m Fee includes ail plumbing fixtures in the dwelling and the first 100 feet T"t[ h -1'1 C' j-f 2 2 or water service, sanitary sewer and storm sewer. See fees below. MrM Is n��w 4\rel FIXTURES QTY PRICE AMT -rt r' V6 Sink 9.00 MNq A"- """' Lavatory 9.00 Owner Tub or Tub'Shower Comb. 9.00 °"•°h•' m Shower Only 9.00 Water Closet —9.01F,- Dishwasher ,00Dishwasher 9.00 Garbage Disposal �_— 9.00 - Occupant M.*4 Ad*- Washing Machine 9.0ij Floor Drain 0.00 """"• DO Water Heater 9.153 _ Laundry Room Tray 9,00 Urinal 9.00 Other Fixtures (Specify) 900 MOM Ad*— awwNwn I t K char -- 4.(X) Contractor (, ndeuNaw!ally ---- Pa an: 194 _ 9.00 `"M°'"' TU61*OR 97061-1355 �' 9.00 Sewer 1st 100' - 30.00 ""`"'P"~"• jt °"" Sewer -ea. Addit. 100' 25.00 W I �� I` 1 ,, `, Water Service 1st 100 30.00 I hereby acknowledge that I hav3—r-.au this application, that the Water Service ea. Addit. 200' 25.00 information given is correct, that I am the owner or authorized agent of the owner, that plans submitted are in com,Aance with Statc laws, that Sturm &F.ain Drain Ist 100' 30,LJ I am rpgistered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00 number given is correct (If exempt from State registration, please give reason below.) Mobile Home Space 25.00 Back Flow Prevention �rl--1 S' Devico or Anti--Pollution Device 900 1 L Any Trap or Wast- Not Connected to a Fixture 9.00 Describe work new 7 addition O alteration Q repair Q Catch Basin 9.00 to be done residential O non-residential Insp. of Exist. Plumbing 40.001hr Specially Requested inspections 40.00Ihr Existing use of building or property >fr-/L I T _ jd rL—_ Rain Drain, single family dwelling 30.00 Ft 1FW/ Residential backflow prevention devices 1500 Proposed use of - -"- -- bwlaing or property - '(Except residential tacMlnw prevention devices) NOTICE *Minimum Fee $25.00 SUBTOTAL PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED - I"OR A PERIOD OF 180 DAYS AT ANY TME AFTER WORK IS 1;OMMENCED PLAN REVIEW 25% OF SU13TOTAL TOTAL r.ecial Ccn_ - — -- Date issued `�_ by _�� CITY OF TIGARD ELECTRICAL PERMIT - COMMUNITY DEVELOPMENT DEPARTMENT L�� PERMIT ENERGY t 4 - 13125 SW!Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4i 7 i PL RM I T S D: 05 17/9 DATE ISSUED: 0�/17/96 PARCEL: 2S1lODB-00401 SITE ADDRESS—: 15350 511 !' SUBDIVISION. . . . ZONING:C-G BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : Project Description : HYAC: WORK N. RESIDENTIAL--- ------- L COMMEF L I AL AUDIO & STEREO. . . : AUDIO & STEREO. . s INTERCOM & PAGING. . : BURGLPR ALARM. . . . : BOILER. . . . . . . . , . : LANDSCAPE/IRRIGAT. . : GARAGEOPENER. . . . . CLOCK. . . . . . . . . . . s MEDICAL. . . . . . . . . . . . . HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . : VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . .. OUTDOOR LANDSC LITE! OTHERS s : HVAC. . . . . . . . . . . . . X PROTECTIVE 131GNAL. . : INSTRUMENTATION. : OTHER. . : : 4 TOTAL # OF SYSTEMS: 1 Owner: --------------------------- -- --------------------------- FEES type amoLint by date recpt PRMT $ 40. 00 JMH 05/17/96 ,G-279.52 5PC"f L 2. 00 JMH 05/17/96 96-27955'.2 Phone #: Contractor. ------- RON GEDROSE $ 42. 00 TOTAL 10765 SW NORTH DAKOTA ---- --- REQUIRED INSPECTIONS ---- TIGARD OR 97=23 Ceiling Cover Elect' l Service Phone #s Wall Cover Elect' i Final Reg ljF 4?T— This permit is issued subject to the regulations contained in the Tigard Murrcipil Code, ate of Ore, Specialty Code, and all other Perm i t e 5i gnat r.rre applicable law:. All work will be done in accorbance with approved plans. This permit willrif wspinot started work within Ibe days of issuance, or if workk is suspended ndee d for more than 160 days. IlqUed By ._OWNER INSTALLATIt 4 ONLY-----__--____._.____.____..____.______. the install=.tion is being made on property I own which is not intended for sale, leac,e, or rent. OWNEt" S SIGNATURE: DATE: INSTALLATION ONLY--------------____-__---- - SIGNATURE OF SUPR. ELEC' N: l ;..�.1.�'w� DATE:s LICENSE NO: Call for inspection - o39-4175 MAY. A. 1996 3: 37PM R R H CONSTRIICTIOd NO. 049!5- T. 21 Community Development RE51RIC1 ED ENERGY WC71RICAL APPLICATIO 13125 SW Hall Blvd, N Tigard, OR 9722' PERMIT Phone (503)639-4171FAX(503)684-7297 DATE 155U,D TDD No. (.503)634-2772 - CITY OF TIGARD Inspection (503) 639-4175 ISSUED BY PLEASE COMPLETE All. SECTIONS I. LOCATION OF INSTALLATION )j 4. TYPE Of WORK Addr.� l r,�i,/�1- f Y) RF51pf1 TIAL- nest led CqFve C L !FOR I-1 SYSTnSTAts) , , , , . , C, A Sate zip - PEPJ,iITS ARE NON-TUNS" A(ItEAM) t �t L�'�ck(�vStl?=SSI 15 NOT STARTF.O WITHIN 180 DAYS Of IISSUA-R F UND WORK S S IRI;DEO OR 780 D,kys ❑ Audio and Stereo Systems ❑ Burglar Alarm 2. CONTRACTOR APPLICATION ❑ Garage Door Opener• #11�//�I � � � eating,Ventilation and Air Contlitioning Svstem• Contracto 'L,J1lG121. ro I Type�--�4C U Vacuum 5ystems' Address I_ K � ��lv ❑ other- Date Z:--,X-) _q I 0 _ COMAIrRCIAI.---Fee for each system 144+44 Property Qwnor ( -4 2`& `214- — r( 3 Jq y (SEE OAR 918.260-260) /- / � i;bssl�rxp�_w�aYaixt� Contrarinr's Board Rep. No. ��( CIS/ ^ ❑ Audio and Stereo Systems Phnne N Boiler Controls -f--- '� ' ❑ Clock Systems 3. OWNER APPI(CATION ❑ Data Telecommunication Installations _ 11 Fire Alarm Installation Print Owner's Name _�`—`— Phone No 9-�9_VAC ❑ Inshumenfation Address�� _- —- ❑ Inrercom and Paging Systems ❑ CityLandscape Irrigation Control—p� ❑ Medical is pennlr Is Issued under OAR 915.120.370 This opoltcnnt agrees M make only ❑ Nurse Calls ro tricted energi Inrnllntloris 1100 volt amps or less)under this permlt and to do the r IS. ins ❑ Outdoor Landscape Lighting' 1�Only use elOctncal Ilcensed persons to do insratlatinns there required (t enJin ❑ Protective Signaling estdenuai and other transections tire exempt from I tenting.These I•a•e asterisksl•) All others need licensing) ❑ Other 2. Cal;for an Inspection when all of'he Installaticnit under this permit are read ` forinsprctlonat503639-a1>5. y /,�•1 / '-r`�-� �dit,�_ [�� TY� 9 P°Rhes!"'pirate permits for all InstallJNons that ate.not ready for I tspettion � NumbQt of System9 /t r' (ice when the Inspector is out to inspect undgr this permlt. 4. Assume responsibillty for assuring that all terreettens requlr►i by the Inspector -No licenses sre required Licenses are required row AN odter irosallatlofu. are done,and _ - 5. Amorne responsibility for taping for a final InspeCtl- when all or the - conttceens are completed. S. FEF$ The person signing for this permit must be the applicant or a person authorized to bind the applicant. a. Enter Fees �� D 6 5%Surcharge L05 x total above) g .9.00 Signature --:_ TOTAL Authority If other than applicant ENERGAP.CHP CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 Nu)y- t: NP9 - 0503 �A lY ill PLANCK# Date: APPLICATION FOR PERMIT TO INSTALL FIRE SUPPRESSION SYSTC-M BUILDING DIVISION, CITY OF 1.-IGARD 639-4171 DATE: _ MDrRc W 13 1��9(o PERVIT 4 Valuation: 1-1 k 53o _ Amt. Paid: Permit Fee: I-z 1. SGS _ 40% Plan Check Fee: r 1 ,110 Balance Due: fi__ 5% State Tax: Plans must be submitter) to the Building Division betore installation. Three sets o(the plot plan, showing the layout and the location of the nearest hydrant is required. New installation:_ Y _ Addition: Repair: ___ Alteration: Complete: _ Partial: Exitw iy: __ Basement: Hood & Vent:� Spray Booth: , IN EXISTING BUILGI^:G: _ IN NEW BUILDING:__ NUMBER & STREET: NAME OF BUILDING or BUSINESS: 0 S V \��` �-�J►� �;TtsT� _ NO. OF STORIES: SIZE OF BUILDING: _ OCCUPIED AS: ML- -kL- ��- TYPE OF SYSTEMS: Wet: ?s Dry: Combination:__ STANDPiPES: OCC.HAZARD: Light ORD.GRP.HAZARD 1ZC 2_ 3_ 4_Extra _ DENSITY-0,1� GPM/Ft2 DESIGN AREA 1 S ft-2SPRINKLERAREA 1�- ft2 SPRINKLE,,", ORIFICE SIZE: k11- "K" FACTOR S. le TEMP. RATING 17i7;' OWNER: D2AX 117"1L.AMKL1N ADDRESS: '33D �1� L ��co�ty ST• CONTRACTOR:�� '/ PLANS DRAWN BY: L`�uN INR ��=s►1LioOADDRESS: __ 3�� S I.J 1_16{t9-6 T )CGAtD J I� 812.2.3 - —r REMARKS: APPROVED permits includes oniy work described above an.1/or on plans and specification bearing the .,ame permit njambe, and will c(,mply with all applicable codes and ordinances of the City of Tigard. SPRINKLER COMPANY: _ _ 1 Rk'TTb P Lb , PHONE: to Zv SIGNATURE OF APPLICANT: _ iL ✓�Cl.�+ _ BUILDING DIVISION: PERMIT VALID FOR 180 DAYS hP,lognsd>ts«imceim 1 CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125Syy�W/Hall Blvd.Tigard,Oregon 97223.8199 (503)830.4171 ,Z1 V i I Ori. w . A �.T - -, � :{ Y14?W 1.:,y n•� v ;C.(. F�". mCG., C:cti� .� 1i?..'..:.. !:Si1DENTIAL LINI r._ . ISCELLgN: Lt OR LF.CS. . . . . �� 1 w „�A _-reF�. . . . . . . c f'I'""'/I/r"tlR1Gr1T1�r!. . c!i n,DDI L .F.`JY osr . w . . LA 201 /i l�rlZl c\r11 r.. . . . . , , . Uzi wr t'.�i'</'�}1,}1 L1i•�L.. �.. , � TtE—D V:NERGY.. ti?t . . . . . . a^ J.",1_/PriNC _. . . . . l',;F`. HM/ SVC/rt)P. Y . 0 E•�'"1. + ;: np-. .;,",�1 �c 11t .... I' `1?'I^R LABEL ; !.';' ' , ,• . "RVICE/F"C"C �"00 amp 0 w/Sf.'?11�;(ILL OR �Fry"�-�EDER: kyr t�}�E+f'� 1I/NrySrECTI" , "Y 00 a I<I�.1. r . w • u �: JA I l'w 164 CJ J F7 rv�(.. (]q x"1""' 1 4 '.i l P:.'1 lit'W. Y r M I 60amp. . . Y . w . 0 ��dl �:r1')" L f•;hiC'�{ C I F;C, 02 I N F�LCIN't am P/vaIt. . . 1 _..La C7 C'" '�I Tei, ) �.�' ti VOLT ��:�"'lthrn• ,a1) rr; e ,- Community Development I 'rCa-�Cr-ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Qc Vic_ Tiqard, OR 97223 PI?nck/Rec. # �, Permit # C 7 77 i— _ Phone (503) 639-4171 Date Issued _ CITY Off TIGARD FAX (503) 684-7297, Issued by _ TDD No. (503) 684-2772 2 Inspection (503) 639-4175 1. Job Address: �n '� [4. Complete Fee Schedule Below: �"'' �� 3 G4 Name of Development Number of Inspectiove per permit allowed - Address SW 109th 8 Naeve RrI F2- h mduied items Cost(ea� Sum _—_— -----4- City/State,/Zip T l g a is d , Or 97223 4a. Residential-per unit 4 1000 sq h or leas $11000 Name (or name of business)_OH S U Cis I N I C-'I'I to IBJ) Each additional 500 ap It or portion thereof $2500 t Commercial[X { Res dential❑ Landed Energy $2500 Fath Manuld Home or AAndular 2 Dwelling Sewire or Feeder $6800 .2a. Contractor- installation only: 4b. Services or Feeders Installation,alteration on relocatior 2 Electrical Contra ',, ,- Rural Electrics Inca_— 200 amps orl,,ga _ 9 Wo 00 540.00 2 Address—_i' 85 Nf� Fl am Ynun Par�way 1FAr' O 201 amps to 400 amps $6000 2 „A 401 amps to 600 amps $120 00 2 CityHillsboro State OIt Zip 97124 eel amps to 1000 amps $16000 2 Phone No. L-- � , yQ _ Overl000ampeorvone _1- $ 4000 _ 0 2 Contractu 's License No. _34-82C Reconnect only __ $5000 — Contractor's Board Reg. No._ ,c. Temporary Services or Feeders r 1 Installation nitarahon or relocation Signature of Supr. Elec'n A / �—.�_ 200 amps or lase $5000 T 201 amps la 400 amps E75 00 License No. 4062-S Phone No. 648-6 6401 amps to60oampo $ loon ---+' Over 600 amps to 1000 volts -- 2b. For owner installations: see W above 4d. Bunch Ci►cuilm Print Owner's NameT _ ` -_T Nevi,alteration or extension per panel Address a)The lee for branch arcuds with City_ —� ^- State - Zip - pury''eM of service or boder Ase. Phone No. —_— -- Eachbrarc, . _n1 1.62_ $500 -_F1lajo b)The toe I ,bran:h mauls without The installation is being made on property I own which is purcha.-,of service or feeder fee. Fast branch cucud %3500 _ not intended for sale, Wase or rent. Lad additional branch nrcud $5 00 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 1 3. pump ump or irrigation circle $40 00 7 Plan Review section (l, required): EcEach sign or outline lighting $4000 _ Signal circu4(s)or a:imded energy Please check appropriate item and enter fee in section 58. panel alteration or isegnsion 1 $4000 40,00 _4 o1 more residential units in one structure Minor Labels(10) $10000 _ _Service and fender 225 amps or more System over 600 volts nominal 4f. Each additional inspection over f,Classified area nr structure containing special occr-nancy the allowable in any of the above r as desc tried nspeclion ed in I I E C Chapter 5 Per ho.n W_ $3500 $5500 Submit 2 sets of plans with application where any of the above In Plant $5500—v - annly. Not required for temporary construction services. S. Fees: NOTICE 5a. Enter total of above fees $ 170-00 5%Surcharge(.05 X total fees) $ �Sp PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ O')THORIZ.FD IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPEML)ED OR ABANDONED FOR Plan Review if required(Sec 3) $ 432.50 A PERIOD OF 180 DAYS AT ANY TIA.'.c AFTER WORK IS Subtotal $ x_00 COMMENCED. 