Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
9561 SW WASHINGTON SQUARE ROAD
A r Lo S cm LEGIBILITY STRIP 0 I 2 3 4 5 IO 11 I!2 1�3 14 18 1�7 1�8 1'9 20 21 2�2 2�3 24 2�5 26 2�7 2�8 29 30 Omm.l em ZI I I 01 HONt 0 loa i b oz25X - T'4 �., r .q. •. - .RYn.^' .-. .. -: l!1 ... .�o� .`.. � n4'._ i� � - ��-�r�. ,'T�'*q�^?!".�.Le�c AM. •;:.*MY. . ., ., .. ,... .., .. -,. .. ..,'i'°"P` � .'p�*�'^.• �"' ' ... ........ ,.., "�fA�tMTY°"!A4'1RR*s��M!s�`„.. er , �mu�sM*4+,tk`.ia �.,rr!wr,,.: Hyl U- . 0 — U i1oz -5; LJ c? 3w N_ Q tz�= `40z �a �n en ti Z �� � 1., Fav V) y ` G _G S. Qom` O .� g,Qz LAJ C) r CL ul 1 Q, L) ET T-STAT VAV-1 b'♦ Z O N EXISTING EX4AU6T FAN TO MEMAN b' AFM GFM � t i IQ''♦ 14'# 14'# I I iMALL SUPPLE' AIF. O It LLJ cy Q � .�/.,4.G. FLOOR PLAN SCALE 1/4' r I'-®' 0 o Q 3 w cr LTJ 0 V) CY EQU1f`, 1ENT SGHE12ULE _ ��a A1� BRAND TITU6 VAv BOX I / MOf,eL PTQP-5/11 j VOLTAGE . 208V/I PHASE 00I AMPS : 4.2 L, N.P. : 1/3 r I D Y CFM : 12000 b E.SF' ADI��_� w E�E�._►SAT "� ' r VOLTAGE : 208v/3 PHASE AMPS : 36.1 KW 1.5 T U � o < Vl -- 0 ;(D — ; CITY OF TIGARD •� z w Approved. I 1 �j ( n Conditionally Approved... ............... ! I f"" -1 For Wy the v.'o k a:descriU-r d in: a PERMIT P1U. Seip LeflerF= to. c,!l1..w..... ...... ...... l 1 _ Alta:h......................., .... ( U Jc,o At'�r�is: L�.1�-,h_ _ H E_F T 1 '1161 " %ASIISQR0t, Int I11)H R1�1. 4 1 rr~,»rw.pra„wnrv��.M^R.M1.a�N•*�a+•FrA1Pam! vH+*nN+M+c^s3�P»�'.u_.�.wVw.a.m.�rw^^^,:.., - _ _._.-.. .. .. .,. _. ... ;.;._. ......... .._ .. _ _ _ _.. .. ..w..,�_. .........,:.,.:.,. .... ..... - ._._-._.�,..__ .. .. _....-_.._ _....—�._.._ -- � — _ _ __, ._... -.., C w :.,, .- .. :.•� :, � ... z .kret, ver+ r...,, —LEGIBILITY STRIP O I 2 3 ' 6 7 p �m 6 9 10 1 1 12 13 14 16 17 16 19 2C 21 22 23 24 25 26 27 26 29 20 immai 31 1111 of q -3N1 sO OZ �I l t LL11�1 � 1 1.� I L ��1��,1_��rl�ll!� l i.!Iili1 �11�111i11�1I1!llili�llilillll l!ililllllililtli�ll lllillli�iltll!111 !til 11!11 lili!il!�I!illlilll !Ililllil!II!II Ii�Illlilill iLll lil��li I;li I 0z25X • �p;�+n ..n�,.��p ..eao.�!M ru .•r„...r.xn rsM•,..w:yi.,,,•MxP 1'�.!” �}p��MWNM7 !1i�1'�N11�kC1dwB�lNiMlvC�.n.M.ba�r:�xe�b�hkYa M{Mc'M'Mal �NWM�tVtlMdM�:+}�WY'uhMw.Nw(,`*k9Y�dM� T �7Nr Y%'�ry 4 ADDRESS: �^ Vi 1 Gl. F�1 n r H J f^M J .J ..1 1 1 i:\record;\n.icroflm\targets\building.doc � a)-6 a o nv o a c E i n Eno > o N z o �° > °' Z a �.�,c v � a € may E9 U � rao � �nccrs N N V! ['2' Q7 O c n c N � � a� aci �i m � — �oaaoU > � � uv_ aom MoM . rna� n o Nacmvcd _ cW n � � �� > QEa c n c U. � � o 'Ji J 5 mg ��c3 °� a toa roLLL N n co uni O c Z Z aN -0Or Nn`n o ��- m N ; Y O tC'L y tUU 'B & T . 8 f�X9 �O S MO a= c0 O o m u 1 n x Z ab o f O N a� ab � 2 o y S N ❑ cow c c ao� naC7 rn y m 0 oEr o a � � aNinc9i0nnaGmw� cc oE� � co� OtOuni Z � 8° U E � aErvBaVO avaSvo cnE. iitoV.S �i 0o 0o co co 00 00 00 co 0orn ao w co 0o o rn rn rn a> a) a) 0 am am �i �i o� rn rn rn u) ai h in _ _ N 7 cJ i� a i5 a c3 'nn M v o v d a a m cn co v> F A >' w cr ❑ w w w w w om ❑ ❑ ❑ ❑ Of ❑ ❑ ❑ ❑ ❑ o 0 CLD � m o > J M ti O X Z Z Z 0. d d Q d J n < cn J (n U)p o LL O oo O Q z z z Q a a S zU- da a O CT) m CL c Z d d a x s O Go a Q ❑ 0 0 0 cn cn J J W to cn v� 0o 0 m ❑ o ❑ C9 C7 C7 C7 0 ❑ c-j O C9 C7 U D N c O � 010 N~ � N d (0 U co co 00 O 0o co w w m O co W 00 W 00 W a Q17) O) 41 tT T T T 0) O O (h T Qr O O) O O ch N U) N N V N to (V a� m }' m 00 9) diz o Ln LO 0 CC c N 2 c v mo a 1 a x a m m C c o d co ?3 > CL _ o c n y c o > `U € p € € o o Z o •- a a m a ° a a ai ani d — > ci O a J LLJa o xs N >o is m 2 S d w N Y S e ❑ c (� .a L N Cl. in T c N ai .a N c 0 C d U a ` u 5 c9 c� iL ❑ '� LL —w cn UL = LL NO U1 00 t_. N O O O O N N O o O O O O N N O C i c7 O N 7 0 c0 Z O N Qr O N Mm O r O N co 0 0 0 0 o ` P r 00 r - r- 0 o un 0 u`� r` co 0 0o U U U V U U '-) U -) U U UC� U U U U U V V a a a na a s n. a a a a s a a a a a a a (.0 N Q D :D :) D 7 D :D D :D D :D :D Z) D J Z) D :D U m m m m m m m w m m m m m Lo m m m m m m N_ N � O Z _o Q O W cT OL rn a OF c?i c c d J_ZZ (�io50 D c, ao w � rn rn OL N 7 (D W N Z V m J a 7 b d O > J M ti O o U) p N a Q o a a) m CL y (]0 0° > N C O v 0H N N Q � Rl U OD a 0 o N W � � ^� N W � n 4-0 Q V 0 cr c c~n n tA _J o 0 O U cz a a, LU u N J 2i N o N a o = CF) c`Juo � O N z U a cD N 2�i Q m N k i6 $ G m $ m m § \ f § d a d a § /m j ) { j { { G � }CL k _ � C) 6 / k 2 k 2 2 9 § $ § ƒ § f ƒ 00 £ � T- o j j § j § § m I0 § � \ U 7 f 2 7 7 a)00 CO � © � k .> � © k k § k Q § 3 2 7 ^ � � / b % q # V, LL -j ) ) { t p ƒ i e \ < I & k \ / ) \ 6666 41 \ co ( / ) \ % \ k E § E § a E E « ] § 3 2 ] i i cc k/ )ri) m \\ \ $ $ m m m \ m — m < a m a i \ � § § Q & £ 3 § { 0 ( � 0. m m ® m �> ) R qtt 00 In / k 2 / 2 \ ƒ §ƒ 7 ƒ f � CY) J � W m m / / m § 7 0 � � 2 § m m § § 2 IL k \ \ \ \ § $ .