11 Trust Account 8 $ Balance Due $ 21249.,QO Ii 4�• rl It/% CITY CSF TIGARD DATE ISSUEDI: OaIZ:6/136 COMMUNITY DEVELOPMENT DEPARTMENT 13126 SW Hall Blvd.Tigard,Or*gon 97223*8199 (505)639.4171 PIARCEL: 5'SBD I V 16 1 ON. ZONING: C--,'i 9LOCK. . . . .. . . . . . L.0 , . . . . . . . . . . LHANT NAME. . . . . :OHSU MEDILAL CLINIC Jbf-11 114U. . . . . . . . . . : FIXTURE UN I TEEL 159 A-1136 OF' WORK. . . :NEW DWELLING UNITS, 10 TYPE OF USE:. . . . . :COM NO. OF BUILDINGS: I Nil*Al-(- TYPE. . . . :EUSWr- 111PERV GURr-ACE: f Remar-kis : (74 new 13, 815 sq. ft. Medical clinic. 1-4qrlei-c — -1- - - . .. 1— - -- -- --.- FrEc DR"X—FRANKLIN tjepe amount by date recpL -,3w 5W LINCOLN 5 PF,141' $ JP-H 02/27/96 9(;%--,2iL-. I NGP, $ 45. 00 J*H 02/27/96 PORTLAND OR 97201 f-Jlcitle #.- 2,26-6,500 ,,oritractor . f,(.'iNTRACTOR NOT' ON 1`iLl- -li(ineTOTAL- 1414 REQUIRED INGPECTIONE--, This Applicant agrees to comply vAth all the rules and regulations 5 a 4 P t- I ri s 1.)e c.-t i arr of the Unified Sewage Agency, the permit expires IR days from the Me issued. The total amount paid will be forfeited if the ....... permit expires. The ;'gency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement giveni the installer shahprospect 3 feet in ail directions from the distAnce given, If not sc located, the installer shall purchase a "Tap and Sid* Sewer" Permit and the Agency will i-stall a lateral. d Fay: - Call for ;.nsipectior, 1 r pant Name:_ -� N -[i' Accumulative Sewer Tally This SWR#: 16 �q This PLM#:—e(. Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New Value Capped off value added # added total #s total Count off#s count value values I� Haptisvy/Font 4 Bath- Tub/Shower 4 Jacuz/Whpl 4 Car Wash - Each Stall 6 - Drive Through 16 Cuspidor/Water Aspirator 1 Dishwasher - Commer 4 Domest 2 Drinking Fountain 1 Eye Wash 1 Floor Drain/sink 2 inch 2 3 inch 5 4 inch 6 Car Wash Drain 6 ( 1 Garbage Disposal 16 Dom Ito 3/4 HPI Comm Ito 5 HPI _ 32 Ind lover 5 HP) 48 Ice IVlachine/Refrigerator Drains 1 Oil Sep(Gas Station) 6 Recreational Vehicle Dump Statien 16 _ _Shower Gang (Per Head) 1 Stell 2 — Sink Bar/1-3vatory _ 2 _ c, Bradley 5 Commercial 3 Service Swimming Pool Filter _ 1 Washer, Clothes 6 ^� v�ater Extractor 6 Water Closet, Toile; v 6 Urinal 6 TOTALS _� 1 Total fixture valu,;s:�r�� -- divided by 15 = T�f L) ED HISTORY FLM# rowar DU# SWR# �t�f, ft ddh d PL.M# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# FLM# EDU# SWR# PLM# EDU# SWR# PI-M# EDU# SWR#� F'F:F�(+fI1 SUED . . . . : _ ` CITY OF TICARD DATE I LSUED: COMMUNITY DEV'-:LOPMENTDEPARTMENT 13125 SvV Hall Blvd.Tl9arJ,Oregon 97223*8199 (503)639-4111 PARCEL: SIIIZADS--0121401 ilj. v I;.jk U14. . . . ZONING: C-6 _iJlli. . . . . . . . . . ("LASS OF WORK. -NEW GAPBAGE DISPOSALS. : rz MOBILE HOME SPACC."J, : 0 TYPE OF USE. :COM WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 2' ' .. (jCCUPANCY ORF-". . :SL". I LOOR DRAINS. . . . . . 9 1� ruir,s. . . . . . . . . . . . . . 'RE JRIES. . . . . . . I WATER HEATE 5. . . . . : CATCH BASINS. . . . . . . : 0 fly TURES-.----- - - —11-- LAUNDRY TRAY' - 0 t')F RPIN DRAINS. . . . . : I,` I NK5. . . . . . .. . . . 231? URINALS. . . . . . . . . . . 71 (:'OPEASE. TRAPS. . . . . . . . 0 1-')IJ ATOP I EE . . . . . : B OTHER r'IXTUREG. . . . . G I(lB/:,HOWE r%L. - . '. L*:-m' SEWER LINE (ft) . . . S 0 Wr�TER CLOSET5. . : E WATER Lll',iE ( f7t ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 ;?Vrmar•ksg Plktmbing for- new 1:3, 215 sq. Ft . ln(?dic.'al clirllc. neri FEEE t '/P�� amc)-.(nt 1.)y rJate t-E-ct)t PRMT $ 576. 00 JMH 0c--127/96 96-27637`7 PLCK $ 144, 00 JMH 0,1/'17-'7/`)6 96-27E,- 5 P CT $ 28. 80 JMH 96--E!763�,; - ntractot-.- & r)ONG PLUMBIN0, "IC.. L:4 SW JEAN RD. , BL.DG. F', SUITE 170 OSWEGO LR #. 040369 REOUIRED INSPECTIONS s permit is issued subject to I-e regulations contained in t?e Water 1-inc, Insp and Municipal Code, State of Ore. Specialty Cedes and all other T(3p-o�1t 1risp -Aicablt laws. Ali work will be done in accordance with Dt-jrikirig Fc),.Aritai raved plans. This permit w il). expire if work is not started RV'/Ba0( .' 1c)Y,) Pt-pv .nin 18e days of issuan:#, or if work is suspended for more f irial inspect icor'. ov 181? days. -ted By - inspectioii L 1 '�-i)W City of Tigard PLMB NG PERMIT APPLICATION Planck/Rec. # 2 - 102- L- 13125 SW Hall Blvd. Permit # -!9� -t;116.3? Tigard, OR 97223 �,� �� =I� 5v kc?0--eO&O (503)1 639-4171 MINIMUM $25.00 PERMIT FEE + ST. 3-sURCHARGE ,r„•., Naw Slnqle_Family Residences Only a,,• - L.i r"/'L IP W �/ ❑ 1 BATH HOUSE:$140.00 O 2 BATH HOUSE$195.00 Job - �(j (l / C3 3 BATH HOUSE$225.00 Andress cy,+.en. Fee includes all plumbing fixtures in the dwelling and the first 100 of water service, sanitary sewer and stomi sewer. See fees below. ft-is »aFIXTURES (]TY PRICE AMT Sink '? 9.00 '7 1$ Mh Ad*- �.^• Lavatoi-y 9.00 .n � Tub or TublShower Comb, 9.00 Owner Shower Only 9•� Water Closet 9.00 V r,• ., ..,,,....� Dishwasher 9.00 r� c Garbage Disposal 9.00 Occupant ,,,,.. ��• Washing Machina 9.00 Floor Drain ,Z_tyxv_ ,• 9.00 11 arsr. DO Water Heater 9.cv 1 16 Laundry Room Tray 900 --- ,r,- Urinal 9.00 t �c1zS c �� /rlYQ-�,� L Other Fixtures (Specify) 9.00 14 w.rw Ad&- vhaa 9.00 Contractor _ 9.p9 S'Cf • no 9.00 Sewer 1st 100' _ 30.00 s,.,.R.QWV~N. cM sa.r..me. Sewer -ea. Addit 100' 25.00 ) r,� �� Water Service 1st 100' 30.00 I hereby acknowledge that I have read this application, that the Water Service ea. Addit 200' 25.00 information given is correct, that I am the owner or authorized agent of Storm 8 ra Rain in 1st 100' 30.00 the owner, that plans submitted are in compliance with 10tate laws, that I am registered with the Construction Contractor's Boaro, that the Stone &Rain Drain Addit. 100' 25.00 number given is correct. (if exempt from State regl;Uation• please --- 25.00 give reaso^ below) Mobile Home Space Back Flow Prevention V Device or Anti-Pollution Device 900 I J Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new addition O alteration,Q repair Q Catch Basin 9.00 to be done reside bat O nen-residential _ - insp. of Exist. Plumbing 40.00/hr Specialty Requested Inspections 40.00/hr Existing use of Rain Drain, single family dwelling 30.00 building or property -- Rcsidenbal backflow prevention devices 15.00 Proposed use of budding ^r property �1(�/CAS ��/^� *(Except residential backflow prevention devices) NOTICE 'Mir imum Fee $25.00 SUBTOTAL SrjFj PERMITS 2ECOME VOID IF WORK CR CONSTRUCTION 5% SURCHARGE AUTHORIZED IS NOT CCMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED --- FOR A PERIOD OF i30 DAYS AT ANY TIME AFTER WORK IS PIAN REVIEW 25% OF SUB•i0•rAi_ '�t COMMENCED. TOTAL Soecial Condkions Date is;ollid /�(�_�_by -=-- Tenant Name: 1 Accumulative Sewer Tally This SWR#: X16 O050 Address: S Ccs , --_ ".is PLM#: qG - G6Uy Fixture Value Previous # Previour Credits Capped Fixtures Fixtures New New Value Capped off value added # added total #s total Count off #s count value values Baptistr /Font 4 Beth -Tub/Shower 4 -Jacuz/Whpl 4 Car Wash-Each Stall 6 -Drive Through 16 CuspidorfWater Aspirator 1 I Dishwasher-Commer 4 -Domest 2 Drinking Fountain 1 Eye Wash 1 Floor Drain/sink 2 inch _ 2 3 inch 5 4 inch 6 Car Wash Drain 6 Garbage Disposal 16 Dom Ito 3/4 HP) Comm (to 5 HPI 32 Ind(over 5 HPI 40 Ice Machine/Refrigerator Drains 1 Oil Sep(Gas Station) 6 Recreational Vehicle Dump Station 16 Shower- Gang(Per Head) 1 _ Stall 2 Sink- Bar/Lavatory 2 y 80 Bradley 5 �— Commercial 3 16 Service 3 f 3 Swimming Pool Filter 1 Washer, Clothe.4 6 Water Extractor 6 Water Closet, Toilet 6 Urinal 6 ,rOTAI_S Total fixture values: 1,7q_, divided by 16 = �.'�� EDU HISTORY PLM# DU# ';\'!R# }Ljjg It ddh 0 PLM# EDU# SWR# -- -- PLMN EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PI_M# EDUN SWR# PI_MN EDU# SWR# PLM# EDU# SWR# PERMIT PERMIT #. . . . . . . SIT95-0040 CITY OF TIGARD DATE ISSUED: 0--'/05/9C- CUMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)639-4171 PARCEL: 2S110DB--00401 .;BDTVISI0N— *c- ZONING: C---G OCV. . . . . . . . . . . . PE OF WORK: NEW PAY I NO '. . . . . . . . . Y 13ESO. NO. VOLUME: 0 Cy GRADING .. . . . . . . . . Y VALUE. . . $ 73720 . LL VOLUME: 0 (,y LANDSCAPING iG FILL?. . . . . . .. y SITE PREP?. . . . . . . 'ILS RPT RCQD" . %V STORM DRAINS?. . . : IMPFRV SURFACE: 37.'x44 sf C r,ite 'marks : U3 Work permit -ror 13, 1211'j- q. Ft. medical c] illi.(:. qrley.: ..........- F7LLC type aw M o U ri t by date i,ecpt ;0 SW LINCOLN ST SWM $ 1414. 55 S 04:/05/96 96-275636 EROS t 100. 00 D 0J,/05/96 96-275636 IRTLAND OR 177ii01. ERPC $ 32. 5171 B 02/05/96 96-215636 irie #: 11�.G---6500 ERPC $ 317.1. 50 B 02/05/96 9&-- --r• SWM 3L00 Ell 02/05/96 96 I 75 S 0�`1/ 5/9 6 '3U F1 CONSTRUCTION PRMT $ 355. 12112A P 02/05/96 96-275636 !Ql SW TAYLOR PLCK $ ;!230. 75 B 0 0 6 9C,-27: 6'"s C., , ELAND OR 97205 r)T,,e #: 2..:.,8-7177 t L50P. 85 TOTAL 38304 REOUIRED INESPEC*rIONS ":s permit is issued subject to the regulations contained ir. the Erosion Control gard Municipal Code, State of Ore. Specialty Codes and all other Excavation Insp applicable laws. All work will be done in accordance with Fill 1risipec-tion approved plans. This permit will expire if work is not started Grading Insp within 1184 days of issuance, or if work is suspended rcr tore 53trin Drain Irisp than 18e. days. Lngirieer.ed gradi incl Inipe(-t ioyi ;---Mr(y%06r2- -------- %!.ted By Call -For inspection - 639-4175 Cid of Tigard Commercial Building Permit Application 13125 SW Hall Blvd. � .3 Tigard, OR 97223 (503) 639-4 i, 1 y Jobsite Address Tenant: (lVIce Use Only rnf � � Syne# -- i Valuation: Pla�ick/Rec # -�- � / _ . Permit # t. Owner: �.�Y� u t V,-A V`�� , y` --- Map & TL # 7_al (n�(?� Address: 2�t� rpt INC0�1n Approvals Required ., A �A A,) (If Y-?,' �' Z Planning SDR �� -C'1U23 I-hone: U��. ' �0 —_ Engineering Other Contractor: / Address: ) C? JI l 1 l��t , i,�rY f -7 Typ% of const: Occupancy class: �> Phone. _ _ � _ � , r / , E Spnnklered7 ( Yes �No Contractor's License (attach copy of curreol Oregon license) Sq. ft. of project: _ Contact name phone ��/� PV, 2)1'• Story (1st, 2nd, etc.) f A : Proposed use: Arr,hitect/Engineer: �.�`/1.�t(LT1M 'J' / 't n f Previous use: I, Address: Note Plumbing & mechanical plans r•� must be submitted at time of Phone building permit application `�� - �' � �`'> 1 f (�/� JUB DESCRIPTION: 1 G"' K. t- ��C 1(tiQUJ ` ACV y IVU,)ILA CC"(C. �. a (�� V1,4 VA trW Applicant Signature b Phone number �J Received by: Date Received: ?� Permit # Account Description Amount Amt. Pd. Bal. Due Bldg. permit (BUILD) ` Plumb. Permit (PLUMB) _ Mech. permit (?TECH) _ ota:• Tax (TAX) Blclg: Pluvib: Mech: Plan Check (PLANCK) '�, V 1�4 i Bldg: Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Lev Charge (PKSDC) Resider 'al TIF (TIF-R) Mass Transit TIF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-0) ',Nater Quality IWQUAL) �� d ✓ ��Zs 5-5- Water s^Water Quantity (WQUANT) �'� �� ✓ y i y ri F;re Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) Ice' ✓ � r v Eros;on Planck/IJSA (ERPLAN) Erosion PlanrklCOT (EROSN) -- J�5- TOTALS: C' '�1 �! i - j;/Z) December 22, 1995 CITY OF TIGARD OREGON Ankro.n Moisan Architects 6720 SW Macadam S-100 t / �7PV1 th Portland, OR 97219 Re: OHSU HEALTH CENTER - N� SW 109th & SW Naeve Striet PC11-91C SIT95-0049 A review of uhe building sitepplans have been ccmp.leted. Submit four (4) sets of revised plans of Sheets fiS, Cl, C2, , 1.1 and Al .2 with the following requirements detailed on applicable pages: Site ( U Sizing of all sto m drainage pipe shall be in accordance with OPSC, Table v 14-2. Provid4 two (2) sets of hydrodynamic calculations prepared and stamped by a licensed engineer. y �2J Provide a copy of the soils investigative report referenced in. Section 02010, Project Manual. L 3. Complete the enclosed Soils Special Inspection form and return with your resubmittal . Accessibility / rte k" '6� �� 1. , At each entrance to the accessible route crossing the vehicular way, Ott, � prc.vide a defined area not less than 36" wide with detectable warning in accordance to OSSC, Section 3109(p) . C; Pr,.,vide one additional accese=.ble parking stallraccess aiF-le and signage [URS, 447.233 (2) ] . Fire and Life Safety Fire apparatus access shall not be ob,;tructed [UFC, Section 10.205] Contact Gene Birchill, Fire Marshal, at 526-2502 regarding the proposed gate at each parking lot entrance. Val,istion �1. Provide the project cast for all si:e development. work. � J If you wish to discuss any of these items, please give me a call. Sincerely, Fames Funk Plans Exarni,.er sit95-0048\poll-91c 13125 SW Hall Blvc, Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 - k ANKKOI` t MOI SAN ASSOCIATED KCHHITFLTS .lanuan 2, 1996 OHSU TIGARD HEALTH CENTER Addregs: SVS 109th & Naeve Street 251101 W; Tax Lot 401; Zoned: C-G ,1.tn: Mr. James Funk 'Ie: BUILDING SITE DEVELOPMENT PLAN REVIEW APPLICANT'S ANSWER SHEET TO REVIEW LETTER OF 12/22/95 Site. 1. Please see attached exhibit "A". Draina e Calculations for storm drainage pipe sizing. 