� u 2 | Cl. / m / > / § d 7 G _ { 2 G ' \ ` G c\ \ 0 2 % f >LLJ ) k I o f f ) e E § § \ \ \ « u g ) m w u U C N Y CDC > N n # C O n : �' a p N Y A �j IT'3 h Tj YO t 0 N N y S N 7 Q 0 .iN.0 N Z N''3c38 � 'd 7 O c _ d) 03 ro 0p00 co 0p 0p Ql _Q e T C � 01 41 ro c1 r [7 M N L6N r 0.s N a a a a Ln �a ro v m o 0 0 ,u-, o n o r U (D L^ U U U 4. ro v `o > z� tD O U w U) J J J (n fn O a U Z (n cn 0 Oi o ty n a U- U- LL a a O O o0 0 0 n o 0 0 Ll.) 0 cJ C�7 C7 o U U U U U U) o y � d U � o a) o) mm � a> m09 0) a LCA ro 2 M C;3c-i N ,,,. Q a a a a ro a V) N Q; Bw OD a o p Cc v 0 w 7 P J c N (3) o. ^ y lid .0- U o N N IL lL LL L ,c 6i aani at a) It a -1 LL. EDLTi Gj' U U N 00 O O cN- U') m rl I,- coo w N r > U U U U U U U U U U cD N v m J a d W W W W W W W W W W y v 0 z v v _ C r m CL O o O p n w n a', J LO V a U W a (� 0 w cn 0 y o z a < < < z < �i o p Q a a a p a 00 07 m O w w O fn In (n w (n ❑ o o of cD cD o n (D v c O 010 f- N Q Rf ca V r' rn co» rn rn coi rn w m n N :0 is Q (� y Ooi co Q 16 Ln u) ❑ ui to CL lll Cif a 1— a V) o � a q c ~ J a o o CO 47 N 'V .• o a a n o W u c U- d C 0 u J y yy [a y — N V� a Q a a u U) c7 0 0 a uoi o 04 CO o 0 o 0 0 N r 5 0 0 0 U U (-) l7 U cD N Q w Ili w� i w w w w w E u � z � d m a a 0m CL �v o > J N O O d w w C z z © o o O 00 m v 10- Y)Y) ❑ o 0 C �0 O •N H r rn d � ❑ c^7+ N (n N �_ 47 A ❑ V w ❑ cZ rs r f- o '= oLLI m m n U c LL d E N CL ❑ a c`� OO) al co O rav co v u cp CV Q � \ � z \ G a § a e a § § m m / / f \ / \ % § k k D § § a $ § $ e a a a ® w A d a 7 _ _ = m n ix tt & I w it rt w x _ _ 0- / m \ \ W 3 ) ) / m om / C $ § 3 m m R H � �> 2] CV) LO ƒ m q m m ¥ F- m e m = w A m 9 v } § / I / / } ) } ƒ & } / z z } \ 0 � ( / \ 3 = z = = m n n n = m = e r e ) c u m o o e e@ o a o e e e = o 0 ro 2 � �� / m M \ / t-- � 0 0 3 a a § R 3 a a a a « a ® ® E 4 & $ / .> 3 Q d ] � % $ m < m � \ = cl § } \ \ k \ / ƒ e § D § § § ® \ \ 2 2 2 / f \ i \ \ t t \ / ) k f ® ) E E Cl. » 'M » 2 t a » G F k } CL CIL f ) ƒ % f U. f o = / / 0 ) S G. ƒ E E 17 ° 0 0 8 0 0 0 ) a o 2 $ 0 « m a § \ / _ to G m � m F 0) E & < a - w t w w t- f,- w w w n ■ 0 / § o § Q Q o o Q o o , o o O b o 0 $ & 10- � CL CL CL a CL n. (I a M [ a a a. CL a = a = _ = a = _ = a a 2 = = a a = = a M m m m = = in m m = m m = m m CO m a m CO N 0 zCL p q O p p y o oo La v p 7 L > = J Qa O D CnIn H U to a <U) < Oi o of a aa. a O O m W C o = U w 0 w v C U rn N N d � Lor) a A V y 4 � CL l/1 T ( L Up U (C J � U U C c LL .n C l0 to U N Li o U rn u� o 'R g § v o N � >U U U U U co D N Q W W W W W UU) CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 639-4 i 71 Date Requested: _ / A.M. ^ P.M. MST: _ Location: •—Q —_--- -- BUR_ 73 Tenant:_ Ct Suite: Bldg: MEC: Phone: � PLM: my aer: _ ��—Phone: ELC: — 5 ELR: _ SIT: BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE Site Posth3eam Post/Beam Po3t/Beam Cover/Service Sewer/Storm Footing Rocf UndFI/Slab Rough-In Ceiling Water Line Slab Framing Top Out Gas Line Rough-In UG Sprinkler Foundation insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storni Furnace Temp Service MISC. Masonry Ceiling Rain Dtain A/C LIG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I leat Pump I,ow Volt prrovec Approved Approved Approved Approved Appr.'Sdwlk l�TT' rovrd Not Approved Not Approved Not Approved Not Approved /'i�lA FINAL FINAL FINAL. FINAL, L C.7 W O Call for reinspection O Reinspection fee of S required before;text inspection 0 Unable to inspect inspector: �� Date _.. �_� �� Page _of CITY OF TIGARD DEVELOPMENT SERVICES 13125 S W Hall Blvd., Tigard,OR 97223(503)639-417, CERTIFICATE OF"' OCCUPPNCY PERMIT #. . . . . . . : BUPI)&-007�� DATE MUM ('5/26/98 PARCEL: 1sjc,(,C0--01107 ATL ADDRESS. . . 09561 Sw WASHINGTON SQUARE RD ZONING;C-G ,UBDIVISION. — t iLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . JURISDICTION- TIG -- ---------------------------------------------------------- CLASS OF WORK. -ALT TYPE OF USE. . . aON TYPE OF CONST P&N OCCUPANCY ORP. :M OCCUPANCY LOAD: 23 TENANT NAME. . . :STRIDE RITE Remarks : Tenant modification Vnere IAGHIN(YrON E-3ULIAPE' INC -0 BOX 21543 ,EAT TLE WA 98111 -hone #: nontractor: AURIZON RETAIL. ;ONSTRUCTION INC' 1516 9 GREEN BOY RD WI 53406 414--6313-6000 Mpg #. . : 009858 This Certificate grant occupancy of the above referenced building Or portion Khereof and confirms that the building hats been inspected for compliance witil rho State of Orgon Specialty Codes, for the group, Occupanry, and use under thich the referenced permit was 19st.ted. TASK SPEC;TOP BUILDING OF=FICIAL ros"r IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Linc: 6394175 Business Phone: 639-4171 Date Rey,csted: �� — A//M. P.M._ MST: Location: q�] (<� r % %[, ���.'Z� Y` � G� �4 - BTJP:_ Tenant:_ `3l L - }- `T — Suit e: Bldg: MEC: Contractor: J��(/ _�!