2. in lieu of a soils investigative report, the building's structural design was based on the UBC ,ail bearing capacity tables. The applicant proposes to have present at the site, Jim Embrie, a representative of the Carlson Testing Agency, to observe the condition of the soil when excavated for suitability, prior to laying of concrete reinforcing. If'required then, testing � ) will be pc,i6rmed. See attached exhibit"B" for Soils Special Inspections Form. Accessibility. 1. Refer to architect's drawing detail No. 2/A 1.2 and notifyarc}iti et ct 'f thick vinyl roadway paint will be acceptable to City. An additional accessible parking stall was added per revised plan No. Al.I of 12/20/95 submitted to the City on 12/26,'95. See attached partial plan exhibit"C". Fire and Life Safety. i. 'i he proposed gates at each end of parking will be deleted fron) construction scope of work. V Valuation. A. See attached exhibit"D", site development project cost. L Mr. Funk, please let tie know at your earliest convenience if the attached meets your requirements or if you have questions. "Thank you. Sincerely, ANKROM MOiSAN ASSOCIATED ARCHITECTS Mario Espinosa (ln i F Project Architect ((// Attachments: Exhibits"A"through"C". c. Mr. Matt Baker PROJ\MOTIGARDA5Po1 6720 s.w. Macadam,Suite too,Portland, 1re90n 97219, 504/245-71no, FAX 504/245-7710 Principals:Strwart H.Ankrom Thomas Moisan,Oavid N.Vin.da,Lom.;rir C.Kellow,Jeff Hamilton,Kare,i Px wery s. CI TY GF G�i�D 13MIT '911 E ELC96 - 101" COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 02/20/96 13125 SW Hall Blvd.Tigard,Orogun 97223*8199 (503)639-4)71 PARCE.L: EG1101]18-00,1401 A i L /11--11410 )L,I;DIVIE-;ION. . . . WWI ZONING:C-G A-0cl,. . . . . . . . . . 11.10ject Description : Install one temp service at, feedor tL .200 alI;JS ot- JeS:: --RE0IDE6,r1AL UNIT----- .---_.TEMP SRVC/FEEDERS-------- -----MISCELLANEC)US-------- 1000 ':jr 01' LESS. . . . . 0 0 - 200 amp. . . . . . . : 1 PUMP,-r RR I GIT I ON. . . . : 0 ACV: PDD" L 500SF. . . . 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT L'''NE LTG. . : 0 .-IMITED LNf-* RUY. . . . : 0 401 -- 600 .amp. . . . . . . : Ili S 1 G N A L/P A N 1-:'L. . . . . . . 0 ANF. HP,,' SVC/FDR. . : 0 601+amps-1000 volts. : Q1 MINUR LABEL ilk)) . . . 0 i+l)rlli- INGPECTIONb— CIRCUITS -- - 200 amp. . . . . . : la '.,I/SERVICE' OR FEEDER: 0 PER INSPECTION. . . . . : 0 01 400 amp. . . . . . ; 0 Ist W/O SRVC OR FDR. : 0 `CR HOUP. . . . . . . . . . .. . 0 01 600 r.Amp. . . . . . s 0 EA ADD' L BRNCH CIRC; 0 IN PLANT. . . . . . . . . . 01, 101110 aMP. . .. . . - 0 REVIEW . 000-4 amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 0- 00 VOLT NOMINAL, vcurlrlet Only. . . . . . 0 Lv(-/FDR APIP:— : CLF455 AREA/' E(- OC;11". , Wne'-•. FEES ! 11U type a mc,1.1 Tit by date recpt 5350 SW ROYOTY PKWY PRMT 50. 00 CJS 02/20/9t'., 96-27608,1, InGrii) OR 1)71212,3 ` PCT - 50 CJS &:/20/96 ')62760Li ;-Ione #. Jr?AL- ELECTRIC IldC 0 T 0 T(:i L -f`1S NE ELAM YOUG P11,WY . LLSPOR0 OR 1)711,`4 REQUIk,-D Ii4SPECTIONS .. !ione at: leut' 1 Service ,-.�g 0. . . L al e,i,t' I F-i n A 1 is ptreit is issued subject to the regulations containid in the .gar d Municipal Code, State of Ore. Specialty Codes and ai' other FeT-W I—tt I—,Rt 1.17 .0licable laws. Al: work will be dine in accordance with -Drovtd plans. This pervit will expire cork, is not started :F,.n 188 6ys of issuance, or if W is suspended for a .,e in 189 days. Issued by --OWNEF'' INSTALLATIOt i ONLY—. le installation is being made on property I own which is not intended for ;,le, lease, or- r-ent. ANERIS SIGNATURE: DA7r- 0014T PACT OR .1NGTALL1-4T10Pi GNA I URE OF 2 wiR. ELLE, N; Call for inspection 639•-4i'/;; Community Development ELECTRICAL PERMIT APPLICATIO'J 13125 SW Hall Blvd. Tigard, OR 972211 t'!anck/Rec. # y6 ,,2 7,6oi— ., Pei reit # Z.c 9G C>(yo;7 Phone (503) 639-4171 Date, Issued c r26- CITY OF TIGARD FAX (503) 684-7297 Issued by � S ��,,,�,•• TDD No. (503) 684-2772 �� -- Inspection (503) 639-4175 1. Job Address: C"A�f �' 4. Complete Fee Schedule Below: _I vcw /S.3 so .�w y Name of Development 0> SU-T IGARD CLINIC Number of Inspectiol,i per pwrmit allowed Address SW 4 9th N C —_ Service included Itf,ms Cosrlea) Sum CO/State/Zip- Tigard, Or 97223 4s. Residential- per ur 1 1000 sq It r,r lcw $11030 Name (or name of business)__Y Frnh additional Soo sq f' or "-- portion thereof $2500 ! Commercial S Residential❑ timaed Energy $2500 Fach Manuld Home o-ModiAar f Dwelling Service or Feeder $6e 00 2a. Contractor installation u,1ly: 4b.Services or Feeders Installation al!aration,or relocahon Electrical Contr�Ictor_ R �1 EieC , Inc, _ 200 am-e or less $6000 Address 5285 NE E1im�o -parkw #p9 p 2otamocto400unps -� $8000 41'arr a to 600 amps $12000 City_Hi1.1 -,;bc)ro S',a!e__ M Zip y71_2_4_ W .Qeto 1000amps —_ $18000 Phone No. 6 4,9—Fi F 9r, _ Cw 1000 amps or volt, $34000 ? Contractor's LicenSP hr` jA-$2C_ Pw-on,—1nn'v $5000 Contractor's Board Reg. I!o. 47478 4c. Temporary ren `,ervices or Feeders ) Installation,alteration rurocatlon Signature of Supr. Elec'n_ -914 � � _ 200 amps or less � t.5o 00 50.00 Licer 3e No. 4 U 6 2-� Phone No 6 48-66 9 201 amps b400 an SM 00 -----� -- 401 amps to e00 ar!ps Ino 00 Over 800 amps to'.000 volts 2b. For owner Installations: see W above 4d.Branch Circuits Print Owner's tVame _ New allegation or eldamion per penal Andress a)Tho fee for bronco circuits with City _— Slate Zip^ purchs"of aarvk•a or baby Ars. Phone NU. --- ---- Each branch circus $5 on _ b)The lee lar branch arcade wifhouf The installation is being made on property I own which is pumilis"of eervks or bed*be. no' intend,)d for sale, iease or rent. First Manch arrwl __ S1500 Each additional branch orcud $500 Owner's Signature _—� _ 4e. Miscellaneous (Service or feeder not included) 3. Plan f7evie'w section (if required): Each pump or irrigation circle $4000 Each sign or outline lighting $40110 Signal arcud(s)or a I!mded energy Pleass check approprWe item and enter f-e to section SB. panel alteration or extension $40011 4 or more residential units to one structure % .r Labels(10) $10001 W Service and feeler 225 amps or more System over 60)volts nominal 41. Each aoditional inspection over Classified area or structures containing special occupancy the anlowat In in any of the above as described in N.E.C. Chapter 5 $3500 $5500 _ Submit 2 seta of plans with application where any of the abcve --- $5500 -- ",ply. Not requited for temporary construction services. 5, Fees: NOTICE 5a. Enter total of above foes $ 50 . 00 i— 5%Surcharge(05 X tctdl fees) $ PERMITS BECOME tfOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for CONSTRUCTION OR WONK IS SUSPENDED OR ABANDONED FOR Plan Reviev, if required(Sec 3) $ A PERIOL -'c 180 DAYS AT ANY TIME AFTER WORK IS Subtote- $ Z COMMENCED 11 Trust Acc nt Ar $ Dal-nice Due s 52 . 50 aaUt.w1ev,W off.aW BUr-155 050J, /� �,✓� DATL I SGULD: 0r__!12E196 CI'1Y OF T IGARD ,COMMUNITY DEVELOPMENT DEPARTMENT 51 T,13125 SIN Hall 91vd.Tigard,Oregon 97223*819C (5031639-4171 .3UBl)i v 1;J 1 N. ONING:C-0 13'.0 C K. . . . . . . . . . . . . . . . . . REI SGUE. FL 0 0 R FURCA S LX TIE-R I f- W C4 L.L Pv;.TF ��J CLADS OF WORK— NEW FIRST. . . . 13,815 -F N.- S. 1HR E: TYPE OF USE. . . :COM SECOND. . . : 0 :5f PRUIECT 0PENING13? - ---- - - TYPE OF CONST. 15i`4 lb Sf Ns B: Y E. W OCCUPANCY GRP. »B2 70TAL 13815 S f FOOF CONS) . F I 1*1:'. RET OCCUPANCY LOAD: J,06 BASEMENT'. : 0 s f V.Pr" SEPI. RATED: STOR. . I I IT. 0 f GARAGE. . . : 0 s OCCU SEP. RATED;: 85MT1 . MEZ12 ?: REDD SETBACKS---- REQUIRED-- - FLUOR LOAD- -, 0 psf LEFT: 0 ft RGHT. 0 ft FIR SPKL:Y SMOK DET. . :Y DWELLING UNITS: 0 VRIN17 . 0 ft REAR; 0 ft FIR ALRM: Y HNDILP ACC,.Y 2 E D R IyI 0 BA I ii,,".:. II IMP 3-1344 VIR- 0 CORR.'v PARI-IINGi 0 VALUE. $ ,: 1500000 Remav-Fis, : A crew 13, 815 v q. ft. medical L:I i n i c. Owner: DRAX -FRANKLIN type amount Dy date V'e(.'P L 'L.CK `55( T I 30 SW LIN(IOLN S1 F 4 7�) 1 1/30P45 932*7 FIRE $ 157.1. L0 JI) 11/30/9; .,5.-27340: PORTLAND CM 1)7a0i PRMT $ .33.33. 0 0 JSD 0 & 6 L" Phone #- 2f,2`.6-6500 5PCT $ 196. 6`5 ,.TSD O2/L2/96 96-2762, E R 0 15 $ 37(-. 00 JF3E1 I�i_/C'22/'*,,6 96- E762'i Contractor: ._ERRE $ 122. 20 JGD 02/22/9f. 96-j,7621, R & 11 CON5TRUC VION EP171C $ 122. 20 J9D 02/iRL196 96-276r:'0, 153121 UW TAYLOR TIF" $ 5664. 00 J5L) 0c:/EE/96 96- L 76 E� f i F >k I 3E I a. 00 .155 OE, C-"1�6 -36- PORTLAND UR 97205 Phone if: 228-7177 S 27761. 70 TOTAL. Reg #. . . 38304 REQUIRED INSPECT :01NIS 'this permit is issued subject to the regulations contained in the 'Litvi.tc `itepl. Insp High sttr-eToUtri Into Tiganj Municipal Lode, State of (Ire. Specialty Codes and all other Reitif Pteel !:,lsp '.pt-inkler, Under-s applicable laws. ha'l work will be done in accordoice with Slat) LTISP RnUgh approvpd plans, This pert/-, will expire if work is not started Fvaming 1115p bpvinkler Fireal within 00 days of issuance, or if work 15 suspend I for more Root- nai ' rig Insp Fire Alar-m Insp than IN days. Ins i.t1stion Insp r;moke detecto,- i Sheat- Wall Insp Appr-/ 3�:jwll-, ins[.-) Flt-ewaill Insp Misc. Inspection C.yp Boat.c" lisp Final inspection I- e) FIlittoe " llinalle retnooe— 11sp LV "MI4 iF15P 44olts in caricret -ti-it-al WFI(Ji i�.k e d Call for inspecti -m C-39 -4175 �1+�plo�ommercial Budding application C;ty of rigaldo ' 7 "� Zti �� o t j �, 1 v C F S) = l- ? `i 1 ✓ r :.�'� s' J"t i 3125 SW Hall BKd., yr r� 1 Tigard, OR 97223 (503) 639-4171 ddr9--r.: V1� 1 �5'f Sit A Vf• /� Joh,ate A �--r-- 't Ot'(lcet,l�e On tenant: �.' �'[SU _, Suite 4 P!anck'Rec At Valuation: 1 DO "J00 r Permit �5UZ #�.�_ Owner. --� X�_L 12A L-J ---- Mao 3. TL �" > I I C 7(3 - 2� I Approvals P.te�q/uL_d — TI.AK 11(Z , "L72U) Planning � �- �Y•,,,�1�_' — Engineering _-._-- 1 Other Contractor. �.. LV�1L� Type of const: --r - _- -�-�- 2 Occupancf class. Phone* 5-0 SDrinklered"' Yom) Nn � _,,nractor's License , a 304 � � -23-`,� ar'�c,ti :^c5y of cu regon iicerse) C• ft. of p=je,- _ -- C-Lntact name 3 Ghene: KJ€d� "553 Z Story (1st. Vid, etc.) ^^- Proposed use: p1 �_�L L�=- Architect/Engineer' Previcus use: Ads �5� �12Q_s W MAc� u �z� l� Note: Plumbing & mechanical rears be submired at };me of cu dirg permit aeolica*on. Phun2 �c g c F��r i��:r:•, ��_�;TQ R-`t M�.LJ1�.t(-- G�-_�rl!C- �L_.��15 �--- S � AC 44 5 166 Applicant Signature 3 Phone number Received by: --- Commercial Buk ir_g Permit Application City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 Jobsite Addrpss: Office Use Only Tenant: _. Suite # Planck/RQc # Valuation: -- Permit 4 __ -- Owner —---------- ---- -- - Map & TIL Address _ _-- ----- Approvals Required Planning Phone -- -- Engineering Other Contractor: addres __-- _-- — Type of const. — - -- — —---- Occupancy class ---- Phone _ _ —_-- — — Sminklered7 Yes No Contractor's License -- (attach copy of current Oregon license) Sq, ft. of project —_______ Contact rame & phone _ Story (1st 2nd. etc.) Proposed use Architect/Engineer: --_ Previous us-2 Note Plumbing & mechenical plans must be submitted at time of building permit applica ion Fhone —_ JOB DESCRIPTION __ __ -- ----- Applicant Signature & Plione number Received by, Date Received _._ P&MIt 0 Account Oescriotlon Amount ArrL Pd. Bal. flue �--- Bldg. P vrmit (BUILD) Plumb. iPerrnit (PLUMB) _ Mech. Permit (MECN) State Tax (TAX) Bldg: Plumb: h1ech: / Plan Check (PLANCK) c > �i �i `f5 Sidg: Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) F^sidential TIF (TIF-R) WisysTransit TIF (TIF-MT) y,0t Commercial TIF (TIF•C) 3��1$�� •o-6 ,r L Industrial TIF (F;--I) _ Institutional TIF (TIF-'S) Office TIF (TIF-C) y Water Quality (WQUAL) Water Quartity (WQUANT) Fire Life Safety (FLS) ' V� { Erosion Cntrl Permit (ERPRMT) `i 76 7G V a Erosion Planck/USA (ERPLAN) _� s-2- V 1 2 c y l rosion Planck,COT (ERCSN) f 1 C /j,2-- TOTALS: c, z3, �3�0� DATE PLANS CHECK NO.: Z- - /- PROJECT TITLE: COUNTYWIDE �ti�r� i V� , TRAFFIC IMPACT FEE APPLICANT: WORKSHEET ��av\ MAILING ADDRESS: n (FOR NON-,:-,I.NGLE FAMILY USES) Z(? �(t I (✓ �1,�GLtM CITY/ZI?/PHO E: RATE PER O 7 LAN 'F C8TEGORY TRIP TAX MAP NO.. RESIDENTIAL 91:0:01 BUSINESS AND CUMMER IAL S, N .ADDRESS: 14 . I I INDUSTRIAL $153.00 INSTITUTIONAL $66.00 PAYMENT METHOD: CREDIT INSTITUTIONAL ONLY: BANCROFT PROMISSORY NOTA URE CATEGORYESCRI N USE EEKILIV AVG TRIP RA WEEKEND AVE TRIP RAT DEFER TO OCCUPANCY z U MF lCtGC BASIS: CALCULATIONS: w�eYJAAj Aky AV'f WA .le n0 S�,'IZC,`�l>' (c`�,`�zf,nn 'ROJCC� OEl1EHA77CM: ADDITIONAL NOTES: FOR ACCOUNTING PURPOSES ONLY: ROAD AMT.: TRANSIT MAT.: YAA1EO BY: 1/ '✓I r CC: WASHINGTON COUNTY TIF NOTEdCIOK form"fl 0 Dacember 8, 1995 CITY OF TIGARD OREGON Ken "Anavarro Ankrom Mloisar. Architects 6720 SW MacAdam Blvd. S-100 Portland, OR 97219 TRAFFIC IMPACT FEE FOR OHSU MEDICAL CLINIC, Enclosed with this letter you will find a calculation sheet showing the computation that I as been performed to determire the amount of the Traffic Impact Fee (TIF) to be paid for the project noted abuse. The amount of the TIF is $68,921 .00. You have three payment options available to you. The first is to pay the TIF at the time you are issued a building permit. The second is to arrange for payment over time by signing a p nnissory note (if you wish to excruiso this second option please contact me for additional details). The third option is to doiQr paym-nt until occupancy. Traffic impact fees are subject to an annual increase of up to 6% if not paid or financ(d p,ior to July 1 st of each year. Please note that you may appeal the discretionary decisions rnade in determining the appropriate category and the amount of the fee based on that cr-,egory. A notice of appeal must be received by the Cid Recorder no later than 5:00 p.m. on December 22, 1995 and must be accompanied by the $625.00 appeal fee required by Washington County. Although filed with the City Recorder. a o appeal would be heard by the Washington County Hearings Officer. Attached is tho Countywide Traffic Impact Fee Payment Option Foram which must be completed and returned to the Development Services Technician Team by December 22, 995. If you have any questions, or if I can be of further service, please contact me at. 639- 4171 . Bcnnie Mulhearn Development Services Technician c: TIF file Building file Owner 131225 >W Hall Blvd„ Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 -- — - -I DATE. _ PLANS CHECK NO.: PROJECT THE. COU-PiTYWIDE TRAFFIC IMPAC' FEE APPUCANT: WORKSHEFI f)vlyy- m Mol`Ax,--N �1,k-lf-CSS (FOR NON-SINGLE FAMILY USES) MAILING ADDRESS: ( ZU me ll-W1 4-j- 100 CITY P/PHQNF: RATE PER Oy 072 Z.I`1 �NO USE CATE(' py TRIP TAX MAP NO.: RESIDENilAL $159.00 Z!:Dl I� (2P, --rot-qoI BUSINES§ AND COMMERCIAL 340.00 SITUS NO. 0 ESS: OFFIC 146.00 1EEINDUSTRIAL 3153.00NSTITUTIONAL 366.00 PAYMENT METHOD: 5� 5� CASH 4QIFCK CREOFT INSTITUTIONAL ONLY: BANCROF'I OMISSORY NO use CATEGORY e z use Y AVG. TIUP RAI wEEI�t�D AVE TW PA rf DEFER TO OCCUPANCY r j BASIS: -1�1t!_ 1-T�%rjj1\jx OL i CALCULATIONS: " f Lw tvdn,_, a veva r a ,(� ,� ,c USS c� a PROJECT TROD ClaMOUTIOM: 1.. Z ADOITIONAL NOTES: FOR ACCOUNTING PURPOWS ONLY: ROM AMT. `T 'RANSrT AMT.: 0 sY: CC: WASHINGTON COUNTY I rW NUTF.BOOK form el a December 21 , 1995 CITY OF TIGARD OREGON Ken Canavarro Ankrom Moisan Architects 6720 SW MacAdam Blvd. S-100 _ Portland, OR 97219 TRAFFIC IMPACT FEE FOR OHSIJ MED;CAL CLINIC Enclosed with this letter you wii! find a calculation sheet showing the computation that has been performed to determine the amount of the Traffic Impact Fee (TIF) to be paid ,or the project noted above. The amount of the TIF is $18,882.00. You have three payment options available to you. The first is to pay the TIF at the time you are issued a building permit. The second is to arrange `c - payment over time by signing a promissory note (if you wish to exercise this second option please contact the Development Services Technicians for additional details). The third option is to defer payment until occupancy. Traffic impact fees are sublect to an annual increase of up to 6% if not paid or financed prior to July 1 st of each year. Please note that you may appeal the discretionary decisions made in determining the appropriate category and the a;nount of the fee based on that category. A notice of appeal must be received by the City Recor gr no later than 5:00 p.m. on January 10, 1996, and must be accompanied by the $625.00 appeal fee required by Washington County. Although filed with the City Recorder, an appeal would be heard by the Washington County Hearing- Officer. Attached is the Countywide Traffic Impact Fee Payment Option Form which must be completed and returned to the Development Services Technician Team by January 10, 1996. If you have any questions, or if I can be et further service, please contact me at 639- 4171 . Randal R. Wooley City EnginF:er c: -IIF file Building file Owner 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 — - Cit,,, of Tigard MECHANICAL PERMIT Planck/Rec. 13125 3w Hou Blvd. APPLIQATI O{ Permit # MrC 1, 5 -("/7/ Tigard, OR 97223 !1, I� " (503) 639-4171 Tabb 3A 0 T PRICE AMi Job l Og'"SL! S�►) V E !1 Permr. Fee -0- -0- 10.00 AddresssrS A O D 191Z. 21 SuppWMrital Permtt 3.00 urea . to L1) Incl ducts &vents ILK) urnace N Owner J�/ S L l INA CO LM 2) ncl. ducts d vents d 50 "" r WF oar umanctr --+— F0aTt�N>, 010. a�w>i incl. vert 6.00 — -- scMrdLoeui user wet �atrr S AdA 311 4) or °oor mounted heater 5.00 ..,. .. �- Occupant 2 J` 5 W G_, -T {f, �D �!5, aDpllant q permit 300 7 •^^� J L w —�eF urtg, retro an. AA _ 61 coodng, absorption umr (3.00 uTer or comp, neat ^c rip, air cond. C 7 to 3 HP ahsorp unit 1OOK BTU 6.00 -M. .r �-`Boder rr comp tear-•ump, .vr cond. }15 F;? absorp ur^ to 500K ETTU I 11.00 r Contractor �'_ aer or camp, en, oump, air cono, '— n, c30 HP; absorp t 5-1 ml BTU 15.00 new pumo, air who 0) Z0-50 HP: 305orn anit 1-1.75 mil ?TU 72.50 -TTe—re-by ac noweage :rat i haye read tis aopncaoon, :1�T IF o,er or ;omp, qat pump, air ane. �I Information given ;e correct, oras I am the owner or authorized I 111 .0 HP- aosorp ur,t ' 75 mil BTI' 37.50 agent of the owner, that plans submitted are in compliance with ,r nanT urn ,r, State sews, that I am registered with the Construction Cantractor's 12) 10.0011 CFM 4.50 1 5 rJ Board, that the number given s correct. (If exempt from State man .ng_un 171 registration, please give reason below) 13) 10 000 CTM 7.50 un portable 14) evaporate c00,81' 4,50 Ent rn 'onnncteo ----- -_ 151 to a s,ngle aur 3.00 enutatan system riot 16) Included in appiience uerrrnt 4.50 cod ;ery by 171 mecnan.cal exhaust 4.50 escrL^ wo neweu3Uon V atgrati0n t, repair ( ommerc,a or n ustra. to be done r isidential Q non-residential NJ 181 type ncinerater 30.00 surq se ;r--`-- her .e.. wnodscove. water bu,lainq or protrRy _VhC.AAT 1•.AM2 191 Rt3ter, solar, clothes dryers, etc 4 5050 Proposed use of 20) Gas piping one to four ouUets =00 building or property M e 01 CA - G-1.1 N I L 211 More than aper outlet (each) 2.G0 Type or wel-oil O .atural gas X LPC O electric V L NOTICE Minimum Fee S25.OJ SUBTOTAL } PERMITS BECOME 11010 IF WORK OR CONSTRUCTION �y AUTHORIZED IS NOT COMMENCED 'NITN!N 180 DAYS. OR S'/ SURCHARGE IF CONSTRUCTION OR WORK S SUSPENC20 OR I AEANOCNED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN RE-VIEW 251,/ OF SUBTOTAL AFTER WORK IS =OMMENCED -- - ZL TOTAL U I Special f.onditions t� Date iccued by taunrimostTw[ct•orr 1400-30-1905 09152 503 6P•4 7297 '97% P.04 MECHAHICOL CITY OF T I GARD PCRMIT #. PER T MEC9-.--i -1214C" COMMUNITY DEVELOPMENT DEPARTMENT DATE IGSLJEE,- /22/96 13125 SW Hall lb;vd.Tigard,Oregon 97223e8199 (503)639-4171 �'JMLEL: C'.73 11 ODE--0040 1 I-L (41)DRL�- toy SUBDIVISION. . . .. .* ZONINGt L--b E'l-oct'— . . . . . . . . . LOT. . . . . . . . . . . . . . CLA GS Y OF WORK— NE6, FLOOR --URN. . . . : lb C-IJAP COOLERS: 0 TYPE OF USE. . . . :COM UNIT HEATERS. . : 0 VENT FANS. . . : 0 UQCUPANCY GRP. . :B2 VENTS W/O APPL: 0 VENT SYSTE115c 0 SIORIES. . . . . . . . BU1L.ERG/COMPRE:i5'3RS HOODS. . . . . . . : 0 FUEL TYPES— 0---3 HP. . . . - I DOIIE�3. INCIN: 0 , /GAS/ 3-15 HP. . . . : 1 COMML. INCIN: 0 MAX IfL47UT: 0 BTU 15.-•,30 Hp. . . . : 0 REPAIR JNITS: 0 FIRE DAMPERS'). - , Y 30-50 HG. . . . : 0 WOODSTOVES. . .- 0 GAS PRESSURE:...: M 50-1 tip. . . . 0 CLO IDPYERS. . : 0 NU, OF AIP HANDLING (1N17S OTHER UNIIS. s 0 I URN ( I OOK BTU: 18 GA5 OUTL1.--' 1'5. I r-U,"n ) =100K BTU: L, .marks: A new 13, 815 Sq. ft medif.-al clinic. nwncr-. FEES `AX---FPANKLIN type -1mi'Unt b cJati r e c p t 5O SW LTNICOLN E.T PRMT $ 19 2.. 51ZI JSD 02/22/96 96-2764. P L C 1-1, it 8. 1 511 0--/221/)6 r36 '12 7 62' :RTLHND OR 9/201aOl 5PCT $ 9. .�3 JE3D 02/,E2/96 9 6— I-1 62W ,one #. ' '--r' -611410 'IMPTE CONTROL 14TG & n C �A-j im 26TH nvF". RTLAND OR 97c-'10 o T)� 4 ...2.':3—4 �)3 t 250. 26 TOTPL 'y #'. '%r-GUIRED INSF ECT ION5 ,i permit is issued subject to the regulations contained i the G'-As LiTIP insp ........ ,ard Nunicit3l Code, State of Ore. Specialty Coats and all other I'lechainical Insp Aicatle laws. All stork will be done in accordance with Heating Jl't .j^ovee plans, This permit viiil eApire if wore if not started Cuoliiiq Unt In!-,p .hin 188 days of issuance, or work is suspended for sot, Dl.tct Ins pec-Aicin in 180 days. F ir-e (41ar-m Insp F ir-a Dainper- Misc. inspection [: 1 11�.;k I In 9 F)e ct i C)1) it;-kv I-: d L. Gall fns inspec t. i on -- 639-4175 CITY OF TIGARD March 6 , 199 OREGON Rural Electric Inc. 5285 NE Elam Young Parkway #AQr Hil-isbor2, OR 97124 Project : OH'SU CLINIC-TIGARD , _,ject : E ectrical Plan Review ELC96-0088 The plat c suf,mitted were reviewed for conformity with the 1993 National Elms- -rical CoIe (NEC) and the State of Oregon Electrical Specialty Code. T:ie fo.11owing was noted- 1 . rhe : 993 NEC is the minimum electrical requirement . 2 . The listing instruc _-Dns cn the lighting fixtures may limit the number of fixtures per circuit . 3 . There will be no water lines or HVAC vents overhead of electrical parols . 4 . Mechanical and medical service equipment requires U.L. listing and labeling. A copy of the .listing installation instructions to be on the job site. S . Rebar. (UFER) will be requi•:ed to be the grounding electrode for the electrical service. 6 . Restricted Energy Permits required for Nurse Call system, fire alarm s•{stem, cable. T.V. , security, communications system, HVAC, and sign:, . 7 . The x-ray to be installed and electrical installation to be 'per NEC Articles 517 & GG0 . 8 . The Electrical Permit is 496-0088 and the fees total $2, 249 . 00 . Please contact Michael Rudd at 503-639-4171, ext . 356, to discuss the electrical notes . Thank you for your cooperation , Michael Rudd ?lectrical Inspector elc96-0088\ruralelc.dcc 13125 SW Hall Blvd., Tigard, Of; 97223 (503) 630-4171 W (503) 684-2772 — URAX-FRANKLIN LLC 330 Southwest Lincoln Street Portland,Oregon 97201 "503-226-6500 " 503-226-6509(fax)" RECILEovE � December 22, 1995 DE-0 2 6 1995 CITY OF TIGARD Mr. Randall R. Wooley City Engineer City of Tigard 13125 SW Hall Blvd Tigard, OR 97223 FAX: 6847297 Re: Traffic Impact Fee for OHSU Medical Clinic Dear Randy: `. - We are in receipt of your letter dated December 21, 1995 regarding the "Traffic Impact Fee for the nc\v OHSU clinic. We accept the amount of the fee as stated in your letter($18,882.00), and will be paying it at the time we are issued a building permit. 'Thank you for your time in this matter. Sincerely, Matt Baker Member MATT BAKER FRANKLIN PROPERTIES, INC. 1'.0. Box 25432 (503)292-1970 Portland, OR 97225 FAX: (503)292-5760 ', �aj ANKKOM MOISAN ASSOCIATED AKCHII I C I .1anu! ry 30, 1996 011SU TIGARD HEALTH CENTER Address: SW 109th & Naeve Street 25110 DB; Tax Lot 401; Zoned: C-G Attn: Mr. James Funk Re: BUILDING SITE DEVELOPMENT PLAN REVIEW APPLICANT'S ANSWER SHEET TO REVIEW LETTER OF 1/24/96 Site. 1. Item A. Please see attached exhibit"A". 710 Item B. Please see attached exhibit"B" ti 0 r- 1 2. See attached revised drawings set dated 1/26/96. 3. See attached exhibit"B" for Soils Special Inspections Form. Accessibility. 1. Please see revised detail on A7.1 (1/26/96), side access, 34" hi13h sink,.ounter. Aeere)i rr S"1 1 . 1 <<s � t � � �' � >'-t l ' f� r. �, It1 Irl � .r/v4, rf E-rc .end Life Safety. Please see attached "B". `' �� /)•i1 �� tT� j Item A. Please see revised elevations A4 & details 5,6,7/A13.4. v'[iem B. Please see revised detail 3/A13.1. �l V Item C. Canopy is deleted. Structural. .7,rsd 0 Item A. Detail and calculations will be submitted to the City later. eP We will comply with the draft -top requirement. Detailed drawings will be submitted tc. the City later. > Item A. The X-Rey unit is floor supported, and any information shown in plan is for the X- Ray tube stand alignment and is not structural. The surgery light however, is ceiling suspended and is detailed in 1/.A13.1. 0 Item B. Please see details 15/A 13.1, 11/A 13.2 & 1,2,3/S6.2 and 4,S6.2. f �'" ''� ,6" •rI r� ..