� (( t _ Phone: �� �'f- L��� Y PLM: Owner: _ Phone: � (/w_ ELC: 1 Ll ELR: _ SIT: BUILDING BLDG(coni) PLUMBING MECHANICAL C_ELECTRICA SITE Site Post/Beam Post/Beam Post/13cam Covcr"emm-- Sewer/Storni I'ooting Roof Undi'l/Slab Rough-In Ceiling Water Line Slao Framing Top Out Gas line Rough-In UG Sprinkler Foundation Insulation Sewer IloodUuct Reconnect Vault Bsmt Damp Dr} vall Storm Furnace Temp Service MISC. M:isonry Ceiling Rain Thain A/C I1G Slab Shear/Sheath Fire Spklr/Alm Crawl/I'otmd lh Heat Pump I ow Volt Approved Approved Approvedprove Approved Appr/Sdwlk Not Approved Not Approved Not Approved roved Not Approved FINAL FINAL FINAL FINAL 1. CL J r.r C7 W rO Call fir reins ion O Rei tion fee of S— required before next inspection 171 Unable to inspect Inspector: _ Date: Page_ of��__ CITE( OF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT PERMIT #. . . . . . . � MEC98-0157 13125 SW Hdll Blvd., Pgard,(R 97223 (503)639.4171 DATE IS�UED: 05/05/98 PARCEL: IS126CO-01107 SITE ADDRESS. . . : 09561 SW WASHINGTON SQUARE RD SUBDIVISION. . . . : ZONING: C—G BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: TIG ----------------------------------------------------------------------------- CLASS OF' WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . COM UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . M VENTS W/0 APPL; 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . . 0. FUEL TYPES—_---_--_--- 03 HP. . . . : 0 DOMES. INCIN: 0 3-15 HP. . . . : (15 COMML. INCIN: 0 MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0 GAS PRESSURL. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : 4 FURN < 100K BTU: 0 (7- 10000 cfm: 0 GAS nUTLETS. : 0 FURN >=100K BTU: 0 > 10000 cfm: 0 Remarks: Installation of I GAN box, 3 grills I associated duct work. Owner,: ----------------------------------------------------- FEES STRIDE RITE type amot-int by date recpt 9561 SW WASHINGTON SO RD PRMT $ 28. 00 DEB 05/05/98 98--305487 TIGARD OR 97223 PLCK $ 7. 00 DEB 05/05/98 98-305487 `;PCT $ 1. 40 I)CB 05/05/98 98-3054E*1 Phone Cont v-actor: :)RROW MECHANICAL 10330 SW TUALATIN RD ------------------ _-------------- $ 36. 40 TOTAL TUALATIN OR 97166'7 Phone #: 692-1565 Reg #. . : 000051 ------- REQUIRFt) INSPECTIONS This persit is issued subject tG the regulations contained in the Do-ict Inspectio, Tigard Municipal Cole, State of Ore. Specialty Codes and all other Misc. Inspection applicable laws. PH work will be done in accordance with Final Inspection approved plans. This pervit will expire if work is not started within 180 days of issuance, or if work is suspended for vorp than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-9910 thrmigh OAR 952-90I-9889. You nay obtain copies of these rules or direct questions to O11C by calling (503)246-9187. I Li .1 s s Ue Permittee 6 i g na t(-t v-e ........4-+++-;....................4.................4............................. Call 639-4175 by 7:00 p. m. for inspections needed the next business day ++4......................4............................4...........+++..........t-+4- OVER-THE-COUNTER (OTC) PERMIT i COMMEPCIAL MECHANICAL PERMIT CHECK ILIST Description of Project: _ ! ^ V '1721'4' Oe"Cle- Class of Work: /L T Floor Furnace: Evap Coolers: Type of Use: 4! i, /)I _ Unit Heaters: Vent Fans: Occupancy Grp: Vents w/o Appl: — Vent Systems: _ Stories: Boilers/Comprsrs: _ Hoods: Fuel Types - 0 - 3 HP. Repair Units: 3 - 15 HP. Wood Stoves: _ Max Input: Btu: Air Handling Units CIO Dryer: Fire Dampers: < = 10000 cfm: Oth Units: _ Cas Pressure: H / M / L > 10000 cfm: Gas Outlets: No. Of Units: Furn < 100k btu: Furn >=100k Btu: _ NOTES: �—COMMERCIAL INSPECTION ACTIONS _, FEE MENU $ F Permit Fee Gas Line Inspection $ 7 — Plan Review Mechanical Inspection _S 5% State Surcharge Cooling Unit Inspection $ Additional Permit Fee Shaft Inspection $ Additional Plan Review Fee I -)od Inspection $ Inspection Fee Firs. Suppr Inspertion $ Miscellaneous Fee Duct spection Fire Alarm Inspection Fire Damper Inspection REMARKS: H– Miscellannnus Inspection Fire Alarm Int section ' Final Inspection J. — s FOR OFFICE USE ONLY: w TYPE OF USE OPTIONS(CUM=commercial,CMS=commercial manufactured structure) CLASS OF WORK OPTIONS FOR ALL PERMITS(NEW=new;ADD=addition:ALT=aReration;ACS=accessory; FND=foundation;OTH=other, DEM=demolition:REP=repair, FPS=tire protection system, NOTE=USE OTH FOR FENCES, RETAINING WALL,DETACHED DECKS, SIGNS, AWNINGS,CANOPIES) 1 7,vrcntr doc(ilst) 8/97 I CITY OF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 F'E4MIT #. . . . . . . : BUF'98-0161DATE ISSUED: 04/15/98 PARCEL: IS126CO-01107 S I T F ADDRESS. . . : 09561 SW WASHINGTON SQUARE RD SUBDIVISION. . . . : Z.ONING:C—G BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION:TIG ----------------------------------------------------------------------------------- REISSUE: FLOOR AREAS----------- EXTERIOR WALL CONSTRUCTION— CLASS OF WDRK. :FPS FIRST. . . . : 0 sf r!: S: E: W: TYPE OF USIE. . . :COM SECOND. . . - 0 sf PROTECT OPENINGS?