� - UClarification: Please note that detail 221A13.1 1s the roof parapet, and ' tail I I/A13.2 is the entry canopy. A/e eW Z L 11.1') , (1720 SA. M101tvl1,5t11tV 100,1'"W:U,c�,�)t otl 97219, 504,241-7100, FAX 504/245-7710 Principals:tirrwart 11.Ankn"n, Flumm,Momin,David N.14+nada.Lorta+ne C.Kelkik je11 1lamdtom Karen I mvv Sprinkler 1. The applir-ation and required (3)sets v,ill be sub►nitted to the City by the Firestop Company, sprinkler contractor license#63846 as soon as they have completed their shop drawings. 2. Clearance will be provided around all piping extending through walls and floors with a I" clearance on all sides for pipes 1" through 3 ''/2" and 2" for pipe sizes 4" and larger complying with NFPA requirements#13-4-5.4.3.4 (a). Mr. Funk, ples;se let m� know at your earliest convenience if the attached meets your requirements or if you have questions. Thank you. Sincerely, ANKR4 MOISAN ASSOCIATED ARCHITECT; Mari7Einosa Project Architect Attachments: Exhibits "A"and "B". c. Mr. Mat! Baker PROAOH3 LATIG A RDA3.Ens I Janizary 24 , 1996 CITY rV-W F TIG�D I �r ` Ank.ron Moisan Architects OREGON 6720 SW Macadam, Suite 100 Portland, OR 97219 RE: OHSU SW 109th and Naeve Road PC11-91C SUP95-0502 The plan: and specifications have been reviewed for conformity to applicable codes . Please submit three (_,) sets and specifications incorporating the fallowi Site n of revised plans 9 rPquirements : Correct Building Data Schedule, Sheet CS . A. The building has only two yards for calculating the allowable area increase . B . Applicable allowable area is 12 , 000 square feet with additional for sprinkler protection. Roof str-ru. drainage piping must be connected storm drainage system � _d to an approved Section 1401] . Y [Section 307 and 2905 (f) and OpSC Accessibility i The sink in the staff lounge (5/A? . 1): :il all i)e acc: accordance with OSSC, Section 3109 (k) 3 , essinla in detail 5/A7 . 1 . Provide correct Were signs are provided to identif .room wig h OSSC, Section 310 Y �s they shall tom 1 I 910) (see. 4/A7 . 2) ply. Fire and Life Safety + , I! The occupant load of the buildi.lg giving consideration for no occupant exce,�ds 100 upant load in theven ose after listed i.n your January 8 , 1996 , area calculations letter areas by using 100 squat feet per occupant in the lobby. However, because you have submitted historical evici: -ice of similar facilities owned and operated by OHSU in the metropolit-an writte-'Yea�g)youn request for a modification to section 30_ ( exception will be accepted for review b Building Official . ^'lease submit . Y the 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 Ankron Moisan Architects January 24 , 1996 pg. 2 Provide a detail and specifications for protecting each steel column and rim -4,.,.ist independently of the one-hour fire- resistive construction squired for th south wall . The south wall shall be of one-hour fire-resistive construction with openings protected. A. Windows r-quired to have three-fourths-hour fire- resistive rating cannot exceed 84 square feet [OSSC, Section 4306 (h) I Reduce dimension of window to waiting 1 area . The fire-resist ' ?ness of the south wall shall continue thrr-,ugh the at space . Provide a one-hour fire- resistive assembly that includes protection of the rim joist shown in 22/A!3 . 1 . c ^� �1 The canopy proposed betwe-:.. Grid A and B at Line 1 cannot project more than 12 inc}-e.s into the area where openings are prohibited [OSSC', Section 504 (b) 21 . Structural r(l . Provide details and the engineer' s calculations f(-r attaching the roof diap:iragm to exterior walls . Draft stops shall be installed in attics so the area between draft stops do not. exceed 9, 000 square feet and the greatest horizontal dimension does not exceed 1.00 ' [Section 2516 (f) 4Biii, exception? . Submit an engineer' s design specifications for the following: Root construction supporting the x-ray unit (Detail b/A13 . 1) . B. Design and attachment of the large entrance canopy. Provide Detail 21/A13 . 2 (see Sheet A3 ) . (J VSprinkler 1 . Submit an application and three (3 ) sets of plans and calculations for review. Ankron Moisan Architects January 24 , 1.996 pg. 3 2 . Clearance shall be provided around all piping extending through walls and floors . Provide a 1" clearance on all sides for pipes 1." through 3 1/2" and 2 " for pipe sizes 4" and larger [NFPA 13-•1-5 . 4 . 3 .4 (a) ] . If you wish to discuss any of these items, please give me a call . Sincerely, James Funk Ply -is Examiner bup95-0502\poll-91ca Plan Review x Date rCOREGON Y OF TIGARD � Structural Special Inspections The owner or architect or engineer of record shall complete Parts 9 & D of this form and igen return it to the Building Division for approval prior to issuance of a building permit. (Please note that a separate soils sr�ecial inspection form may be required and additional special inspections may be required for contractor,design items ; Project Address: _ Prmlect Maine: Architect of Record (Firm)_, Phone No: '! Engineer of Record (Fri): Phone No: The following special inspectiuns and structural observations shall be performed according to the State Building Code and the City of 7igard's Municipal Code Chapter 14.06.010 - 14.06.040 unless a schedule of inspections is submitted by the Engineer of Record and approved by the Building Division. A. ❑ Reinforced Concrete ❑ Prestressed Concrete 12 Structural Steel ❑ Structural Mason.y, f'm [Q Field Melding ❑ =ireproofing ❑ Shop Fabrication ❑ Other aT ; ,, - S E. Indicate the special inspector or approved testing agency to perform the special ins,jections noted in Part A above, ncluding addresses and pnone numbers. Submit names, qualifications and certifications of the special inspectors assigned to the orolpr t. i he special inspector or inspection agency shall submit a final signed report to thy Building Division stating that all items requiring special inspection and testing were fulfilled and reported and, to the best of his/hei knowledge, in conformance with the approved design drarnngs, specifications, approved change orders and the aDolicable workmanship provisions of the U.B.C. (see U.B C. 7015 for soi!s special inspection final report requirements). !tems not in conformance, unresolved items or any disaepancies in inspection coverage (i.e., misssd ,nspections, I pe odic inspect-ons when continuous was required, etc.) shall be specifically itemized in this report. C. Cl Structural Site Observation by Engineer of Record 71e owner hereby agrees to employ the spec.al inspector, approved testing agency and,or engineer for the above-noted special inspections andior structural observation. Signature of Owner Pnnt Name Phone No. Firm Date Structural Plans Examiner signature s+n1 eoc 13125 SW Hall Of/d., Tigard, OR 97223 (503) 639-4171 C)D (5123) 684-2772 Ft ANKROM MOISAN ASSOCIATED ARCHITECTS February 12, 1996 OHSU TIGARD HEALTH CENTER Address: SW 109th & Naeve Street 25110DB; Tax Lot 401; Zoned: C-G Attn: Mr. James Funk Re: BUILDING SITE DEVELOPMENT PLAN REVIEW APPLWA_NT'S ANSWER SHEET TO REVIEW LETTER OF 2/7/96 Site. Item A. Please see attached revised cover sheet #CS. See existing sheets#C2 (Site Plan)of 12/21/95 and M3 of 10/27/)5 for rr')f drainage n attached-sheet.A/1L2 detail 4a on A/13.2. Existing details 3 and 8 are substituted with detail 4 and 4a. Accessibility. 4: Please see revised attached sheet A/7.1 detail 5. g' Signs identifying rooms will comply with OSSC Section 3109(o)as noted in attached sheet A7.2,detail 4. -Fire and Life Safety. - � ��. w�l y, L 1� Please see attached revised details#3,4 & 9 in shee A/13,1. Structural. For item 2, please reference sheet# M.2 and detail # 4/a/13.4 submitted on 2/8/96. L2: Please see attached structural calculations. 3. Detail 22/A13.2 was erroneously shown in previous drawing. Please reference detail �1 iNE (22/Al2.1,�(3) grid bubbles will be amended with new 22/A13.1 detail. Please see attached Special Inspection Form with agency name shown. Mr. Funk, please let me know at your earliest convenience if the attached n1CC.tq your requirements or if you have questions. 'Chank you. Sincerely, ANKROM MOISAN ASSOCIATED ARCIIITI--C'I'S Mario E inose Project hitect Zttach nts: (4)sets of(6). L . Baker PROWNSIATIGARDAS Ens 6720 S-W, Macadam,Sttity terra,Portland,Oren 9721(,, 50;/245-7100, PAX 504/2.45-7710 Princilaah:Stewart H.Ankrom, Moma.Moivan,David N.Vonada,Lortaine C,Kellow,Ietl F lamilton,Karen Kiwrry February 7, 1956 i CITY OF TPGARD 1 Ankron Moisan Architects \ OREGON 6220 SW Macadam, Suite 11j0 Portland, OR 97219 \ / RE: CHSU (P.R. RESPONSE) / SW 109th & Naeve Road PC11-91C EUP95-0502 The plans and specifications have been reviewed for r_onformity to applicable ,:odes. Please submit four (4) sets of resised pians and specifications incorporatir,g the following requirements: Site 1. The buildinc data sheet. (Exhibit "A") remains incorrect--the area increase allowed by having separation on two sides is 12, 000 square feet [OSSC, Section 506 (a) 11 . A. The area increase permitted for providing fire sprinkler protection is three times the area allo:ved by 506 (a) 1 [OSSC, Section 506 (c) I Provide new CS sheets. '2. Specify the location of the roof drainage detail. Aocessibility �1. Detail 5/A7.1 still details doors and cove base for the sink in the staff i lounge. Provide correct detail. and new A7.1 sheet.,. 21 Address Item 2 within the plans. Fire and life Safety Address Iten, :s (omitted) . Structural fit). Item 2 must be addressed and submitted prior to permit. �x Item 3H: I am awa-e (Df those det&ils of design but the engineer of record L shall provide his desicm calculations for review. �. Provide Detail 22/A13.2 referenced on Sheet A3 ac requested in Item 4 . 4�. Complete the enclosed Special Inspection rurm and return. If you wish to discuss any of Lhese items, please give me a call. Sincerely, i / James Funk Plans Examiner bup95-0502\poll-91cb enclosure 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6039-4171 TDD (503) 684-277/2 — -- 02 061996 09:41 5032925760 FRANKLIN FRCFERTIES PAGE FEB-06-1996 oq:,;.q AtJICROM MOISAN 503 245 7710 P.01/el Plat Review a C/f [ ^ /r� Date �..�- CITY OF TIGARD snTz q5 OREGON �tructusal 5p+c?a1 rna�eoAons � �. The owner or arChrlect or engineer of record .hall complete part 8 g D of this loan and then return It to the Building Division for e�p►oval .Cr to issuance or a building permit. (P)Qaxo note that a separate lolls special Inspectlen term may be :eauired and additional sc:scial InSpeCtlone may be required for contractor design items,) ProNct Addn4s: I-5.S!5 f7 Project Name: Architect dt Record (Firm): r([� � f Phone 0 Engineer of Rebord !arm): F'F - _ Phone No:(co3) -7 The following speciai inspWicris and c!ruciural observations chap oe performed accorbinw to the Stats Building Code and the City of T0gard's Munu•ipal Code Chapter 14.06.010 • 14,06.040 unlesa a schedule of inspections is submitted by The Engineer of Recoed and approve" by the Building Division. A. X Reinforced Concrote ❑ Preerressed Concrete StnjMn J Steel ❑ Structure) Masonry. fm . Hold Welding i ❑ FirMproofing ❑ Shop Fabncabon Other ry y, ��! �_ 41;6. indicate the special inspector ��-�-G- � erfcrm the apeda) inscpe`ctions noted in Pan A above, includl g addreasas and phe alifloations and c*rtiflcabons of the special Inspectors 6aa19nsd to the pmi&ct. The / gency chall submit a flnaJ signed report to the Building Division stating that all item! repu,,,,,w -._ IUng Were fulf riod and repCrrted and,to the best of h1eier knowledge, in conformance with the approved design drawing', specifications, approved change enders and the snr"Ir'aDle woncm3nsh, provisions of the U.B C. !see U.B.C. 7015 for soils special inspection final report requirementf). Itefna not i.; .,onformarice, unresolved Items of any liac"Pancias In insroc 011 WVQrage (i s., rrM*d InspeCUOnu, panodic inApvc+Ions when owtinuous was required, etc.) shall be !oacircally hemved in this report. C. [] Sin,ctu-sl Site Observation by -nginoer of Aecoro 17I The nwnar hereby agrsea to employ the abatis Inspector, approved testing agency and/or engrr+eer for 1he above-noted special in Ochoa% and/or SUvctural obseniation, Signature of Owner ----�---- Print NamaN_1e.�rF.,,� i F`,M Phone No._ 2i:92 - jq*`1C Firm 12,x- ,c -p`r,,l , LJ�J�L�. _ Dais-_ F t-B (.•� \q9� - Structural Plans Examiner Signature .rr.. 1131215 SW Hall Btvd.. T Bard, CR 9722.3 (!03) 639.4171 TDD (503) 684-2772 J Y GIS OF TIGARQ January 5, 1996 � �S� r OREGON S/ Ankron Moisan Architects 6720 SW Macadam, Suite 100 Portland, OR 97219 Re : OHSU 109th & Naeve Road Pcll-91C BUP95 -0502 The plans and specifications have been reviewed for conformity to applicable codec and it has been determined that the building was not designed for the property shown . Submits four (4) sets of revised plans, incorporating the requirements of the Site Plan Review letter of December 22 , 1995, for building design specific to the property. Submit a copy of the soil report required by the Project Manual, Section 2010 . Provide a tire-rated exiting system within the building. Provide correct building data. If you wish to discuss any of these items, please give me a call . Sincerely, James Funk Plans Examiner bup95-0502\pcll-91c 13125 SW !fall Blvd., 11gard, OR 97223 (503) 639-4.171 TDD (503) 684-2-772 — -�� OREGON HEALTH u�ENCES UNIVERSITY jAW 19 1'sy6 I University Hospital&Clinics � Mernbecher Chiluren's Hospital ........ ('enters of Emphasts January 17, 1995 M: Mario Espinosa Ankron, Moisan Associated Architects r 672.0 SW M, 4am Avenue, Suite 100 Portland, Oregon >7/.r i Re. OHSU health Center Tigard, Oregon Dear Mario: This letter is intended to clarity the occupancy load we anticipate at the new OHSU Health Center in Tigard, Oregon. Currently, we have three clinics that are operational in the Portland area. Our clinic at SW 45th and Vermont has been open for a little over two years and is currently the busiest of the three. On a busy day at this site, we will see bet"ecen 100-120 patients in the course of the day. Additionally, there would be a full time staff of about 25 employees. On rare occasions, we m ty also have an open house or conference where the building would have a larger number of people at one time. However, 1 believe the above numbers would be more representative of a typich' day at our facility. Please do not hesitate to call if you have any questions. Sincerely, Richard K. Nichols Associate Hospital Director Director, Integrated Primary Care Organization & Ambulatory Care Operations mpnq the RKN kmm 3181 S.W. Sam Jackson hark Road, Mail Code MBS, Portland, Orei;on 97101-3098 Telephone(503)494-8744, Fax(503)494-8020 Exhibit "B" f A 'NKKOM MOISAN ASSOCIATFP A &CHITECTS ,1^nuary 25, 1996 OHSU TiGARD HEALTH CENTER Address: SW 109th & Naeve Street 251 IODB; Tax Lot 401; Zoned: C-G Attn: Mr. James Funk Re: BUILDING SITE DEVELOPMENT PLAN REVIEW AREA CALCULATIONS FOR OCCUPANT LOAD Dear Mr. Funk, Regarding the occupant load ►or the above mentioned project, and as agreed on our last meeting, following is a descript: n of our request as approved by you on 1/19/96. BUILDING CODE SECTION: 3305(8) BUILDING REGULA'T'ION REQUIREMENT: Walls of corridors serving ........ other occupancies having an occupant load of thirty or more shall be not less Chan one-hour fire resistive construction, and ceilings shall not be less than that required for a one-hour fire resistive floor or roof system. PROPOSED DESIGN (As approved): Corridor walls in this B-2 o'.:cupancy clinic are constructed of 5/8" gypsum board each side of 20 metal studs at 24" o.c. Walls terminate 6" above unrated ceiling. Door:: -ind openings within corridors are unrated. Building is fully sprinklered and contains a supervised ionization detection system with detectors located in all circulation and waiting areas, spaced per manufactu,er s rating. The nature of the clinic use make rated openings and corridor protection impractical. Building is 13,815 s.f., free standing on site. REASON FOR ALTERNATE: Building use is such that visit-rs will be generally supervised by staft. Nature of use suggests building will be at betwcen IoO to 120 patients per day, additionally, there would be a full time staff of about 25 employees, See attached exhibit"A". For calculating the occupant load with the allowed exclusions for accessory areas approved by your division, we inrluded the(3)different area uses as shown in attached exhibit"B" which requires the conference room and the library areas to be divided by 15 and 50 respectively and dividing the remaining area(after allowed exclusions)by 100. Macidant,stntr na,.limtland,Oregon 97219, Sn4,i4; � ,,, FAX 504,245-7710 14",c,p.,l.:`u„.u1 I I.Ankr,an, Thomas Morvan.11ar,d N.Vottada.Lnrralnr( .F;.II,,,,.lrfTHamilton,Kam,Nlwrrp The total general area (areas A-' & K-M) after deductions is 7,654 s.f. divided by 100 yields 77 occupants. (note that the n,_-Jrecords is includ,.d in this count and it was not deducted). The Conference room area of 32.6 s.f. dividcd by 15 yields 22 occupants. The Li',)racy room area of 407 s.f. divided by 50 yields 9 occupants. Total occupant load 108 occupants. Attachments: Exhibits "A" and "B". c. Mr. Matt Baker PROPOHSIATIGAROASL03 SEE 35MM ROLL # 20 FOR O`J ERSIZE-D Do CUM..E T p��--� �SEc,T. 3 �D� �4� cx4EPno� • �:� '_6s5aR-�{ u 3E; �. � � L LG) a►ZCAs> (z /,I.(, [G�Z) r - fir? � ( + t"17 flP . � � 4" S 7 I -�Ta P- 186/0-4 c 71 Go l ` 17 . . 16 (-weo 1 `i0 - 4 7. -Z�, 5 f�2ss 1 9 .41 pArl4eco«� 7 ef-col-P5 = 22S O . 25 102 . 81 SAS E wa Y 154 _ I . 5 -- Z,3 G 4. 59 rj v 8' til l 1�5� L4-4q 4 5� e, - ti1 uQ-Se l 7d- 4-2 S5 . G4 Sud wa tT 172q - 3 l FJTvVz � I20 - �21 ZZ£� 325. 73 CorAPOrCle Q-5 r V)lf y, 0 ootA �_ ( o 8 �8 �o � • 02%06196 1��: 11 ANKROK MOISAN 2002/004 1 consulring Engineerr February 6, 1996 Mr. Mario EspinoGa AnKrorr,Muisan Architects 6720 SW Macadam, Suite 100 ('ortland, OR 97219 RE: CHSU Tigard Health Center Pian Examination Comments Permit No. PC11-91C BUP95.0502 Dear Mario: The following are our responses to the structured comments made by City of Tigard Plans Examiner, James Funk, dated January 24, 1996, regarding the building permit package for the CHSU Tigard Health Center: Item 1 Complete. Please reference sheet S2.2 which has the diaphragm nailing called out near Grid 8 - F. Also, referencia Details 13 and 14 on sheet S6.2 which shows the diaphragm boundary extending to the outside face of the stud wall over the top plate. UM;A Complete. Please reference attached calculation sheet PC1-1 and Detail 13/A13.1 already drav,n. The detail shown iu adequate fr„ the design loads as long as Unistrut P-1000 (rr:nimum) is used throughout and connected according to the manufacturers recommendations. If you have any questions or require further information please call me. Sincerely, Eric Schmidt ES/h!q At'u-ichmrnt (scnr'dr M(Y2 a I i 707 S w Washington Sl Suite 600 Portland, OR 97205.3523 (503)227-W' Far(503)227.7990 Seortle Portland San Francisco Loc Aopolos PAaanls Son ologe Cairo Consulting Fnglneers February 13, 1996 Mr. Mario Espinosa Ankrom Moisan Associated Architects 6720 SW Macadam,Suite 100 Portland,Oregon 97219 RE: OHSU Tigard Clinic Dear W ario. Attached please find calculation sheets 1 through 3 dated Fe,,,ruary 12, 1996, which verity the structuis! adequacy of the entry canopy as shown on the building drawinl,s dated December 1, 1995. Analysis was based on the requirements of the 1991 Uniform Building Code. !f you have any questions or require further information, please call me. Sincerely, Ronald G. Kernan, P.E. ii'8 RGK/hlg �tamtn xnaraq �� Y 30 5 IVT U UP' 707 S W Washington St state 600 Pu rfland, OR 97205-3523 (503)227.3251 Fix(503)227-7980 seettle Portlend den Frenelsee Lot Ae/elet Pheenlr Son Diego Celre 7001700 In I B P I 90 £l 70 - BUILDING PERMIT CITY OF TIGARD PERMIT#: BLIP2002-00261 DEVELOPMENT SERVICES DATE ISSUED: 8/12./02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S110DB-01300 SITE ADDRESS: 15350 SVV PACIFIC HWY SUBDIVISION: PP1996-010 ZONING: C-G BLOCK: LOT: 002 JURISDICTION: TIG REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSI-RUCTION CLAS:: OF WORK: AL-1 FIRST: sf N: S: — E: W TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: 11.2 TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 100 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEW. 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: IMI' SURFACE: PRO CORR: PARKING: VALUE: $ 25,000.00 Remarks: section off a portion of the existing OHSU clinic to create Washington County realth department. Owner: Contractor: OREGON HEALTH SCIENCE_ UNIVERSI S C JACKSON CONSTRUCTION INC 3505 SW VETERANS HOSPITAL RD 21800 NW FISHER RD PORTLAND, OR 97 201 BANKS, OR 97106-7516 Phone: Phone: 503-324-3232 Re, #: LIC 43139 _FEES REQUIRED INSPECTIONS _ Type By Date Amount R;:-.ceipt Electrical Permit Required PLCK CTR 7/1/02 $184.15 27200200000 Framing Insp Insulation Insp FIRE CTR 7/1/02 $113.32 2.7200200000 Gyp Board Insp PRMT CTR 8/12/02 $283.30 27200200000 Sus') Ceiing Insp 5PCT CTR 8/12/02 $22.66 27200200000 Final Inspection — Total $603.43 This permit is issued subject to the regulations contained in the Tigard Municipal Cade, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 10 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2344. permittee Signature: 1 1 Issued By: r ' --- —.� --- --- Call 630-4175 by 7 p.m. for an inspection the noxt business day Building Permit Application City Of TigardDatereceivcd: 7 / e '- Permitno.:n�ri/ oa ; Address: 13125 SW Hall Blvd,Tigard. ()f. '1723 Prgi�:Uappl,no.: pircdate: City njTignrA Date issued: B ) Phone: (503) 639-4171 yr._.. ' Rccciptnrt Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ 1&2 family:Simple Complcx: J ;Job family dwelling or accessoM U Commercial/industrial U Multi-family U New construction U Demolition on/alteration/replaccn,_nt �d Tenant improvement U Fire sprinkler/alarm U Other _ (15 rJ'v S"�Ks�� i�lyyy Bldg.no.: Suite no.: Lot: Black Subdivision: Tax map/tax IoUacrount no.: Project name: \'r,*sur _ Description and location of work on premises/special conditions: 'FAST•Muhl A 011t NI It FOR SPECIAL INFORMATION, USIE CHECK1,14 Name: ' ' Mailing address: 3 _S\V I &2 family dwelling: City: - �slatc:p "LIP: --J7 20 Valuation of work...................... ................. Phone: - Fax:"4.r I;mail: No.of hLdrooms/paths................................. Owner's representative: J-,a - ,,zs�N+ Total number of floors................................. Phone: -sn 6.rI - s« I n ,til New dwelling area(sq. ft. Garage/carport area(sq, ft.) Name: S"1"b_A I--n.--�1_Atex t rfsst�$� Covered porch area(sq.ft.) ......................... Mailing address: - Deck area(sq. ft.) ........................................ _ City: 5t:uc pr ZIP: 9-72R& Other structure area(sq. ft.)......................... _ ------ Phone: c pA--4 22 Fax444-4i%J I mail: � - Commereial/industrial/multi-family: Valuation of work t - ► Existing bldg.area(sq.ft.) .......................... (3&15_S� _tusiness name. l' - �- New bldg.area(sq.ft.) ....... Address: _42Co3 City: -itate: 7,111: - Number of stories........................................ l - - -- Type of construction _-_ Phone: Fax: E-mail: '.,...,..... Occupancy group(s): Existing: - CCB no.: / 'Jrii - — --- -- New: E3 City/metro lie.no. Notice:All contractors and subcontr%ctors are required to be lir:ensed with the Oregon Construction Contractors Board under Name: �rM s, As �� t nu (' pdovisions of ORS 701 and may be required to he licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing,the followii;-,reason applies: Contact person: Plan no.: -- - - Phone Fax: E-mail: Name: SQL Contazt person: r, mr,:,Blde44" Fees due upon application ..........................$ -.-_-- Address: 3-2, Itis 4,yaSr.1rT' 2_ _ Date receival: City: F'6r - State:(::? ZIP: 1b7 240) Anurunt received ......................................... Phone: ?gyp,-tt22 Fax:?A*-VZ E-mail: -_ Please refer to ice schedule. hereby certify I have read and examined this application and the Not all Jurlsdictlnns accept credit cards.please call Jurlsdicaon for noir mfmmamm. attached checklist.All prr,-isions of laws and ordinances governing this I U Visa U Master-ard work will be complied with,w,W-her sped F- aIn or not. C.