----------- TYPE PENINGS?----------- TYPE OF CONST. ; ? . . . . 0 sf N: S: E: W: OCCUPANCY 3RP. :M TOTAL.------: 0 sf ROOF CONST: hTRF— RET? : OCCUPANCY LOAD: 0 BASEMENT. : 0 sf AREA 5FP. RATED: STOR. : 0 HT : 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED: BSMT?: MEZZ?: REDD SETBACKS-------- REQUIRED-------------------- FLOOR LOAD. . . . : 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL:Y , OK DET. . : DWELLING 11NI'TE: 0 FRNT. 0 ft REAR: 0 ft FIP, AL.RM: HNDICP ACC: BEDRMS: 0 OATHS: 0 !MP SURFACE: 0 PRO CORR: PARKING: 0 VALUE. $ : 0 Remarks : Alteration of 18 sprinkler heads for commercial tenant occupancy. Owner: ____.._________.___..__..__.__..._.-------.--.—.---------------------_-_-- FEES ----__--_-----_— WINMAR PACIF'C type amolAnt by date recpt 700 f-IFTH AVENUE PRMT $ 25. 00 DLH 04/1. 98 98-304973 #2_600 SPCT $ 1 . 25 OL,H 04/15/98 98-170',773' SEATTLE WA 9810- FIRE $ 10. 00 DLH 04/ 15/98 98-304973 Phone #: Contractor: ---------- -------------------- WYA'TT FIRE DROTECT I ON INC. 9095 SW BUFNHAM TIGARD OR 97233 Phone #: 684-2_928 $ 36. 25 TOTAL Reg #. . : 000640 --REQUIRED ACTIONS or INSPECTIONS----- This NSFECTIONS------ This permit is issued subject to the regulations contained in the Sprinkler Rough— _ Tigard Municipal Code, State of Ore. Sperialty Codes and all other Sprinkler Rni-igh— applicable laws. All work will be done in accordance with Sprirrl<ler Final approver+ plans. This permit will expire if work is not started Sprinkler Final _ within 188 days of issuance, or if work is suspended for more Misc. Inspection t. in 188 days. ATTET ION: Oregoi law requires you to follow the rules adopted by the 'lregon Utility Notification Center. Those > rules are set forth ii, LAR 952-001-9818 through OAR 952-8181987. You many obtain a copy of these rules or direct questions to RK —�� by railing (583)246-1987. L C7 W - - - - Permittee Signati-ere : Issi-red By: 4'++++4'++++++++++'r+ F+.++++++...... '++++++J'++++4'++++++++++++++'+'++++++..+++'f'+'++++++ Call 639--4175 by 7:00 p. m. for an inspection needed the next bi_rsiness day ++++i.++++++++F++++++++++++++++++++++++++++++++i.+++++++++++++++++++++•F++...'+++++ Fire Protection Permit Application Plan Check# CrrY OF TIGARD Commercial or Residential Rec'd By.. %f/ 13125 SW HALL BLVD. Date Recd T'IGARD, OR 97223 Print or Type Date to P.E. ., (503) 639-4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST Permit# _ C filled y Job N^.Ji of Dev lopro HProject 1 1 _Y i�_ 9�. Type of SystemComplete A or B as applicable) Address dp�LO �>1 A.)Sprinkler TWet [� Dry C1 Standpipes 77 (A Owner M ling' des Hazard Group (, ; i,� 1UC� Additional Ity/Stato i I Phone Information Density Name Design Area Occupant Mailing Address K.Factor City/Statezip Phone A.1) Sprinkler Project Valuation $ Contractor Name— _ 9 _ B.) Fire Alarm (Sprinkler or k �� �� 1 �) ��_ Ci Alarm Company) ail_in Adores r Submittal Shall Include Bettery Calculations YES❑ Prior to permit C l 1`t v n 1(�.1� Issuance,a City/State zip Phone Individual Component YES❑ copy �p _ Cut Sheets ' of all licenses T k�l� Y�t� IJ��_ ��ZZ? (P(�i'�,Z���Ftl B.1) Fire Alarm Project ValuationA are required if State nsCb t.Cont.Board Lic.# Exp. Date I $ �4 expired in COT i , l database 1�� I ( .�� , Project,Valuation S & or B) $ Nam N Permit fee batsed on valuation (see chart on back) $ zs tX7 Architect Mailing Address 5% Surcharge $ , 2� City/state zlp Phone FLS Plan Review 40% of Permit Describe work A.)New O Addition O Alteratiun V Repair O TOTAL � 7�/ •ZC� to be done: ` J B.) Modification to sprinkler heads only: 1. 1-10 heads=No plans required Plans required: Submit three sets of plans,Including a vicinity map and 2. 11—Plan review required the location of the nearest hydrant. _ 1 hereby acknowledge that I have read M appNcation,that the infor netbn given 0 Number of sprinkler heaps: correct,that 1 am the owner or ai thortad agent of the owner,and Inst plans submitter' are in compliance with Oregon Slate laws. Additional Description of Work: :lgnoturo of ner Beat Data A.)In Existing Building In New Building ❑ Building CoWtact Pe n a e — Ph�gne Data B•) Commercial Residential C] J) FCR OFFICE USE ONLY: ' No.of stories: Plat# MapfTL#: .;. F- Sq. Ft: _- �, Notes w — Occupancy Class �Tv,,e of Construction L\firesupr.doc CITY OF TIGARD f BUILDING PERMIT FEES TOTAL STATE BUILDING VAI.UATION OF PERMIT F.L.S. TAX PERMIT PROJECT FEES (40%) (5%) FEES 1-1500 25.00 10.00 1.25 36.25 