-dit card numhe:. _ ap reA Authorized signature: Date: ]/ I/Ct 2 Name of cardholder as shown on credit card a Print name: Cardholder signature _ Amount Notice:This permit application expires if a permit is not obtained withir 190 days after it has been accepted as complete. ">-461►(&MCOM) 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. I C i Building Fire Protection System 3** i rJechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. Aftcr plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contactor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *Ft)r over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plans bear the originGl seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. ldsts\forms\COM-matrix doc 9/24101 Ci , ' OFTIGARD 24-Hour WJILDING Inspection I.Ine: (503)639-4175 MST INSPECTION DIVISION Bu3iness Line- (503) 639-4171 13UP Received Date Requested.; AM-- - -_ PM BLIP Location -14 Suite_ MEC Contact Person . Ph 313-1 PLM Contractor r - 411 1 Ph( SWR . BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post& Be, n Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other. Final PASS PART FAIL Post& Beam Under Slab Rough-In Water Service Sanitary Sewer IL Rain Drains Catch Basin/Manhole Storm Drain . ....... - Shower Pan Other Final PASS PART FAIL MECHANICAL Post& Beam Hough-in Gas Line Smoke Dampers Final PASS PART FAIL Service Rough-In UG/Slab Low Voltage Fire Alarm n _* I F1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S PART FAIL SIT IT Please call for reinspection Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Data A2 Insoartor Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL ELECTRICAL PERMIT- I TY OF T I G A R D RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2002-00202 13125 SW Hall Blvd- Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 9/20/02 PARCEL.: 2S110DB 01300 SITE ADDRESS: 15350 SW PACIFIC HWY SUBDIVISION: I-IP1996-010 ZONING: C-G BLOCK: )T: 002 JURISDICTION: TIG Proiect Description: Low voltage for data tolecommunication installation. A RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT: GARAGE OPENER: CLOCK: MEDICAL. HVAC: DATAITELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR L.ANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 _ Owner: i Contractor: OREGON HEALTH SCIENCE UNIVERSI OREGON ELECTRIC CONST/GROUP 3505 SW VETERANS HOSPITAL. RD 1010 SE 11TH AVE PORTLAND, OR 97201 PORTLAND, OR 97214 Phone: Phone: Req #: LIC 203 SUP 4460S ELE 26 95C -- FEES _---� - Required Inspections___ Type By Date Amount Receipt L(-jw Voltage Inspection PRMT CTR 9/20/02 $75.00 2720020000 ( lect'I Final 5PCT CTR 9120102 $6.00 2720020000 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 -pproved plans. This permit will expire if worst 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 OAF? 952-001-0010 Through OAR 952-001-0080. Yc,j may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. Issued by y y,Z,I�/1 j;Lam_ Permittee Signature L' OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ y_1 j T� (� /�• r)ATF: LICENSE NO: Cail 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application Aii City of Tigard , Date received 1 Z- IseItno.i Pro.e'Vappl no.: Expire date: Crry of Tigard Address: 13123 SW Hall Hlvd, tg'�ardi�9 ; 1 — Phone: 503 639-4171 Date Issued: ( ) L By Receipt no,; Fax; (503) 598.1960 SEP �. 7 M2 Case file no payment type. Land use approval: _.� C!1 I � " ., r ,)r ❑ I &2 family dweiling o: accessory Cumtnercial�indurrial s New construction Q O ivfuld-family O Tenant improvement 9`---"Y) QAddirion/alteration/re.placemrnt !J Other. C1 Partial e : a e Job address: aD SW ifJ COa3t. 11.✓ ISldl t.., tiuic ro.: Lor Block._ Subdivision �` -- — --�=— Tax map/tax lot/account no.: Project name: �J Ca South C IRnOrtion and location of work on remises Estimated dare of cornpletion/inspaction: C l�".v premises- VO ag@ a —a 1 � Job no: 6 3224-122 Business name. F■■ Max e OI E 6ctl' C roll Dptcr�iplloa _Qty. (n.) Total no.int Address: 1 010 SE 1 1 th Ave N■MtaaldeNlol-einnlcortnaltl-familYper Ci dwelnngttnll,Inc ludrsanng achedgac. ry rtridState OR 21P 97214 Servlcelncludcd: Phone: �03-23 r9Q0 234— Inimbil; 1000 sg,fl.urless 4 CCB no.: 20 Elcc. bus. lic,no. z 6__ 55C Each additional 900 sq,A.or porion thcroof Ci / etr C.no.: r — Limited encry� residentiol 2 - Limited enc , non-residential 2 Signah ry n 7-07 Each monufacturad home or modular tlwshing g r Date Service and/or feeder Su Oct.name r Z p � ]"I{ j(011 � Liunscno: L)4�f1� Scrvlreccrfcrdrrr-installallon, PROPERTV OWNER alterationorrelocatlnn; 200 a s or less 2 Name(print); _ 301 amps to 400 amps 2 Mal ling address' r - 401 amps to Goo amps 2 City; - --- 601 amps to 1000 amps .� 2 - i_. State: LIP;` Phone: "— Ovrr 1000 amps or Vohs 2 rFax: main: Recanncct on� I Jwatur i• 'tallation: The instailation is being made on oroperty i own Temporursrrvitrsnrrcrdprt- whioh is not Intended for sale, lease,rent,or exchange according to instauaaon,alrc:.iron,nr r.lnratlnn 0r'.S 447,455,479,670,701. zoo amps or less 2 Owner's si nature 301 ams to 40o amps _ 2 y Date 401 to 600 ams a Branch ctreuite-neN alteration, - Name: or extcosloo per panel: Address: `-' -� A. Fee for branch cl cuits with purchase of _ service or reciter fee,each bwnch circuit 2 C� — — _ State._ 21P: 8, Fee rot branch circuits without purchase Phone: Fa'• E-mail; of series or f:eder frc, first branch circuit: 2 GE11M LM Each addir opal Franch circuit; ' Mloc.(See fice,rrrcedernot Include sip vr-ice neer 1'S ampstornmercml J Hcahhtyn faciGry Each ump or;rripalion circle 2 U Service over 320 amps raring of 1&2 7 Hazardous loeatinn Each sign or outline z family dwellings 0 Building over 10,600 square fact four or Signal eircuivs)or a limited energy panel, 0 System over 600 volts nominal rnore residenrral unia In one strueturr, attcration,or extension' 1 1 75 7 0 Building over three stories ❑Feeders,400 amps or more — 2 - 0 Occupant load over 99 persons 'Deuti 'hn: 0 Menuracturcd sftunures or RV rk 0Egrestallghnng plan DOther, Each adWiloral:nspectionovertheallasvableInenyofthe Per rabovt: Submit—sets of plant wInvesli with any of the above. ' tiO on — — �—r— Kition I'= �----"-"""—`-�� J I -- T abo.a arc not applicable It,temporary construction service. Othcr -- -` - — — - F___ �unuhdrium aeccpt credit caidt.ple.yc celljonsdteduu for nrore inrummtion. Notice; This permit application Permit fee ........, S 7 00 e 0 MastcrCard Plan review expires if a permit is not obtained (at _ %) S Credittrl nutnbrr within 180 da f alter It has been Slate surchar c 3% Bard—`— accepted as complete. TOTAL..... ..............S .0 0Ca Ider ar'turc -� — A,nount 440-4613 rWoolr,M) ase-a 200/100 d 66e-1 -rload ILII t0-�I-d3s CITY OF T I G A R D ELECTRICAL PERMIT PERMIT#: ELC2002-00471 1 DEVELOPMENT SERVICES DATE ISSUED: 9/13/02 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 r ARCEL: �S I WDB-01300 SITE ADDRESS: 15350 SW PACIFIC HWY SUBDIVISION: PP1996-010 ZONING: C-G BLOCK: LOT : 002 JURISDICTION: TIG Proiect Description: North end of hldg. Install 4 branch circuits and 1 low voltage (move fire alar n pull station 1 RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS 1000 SF OR LESS: 0 •• 200 amo: PUMP/IRRIGATION- EACH ADD'L 500SF: 201 • 400 amp: SIGN/JUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR L DEL- (10): SERVICE/FEEDER _ �- BRANCH CIRCUITS--- ADD'L INSPECT 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT: 601 - 1000 amp: _ _ PLAN REVIEW SECTION - 1000+ amp/volt: — -- >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC/FCR >= 225 AMPS: CLASS AREA/SPEC OCC: J Owner: Contractor: OREGON HEALTH SCIENCE UNIVE.RS' OREGON ELECTRIC CONST/GROUP 3505 SW VETERANS HOSPIrAL RD 1010 SE 111-H AVE PORTLAND, OR 97201 PORTLAND, OR 97214 Phone: 503-454-224' Phone: Rog #: I-IC 203 SUP 44605 ELE 26-95C _ FEES _ Required_I_nspec.Cons_ -Type By Date Amount Receipt I tall Cover PRMT CTR 9/13/02 $141.80 272002000C(I I I ow ve",age Insrection Elect'I Final 5P(-,'F CTR 9/13/02 $11.34 2.720020(100( Total $153.14 i chis 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 aceor:'ance with approved plans This perp i;::III expire if work is not started within 180 days of issuance,or if work is suspanded for more than 180 days ATTENTION Oregor law requires you to follow rules adopted by the Oregon Utility Nctification Center Those rules are set forth in OAR 952-001-0010 through l AR 952-001-0080 You may obtain copies of these rules or direct questi)ns to OUNC at(503) 246-6699 or 14800-332-2344 Permit Signz ure: _1 Issued By: OWNER INSTALLATION ONLY The ingt:-;ation is being made on property I own which is not iniended for sale, lease, or rent. OWNER'S SIGNATURE: _ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE CF SUPR. ELEC'N: DATE: LICENSE NO: - ----J C_ - ----- -- — ------- -- — Call 639-4175 by 7:00pm for an insper:tion the next business day k �2io I Electrical Permit Application to • — Date received' i' -. L Yetin.t no'; L• �. 7 City of Tigard i � PtojccVExpire no,; dant: Gly ojTigorrl Address: 13125 SW Hall Blvd,Ti OK �3` Date issue,', By: Rccteipt no.: Phone: (503) 639-4171 Fax: (503) 596.1960 SCP ] Q 2002 Case file no.: Payment type: Land use approval: (�i i v O I dr 2 family dwelling or accessory Jd Commercial/industrial ❑Multi-family CI Tenant improvement New construction ®Addition/alteration/rcpincemerit 7 Either: —❑Pimal Jobaddress: 15350 SW PaClflc HW Bldg. no� Suite no,: Tax map/tax lot/accountno.: Lot- -- Block Subdivision: Project name: tion and location of work on remises --laa._�'r� ou�L C7� P _ Rpmot3el-nc�rthend of b�dg Estimated date of compiction/inspection• w Office space q' s Job no: -� �------ - - - —- _ Fm Business name: __nrst-rip'lon QtyT e �esl�n Eler—tr_�Grouo - —Aaarcss: 1010 SF, Ave _ NewresiOntial sinetenrmuln familypct dr.ellingunit.tncludrsanwhedpMr. _City' — ortlUnd State: Z(Pc 97214 Ser.irrinrmeed; Phone: d_Ag , Fax: •mat L 1000 A.or less tach additional 500 sq.n.or portion three 1 Elec.bus.lir no: z 6 Limited energy, residential _ z r_iry/ to lie.rip: L Limited energy, non•rvsldontial 2 Ench monufacturcd home or modular dwelling i s Fvi u' )� Date Servile AmPor feeder 2 up cirri- non print ---� I rinse nn. 4 0 $0,vises or feeders—instal lotion, alteration or relocoliont 4wNEIR 200 amps or less _ — 2 ?01 ams to 400 am s 1 TAI Name(print); _ r � Mailing address: C Ur t� — 401 ams to 600 Imps 1 — 601 amps 10 1000 amps City: $tate ZIP: Over 1000 amps or volts 2 Phone: fax: I E-mail: Reennnact only 1 O"er installation: The installation is being made on property I own Temporary deniers or lepderc which is not intended for sale,lease,rent,or exchange according to Installation,al!eryion,orrelocotion: "447, 479,670, 701. ��amps or toss201 ams to 4 a sre: Date: 401 to 600 ams _z Branch circuits-nc.v,slterotlnn, or exlension per panel: Name- _ A. Fee for branch circuits wati p-rchase of Address' _ service of feeder rec,each branch chrult 2 Cllr: T$[ete; ZIP: B. Frc flat branch circuits wtdsout purchou - --- Phone' E snail; - —- of servile or feeder fee,first branch circuit 1 46. 5 2 EaFa.• — - -- ch additional branch circuit PLAN REVIEW(11"Wase clieck Ufi that apply) Mise.(Service or feeder not included), O Service over 225 amps+rommeraal ;I tirahn-G,tc lacihty Each pump or irrigation cirrl^ 2 O Service over 1].0 amps-rating of I&? Ll Hazardous location Each sign�r oul!t lighting Y 2 family dwellings 0 Building over to,ow square feet fnur or Signal circunts)or s::mfted energy panel, U System over 600 volts nominal more residential units in one structure alteration. or eittenslon• 75 QQI J Budding over three storie< u rcedere.400 amps or marc 0 Ckeupwi load over 99 persons O Manurherured structures or RV park 'Description; �f� 7EgtestAi6hting plan JCather' i4aehadd{gmulinspcclionover the allnwablrintinyntsheabove• K Inspection ��-- Subrnit_srts nr plans sritt.any or the above. Invcsti inion fee _ The above are not applicable in tenipomn construction service. Other .........3 -- Nut,ill jttnedlcunns acuspt credit cools,please anti jurtfdictlon fur marc ina furmdPernit fee on Notice:: This permit application ............. f}8--- S -4.41 D Vim 0 MasterCard expires if a permit is not obtained Plan review(at — %) cleat Carl numtx• within 180 days utter it has been State surcharge(9%).....S "�"t TOTAL.L ,. accepted as complete. a .1 N4mc of car�Tt(rider at shown on tic it rnrd - _ S Ninholder s gnature Amount i 44o.461' (61001CO'.tl 111-d 100/100'd 160-1 _008:1 9160 ao—of—gas CIT'! OF TIGARD __ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: rLM2002-00266 13125 SW Hall Blvd., _i igard, OR 97223 (503) 639.4111 DATE ISSUED: 10/31/02 SITE ADDRESS: 11,350 SW PACIFIC HWY PARCEL: 2S110DB-01300 SUBDIVISION: ZONING: _�- RL.00K^_- LOT_ JURISDICTION: _ CLASS OF WORK: ALT GARBAGE DISPOSALS: � MOBILE HOME SPACES. — TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUP/',4CY GRP: B FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: 2 OTHER FIXTUP TU'S/SHOWERS: 1 SEINER t INE: ft WATEI< CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Capping (1) shower stall, (1) lav and (1)water closet. Adding (1) 2"floor drain, (1) lav and (2) sinks. No ct ange in EDU's. Owner: FEES _ —� Description ►late Amount OREGON HEALFHSCIENCE IJNIVERSI - — 3505 SW VETERANS HOSPI, AL RD II'LUMI31 Ile,nrnt I-ce 8/12/02 $116.20 PORTLAND, OR 97201 1111LUMB) 1"ernrit Fee 8/12/02 $0.00 I AXI 8°„State I ax 8/12/02 $9.30 I I'AX)8°4 State far 8/17./02 $0.00 Phone 1• 503-494-1244 Contractor: — Total -$1;<.50 M D. WHITED PLUMBING '11625 NW LOST PARK DR PORTLAND, OR 9722.9 REQUIRED INSPECTIONS Phone 1: 036_9693 Rough-in Insp --- --------------- ------ --- Top-out Insp Reg #: LIC 34751 Insp existi rg/copped fixtures PLM 37-10,'13 Final Inspection his permit is issued subject to the regulations contained in the Tigard Municipal Code, Slate 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 surfed wiinin 180 days of issuance, or if work is Suspended for more than 180 days. AT-i ENTION- Oregon law requires you to follow rules adepted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. I�sued By: Permittee Signature: Call (503, 39-4175 by 7:00 P.M. for an inspection needed the next busir)6ss day Building Fixtures Plumbing Permit Application OFFICE USE g Date ieceivcd: 'J 1 7 Permit i City o Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd.Tigard,OR 97223 projecdappl.no.: a date: city if Tigard phone: (503) 639-4171 Fax: (503) 598-1960 � '�°� � r Date issued: B Receipt no,: ill is �t.11. __,; _ r... :, ,r+ `-rpt Case rile no.: Payment type: Land use approval: B' – 7IJNew family dwelling or accessory U Commercial/industrial J Multi-family Tenant improvement construction J Addition/alteration/replacement J Food service LI Other:_ no ; s Description Qty. hcc(ea.) Total Job address: 1 ST {�\ �L�LA! - Mew 1-and 2-fanilly dwelling%on Bldg.no.: Suite no.: (includes 100 ft.fur each utility connection) Tax map/tax lot/account no.: SFR(1)bath -- Lot: Block: Subdivision: _ _ SFR. (2)beth - - Project name: \�/,�„„�,-�,y�__�a.l!_ �5._—_— SFR(3)bath --- 111 7Ir: �j Each additional bath/kitchen City/count c -��4 Site utllh'^•' Description and location of work on premises: -Dna-*3AQc- — Catch !rain 7r -Ka l M t' go. --- p we+1 '• ,ch line/trench drain Est,date of completion/inspection: 2�� FootinE urain(no.lin.ft.) CONTRACTOR Manufactured home utilities Business name: ' la_”. i•rt t r M 6 Manholes _ Address: I�, �Q'Zi Rain drain connector City: — Sanitary sewer(n•)_lin. ft.) State zlr: �R?- ry — Phone: V - Fax: E-mail; Storm sewer(no. in, Water service no.lin. fl. CCB no.:.3Plumb.bus.reg.no:�?- Fixture or item: City/metro lic.no.: — — - Absorption valve Contractor s representative signature: Back Flow preventer Print name: Date' Backwater valve IPERSO-V Basins/lavatory Clothes washer Name: $ Sy,� ;R--op I Dishwasher Address:G-175_-� t Drinking fountain(s) City: # ,a_y� _ State: 7.IP:1ej'�OO Ejectors/sump phone:Gait-i}¢�- FaxC }�(ot5re F-mail: Expansion tank s Fixtu wcr cap Floor drain floor sinks/hub _ tPh Jc(print). --. .-- —_-- Gar age_ is oral ngaddress �S I N �►+�� Hose ibb Statel0 ZIP:y7 ice maker e: 4-22 -- fa' F: mail: Intrtceptor/grease trap r installation/residential ina:ntenance only: The actual installation Primer(s) - will be made by me or the maime,rice and repair made by my regularEWate omm a t�- employee on the property I own as per ORS Chapter 447. n(s) lav 9115 1 _ Owner's si mature:— _Data. /shower pan _ _ — Name: � _ City: State: ZIP:�"� _ Ot er. Phone:2 -C -7 Fax:Zq-�-p -mail: o� — Minimum fee. ........ g /t Not all jurisdictions accept credit cards,please call jurisdiction rot more information. Notice: This permit application Plan review(at _ %) S 0 Vise U MasterCard expires if a permit is not obtained State surcharge(8%)....$Credit card cud number: — - within 180 days after it hai,been $ '�� (j Expires TOTAL....................... -- accepted as complete. Name of urdhnlder ae shown on credit card— s Grdhol er signature Amount 110Ibtd(61M/COM) 9e. PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only _FIXTURES (indlv!dual QTY (ea) AM' NT (includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (es,; AMOUNT Lavatory �� .6.60 for each utility cunnectio_nZ___- _ _ One 1 bath Tub or Tub/Shower Com __ _ $249.20 b_ 16.60 Tw2_(2J bath _ 4350.00 Shower Only 16.60 _ Three3 Lbath . -_ �- - -- - --- _ $399.00 Water Closet 16.60 16.60 _ SUBTOTAL Urinal _ 8%STATE SURCHARGE DISTNasher 16.60 PLAN REVIEW_ 25%OF SUBTOTAL Garbage Disposal 16.60 v� TOTAL �- Laundry Tray 16.60 Washing Machine 16.60 Floor Drain;Floor Sink 2" 16.60 3"- 16.60 PLEASE COMPLETE: 4" 16.60 Water Heater O conversion O like kind 16.60 uantity b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. _ �Ca{�ped MFG Home New Water Service 46.40 Sink - MFG Home New San/Storm Sewer 46.40 Lavatory _ - Hose Bit a 1660 Tub or Tub/Shower Combination Roof Drains 16.60 Shower Only _ - Drinking Fountain 16.60 Vtrafer Closet _ --- Other Fixtur t(Specify) 16.60 Urinal Dishwasher -- C�I .YTuQ£5 Garbage Disposal !aundry Room Tray -- Washing Machine _ -- Sewer-tat 100' 55.00 Floor Drain/Link: 2" 3" Sewer-each additional 100' 46.40 4" -- - Water Service-1st 100' 55.00 Water Heater Water Service-each additional 200' 46.40 Other Fixtures I Storm&Rain Drain- S eci 1st 10D' 55.00 - Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential B3r,kflow Prevention Device' 27.55 Catch Basin - 16.60 ---- Inspection of Existing Plumbing or Specially 6250 -_'-_---_-- Requested Inspections er/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL iso-etrlc or riser diagram Is reqs Ired If - -- - - --- -------..__- _-._.-_ Quantic Total'-, >9 "SUBTOTAL - -- --- -- - ----- --- - - 8°/s STATE SURCF'ARGE "PLAN REVIEW 25%OF SUBTOTAL --- -- -----_�--Required only It fixture gly tutal Is>9 TOTAL `Minimum permit fee Is$72.50 s 8%state surcharge,except Residential Backflow Prevention Device,which Is$36.25+8%state surcharge ""411 New Commercial Buildings require 2 Gets of plans with Isometric or riser diagram for plan review. I\dsts\forms\plm-fees.doc 12/26/01 Tenant Narne: OHSU-W_a Co Health Services Accumulative Sewer Tally Site Address: 15300 SW Pacific Hwy This SWRA N A _-.- This PLM# 2002-00266 Fixture PO Value PrevioL!s Previous Credits Capped Fixture Fixture New New # value capped off value added added tot,-: total - count off#s count # E3eptisory/Font 4 _ value #s values - 0 0 Bath-Tub/Shower _4 - - 0 0 0 -Jacuzzi/Whirlpool 4 0-- - _ - 0 0 - 0 0 - — Car Wash- Each Slail g 0- _ 00 0 0 - 0 - Drive through 16 - 0 0 Cuspidor/Water As irator 1 - 0 0 -Dishwasher Cornrnercial 4 -. 0 0 0 Domestic _ -2 0 0 0 0 0 _ - Drinking '=ountain 1 - 0 0 Eye Wash 0 1 0 0 Floor Drain/Sink-2 inch 2 -- 0 0 0 0 -; - -___ _ 3 inch 5 -0 - 2 1 2 ----- 4 inch 6 0 0 0 0 0 0 0 0 - 0 Car Wash Dr - g 0 Garbane Dis osal -- 0 0 0 U -^ Domestic(to 3/4 HP) - 16 - 0 -� Commercial(to 5 HP)_ 32 - --- -- 0 0 0 0 Industrial(over 5 HP) _ 4g - -- y - 0 p 0 Ice Machine/Refrigerator Drain 1 _ - - -- 0 0 Oil Sep(Gas Station) _60 0 0 0 --- _ Rec. Vehicle Dump station— 0 0 16 - --- -- 0- 0 0 0 - -- ihower-Gang (per head) 1 - --- _ 0 0 - Stall 2 _O_ _ _ 0 0 - 0 .-- ink-Bar/La--vatc�ry - - 1 2 —0 .1 2 _ 1 - -2 Bradley 52 1 2-- -0 0 _ -Com;nercial 0 0 0_ 3 -�- 0 - ---- -_ 0 0 Service 3 - - 2 0 0 0 0 0 1 0 - — Nnriming Pool Filter - _ 2 - ---_ 0 0g 6 _ asher-Clothes 6 ---- 0 0 - ater Extractor 6 _ 0 0 - 0 _ ater Closet-Toilet 6_ 0 0-- - -- 0 0 nal 6 0 - 1 6 0 ----.._ 1 -- - - 0 0 0 — Previous EDU Count 10 160 - 0 -0 _ Capped EDU Credit 160 TALS 0 160 30 10 4 10 1 160 Current Fixture Value 160 divided by 16 = 10.0 Current EDU Previous Fixture Value 160-- divided by 16= _ 10.0 _Previous EDl1 1 EDU = $2,300.00 Change 0 _ divided by 16 = 0.0 Enfor EDU Change Here over (under) b 'TORY �% s. Per Jairne, 10 UU's PLM# �/ !� - -----_ ___EUII# SWR# -----------__ PLN/i# - -�__ EDU# -- ----PLM# EDU# EDU# VV RT �la rde: � Date: Signature of person that calculated this rally.sheet and date perfromed q ilrpd CITYOF TIGARD CERTIFICATE OF OCCUPANCY DEVELOPMFNT SERVICES PERMIT#: BUP2002-00261 13125 SW Hall Blvd., Tigard, OR 9722:1 (503) 639-4171 DATE ISSUED: 8/12/02 PARCEL. 2S110DB-01300 ZONING- C-G .JURISDICTION: TIG SITE ADDRESS: 15350 SW PACIFIC HWY SUBDIVISION: PP1996-010 BLOCK: LOT:002 CLASS OF WORK: ALT - TYPE OF USE: COM TYPE OF CQNSTR: 5N OCCUPANCY GRP: 11.2 OCCUPANCY LOAD: 100 TENANT NAME.- REMARKS: AME:REMARKS: section off a portion of the existing OHSU clinic to create Washington County health department. Owner: OREGON HEAL TH SCIENCE UNIVERSI 3505 SW VETERANS HOSPITAL RD PORTLAND, OR 97201 Phone: 503-494-2244 Contractor: 503-644-4222 S C JACKS60 %Y- ACTION INC; 21800 NW FISHER RD BANKS, OR 97106-7516 Phone: 503-644-4222 503-324-3232 Reg#: ; IC 43739 This Certificate issued 11/4/412 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliaprc� v��ith the Statp- f regon Specialty Coles for the roup, Occupancy, ar.d usl urtidPr which th f renced permit was �u /,/ l ' Il 6 L� ---_ -f ---- - Wff.DING-f PECTOR BUILDIN - POST IN CONSPICUOUS PLACE CITY OF Ti IARD 24-Hour BUILjING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST Received _ _ Dale Requested —AM PM 6UP Location /s"3 S� u g w'�7.- Suite_ _-. MEC Contact Person ? - � 12- ', Ph(--- ) -�_-y- ------- _3 PLM Contract - ------ Ph(—) ------ -- SWR — — - ------ ILDIN Tenant/Owner _ ELC Footing ----- Foundation ELC f Ftg Drain Access: _ -- - - -. ELR Crawl Drain Slab inspection Notes: — SIT Post&Beam --- - - 4hear Anchors ------- - Ext Sheath/Shear Int Sheath/Shear — Framing Insulation - --�---^----- ---�- Drywall Nailing Firewall /1� /u Fire Sprinkler q Fire Alarm — Susp'd Ceiling -- -- - -- _ _ Roof ART FAIL -- ---- ---- - Post — Undor 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_ ELECTTR_ Service __ - Rough-In UG/Slab Low Voltage Fire Alarm - -- _ Final PASS PART FAIL [l Reinspection fee of$ -__ - required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. _ SITE Please call for reinspection RE: Fire Supply Line --_ Unable to inspect-no access ADA `� Approach/Sidewalk Date _ _`� � Inspector 7� Ext Other: Final I DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIG ARD 24-Hour BUILDING Inspection Line: (503)639-d'75 MST ----- -- — INSPECTION DIVISION Business Line: (503) 639-4171 BUP --- --- --- - Received ----.,. Date Reques+ed_&_ Y — AM----PM --- BUP -----__ --_---__--- Location -j �Z/ -� � r ' --- —Suite -_ MFC Contact Person __ —.______ /�� Ph( ) S�yY PLM Contractor — __- Ph(—) ___ SWR — BUILDING TenanVOwner _ ,_ - _ ELC Footing -------- CG( �[✓ / /'t hY tk,-4 u17 ELC -- - -- . Foundation ACCO,s: Ftg Drain ELF! _ Crawl Drain Slab Inspection Notes: , SIT — Post& Beam o � Shear Anchors l Ext Sheath/Shear Int Sheath/Shear Framing -- -- — - — — - Insulation �.. Drywall Nailing — Firewall /V" Fire Sprinkler - - - - Fire Alarm Susp'd Ceiling --- _ - - Roof Other: Final PASS PART FAIL --- -- - - --- _ _. ---- PLUMBING-T--- ----- Post& Beam--� - Under Slab - ---- --- - --- - - -- — Rough-In Water Service -- Sanitary Sewer — s f7ain Drains - Catch Basin/Manhole Storm Drain - Shower Pan Other._ -- ------ ---- ` -- - ---- Final _ PASS PART FAIL MECHANICAL _ Post A Beam Rough-In _— ---------- Ras Line Smoke Dampers --- Final \ BART FAIL -- ---- LECTR�L Service Rough-In UG/Slab Low Voltage -_ ---- l=ire Alarm F PART FAIL f ] Reinspection fee of$----- required before next inspection. Pa at CitYHall, 13125 SW Hall Blvd SITE — [ Please call for reinspection RE: -- _ —_ Unahle to inspect - nc. accass Fire Supply Line ADA Approach/Sidewalk Do to 6T InepeCtor _- �- Ext Other: Final DO NOT REMOVE this Inspection record from the,fob site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4170 MST INSPECTION DIVISION Business Line: (503) 639-4171 ---_-_-_--____---.-- / BLIP -----.. ---- Received —_.-- __-__-_Date Req insted -- � (� AM----__ -- PM BUP .._-- Location II ___ — r —1�s� — � � SUite—.----------- MEC _ 2 Contact Person Ph( ) 1 Z a_= PLM Contractor . . - _--_ — —__—_ Ph(--) _ -_ SWR BUILDING Tenant/Owner �� -s ____ ELC -- -_ Footing ELC Foundation .•--- _- - _- Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam _- Shear Anchors / Ext Sheath/Shear f Int Sheath/Shear Framing -- - -- Insulation Drywall Nailing ----- - - Firewall Fire Sprinkler Fire Alarm i d Ceiling RooG- UtnN,: Final PASS PART FAIL - PLUMBING �`�------- _ Post& Beam Under Slab - --- - - ----- Rough-In Water Service - ---- - — -- Sanitary Sewer Rain Drains --- — Catch Basin/Manhole Storm Drain -- --- - Shower Pen Other: -- ----- --- ----- Final PA T FAIL ---- -- - ECKf sRCAL - ---- - - ---- ------ - - Rough-In - Gas Linp Smoke Dampers - -- -- -- - -- ''iffl3►_ ASS P T, FAIL - - - - -�-- ELECTRICAL Servicp Rough-In - - — - - --_ UG/Slab Low Voltage Fire Alarm Final El Reinspection fee of$ _ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd, PASS -PART FAIL SITE - - F-1 Please call for reins pec fon RE: Unable to inspect--no access Fire Supply Line ADAPPoach/Sidewalk Date 's "_ _-- Inspector Other: Final DO NOT REMOVE this Inspection record from the jnb site. PASS PART FAIL