1,501-1600 26.50 10.60 1.33 38.43 1.601-1,700 28.00 11.20 1.40 40.60 1,701-1,800 29.50 11.80 1.48 42.78 1,801-1,900 31.00 12.40 1.55 44.95 1,901-2,000 32.50 13.00 1.63 47,13 2,001-3,000 38.50 15.40 1.93 55.83 3,001-4,000 44.50 17.80 2.23 64.53 4,001-5,000 50.50 20.20 2.53 73.23 5,001-6,000 56.50 22.60 2.83 81.93 6,001-7,000 62.50 25.00 3.13 90.63 7,001-8,000 68.50 27.40 3.43 99.33 8,001-9,000 74.50 29.80 3.73 108.03 9,001-10,000 80.50 32.20 4.03 116.73 10,001-11,000 86.50 34.60 4.33 125.43 11,001-12,000 92.50 37.00 4.63 !314.13 12,001-13,000 98.50 39.40 4.93 142.83 13,001-14,000 104.50 41.80 5.23 151.53 14,001-15,000 110.50 44.20 5.53 160.23 15,001-16,000 116.50 46.60 5.83 168.93 16,001-17,000 122.50 49.00 6.13 177.63 17,001-18,000 126.50 51.40 6.43 186.33 18,001-19,000 134.50 53.80 6.73 195.73 19,001-20,000 140.50 56.20 7.03 2C3.73 20,001-21,000 146.50 58.60 7.33 212.43 21,001-22,000 152.50 61.00 7.63 22.1.13 22,001-23,000 158.50 63.40 7.93 229.83 23,001-24,000 164.50 65.80 8.23 238.53 24,001-25,000 170.50 68.20 8.53 247.23 25,001-26,000 175.00 70.00 8.75 253.75 26,001-27,000 179.50 71.80 8.98 260.28 27,001-28,000 184.00 73.60 9.20 266.80 28,001-29,000 188.50 75.40 9.43 273.33 29 001-30,000 193.00 77.20 9.65 279.85 '10,001-31,000 197.50 79.00 9.88 286.38 -� 31,001-32,000 202.00 80.80 10.10 292.90 32,001-33,000 206.50 82.60 10.33 299.43 w 33,001-34,000 211.00 84.40 10.55 305.95 -� 34,001-35,000 215.50 86.20 10.78 312.48 35,001-36,000 220.00 88.00 11.00 319.00 36,001-37,000 224.50 89.80 11.23 325.53 37,001-8,000 229.00 91.60 11.45 332.05 is\firesupr.doc CITY OF TIGARD BUILDING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : BUP98-0073 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 04/14/98 PARCEL: IS126CO-01107 SITE ADDRESS. . . : Oq561 SW WASHINGTON SQUARE RD SUBDIVISION. . . . : ZONING:C—G BLOCK. . . . . . . . . . . . . . . . . . . . . . . . JURISDICTION:TIG --------------------------------------------------------------------------------------- REISSUE: FLOOR EXTERIOR WALL CONSTR!j::TION-- CLASS OF WORK. :ALT FIRST. , 129Z4 sf N: S: E: W: TYPE OF USE. . . :COM SECOND. . . : 0 sf PROTECT OPENINGS?---------- TYPE OF CONST. : ? . . . . 0 sf N: S: E: W: OCCUPANCY GRPI. :M TOTAL-------: 0 sf ROOF CONST: FIRE RET? : OCCUPANCY LOAD: 10 BASEMENT. : 0 sf AREA SEP. RATED: STOR. : 0 HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RAI ED: 04C BSMT?: MEZZ? -. REDD SETBACKS-------- REDU I RED-------------------- FLOOR LOAD. . . . : 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET. . : DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC: BEDRMS: 0 BATHS: 0 IMP, SURFACE: 0 P1140 TORR: PARKING: 0 VALUE. $ 451ZI00 Remarks : Tenant modification for "Stride Rite' Owner: ----------------------------------------------------- --- FEES ---_-_—_ WASHINGTON SQUARE INC type amol.tnt by date reept PO BOX 21545 PLCK $ 169. 33 BON 02/03/98 98-302987 SEATT!—E WA 98111 FIRE $ 104. 20 BON 02/03/98 98-302987 PRMT $ 260. 50 GEO 04/14/98 98-304945 Pdrjne 5PICT $ 13. 03 GEO 04,114/98 98-304945 Contractor: HORIZON RETAIL CONSTRUCTION! INC 1516 S GREEN BAY RD RACINE W1 53406 --------------------------------_._____ Phone #: 414-638-6000 $ 547. 06 TOTAL. Peg #. . : 009858 --REQUIRED ACTIONS or INSPECTIONS----- This permit is issued subjeci to the regulations contained in the Framing Insr.) Tigard Municipal Code, State of Ore. Specialty Coder, and all other Insttlation Insp applicable laws. All work will be done in accordance with Gyp Board Insp approved plans. This permit will expire if work is not started SUSP Ceilng Insp within IN days of issuance, or if work is stl;pended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Lftility Notification Center. Those rules are set forth in DAR 952-89I-8818 through OAR 952-0101987. You many obtain a copy of these rules or direct questions to O(JNC by calling (583)246-1987. Permittee Signati-tre - IS!iUed By- .... . +++++++++++++++++++++++ ++ +++++++++++++++++ .... Call E.39t:75 by 7:00 p. m. for- an insper-tion needed tt-ie next bUSiness day ...... ...................................................................4 +++++ CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC98-018+ DEVELOPMENT SERVICES DATE ISSUED: 04/13/98 13125 SW Hall elvd.,Tigard,OR 972:3 (503)639-A'71 PARCEL: IS126CO-01107 SITE ADDRESS. . . :09561 SIJ WASH I NGI ON SQUARE RD SUBDIVISION. . . . : ZONING:C-G BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG Project Description : Installing first branch circuit and 13 additional branch circuits -----RESIDENTIAL UNIT---- ---TEMP SRVC/FEE:DERS-- - -------MISCELLANEOUS------ 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 f SACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : lb SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL./PANEL.. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. . 0 MINOR LABEL_ ( 10) . . . : 0 ---SERVICE/FFF-DER---- -----BRANCH CIRCUITS------ ----ADD' [- INSPECTIONS--- 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 13 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 -- -- ------------ -FLAN REVIEW SECTION------------------ 1000+ ECTION------------------- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR ) = 225; AMPS. . : CLASS AREA/SPEC OCC. : Owner: __.--------_----------•------______________---.___._..________ FEES FRAHLER ELECTRIC type amol_tnt by date reept 11.860 SW GREENBURG RD PRMT $ 100. 00 B 04/13/98 98--304887 TIGARD OR 97223 5PCT $ 5. 00 B 04/13/98 98-304887 Phine #: -------------------------------------------- RAHLER ELECTRIC CO $ 105. 00 TOTAL_ 11860 SW GF?F_ENBURG RD --- --- - REQUIRED INSPECTIONS --- -- TIGARD OR 97223 Ceiling Cover Elect' l Service Phone #: 639--4627 Wall Cover Elect' 1 Final Reg #. . : 000374 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable lfws. All wurk will be done in accordance with approved plans. This permit will expire if Mork is not started within 180 days of issuance, or if work is suspended for more than 18P days. ATTENTION: Oregon law requires you to follow the ruleq adapted by the Oregon utility Notification Center. Those rules are set forth in OPR 952-001-0010 through OAR 9552-001-1987. You may oitain a copy of these rules or direct questions to OLaC by cal (503)246-1987. 1 Fn' rmittee Signat-_rre : - vllin 6 _ Iss�ted By : tJ► �� ul ---------------------------OWNER INSTALLATION ONLY------------------------------ The installation is being made on property I own which is not intended for -ale, lease, or', rent. r ()WNF R' S SIGNATURE: _ _ DATE: c0 J ------------------------CONTRACTOR 1`46TRI_LATION ONLY--------------._______------ SIGNATURE OF SUPR. ELFC' N: �'L C DATE LICENSE NO: +++++++++++'i-++++++++++++++++++++++++++++++++++++++t+# 4 +++++++t+++++++++++++++++ Call 639--417'- by 7:00 p. m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++++4+ : ; 4-++++++++++++++++++++++++ CITY OF TIGARD Electrical Permit Application Plan Check---- Recd By 13125 SW HALL BLVD. its LU Gate Rec ;LIV 'd� TIGARD OR 97223 Date to P.E. Phone (503)639-4171, x304 IPPR 1 1995 Date to DST Print or Type � Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit a Fax (503) 684-7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development_ WASH I NGTON SQUARE _ Number of Inspections per permit allowed Name(or name of business)_ STRIDE RITE Service Included: Items Cost Sum Address 9561 S.W. WASHINGTON SQUARE ROAD 4s. Residential-per unit 1000 sq.ft.or less $110.00 4 City/State/Zip TIGARD, OREGON 972?-L Each additional 500 sq.ft.or portion l $25.00 1 Commercial ® Limned Energy Residential ❑ ergy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 _ 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b.Services or Feeders Electrical Contractor_ FRAIILER ELECTRIC COMPANY Installation,alteration,or relocation Address 1186Q Sl �N J GREGURG ROAD J 200 amps or less $60.00 2 201 amps to 400 amps $80.00 2 City T I GA Imo__.State O R Zip 97223 _ 401 amps to 600 amps $120.00 2 Phone No. _f;"39-4627 601 amps to 1000 amps $180.00 - 2 _ Over 1000 amps or volts $340.00 2 Job No. 82 D5 Elec.Cont. Lice. No. 34-13C Exp.Date 10/1/98Reconnect only $50.00 -_ 2 OR State CCB Reg. No. 37410 Exp.Date 7/2/98 4c.Temporary Services or Feeders ;OT Business Tax or Metro No. 1987 Exp.Date 12/1/92 Installation,alteration,or relocation 200 amps or less $50.00 2 Signature of Su r. Elec'n� L 1✓ �i-ft-G�.. 201 amps to 400 amps v $75.00 2 9 p 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License Nc __ 18165 _. Exp.Date-1 Oil/98 see"b"above. Phone N 739-4621 - ---- - 4d.Branch CUsuils New,alteration or extension per panel 2b. For owner in a) APUCATI01� a)The fee for branch circuits with purchase of se►v/ce or Print Owner's Name -_ feeder fee. Address _ Each branch circuit $5.00 2 State b)The fee for branch circuits City_ __ State _ ipwithout purchase of Phone No. service or feeder fee. First branch circuit _l_ $35.00IlfL_ 2 The installation is being made on property I own which is not Each additional branch circuit_ $5.00tic ,0� 2 intended for sale, lease or rent. 4e.Miscellaneous (Service or fender not included) Owner's Signature___ _ Each pump or irrigation circle �._ $40.00 _ 2 Each sign or outline lighting $40.00 _ 2 3. Plan Review sectiort (if required):' Signal circuit(s)or a limited energy panel,alteraticn or extension $40.00 2 Minor Labels(10) $100.00 Please check appropriate item and enter fee In section 5B. _ 4 or more residential units in one structure 4f.Each additional Inspection over H-- i Service and feeder 225 amps or more the allowable In any of the above . System over 600 volts nominal Per inspection $35.00 r Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C.Chapter 5 In Plant $55.00 C *Sktbmit 2 sets of plans with application where any of the above apply. 5. Fees: 100.00 Not required for tew.porary construction services. Sa.Enter total of above fees $ w 540 Surcharge(.05 X total fees) $ 5 NN -� NOTICE Subtotal $ -- 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required(Sec.3) $ NOT COMMENCED WITHIN 100 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ - IS SUSPENDED OR ABANDONED FOR A PERIOD OF 1t:0 DAYS AT ANY TIME AFTER WORK IS COMMENCED. Trust Account 1t _, I V JL $ Total balance Due rwsrscELcse Arra nev!vse Its CITY 00'TIG•ARD Commercial Building Permit Recd By .13125 SW HALL BLVD. Tenant Improvement DateRec'd ? >'- l -, �y TIGARD, OR P7223 Dale to P.E. -le,-94r (503) 639-4171 Date to DST 3 .-11�1 aR' Permit# -CC7✓ Print or Type Related SWR# Incomplete or illegible applications will not be accepted Called„cL 9Y 2—zll /92rr5 Name of Development/Proiect Existin Build ew Buildin AJa 5r1:'� daN g g g Job SfhiG ��iv1i Address Street Address s e ra Building Data Bldg# Citx!State zipJ7 Existing Use of Building or Property: -- Name t f r1,� `e�.t c.' (Xe F-i�i' 'S ti Q td o Proposed Use of Building or Property: Property 5/"DIE � r mi 1 } I Owner Mailing Address Suiteca-JA 4 M' ) Ant F\ No. Of Stories: / 7 City/State Zip G_ Phone k) Sq. Ft. Of Project: Occupant Name ' 4:-2 R1. Occupancy Class(es) Name Contractor Types) of Construction Poor to permit Mailing Address Suite ;suance,a copy Will this project have a Fire Suppression System? of all licenses Yes` ' NO are required if City/State Zip Phone �j--" — ---..� expired in';.O.T I Americans with isabtlities Act(ADA) i database _ Valuation X 25% = $ Participation Oregon Const.Cont.Board Lic.# Exp.Date Complete Accessibi 4 Form I Project $ '— Name r/o Valuation YS, Com) Architect / ,-� �u S/¢after Plans Required: See Matrix for number of sets to submit Marling Address Suite TAWon back CitylState Zip Phone I hereby acknowledge that I have read this application,that the information IL r rnnC��CA ya3� .��}(�,� � given.is correct,that I am the ONner or authorized agent of the owner,and -- that olans submitted are in eor pliance with Oregon State Laws. Engineer Name (/d EKprY ss _ ai at9re of�Q ,ner/� n\t e3hryr�7sisSY Gate, .t ri �/' CAu4Mail ' ing Suite (3)) fc3Sf — � ! / Contact Person iJame ` Phone G� CitylState Zip Phone - FOR JFFICE USE ONLY Indicate type of work: New O Addition O DemolivaaO Map/7Lg Land Use: F_ Accessory Stnicture O Foundation Only O `Alteration - _ _ JI Repair O Other O Notes: i Description of work: '4t-,,<;; 7,-,t�►zxterro TIF Parks: Estimated,*of Employees --- --- --- Note: Site',Nork Permit Application must precede or accompany Building r j' Pe,mit Application I1C0MNEW.DOC (DST) 8197 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLAINS OUT TO DST EXAMINERS (Note a.) TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE SITE 1 1 -- -- 3 O,o,u) -- -- B (New or Add) 1 1 -- -- 3 -- F (New or Acid or Alt.) < 3 -- -- 3 (j,o,f) M (New or Add. or Alt) 1 1 -- -- 20,o) B & M (New or Add) 1 1 -- - 3 (�,o,w) -- -- P (New, Add. or Alt) 2 -- 2 -- -- 2(j,o) -- B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) -- E (New, Add. or Alt) -- -- ? -- -- 2(j.o) B & N1 & P & E (New. Add) 3 1 1 1 3 (j,o.w) 20,o) 2 (j,o) B or B & M (Alt) I 1 -- -- 2'0,o} __ w B & M &P (Alt) 3 1 2 -- 2 U,o) 2 0A - B & M & P& E (Alt) 3 l 1 1 20.o) 2 (j,o) 20.o) NOTES: -KL.Y- a. Before returning to DST, P' ins examiner gets appropriate j = Job B = BUP number of revised plans from applicant. stamps and completes, o = Office M = MEC updates and adds actions. f= Fire P = PLM u = USA E = ELC b. Shaded areas designate AL'1"Sut rnittttls of Iv w= Wash. County F = FPS c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. w Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with calculations. h unatnc Dor_ Ib CITY CSF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard,OR 97223 (503)6394171 ELECTRICAL PERMIT — RESTRICTED ENERGY PERMIT #: ELR98-0046 DATE ISSUED: 02/13/98 PARCEL: 1S126CO-01107 SITE ADDRESS. . . :09561 SW WASHINGTON SQUARE_ RD SUBDIVISION. . . . : ZONING:C—G BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . .7URISDICTN: TIG Piro j ect Description: Replace existing cabinet for sign. ---------------------------------------------------------------- A. RES I DENT I AL_ --- ----— B. COMMERCIAL-------------------_------___._____.___.._.___ AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . : BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . : GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL. . . . . . . . . . . . . HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . . NURSE CALLS. . . . . . . . . VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE: OTHER: : : HVAC . . . . . . . . . . . . PROTECTIVE SIGNAL. . : INSTRUMENTATION. : OTHER. . :CABINET TOTAL t OF SYSTEMS: 1 Owner-: --- ------------ ---------------------------------__ FEES ------- ------ —_ STRIDE RITE RETAIL CORP, type i-rmoi.rnt by date r-ecpt FIVE CAMBRIDGE CENTER PRMT $ 40. 00 GF-O 02/13/98 98-303265 CAMBRIDGE MA 02142 5PCT $ 2. 00 GEO 02/13/98 98-303265 Phone #: 517 491-8800 Cont v-act or-: - E S & A INC 42. 00 TOTAL 1210 OAK PATCH RD -- ----- REQUIRED INSPECTIONS --------- EUGENE OR 97042 Low Voltage Insp Phone #: 541-485-5546 Elect' l Final Reg #. . : 02.11 1 ?.2 This persit is issued subject to the regulations contained in the figard Municipal Code, State of Ore. Specialty Crdes and all other applicable laws. All work will be done in accordance with approved plans. This persit will expire if Mork is not started within 180 days of issuance, or if work is suspended for sore than 18N days. ATTENTION: Oregon law requires you to follow rule adopted by the Oreqon Utility Notification Center. Those rules are set forth in OAR 952-001-8818 through OAR 952-081-OW. You say obtain copies of these rules or direct questio 5 tp�MK at (503)246-1987. j 1 =_. s i_t e d by � c!C_—__-----_-_.._. Permittee S i g n a t u r^e INSTALLATION ONLY-------------------------•------- The installation is being made on property I own which is not intended fog^ �z1e, lease, or rent. OWNER' S SIGNATURE: _ — DATE: ti '" —CONTRACTOR INSTALLATION a RTGNATURE OF SUPR. ELEC' N: DATE: ---- --------�� --- w L I SENSE NO: ��.._ —_ _.._.___ ___.-_.-..__—.----.-_--_. f.++.}.-+.+.++++++++++-I-+++++++i-+++++++++++++++++++++++++-1-+++++++++++++++++ •+++++++++++ Call 639-4175 by 7:00 P. M. for an insp r-tion needed the next bi_isiness day +++++f.++t++++tt+++++++++t+t++++++++•hF++ttt++-F+t++++++++++++++++++++f•++++t++i-++++ Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 13125 SW Hal; Blvd. Tigard,OR 97223 PI RMIT# G _�C) Phone (503) 639-4171 FAX (503) 684-7297 DATE ISSUED_!_- TDD No. (503)684-2772 CITY OF TIGARD Inspection (503)639-4175 ISSUED BY PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATI N GGJb I 4. TYPE OF WORK S-r►e�Dc i�-t1� vJA��r�� �� wAQN . �_rZD , Addressn RESIDENTIAL—Restricted Energy Fee . . . . . . . . . ,�Q.QJ► P-0 P-1 t.Aly D � vl�ZZ3 (FOR ALL SYSTEMS) City i State zip Check Type of Work Involved: PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WOQK ❑ Audio and Stereo Systems 15 NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK 15 SUSPENDED FOR 180 DAYS. ❑ Burglar Alarm 2. CONTRACTOR APPLICATION ❑ Garage Door Opener' /1 , 1 El Heating,Ventilation and Air Conditioning System` Contractor ES"tc -_ type ��`.N ❑ Vacuum Systems' 71 y�� 1n ❑ Other Address_1 LL�.�_Lj2)--- "�� —1�D-' -- Date Z 1 ✓ 1 1 C•) -_ __. ___ __ ____ COMMERCIAL—Fee for each system . . . . . . . . . $40,00 -- ---T— (SFF OAR 918-260-260) Property Owner ��� _= Check Tyne of Work Invol!' 1 Contractor's Board Reg. No. ❑ Audio and Stereo Systems �r`_ ❑ Boiler Controls Phone# �� �'� Y� ❑ Clock Systems ❑ Data Telecommunication Installations 3. OWNER APPLICATION ❑ Fire Alarm Installation ❑ LIVAC 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 918320.370.This applicant agrees to make only ❑ Nurse Calls restricted energy installations(too vok amps or less)under this permit and to do the ❑ Outdoor Landscape lighting` folloydng 1. Only use electrical licensed persons to do installatlwis where required.(Certain El Protective Signalin residential and other transactions are exempt from licensing.These have Other G N __ asterisks(*).All others need licensing). 2, Call for an inspection when all of the installations under this permit are ready for Inspection at 503-639-4175. -- Number of Systems 1. Purchase separate permits for all installations that are not ready(or Inspection when the inspector Is out to inspect under this permit. •No liceises are required. licenses are required for all other installations, r 4. Assume responsibility for assuring that all corrections required by the Inspector t' are done,and J 5. Assume responsibility for calling for a final inspection when all of the 5. FEES corrections are completed. W The person signing for this permit must be the applicant or a person a. Enter Fees $ –' authorized to bin04L licant. o� CAA4-kL,-J-,�LJ j y b. 5% Surcharge(.05 x total above) $ _ Signature ( ��( 00 TOTAL $ —T Authority if other than applicant ENERGAP.CHP FOR OVERSIZED DOCUMENTS SEE 35 mm ROLL FILM 1 _ �- a: n �y', is "�` �.. �,, I .fi p � � ,. 9 G ll� � �S 1C ,� • , I �' d�� �� �.i •